Journal of urban health : bulletin of the New York Academy of Medicine
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Congestion pricing policies (CPPs) are a common strategy for addressing urban traffic congestion. Research has explored several impacts of these policies (e.g., air quality, equity, congestion relief). The purpose of this review was to synthesize findings from publications examining CPP impacts on road user safety outcomes. ⋯ While some studies estimated short-term increases in injuries and crashes for bicyclists and motorcyclists (likely due to shifts from personal vehicle use to other transportation modes and increased exposure), most analyses focused on longer-term impacts and generally found a reversal and eventual decrease in injuries and crashes after a few years. The relative scarcity of safety outcomes in published literature, along with the wide breadth of CPP types, implementation contexts, and outcomes measured, demonstrates that more research on safety outcomes is needed. Cities and regions planning to implement CPPs should consider potential mode shifts and safety supports for all road users (e.g., bicycle and pedestrian infrastructure).
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Randomized Controlled Trial
Gender Differences in Impacts of Place-Based Neighborhood Greening Interventions on Fear of Violence Based on a Cluster-Randomized Controlled Trial.
Maintained green space in underserved urban neighborhoods may be an important environmental pathway to improving community health and safety, though effects may vary across population subgroups and by time of day. We examined survey responses from 442 participants (178 men and 264 women), living near vacant lots in a cluster-randomized controlled trial of a cleaning and greening intervention, on perceived safety during the day and at night. At the intervention sites after the intervention, only men reported feeling less unsafe during the day. ⋯ The clean-and-green intervention may have allayed fears for men during the day and supported their ease of movement throughout their neighborhoods. However, at night, it may have had the opposite effect on women. Though our study was under-powered, not designed to test associations stratified by gender, directions and magnitudes of associations differed substantially, indicating a need for further investigations into potential gender differences in the benefits of green space, to inform and better tailor interventions to improve perceived safety for all.
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Childhood asthma exacerbation remains the leading cause of pediatric emergency department visits and hospitalizations and disproportionately affects Latinx and Black children, compared to non-Latinx White children in NYC. Environmental exposures and socioeconomic factors may jointly contribute to childhood asthma exacerbations; however, they are often studied separately. To better investigate the multiple contributors to disparities in childhood asthma, we compiled data on various individual and neighborhood level socioeconomic and environmental factors, including education, race/ethnicity, income disparities, gentrification, housing characteristics, built environment, and structural racism, from the NYC Department of Health's KIDS 2017 survey and the US Census' American Community Survey. ⋯ We found that housing and built environment characteristics, such as density and age of buildings, were the predominant features to differentiate the socio-environmental patterns observed in New York City. Children living in neighborhoods with greater proportions of rental housing, high-density buildings, and older buildings were more likely to experience asthma exacerbations than other children. These findings add to the literature about childhood asthma in urban environments, and can assist efforts to target actionable policies and practices that promote health equity related to childhood asthma.
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Randomized Controlled Trial
Nurtured in Nature: a Pilot Randomized Controlled Trial to Increase Time in Greenspace among Urban-Dwelling Pregnant Women.
Spending time in nature is associated with numerous mental health benefits, including reduced depression and improved well-being. However, few studies examine the most effective ways to nudge people to spend more time outside. Furthermore, the impact of spending time in nature has not been previously studied as a postpartum depression (PPD) prevention strategy. ⋯ When analyzing women who completed the intervention (13 of 17 subjects), the intervention was associated with three times higher nature visits compared to control (IRR 3.1, 95%CI 1.16-3.14, p = 0.025). No significant differences were found in the EPDS scores, although we may have been limited by the study's sample size. Nurture in Nature increased the amount of time postpartum women spent in nature, and may be a useful population health tool to leverage the health benefits of nature in majority Black, low-resourced communities.
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Menthol in cigarettes increases nicotine dependence and decreases the chances of successful smoking cessation. In New York City (NYC), nearly half of current smokers usually smoke menthol cigarettes. Female and non-Latino Black individuals were more likely to smoke menthol-flavored cigarettes compared to males and other races and ethnicities. ⋯ The model also projected that an average of $1,836 in healthcare costs per person, or $1.62 billion among all adult smokers, could be saved over a 20-year period due to the implementation of a menthol ban policy. Results from subgroup analyses showed that women, particularly Black women, would have more reductions in adverse CVD outcomes from the potential implementation of the menthol ban policy compared to males and other racial and ethnic subgroups, which implies that the policy could reduce sex and racial and ethnic CVD disparities. Findings from our study provide policymakers with evidence to support policies that limit access to menthol cigarettes and potentially address racial and ethnic disparities in smoking-related disease burden.