Journal of urban health : bulletin of the New York Academy of Medicine
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The process of urbanization entails social improvements with the consequential better quality-of-life for urban residents. However, in many low-income and some middle-income countries, urbanization conveys inequality and exclusion, creating cities and dwellings characterized by poverty, overcrowded conditions, poor housing, severe pollution, and absence of basic services such as water and sanitation. Slums in large cities often have an absence of schools, transportation, health centers, recreational facilities, and other such amenities. ⋯ In contrast, social inclusion is seen to be vital to the material, psychosocial, and political aspects of empowerment that underpin social well-being and equitable health. Successful experiences of cooperation and networking between slum-based organizations, grassroots groups, local and international NGOs, and city government are important mechanisms that can be replicated in urban settings of different low- and middle-income countries. With increasing urbanization, it is imperative to design health programs for the urban poor that take full advantage of the social resources and resourcefulness of their own communities.
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Prevention Point Pittsburgh (PPP) is a public health advocacy organization that operates Allegheny County's only needle exchange program. In 2002, PPP implemented an Overdose Prevention Program (OPP) in response to an increase in heroin-related and opioid-related overdose fatalities in the region. In 2005, the OPP augmented overdose prevention and response trainings to include naloxone training and prescription. ⋯ Of these 249 overdose episodes in which naloxone was administered, participants reported 96% were reversed. The data support findings from a growing body of research on similar programs in other cities. Community-based OPPs that equip drug users with skills to identify and respond to an overdose and prescribe naloxone can help users and their peers prevent and reverse potentially fatal overdoses without significant adverse consequences.
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We explored the association between neighborhood residential racial composition and breast cancer mortality among Black and White breast cancer patients in Georgia and whether spatial access to cancer care mediates this association. Participants included 15,256 women living in 15 metropolitan statistical areas in Georgia who were diagnosed with breast cancer between 1999 and 2003. Residential racial composition was operationalized as the percent of Black residents in the census tract. ⋯ Individual race did not moderate this relationship, and spatial access to care did not mediate it. Residential racial composition may be part of the socioenvironmental milieu that produces increased breast cancer mortality among Black women. However, there is a lack of evidence that spatial access to oncology care mediates these processes.
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Prescription medication borrowing can result in adverse health outcomes. We aimed to study the patterns of borrowing prescription medications in an adult urban population seeking healthcare in the outpatient, emergency, and inpatient units of an urban medical center. Participants indicated whether they (1) had a primary care doctor, medical insurance, a prior history of substance abuse, psychiatric disorders, or chronic pain; and (2) had borrowed a prescription medication. ⋯ Only a third of those who borrowed medications had informed their primary medical providers of the behavior. In conclusion, borrowing prescription medications is a common behavior in the population studied. Further research is warranted into interventions to reduce such use, especially the impact of methods to improve the convenience of contacting licensed medical providers.
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Adolescents tend to experience more problems with sleep loss as a natural consequence of puberty, whereas teens from impoverished urban areas are likely to witness neighborhood violence and/or engage in risk behaviors that may affect sleep. Data from the Mobile Youth Survey, a longitudinal study of impoverished inner-city African-American adolescents (1998-2005; N = 20,716; age range = 9.75-19.25 years), were used to compare paired years of annual surveys elicited by questions about how sleep was affected when bad things happen to friends or family. ⋯ Conversely, seeing someone cut, stabbed, or shot, using alcohol, worry, and internalized anger were associated with sleep disturbance in a latter year. Although a limited measure of sleep disturbance was used, these findings support further research to examine sleep disturbance and risk behaviors among low-income adolescents.