Journal of urban health : bulletin of the New York Academy of Medicine
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Slum dwellers across Africa have been targeted in interventions whose impacts remain unclear. We evaluated the impact of a livelihood intervention on the sexual and reproductive health and rights (SRHR) of young people in the slum areas of Kampala, Uganda. We carried out a repeated cross-sectional survey in 2014 and 2017 to examine the impact of community-based livelihood interventions on the SRHR of young people in the slum areas of Kampala, Uganda. ⋯ We observed no impact on condom use, consensual sex and sexual assault, the number of sexual partners, knowledge about HIV/AIDS, stigma and discrimination against people living with HIV/AIDS, affordability of male and female condoms, and uptake of HIV testing services. Rights-based interventions are crucial to how we understand the SRHR of young people in complex sociocultural environments. While the livelihood interventions made significant impacts on the SRHR of young people, there are questions about how such interventions address deeply rooted sociocultural practices to maximise outcomes.
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In the Republic of Korea, social distancing policies relied on voluntary participation by citizens and exhibited short-term changes. In this situation, the effects of such policies varied depending on each community's capacity to comply. ⋯ We found that the mean percent change in subway ridership was fitted by an additive model of the log-transformed percent ratio of the restaurant industry (estimated degrees of freedom (EDF) = 3.24, P < 0.001), the Deprivation Index (DI) (EDF = 3.66, P = 0.015), and the proportion of essential workers (β = - 0.10 (95% confidence interval - 0.15 to - 0.05, P < 0.001). We found a distinct decrease in subway ridership only in the least deprived areas, suggesting that social distancing is costly.
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Structural racism in police contact is an important driver of health inequities among the U. S. urban population. Hyper-policing and police violence in marginalized communities have risen to the top of the national policy agenda, particularly since protests in 2020. ⋯ However, despite declines in nearly all census tracts, the magnitude of racial inequities in arrests remained unchanged. During the initial weeks of the pandemic, arrest rates declined significantly in areas with higher Black populations, but average rates in Black neighborhoods remained higher than pre-pandemic arrest rates in White neighborhoods. These findings support urban policy reforms that reconsider police capacity and presence, particularly as a mechanism for enforcing public health ordinances and reducing racial disparities.
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Historical, institutional racism within the housing market may have impacted present-day disparities in heat vulnerability. We quantified associations between historically redlined areas with present-day property and housing characteristics that may enhance heat vulnerability in Philadelphia, PA. We used color-coded Home Owners Loan Corporation (HOLC) maps and tax assessment data to randomly select 100 present-day (2018-2019) residential properties in each HOLC grade area (A = Best; B, C, and D = Most hazardous; N = 400 total). ⋯ Adjusting for present-day concentrated racial and socioeconomic deprivation did not substantially impact overall findings. In Philadelphia, PA, HOLC maps serve as spatial representations of present-day housing and land cover heat vulnerability characteristics. Further analyses incorporating longitudinal data on urban redevelopment, reinvestment, and neighborhood change are needed to more fully represent complex relationships among historical racism, residential segregation, and heat vulnerability.
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The USA incarcerates more people than any other nation in the world. Exposure to the criminal legal system has been associated with a myriad of health outcomes but less is understood about what drives these associations. We argue that stigma due to criminal legal involvement, what we call criminal legal stigma, likely has a larger role in the association between incarceration and negative health outcomes than has been previously appreciated. ⋯ In this paper, we describe a conceptual framework of the health effects of criminal legal stigma drawing on previous research of criminal legal stigma and advances in other areas of stigma research. We outline key concepts related to stigma mechanisms, how they function at structural and individual levels, and how they might cause health outcomes. Finally, we identify potential areas for future research and opportunities for clinical interventions to remediate negative effects of stigma.