Journal of urban health : bulletin of the New York Academy of Medicine
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Based on several stress-coping frameworks, recent studies have suggested that perceived experiences of discrimination, a psychosocial stressor, may be associated with various risky health behaviors. The 2001 Chicago Community Adult Health Study (n = 3,101), a face-to-face representative probability sample of adults in Chicago, IL, USA, was used to examine the relationship among lifetime everyday discrimination, major discrimination, and the use of illicit and psychotherapeutic drugs for nonmedical reasons. We used negative binomial logistic and multinomial regression analyses controlling for potential confounders. ⋯ Similarly, an increase in one lifetime major discrimination event was associated with an increase of misusing 1.3 different drugs on average regardless of experiences of everyday discrimination (p < 0.001). When examining the types of drugs misused, results from multinomial logistic regression suggest that everyday discrimination was only associated with illicit drug use alone; however, lifetime major discrimination was associated with increased odds of using any illicit and both illicit/psychotherapeutic drugs. Mental health and substance use clinical providers should be aware of these potential relationships and consider addressing the harmful effects of perceived discrimination, in all patients not only among racial/ethnic minority patients.
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Substance use and substance use disorders (SUDs) have been linked with marital discord. Relatively little is known, however, about the antecedents of SUDs, the mediators of these factors over time, or their associations with the spousal/partner relationship among urban adults. A better understanding of the longitudinal pathways to marital conflict and to SUDs should help prevention and intervention programs target their precursors within the developmental period in which they occur. ⋯ Other pathways highlighted the continuity of psychological symptoms as related to both substance use in young adulthood (p < 0.001) and an unsupportive spousal/partner relationship in adulthood (p < 0.001). Findings showed that the associations of both distal stressors and the parent-adolescent relationship with more proximal intra- and interpersonal problems predicted unsupportive spousal/partner relationships and SUDs among urban adults. Several aspects of the individual's life, at different developmental stages, provide opportunities for interventions to prevent or reduce unsupportive spousal/partner relationships and SUDs.
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The purpose of this paper is to evaluate the progress made by European cities in relation to Healthy Urban Planning (HUP) during Phase IV of the World Health Organization's Healthy Cities programme (2003-2008). The introduction sets out the general principle of HUP, identifying three levels or phases of health and planning integration. This leads on to a more specific analysis of the processes and substance of HUP, which provide criteria for assessment of progress. ⋯ In particular, those achieving effective strategic integration of health and planning have increased. A key challenge for the future will be to develop planning frameworks which advance public health concerns in a spatial policy context driven often by market forces. A health in all policies approach could be valuable.
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Pedestrians are overrepresented in road traffic injuries and deaths in Nairobi, the capital city of Kenya, yet little research has been done to provide better understanding of the characteristics of pedestrian injuries. This paper presents the data obtained from road traffic injury admissions to Kenyatta National Hospital (KNH) over a 3-month period starting from 1 June to 31 August 2011. A total of 176 persons involved road traffic injuries in Nairobi were admitted to KNH during this period. ⋯ Most of the pedestrian injuries (67.7 %) affected the limbs. The paper argues that safety of pedestrians should be a priority in road safety efforts in the city of Nairobi. Urban road safety planners should adopt existing cost-effective interventions to improve the safety of pedestrians such as area-wide traffic calming to limit the speeds of motor vehicles to 30 km/h, providing sidewalks for pedestrians, traffic calming in residential neighborhoods, people-and-not-car-oriented urban road designs, traffic education, and enforcement of traffic regulations.
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Inconsistent findings on the relationship of sex partner concurrency to infection with HIV and other sexually transmitted diseases (STDs) may result from differences in how sex partner concurrency is conceptualized. We examine the relationship of reciprocal sex partner concurrency (RSPC) to diagnosed STDs among heterosexuals. Heterosexually active adults (N = 717) were recruited for a cross-sectional study using respondent-driven sampling (RDS) from high-HIV-risk areas in New York City (NYC, 2006-2007) and interviewed about their sexual risk behaviors, number of sex partners, last sex partners, and STD diagnoses (prior 12 months). ⋯ Any STDs was independently associated with RSPC (aOR = 1.54, 95%CI = 1.02-2.32), female gender (aOR = 2.15, 95%CI = 1.43-3.23), having more than three sex partners (aOR = 1.72, 95%CI = 1.13-2.63), and unprotected anal sex (aOR = 1.65, 95%CI = 1.12-2.42). Heterosexuals in high-HIV-risk neighborhoods in sexual partnerships that involve RSPC are at greater risk of STDs and, potentially, HIV. RSPC, in addition to sexual risk behaviors and the number of sex partners, may facilitate the heterosexual spread of HIV through STD cofactors and linkage into larger STD/HIV sexual transmission networks.