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Violence is a key mechanism in the reproduction of community disadvantage. The existing evidence indicates that violence in a community impacts the intergenerational mobility of its residents. The current study explores the possibility of a reverse relationship. This study provisionally tests the hypothesis that depressed intergenerational mobility in a community may also spark subsequent community violence. We deploy a county measure of intergenerational mobility captured during early adulthood for a cohort of youth born between 1980 and 1986 and raised in low-income families [R. Chetty, N. Hendren, Quart. J. Econom. 133, 1163-1228 (2018)]. We model the relationship between county mobility scores and two county-level outcomes: violent crime and homicide. We find that a county's level of intergenerational mobility as measured by the Chetty-Hendren data is a major predictor of its rate of violent crime and homicide in 2008, when the youth in Chetty's mobility cohort were young adults (the same age the mobility measure was captured). In fact, mobility is a significantly stronger and more consistent predictor of community violent crime and homicide rates than more commonly used factors like poverty, inequality, unemployment, and law enforcement presence.
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Violência , Humanos , Violência/estatística & dados numéricos , Masculino , Feminino , Relação entre Gerações , Adulto , Adolescente , Pobreza , Adulto Jovem , Homicídio/estatística & dados numéricos , Características de Residência , Crime/estatística & dados numéricosRESUMO
BACKGROUND: To assess whether the 'economic boom' in the tropical seaport city of Barranquilla improved tapped water supplies to socio-economically poor neighbourhoods resulting in: (1) their reduced use for domestic water-storage in large (> 1,000-litre) custom-made cement tanks which are their principal Aedes aegypti breeding sites and (2) their pupae/person index (PPI) values to below their established 0.5-1.5 PPI arbovirus transmission-threshold value, compared to matched neighbourhoods in the: (a) pre-economic boom (2004) period in Barranquilla and (b) economically-neglected seaport city of Buenaventura. METHODS: The simple, accurate and robust water surface sweep-net/calibration factor or total count methods were used to determine the total Ae. aegypti pupae numbers in greater or less than 20-litre water-holding container types located 'inside' or 'outside' these neighbourhood premises. The women residents also participated in questionnaire-based responses about their domestic water supplies, water-storage and maintenance and mosquito life stages and disease transmission knowledge, to subsequently plan appropriate resident education programmes. Microsoft Excel 8.0 with OpenEpi was used to determine the samples sizes and the statistical values. RESULTS: Tapped water supplies to the three poor Barranquilla neighbourhoods were dramatically increased from 2004 to 2023 resulting in their residents significantly reducing their: (a) large cement water-storage tanks from 1 per 6.9 (2004) to 1 per 31.2 (2020) premises (z = 10.5: p = 0) and (b) PPI values to 0.16, 0.19 and 0.53 (mean: 0.29: 95% CI ± 0.4) in each study neighbourhood. In contrast, tapped water supplies remained inadequate in the Buenaventura neighborhoods, thereby resulting in their continued use of many large (> 1,000-litre) water-storage containers (Barranquilla: 1 per 31.2 and Buenaventura: 1 per 1.5 premises: z = - 9.26: p = 0), with unacceptably high 0.81, 0.88 and 0.99 PPI values in each study neighbourhood (mean 0.89: 95% CI ± 0.12). CONCLUSIONS: Improved tapped water supplies resulted in reduced numbers of large custom-made stoneware water-containers, as are employed by poor residents throughout the world, as well as their Ae. aegypti PPI transmission threshold values which, together with appropriate residents' education programmes, are also urgently to reduce to prevent/reduce Ae. aegypti transmitted human diseases globally.
