Journal of urban health : bulletin of the New York Academy of Medicine
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Comparative Study
Separate and Sick: Residential Segregation and the Health of Children and Youth in Metropolitan Statistical Areas.
The purpose of this study was to better understand residential segregation and child/youth health by examining the relationship between a measure of Black-White residential segregation, the index of dissimilarity, and a suite of child and youth health measures in 235 U. S. metropolitan statistical areas (MSAs). MSAs are urban areas with a population of 50,000 or more and adjacent communities that share a high degree of economic and social integration. ⋯ Segregation worsened Black-White health disparities across all four measures, regardless of MSA total and Black population size. Segregation adversely affects the health of Black children in all MSAs and White children in smaller MSAs with large Black populations, and these effects are seen in measures that span all of childhood. Residential segregation may be an important target to consider in efforts to improve neighborhood conditions that influence the health of families and children.
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The world is becoming increasingly urban. For the first time in history, more than 50% of human beings live in cities (United Nations, Department of Economic and Social Affairs, Population Division, ed. (2015)). Rapid urbanization is often chaotic and unstructured, leading to the formation of informal settlements or slums. ⋯ Cochrane Database Syst Rev CD000012, 2012; Brocklehurst et al. BMJ 343:d7400, 2011). In this paper, three case studies are described that support the use of this model in low resource, urban settings.
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Environmental burdens such as air pollution are inequitably distributed with groups of lower socioeconomic statuses, which tend to comprise of large proportions of racial minorities, typically bearing greater exposure. Such groups have also been shown to present more severe health outcomes which can be related to adverse pollution exposure. Air pollution exposure, especially in urban areas, is usually impacted by the built environment, such as major roadways, which can be a significant source of air pollution. ⋯ When considering univariate associations between pollution and health outcomes, the only significant association existed between nitrogen oxides and COPD being negatively correlated. Greater percent tree canopy cover and green space access were associated with higher prevalence of COPD, CHD, and stroke. Overall, in considering health outcomes in connection with pollution exposure infrastructure and ethnic demographics, demographics remained the most significant explanatory variable.
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To examine the relationships between perceptions of neighborhood environment, sense of community, and self-rated heath, we recruited 1798 people aged 60 years and older living in Hong Kong. With reference to the checklist of the essential features of age-friendly cities developed by the World Health Organization, perceptions of neighborhood environment were assessed using a questionnaire covering physical and social environmental domains, which mapped onto "outdoor spaces and buildings," "transportation," "housing," "social participation," "respect and social inclusion," "civic participation and employment," "communication and information," and "community support and health services." Sense of community was measured by the Brief Sense of Community Scale. Self-rated health was assessed by a single question. ⋯ Among the domains of perceived neighborhood environment, "transportation" and "respect and social inclusion" were the physical and the social environmental domains most strongly associated with sense of community, respectively. In addition, sense of community accounted for part of the relationship between perceived neighborhood environments and self-rated health. The results of this study support the importance of perceived neighborhood environments for the sense that older person has of one's community, and self-rated health of older people which may be enhanced through the improvement of neighborhood environments.