Journal of urban health : bulletin of the New York Academy of Medicine
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Studies over the last decade have demonstrated the effectiveness of public health interventions based on social and behavioral science theory for many health problems. Little is known about the extent to which health departments are currently utilizing these theories. This study assesses the application of social and behavioral science to programs in the New York City Department of Health (NYCDOH). ⋯ While NYCDOH has successfully applied social and behavioral sciences in some areas of practice, many areas use them minimally or not at all. Increasing use will require additional resources. Partnerships with academic institutions can bring additional social and behavioral science resources to health departments and benefit researchers understanding of the health department environment.
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A series of studies have demonstrated that people who live in regions where there are disparities in income have poorer average health status than people who live in more economically homogeneous regions. To test whether such disparities might explain health variations within urban areas, we examined the possible association between income inequality and infant mortality for zip code regions within New York City using data from the 1990 census and the New York City Department of Health. ⋯ An increase of one standard deviation in income inequality was associated with an increase of 0.80 deaths/1,000 live births (P <.001), controlling for other socioeconomic factors. This finding has important implications for public health practice and social epidemiological research in large urban areas, which face significant disparities both in health and in social and economic conditions.
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The article begins with a discussion of the rationale for studying the relationship between residential environments and cardiovascular health. Existing empirical research relating residential environments to cardiovascular outcomes and risk factors is summarized. The research areas discussed include neighborhood socioeconomic characteristics and cardiovascular disease, the effects of residential environments on physical activity, and the effects of residential environments on diet. ⋯ Key challenges in investigating the relationship between residential environments and health are discussed. These challenges include characterizing environments (including definition and geographic scale as well as conceptualization and measurement of relevant features), the limitations of observational studies, and the need to evaluate the health impact of interventions or "naturally" occurring changes in local environments. The need for interdisciplinary work is emphasized.
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The cumulative epidemiologic literature indicates that many injecting drug users (IDUs) initiate injection as a mode of drug administration during late adolescence or early adulthood. Recent studies have shown that IDUs are often exposed to viral infections relatively early in the course of injection, highlighting the importance of understanding this initiation process for both epidemiology and prevention. ⋯ Similarly, we know little about the ways that YMSM and other high-risk youth understand risk, the kinds of exchanges and relationships in which they participate in the context of initiating sexual activity, or how drug use is operant in these exchanges and early sexual experiences. In this article, we explore key dimensions of the early initiation of injection and sexual risk, and discuss how a social network approach might be instrumental in understanding the social course of drug injection and sexual activities among youth and young adult populations.