Journal of urban health : bulletin of the New York Academy of Medicine
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The article begins with a discussion of the rationale for studying the relationship between residential environments and cardiovascular health. Existing empirical research relating residential environments to cardiovascular outcomes and risk factors is summarized. The research areas discussed include neighborhood socioeconomic characteristics and cardiovascular disease, the effects of residential environments on physical activity, and the effects of residential environments on diet. ⋯ Key challenges in investigating the relationship between residential environments and health are discussed. These challenges include characterizing environments (including definition and geographic scale as well as conceptualization and measurement of relevant features), the limitations of observational studies, and the need to evaluate the health impact of interventions or "naturally" occurring changes in local environments. The need for interdisciplinary work is emphasized.
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The overarching goal of this article is to make explicit the multiple pathways through which the built environment may potentially affect health and well-being. The loss of close collaboration between urban planning and public health professionals that characterized the post-World War II era has limited the design and implementation of effective interventions and policies that might translate into improved health for urban populations. ⋯ And third, we wrestle with key challenges in conducting sound scientific research on connections between the built environment and health, namely: (1) the necessity of dealing with the possible health consequences of myriad public and private sector activities; (2) the lack of valid and reliable indicators of the built environment to monitor the health effects of urban planning and policy decisions, especially with regard to land use mix; and (3) the growth of the "megalopolis" or "super urban region" that requires analysis of health effects across state lines and in circumscribed areas within multiple states. We contend that to plan for healthy cities, we need to reinvigorate the historic link between urban planning and public health, and thereby conduct informed science to better guide effective public policy.
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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.
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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.