Journal of urban health : bulletin of the New York Academy of Medicine
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Multicenter Study
Developing a conceptual framework of urban health observatories toward integrating research and evidence into urban policy for health and health equity.
Detailed information on health linked to geographic, sociodemographic, and environmental data are required by city governments to monitor health and the determinants of health. These data are critical for guiding local interventions, resource allocation, and planning decisions, yet they are too often non-existent or scattered. This study aimed to develop a conceptual framework of Urban Health Observatories (UHOs) as an institutional mechanism which can help synthesize evidence and incorporate it into urban policy-making for health and health equity. ⋯ Some UHOs were identified as not only assessing but also responding to local needs. The findings from this study were integrated into a conceptual framework which illustrates how UHOs can play a vital role in monitoring trends in health determinants, outcomes, and equity; optimizing an intersectoral urban information system; incorporating research on health into urban policies and systems; and providing technical guidance on research and evidence-based policy making. In order to be most effective, UHOs should be an integral part of the urban governance system, where multiple sectors of government, the civil society, and businesses can participate in taking the right actions to promote health equity.
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Violent crime such as homicide causes significant excess morbidity and mortality in US urban areas. A health impact assessment (HIA) identified zoning policy related to alcohol outlets as one way to decrease violent crime. The objectives were to determine the relationship between alcohol outlets including off-premise alcohol outlets and violent crime in one urban area to provide local public health evidence to inform a zoning code rewrite. ⋯ Each one-unit increase in the number of alcohol outlets was associated with a 2.2 % increase in the count of violent crimes adjusting for neighborhood disadvantage, percent minority, percent occupancy, drug arrests, and spatial dependence (IRR = 1.022, 95 % CI = 1.015, 1.028). Off-premise alcohol outlets were significantly associated with violent crime in the adjusted model (IRR = 1.048, 95 % CI = 1.035, 1.061). Generating Baltimore-specific estimates of the relationship between alcohol outlets and violent crime has been central to supporting the incorporation of alcohol outlet policies in the zoning code rewrite being conducted in Baltimore City.
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High-risk social ties portend differences in opportunity for HIV exposures and may contribute to racial/ethnic disparities in HIV transmission. Discrimination may affect the formation of high-risk social ties and has not been explored as a possible explanation for these persistent disparities. Using data from injection and non-injection drug users, we examined the association between the number of high-risk sex and drug ties with discrimination due to race, drug use, and incarceration stratified by race/ethnicity. ⋯ Discrimination is associated with high-risk social ties among all racial/ethnic groups. But, these data highlight different forms of discrimination within racial/ethnic group are associated with risky social ties. More research is needed to confirm these findings and further explore the association between various forms of discrimination and social ties that may help explain racial/ethnic disparities in HIV.
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This paper is a case study of how Youth ALIVE!, a nonprofit public health organization, blended direct service and policy goals to reduce youth gun violence at a time when guns became the number one killer of children in California. Youth ALIVE! trained young people living in California communities with the highest rates of gun violence to become peer educators and leaders to reduce both the supply of, and demand for, guns. The youth presented health and criminal justice data in the context of their own experiences living in communities endangered by gun violence to help build public policy solutions, contributing to the subsequent drop in gun homicides. ⋯ The youths' successes demonstrate how nonprofit direct service organizations are uniquely positioned to advocate for policy and regulatory changes that can be beneficial to both program participants and society. Direct service organizations' daily exposure to real-life client needs provides valuable insights for developing viable policies-plus highly motivated advocates. When backed by scientific findings on the causes of the problem, this synergy of youth participant engagement in civil society can promote good policy and build healthy communities.
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Intimate partner sexual violence: a comparison of foreign- versus US-born physically abused Latinas.
Men's violence against women-particularly intimate partner sexual violence (IPSV)-is associated with the transmission of HIV. Men who physically abuse their female intimate partners often also sexually abuse them. Latinas are one of the fastest growing populations in the USA and at high-risk for contracting HIV, though little is known about IPSV against physically abused Latinas, including whether there is an association between nativity of the victim and the likelihood of sexual violence by intimate partners. ⋯ Physically abused Latinas who were foreign born had two times greater odds of reporting recent IPSV than physically abused Latinas born in the USA, after controlling for other demographic covariates. Exploratory post hoc analyses examining all pairwise comparisons of IPSV against Latinas born in the USA, Mexico, Central America, South America, and the Caribbean also revealed some significant differences that warrant further study with larger samples. HIV prevention efforts aimed at reducing IPSV in this population are needed.