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Aedes , Abastecimento de Água , Animais , Humanos , Feminino , Mosquitos Vetores , Infecções por Arbovirus/transmissão , Pupa , Dengue/transmissão , Controle de Mosquitos/métodos , Colômbia , Adulto , Características de Residência/estatística & dados numéricosRESUMO
In face-to-face household surveys, field interviewers are sometimes asked to make notes of characteristics of the dwelling unit on the sampled address as well as its surroundings before making contact with a household member living at the sample address. Field interviewer observations of this kind are used to improve efficiency of field data collection and to be used as nonresponse adjustment. However, field interviewer observations can be expensive and the quality of observations needs to be improved. Recently, survey organizations start to utilize Google Street View to conduct virtual observations of the dwelling unit and the neighborhood. This paper reports a feasibility study that evaluates the feasibility of using virtual observations, assesses its agreement with field interviewer observation results, and examine whether virtual observations correlate with survey response status and survey estimates. We found moderate to high agreements between virtual and interviewer observation results. We also found that some observation results are significantly related to response status and survey estimates. However, virtual observations using GSV have coverage issues, which could limit their potential use.
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Estudos de Viabilidade , Características de Residência , Humanos , Inquéritos e Questionários , InternetRESUMO
Introduction: Community-acquired pneumonia (CAP) is a major health concern in the United States (US), with its incidence, severity, and outcomes influenced by social determinants of health, including socioeconomic status. The impact of neighborhood socioeconomic status, as measured by the Distressed Communities Index (DCI), on CAP-related admissions remains understudied in the literature. Objective: To determine the independent association between DCI and CAP-related admissions in Maryland. Methods: We conducted a retrospective study using the Maryland State Inpatient Database (SID) to collate data on CAP-related admissions from January 2018 to December 2020. The study included adults aged 18-85 years. We explored the independent association between community-level economic deprivation based on DCI quintiles and CAP-related admissions, adjusting for significant covariates. Results: In the study period, 61,467 cases of CAP-related admissions were identified. The patients were predominantly White (49.7%) and female (52.4%), with 48.6% being over 65 years old. A substantive association was found between the DCI and CAP-related admissions. Compared to prosperous neighborhoods, patients living in economically deprived communities had 43% increased odds of CAP-related admissions. Conclusion: Residents of the poorest neighborhoods in Maryland have the highest risk of CAP-related admissions, emphasizing the need to develop effective public health strategies beneficial to the at-risk patient population.
Assuntos
Infecções Comunitárias Adquiridas , Hospitalização , Pneumonia , Humanos , Maryland/epidemiologia , Infecções Comunitárias Adquiridas/epidemiologia , Infecções Comunitárias Adquiridas/economia , Feminino , Pessoa de Meia-Idade , Idoso , Masculino , Adulto , Pneumonia/epidemiologia , Estudos Retrospectivos , Idoso de 80 Anos ou mais , Adolescente , Hospitalização/estatística & dados numéricos , Hospitalização/economia , Adulto Jovem , Características da Vizinhança/estatística & dados numéricos , Características de Residência/estatística & dados numéricos , Fatores SocioeconômicosRESUMO
Characterized by early construction periods, as the concentration of low-income populations and a high level of aging, affordable housing communities face prominent challenges such as incongruence between age-friendly construction and the needs of the older adult population. It is urgent to provide pathways and tools for identifying age-friendly issues and optimizing the built environment. The systematic evaluation of age-friendly communities serves as the foundation for implementing intervention measures by developers. Therefore, the construction of a scientifically systematic evaluation system becomes an objective necessity for age-friendly community development. Building upon existing research, this study systematically outlines the subjects, processes, methods, and content involved in constructing an age-friendly community evaluation system. By the methods such as factor analysis and analytical hierarchy process (AHP), the study focuses on the public spaces of affordable housing communities in Shenzhen as a case for constructing an age-friendly evaluation system. The empirical validation of the indicator system is conducted, and the application results are resulted into concrete improvement recommendations and action items, aiming to provide a practical, quantitative tool for community age-friendliness evaluation. The study reveals that adhering to an effective evaluation process, exploring collaborations among multiple stakeholders, determining hierarchical evaluation criteria, and adopting diversified evaluation methods are key to constructing an age-friendly evaluation system for communities. Additionally, the specificity of the evaluation system is influenced by regional demographic structures, policy backgrounds, and the built environment.
