Journal of urban health : bulletin of the New York Academy of Medicine
-
Illicit drug use and mental illness are common among people in prison and are associated with higher rates of reoffending and reimprisonment. We conducted a systematic review, searching MEDLINE, Embase, and PsycINFO to January 10, 2022, for studies reporting criminal justice involvement following exposure to community mental health services among people released from jail or prison who use illicit drugs and have mental illness. ⋯ Eleven of 13 studies reported a reduction in criminal justice involvement among participants exposed to community mental health services compared to a comparison group. Findings indicate a need to expand and improve integration and referral mechanisms linking people to community mental health services after jail or prison release, alongside a need for tailored programs for individuals with complex illicit drug use and mental health morbidities.
-
In Indore, India, BHC engaged 247 multi-sector stakeholders through a systems mapping approach to gather qualitative data across three workshops and four citizen town halls from 2018 to 2020. These data were synthesized with results from BHC's 18 other city activities to build a systems map and identify high-impact areas for engagement. Contextual findings showed a tension at the heart of Indore's growth-Indore's great success as a city has spurred rapid population growth. ⋯ These opportunities are: (1) improving data quality, use, and integration; (2) supporting accountability to, and enforcement of, policies and regulations; and (3) increasing community engagement. Brought together through a better understanding of the key patterns driving system behavior from the context map and leverage opportunities, BHC was able to co-create, with stakeholders, seven "coherent actions" to move Indore to a healthier, more equitable state. When COVID-19 regulations ease, BHC and city officials will reconvene to finalize an implementation plan for these actions.
-
Our study examines the association between Adverse Childhood Experience (ACE) exposure and posttraumatic stress disorder (PTSD) symptoms among survivors of violence. In this cross-sectional study, an ACE questionnaire and PTSD Checklist for DSM-5 (PCL-5) were completed by 147 participants ≤ 3 months after presenting to a Philadelphia, PA emergency department between 2014 and 2019 with a violent injury. This study treated ACEs, both separate and cumulative, as exposures and PTSD symptom severity as the outcome. ⋯ Additionally, as participants' cumulative ACE scores increased, their PCL-5 scores worsened (b = 0.16; p < 0.05), and incremental ACE score increases predicted increased odds for a positive provisional PTSD screen. Results provide further evidence that ACEs exacerbate the development of PTSD in young survivors of violence. Future research should explore targeted interventions to treat PTSD among survivors of interpersonal violence.
-
In Makassar, Indonesia, the USAID-funded Building Healthy Cities (BHC) project engaged 240 multi-sector stakeholders to gather qualitative data across three workshops and two citizen town halls from 2019 to 2021. These data were synthesized with results from BHC's nine other Makassar activities to build maps of the current system and identify high-impact areas for engagement. Contextual findings showed that Makassar leadership has actively innovated and used new technology to improve the city, resulting in improved connectivity and responsiveness. ⋯ Stakeholders found three key leverage points within this context that, if included in every action, could help overcome barriers. These leverage opportunities are: (1) increasing data-driven decision-making; (2) ensuring equitable policy and leadership; and (3) increasing community participation. By combining key patterns discovered in the Context Map with the leverage opportunities, BHC was able to co-create with stakeholders six "coherent actions" that can move Makassar to a healthier, "Sombere (kind-hearted and hospitable) and Smart City." BHC has been working with the city planning office to incorporate the map findings into its bottom-up planning processes and the 5-year mid-term plan for Makassar.
-
Green zones are potential contributors to health by mitigating disparities between low- and high-income neighborhoods. Against the background of different discourses about city parks-parks as restorative environments, parks as enabling places, and parks as sites for encounters between strangers-we ethnographically studied the coproduction of green spaces and health within low-income neighborhoods. ⋯ Parks as "clean spaces" create expectations of order and peace; parks as places of the community are related to play and activities; and parks as urban stage foster interactions between strangers. By generating experiences that encompass different conceptions of health, citizen-led events can contribute to a shift in the understanding of parks as sites of neighborhood decline to parks as places of hope and new beginnings.