Journal of urban health : bulletin of the New York Academy of Medicine
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"Hey, We Can Do This Together": Findings from an Evaluation of a Multi-sectoral Community Coalition.
Multi-sectoral coalitions focused on systemic health inequities are commonly promoted as important mechanisms to facilitate changes with lasting impacts on population health. However, the development and implementation of such initiatives present significant challenges, and evaluation results are commonly inconclusive. ⋯ Direct impacts on community members were more difficult to assess: perceived access to health and other services improved, while community violence and poor sanitation, which were also priorities for community members, remained important challenges. Findings suggest significant progress, as well as continued need.
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Little is known about the physical and mental health outcomes of adults in the low-income, predominantly Black city of Flint, Michigan, following the city's water crisis which began in April 2014 after austerity policies led to the city switching its water source. We investigate these dynamics using data from a longitudinal community-based cohort in Flint. Between June and November 2019, surveys were administered at nine public sites across Flint. ⋯ Increasing physical symptoms was associated with psychological trauma (OR 2.1, p < 0.01) and depression/anxiety (OR 1.9, p < 0.01). In closing, Flint adults, particularly Blacks, experienced deleterious physical and mental health outcomes following the city's water crisis that appear to represent a substantial burden of excess cases. Further research is needed on how austerity impacts community health in economically distressed urban cities and ways to generate capacity to identify and curb adverse consequences.
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New York City (NYC) has experienced large reductions in violent crime over the last two decades, but gun-related violence continues to pose a threat to public safety. Despite strong gun laws, high-risk individuals in NYC neighborhoods are unfortunately still able to access and misuse firearms. This research analyzes NYC's underground gun market by closely examining the flow of guns into the two boroughs where gun violence and crime gun recoveries are most prevalent: the Bronx and Brooklyn. ⋯ Findings suggest that guns recovered in the Bronx and Brooklyn were significantly more likely to originate in states with less restrictive gun laws and more likely to have changed ownership in unregulated transactions relative to guns recovered elsewhere in NYC. Interviews revealed three primary avenues for illegal guns reaching Bronx and Brooklyn neighborhoods: high-volume gun brokers, middlemen, and individuals who make episodic low-level acquisitions from straw purchasers in other states. No subjects identified theft as a meaningful source of crime guns.
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The USA leads the world in healthcare spending but trails dozens of countries in life expectancy. Government spending may reduce overall mortality by redistributing resources from the rich to the poor. We linked mortality data from 2006 to 2015 to municipal and state government spending in 149 of the largest American cities. ⋯ However, among Whites, increases in city government spending were associated with a reduction in mortality of 4.8% (2.1-7.5%), but among Blacks and Asians, increased city government spending was associated with respective mortality increases of 1.7% (0.6-2.9%) and 5.1% (2.1-6.2%). State government spending is associated with reduced mortality in American cities. City government spending appears to benefit White longevity and hurt non-White longevity.
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To adequately address health disparities, underserved populations must be recruited for biomedical research. Particularly, Black women have been insufficiently included in biomedical research for reasons beyond those of participant preference. ⋯ The objective of this paper is to identify and describe innovative community-based strategies for successful recruitment of Black women in research. Three studies are referenced to exemplify recruitment methods and demonstrate promising recruitment results in sample size and screening-to-enrollment ratio.