Journal of urban health : bulletin of the New York Academy of Medicine
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Comparative Study
Findings from the Initial Use of the Healthy Homes Rating System (HHRS) in Three American Cities.
HUD's Healthy Homes Rating System (HHRS) is a modification of the English version, using scoring values developed in England. The goal of the HUD Three-City Healthy Homes Rating System (HHRS) study was to create a baseline of the prevalence and severity of 29 home health hazards in three cities-Detroit, MI; Greensboro, NC; and Alameda County, CA-and to compare the results to the prevalence and severity found in England. ⋯ However, significant differences in the type and severity of hazards across communities were found and were more severe in US sample homes than in their English counterparts. The results suggest that the tool shows promise in its ability to identify home health hazards.
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In the early 1980s, men who have sex with men (MSM) in San Francisco were one of the first populations to be affected by the human immunodeficiency virus (HIV) epidemic, and they continue to bear a heavy HIV burden. Once a rapidly fatal disease, survival with HIV improved drastically following the introduction of combination antiretroviral therapy in 1996. As a result, the ability of HIV-positive persons to move into and out of San Francisco has increased due to lengthened survival. ⋯ The results suggest that the overall MSM population and all the MSM subpopulations studied decreased in size from 2006 to 2014. Further, there were differences in migration patterns by race and by HIV serostatus. The modeling methods outlined can be applied by others to determine how migration patterns contribute to HIV-positive population size and output from these models can be used in a transmission model to better understand how migration can impact HIV transmission.
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Progression of geographic disparities in social determinants of health is a global concern. Using an Urban Health Index (UHI) approach, we proposed a framework of examining the change of geographic disparities in social determinants in small areas. Using the City of Atlanta in Georgia (USA) as a case study, we standardized six census-based social determinant indicators in 2000 and in 2010, respectively, and calculated their geometric mean to assign each census tract a UHI value for 2000 and for 2010. ⋯ The areas that experienced improvement, however, underwent demographic changes as well. This analysis provides support for displacement, rather than improvement, as the underlying factor for apparent change in geographic disparities. Findings suggest the importance of local evaluation for future policies to reduce disparities in cities.
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HIV affects African American gay and bisexual men (AAGBM) more disproportionately than any other group in the USA. The Black Church, which has been a historic mainstay for African American empowerment and well-being, has the potential to be a public health partner for HIV prevention with AAGBM. ⋯ Public health should consider how thoughtful engagement, research, and interventions can support these approaches. Developing partnerships with the Black Church and African American clergy can promote effective HIV prevention efforts for AAGBM.
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Black men who have sex with men (BMSM) are a population at the intersection of two minority statuses-racial minority and sexual minority. Membership in either group, compared to white or heterosexual group membership, may increase one's risk of negative childhood and adult experiences. Baseline data from an HIV intervention efficacy trial (the Black Men Evolving Study) were used to explore the prevalence of adverse childhood experiences (ACEs) among 536 BMSM and associations between ACEs and adult mental and physical health outcomes. ⋯ Findings revealed that ACE score was significantly associated with adult mental health (AOR = 1.21, 95% CI [1.12, 1.30]), but not with adult physical health. All ACEs were significantly associated with mental health, but only physical neglect and household substance abuse were significantly associated with physical health (AOR = 1.69, 95% CI [1.02, 2.74] and AOR = 1.57, 95% CI [1.03, 2.40], respectively). The findings support the need for interventions targeting improved adult health outcomes, particularly for minority groups, to consider the impact of early adversity on health and wellness.