Journal of urban health : bulletin of the New York Academy of Medicine
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A series of studies have demonstrated that people who live in regions where there are disparities in income have poorer average health status than people who live in more economically homogeneous regions. To test whether such disparities might explain health variations within urban areas, we examined the possible association between income inequality and infant mortality for zip code regions within New York City using data from the 1990 census and the New York City Department of Health. ⋯ An increase of one standard deviation in income inequality was associated with an increase of 0.80 deaths/1,000 live births (P <.001), controlling for other socioeconomic factors. This finding has important implications for public health practice and social epidemiological research in large urban areas, which face significant disparities both in health and in social and economic conditions.
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Individual behavior and social contexts are critical determinants of health. We surveyed commissioners or their designees in 22 departments of health serving US cities of at least 500,000 people to examine their use of scientific approaches to influence individual behavior and social contexts. ⋯ Behavioral and social sciences were employed most frequently in the areas of HIV/AIDS and maternal and child health and in the service of changing individual behavior rather than larger contexts, although across departments many health problems and approaches were involved. Commissioners generally found the approaches valuable, but articulated barriers to more widespread adoption.
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Studies over the last decade have demonstrated the effectiveness of public health interventions based on social and behavioral science theory for many health problems. Little is known about the extent to which health departments are currently utilizing these theories. This study assesses the application of social and behavioral science to programs in the New York City Department of Health (NYCDOH). ⋯ While NYCDOH has successfully applied social and behavioral sciences in some areas of practice, many areas use them minimally or not at all. Increasing use will require additional resources. Partnerships with academic institutions can bring additional social and behavioral science resources to health departments and benefit researchers understanding of the health department environment.
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Over the past two decades, public health research has emphasized the role of individual risk behaviors, primarily injection and sexual risk behaviors, in the spread of HIV infection. Much less emphasis has been given to understanding the determinants of these risk behaviors. ⋯ This article presents a conceptual framework that incorporates some of the key contextual domains that may affect drug use behavior. It also presents data from a study of street-recruited drug users as an example of the relations between social contextual factors and frequency of injecting drug use, and discusses some methodological challenges in the study of contextual determinants of drug use behavior.
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In the last century, both the health and life expectancy of Americans improved dramatically. These gains were primarily the result of advances in public health. ⋯ In 1999, the New York City Department of Health (NYCDOH) undertook the task of integrating behavioral and social science into its public health practice. The experience serves as a case study on the integration process at a public health agency.