Journal of urban health : bulletin of the New York Academy of Medicine
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Prior to 1999, dramatic fluctuations in homicide rates were driven by changes in the rates of firearm homicide among men aged 15-24. Since 2000, the overall homicide rate has appeared stable, masking any changes in population subgroups. We analyzed recent trends in homicide rates by weapon, age, race, gender, state, and urbanization to determine whether the risk of victimization increased substantially during 1999-2005 for demographic subgroups. ⋯ Significant increases among men aged 25-44 occurred in Alabama, California, Michigan, Minnesota, Nebraska, Nevada, New Jersey, Ohio, Pennsylvania, Texas, and Washington. The firearm homicide rate increased the most in large central metropolitan areas (+32%) and large fringe metropolitan areas (+30%) for men aged 25-44. We conclude that the recent, unrecognized increases in firearm homicide among men aged 25-44, especially black men, in large metropolitan areas merit the attention of policymakers.
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We examined associations between objective measures of the local road environment and physical activity (including active transport) among youth. There is little empirical evidence of the impact of the road environment on physical activity among children/adolescents in their neighborhoods. Most recent studies have examined perceptions rather than objective measures of the road environment. ⋯ For adolescent boys, residing on a cul-de-sac, compared with a through road, was associated with increases in MVPA of 9 min after school, 5 min in the evenings, and 22 min on weekend days. Speed humps were positively associated with adolescent boys' MVPA during evenings. The road environment influences physical activity among youth in different ways, according to age group, sex and type of physical activity.
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The health care safety net in the United States is intended to fill gaps in health care services for uninsured and other vulnerable populations. This paper presents a case study of New Brunswick, NJ, a small city rich in safety net resources, to examine the adequacy of the American model of safety net care. We find substantial gaps in access to care despite the presence of a medical school, an abundance of primary care and specialty physicians, two major teaching hospitals, a large federally qualified health center and other safety net resources in this community of about 50,000 residents. ⋯ Bivariate analyses show significantly elevated risk of access problems among Hispanic and black residents, those in poor health, those relying on hospital and community clinics or with no usual source of care, and those living at or below poverty. In multivariate analysis, lack of health insurance was the greatest risk factor associated with both prescription drug and specialty access problems. Few local areas can claim the depth of safety net resources as New Brunswick, NJ, raising serious concerns about the adequacy of the American safety net model, especially for people with complex and chronic health care needs.
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Comparative Study
Vicarious exposure to terrorist attacks and substance use: results from an urban household survey.
This study investigated the impact of the 9/11 attacks on substance use in Chicago, Illinois. The study design was a cross-sectional, audio-computer-assisted self-interview survey conducted in 2001 and 2002. ⋯ Compared to pre-9/11 interviewees, post-9/11 interviewees showed significantly less self-reported marijuana use, marijuana use per test results, and cocaine use per test results. Law enforcement and social-structural explanations for the findings are discussed.