Journal of urban health : bulletin of the New York Academy of Medicine
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The high rate of obesity among black women in the USA is a significant public health problem. However, there is limited research on the relationship between racial residential segregation and disparities in obesity, and the existing evidence is limited and results are mixed. ⋯ Multilevel logistic regression models found that for every one-point increase in the black isolation index, there was a 1.06 (95 % confidence interval (CI) = 1.01, 1.11) times higher odds of obesity for black women. In order to address the disparately high rates of obesity among black women, health policies need to address the economic, political, and social forces that produce racially segregated neighborhoods.
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Infrastructure improvements such as pedestrian crosswalks that calm traffic and increase access to physical activity opportunities could alleviate important barriers to active living in underserved communities with outdated built environments. The purpose of this study was to explore how the built environment influences street-crossing behaviors and traffic speeds in a low-income neighborhood with barriers to active living in Columbia, Missouri. In 2013, a signalized pedestrian crosswalk and 400-ft-long median was constructed along a busy 5-lane, high-speed arterial highway linking low-income housing with a park and downtown areas. ⋯ Motor vehicles traveling above the speed limit of 35 mph decreased from 62,056 (46 %) to 46,256 (35 %) (p < 0.001) at the intervention site and increased from 57,891 (49 %) to 65,725 (59 %) (p < 0.001) at the control site. The installation of a signalized crosswalk facilitated an increase in safe street crossings and calmed traffic volume and speed in an underserved neighborhood. We believe these findings have significant public health implications that could be critical to advocacy efforts to improve infrastructure projects in similar communities.
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Inadequate access to healthy food is a problem in many urban neighborhoods, particularly for racial-ethnic minorities and low-income groups who are more likely to reside in food deserts. Although substantial research throughout the country has documented the existence of these disparities, few studies have focused on how this access changes over time or is affected by environmental shocks. This study examined citywide supermarket access in New Orleans as well as racial-ethnic disparities in this access, prior to Hurricane Katrina and at three times afterwards. ⋯ Improvements in disparities to pre-storm levels were not seen until 2009, 4 years after the storm. By 2014, supermarket access, on average, was not significantly different in African-American neighborhoods than in others (IRR = 0.90; 95 % CI = 0.65, 1.26). The slow recovery of New Orleans' retail food infrastructure after Hurricane Katrina highlights the need for an increased focus on long-term planning to address disparities, especially those that may be exaggerated by shocks.
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Drug overdose is now the leading cause of unintentional death nationwide, driven by increased prescription opioid overdoses. To better understand urban opioid overdose deaths, this paper examines geographic, demographic, and clinical differences between heroin-related decedents and prescription opioid decedents in San Francisco from 2010 to 2012. During this time period, 331 individuals died from accidental overdose caused by opioids (310 involving prescription opioids and 31 involving heroin). ⋯ Overall, heroin overdose death, previously common in San Francisco, is now rare. Prescription opioid overdose has emerged as a significant concern, particularly among individuals in high-poverty areas. Deaths in poor and affluent regions involve different causative opioids and co-occurring substances.
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Studies show that those residing in households subsidized with federal housing vouchers exhibit fewer mental health problems than residents of public housing. The role of housing conditions and neighborhood quality in this relationship is unclear. This study investigated the relationship between rental assistance, housing and neighborhood conditions, and the risk of depressive symptomology and hostile affect among low-income Latino adults living in the Bronx, NY. ⋯ Hostility was significantly associated with perceived crowding [OR = 1.18; CI 1.16, 2.85], neighborhood physical disorder [OR = 1.94; CI 1.12, 3.40], and social cohesion [OR = 0.70; CI 0.50, 0.98]. Low-income housing assistance did not have an independent effect on mental health outcomes. However, characteristics of the housing and neighborhood environments were associated with depressive symptomology and hostility.