Journal of urban health : bulletin of the New York Academy of Medicine
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The purpose of this study was to use participatory systems thinking to develop a dynamic conceptual framework of racial/ethnic and other intersecting disparities (e.g., income) in food access and diet in Philadelphia and to identify policy levers to address these disparities. We conducted three group model building workshops, each consisting of a series of scripted activities. Key artifacts or outputs included qualitative system maps, or causal loop diagrams, identifying the variables, relationships, and feedback loops that drive diet disparities in Philadelphia, Pennsylvania. ⋯ Consistent with existing frameworks, addressing disparities will require a focus on upstream social determinants. However, existing frameworks should be adapted to emphasize and disrupt the interdependent, reinforcing feedback loops that maintain and exacerbate disparities in fundamental social causes. Our findings suggest that promising policies include those that empower minoritized communities, address socioeconomic inequities, improve community land control, and increase access to affordable, healthy, and culturally meaningful foods.
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Highway reclamation (i.e., the removal of highways or placing existing highways underground to create mixed-use urban areas) is being implemented around the United States, often touting co-benefits for population health. As part of the Bipartisan Infrastructure Law and the Inflation Reduction Act, the Reconnecting Communities and Neighborhoods grant program is a first-of-its-kind investment in launching even more highway reclamation projects. ⋯ However, little work has systematically examined the extent to which highway reclamation projects provide the promised benefits for neighborhood environments (e.g., reduced air pollution), minimize gentrification, and improve health outcomes. This commentary proposes a framework by which the multidimensional impacts of highway reclamation can be evaluated, unlocking potential new structural pathways toward urban health equity.
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No known studies have examined the relationships between urban heat islands, historic redlining, and neighborhood walking in older adults. We assessed whether (1) individual and neighborhood characteristics (including redlining score) differ by neighborhood summer land surface temperature (LST); (2) higher LST is associated with less neighborhood walking, and whether associations differ by historic redlining score; and (3) neighborhoods with discriminatory redlining scores have greater LSTs. We used data on 3982 ≥ 65 years old from the 2017 National Household Travel Survey. ⋯ Overall, these findings suggest that historically redlined neighborhoods may experience urban heat island effects more often. While older adults living in hotter neighborhoods with "still desirable" or "best" redlining scores may less often engage in neighborhood walking, those in neighborhoods with redlining scores of "definitely declining" and "hazardous" do not seem to decrease neighborhood walking with higher LSTs. Future work is needed to elucidate the impact of extreme heat on health-promoting behaviors such as walking and the types of interventions that can successfully counteract negative impacts on historically disadvantaged communities.