Journal of urban health : bulletin of the New York Academy of Medicine
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In summer 2020, New York City (NYC) implemented a free air conditioner (AC) distribution program in response to the threats of extreme heat and COVID-19. The program distributed and installed ACs in the homes of nearly 73,000 older, low-income residents of public and private housing. To evaluate the program's impact, survey data were collected from October 2020 to February 2021 via mail and online from 1447 program participants and 902 non-participating low-income NYC adults without AC as a comparison group. ⋯ Participants were less likely to report that 2020 hot weather made them feel sick in their homes compared to non-participants (AOR = 0.2, CI = 0.2, 0.3). The program helped participants-low-income residents and primarily people of color-stay home safely during hot weather. These results are relevant for climate change health-adaptation efforts and heat-health interventions.
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In this study, we consider the patient, provider, and public health repercussions of San Francisco's (SF) COVID-related response to homelessness using tourist hotels to house people experiencing homelessness (PEH). We describe the demographics, medical comorbidities, and healthcare utilization patterns of a subset of PEH who accessed the shelter-in-place (SIP) hotel sites during the 2020-2021 pandemic. ⋯ We found that temporary SIP housing increased outpatient care and reduced higher-cost hospital utilization. Our results can inform the future design and implementation of integrated supportive housing models to reduce mortality and promote wellness for PEH.
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Adverse childhood experiences (ACEs) have been associated with poor mental health outcomes in adulthood. Childhood maltreatment is related to both depressive and anxiety symptoms. Our objective was to investigate these associations among low-income, mostly Black and Latino men who have sex with men (MSM), as these may be a particularly vulnerable population group. ⋯ The ordinal logistic model suggested that cumulative ACEs more than triple the odds of being in a higher anxiety category (OR = 3.12; 95% CI: 1.58-6.14), with associations reported for childhood maltreatment ACEs (OR = 1.31; 95% CI: 1.06-1.66) and childhood sexual abuse (OR = 1.93; 95% CI: 0.89-4.21). Childhood maltreatment ACEs, particularly childhood sexual abuse, are salient predictors of depressive and anxiety symptoms among adult urban MSM. Mitigating the impact of childhood maltreatment requires understanding the additional burden of social distress often faced by MSM throughout the life course.
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This study used a natural experiment of a new metro line in Hong Kong to examine trade-offs between transit-related and non-transit-related physical activity (PA) among 104 older people (aged ≥ 65 years) based on longitudinal accelerometer data that distinguished transit-related and non-transit-related PA. Difference-in-difference (DID) analysis compared PA changes between treatment and control groups. We found that new metro stations have trade-off effects between transit and non-transit PA. ⋯ In addition, the proportion of time spent in transit-related PA increased by 6%. The results suggested that new metro stations could generate transit-related PA, but it might shift from non-transit-related PA among older people. Our findings revealed trade-off effects of public transit interventions and have significant implications for transport and healthy ageing studies.
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Low-income populations are at higher risk of missing appointments, resulting in fragmented care and worsening disparities. Compared to face-to-face encounters, telehealth visits are more convenient and could improve access for low-income populations. All outpatient encounters at the Parkland Health between March 2020 and June 2022 were included. ⋯ Telehealth visits were associated with significantly greater reductions in probability of no-show among patients of Black race and among those who resided in the most socially vulnerable areas. Telehealth encounters were more effective in reducing no-shows in primary care and internal medicine subspecialties than surgical specialties or other non-surgical specialties. These data suggest that telehealth may serve as a tool to improve access to care in socially complex patient populations.