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Ambiente Construído , Humanos , China , Idoso , Habitação Popular , Planejamento Ambiental , Características de Residência , Habitação , Pessoa de Meia-Idade , MasculinoRESUMO
INTRODUCTION: Quality of life (QoL) is a subjective measure reflecting individuals' evaluations based on their personal goals and values. While global research shows the role of neighborhood factors like ethnic diversity and socio-cultural dynamics on QoL, these are unexplored in the Nepali context. Therefore, this study examined the relationship between neighborhood environment and QoL among Nepali older adults in eastern Nepal. METHODS: This cross-sectional study involved 847 non-institutionalized older adults (aged ≥ 60 years) from two districts in eastern Nepal. QoL was evaluated using the 13-item brief Older People's Quality of Life questionnaire, where a mean score of < 3 indicated low/poor QoL. The neighborhood environment, conceptualized across three domains (demographic, socio-cultural, and built environment), included ethnic diversity, connections with family, friends, and neighbors, cultural ties, residential stability, and rurality. Their association with QoL was examined using multivariable logistic regression. RESULTS: Around 20% of older adults reported poor QoL. Higher ethnic diversity (adjusted Odds Ratio [aOR] = 0.12, 95% confidence interval [CI]: 0.04-0.36), moderate contact with family and relatives (aOR = 0.26, CI: 0.11-0.61), and high contact with neighbors (aOR = 0.09, CI: 0.03-0.21) were associated with lower odds of poor QoL. Conversely, high contact with friends (aOR = 2.29, CI: 1.30-4.04) and unstable residence (OR = 6.25, CI: 2.03-19.23) increased the odds of poor QoL. Additionally, among the covariates, chronic disease, tobacco use, unemployment, and lack of education were also significantly associated with poor QoL. CONCLUSION: Overall, the demographic environment, socio-cultural factors, and the built environment of the neighborhood influence QoL. Therefore, diversifying the neighborhood's ethnic composition, promoting social connections such as frequent contact with family, relatives, and neighbors, and ensuring residential stability can enhance the QoL of older adults.
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Qualidade de Vida , Humanos , Nepal/epidemiologia , Nepal/etnologia , Estudos Transversais , Masculino , Idoso , Feminino , Qualidade de Vida/psicologia , Pessoa de Meia-Idade , Características da Vizinhança , Características de Residência , Idoso de 80 Anos ou mais , Inquéritos e QuestionáriosRESUMO
Residents' participation is crucial for sustainable old neighborhood regeneration. Residents' intentions to participate in the regeneration are low in China, resulting in unsustainable neighborhood development problems. Therefore, it is essential to investigate the drivers of residents' participation. Residents' behavioral mechanisms are deeply embedded in their social networks, especially in acquaintance social networks typical of old neighborhoods in China. By constructing a mediated moderation model based on the Theory of Planned Behavior (TPB) and danwei system and taking the old neighborhood regeneration in Xi'an as a case study, this paper investigates the paths and mechanisms of the social network embeddedness, TPB, and danwei system on residents' participation intention. The results show that social network embeddedness can improve residents' intention to participate in regeneration through both direct and indirect pathways, and its indirect effect is much larger than the direct effect. Attitude, subjective norm, and perceived behavioral control significantly and positively mediated the contribution of social network embeddedness on participation intention. However, the specific mediating effect of attitude is significantly smaller than the other two. The danwei system has a significant moderating effect in the first stage of the relationship between social network embeddedness and participation intention. These imply that the extrinsic social factor of social network embeddedness is internalized as a driving force for convergence and motivation of residents' participation intentions mainly through the normative pressure and exchange of experiences between acquaintances and that the danwei system reinforces this extrinsic-intrinsic facilitation process through the danwei's "physical presence." These findings provide revelatory countermeasures for exploring the factors that motivate residents to participate actively in neighborhood regeneration and encourage their involvement at the intervention level.
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Intenção , Características de Residência , Rede Social , Humanos , Masculino , Feminino , China , Pessoa de Meia-Idade , Apoio Social , Atitude , Idoso , AdultoRESUMO
Background: Cigarette smoking is the major preventable cause of premature deaths in the United States. Attempting to quit smoking is an important step toward smoking cessation. Although it has been studied extensively, limited information on the association between attempts to quit smoking and neighborhood air quality problems is available. Therefore, we examined the association between attempts to quit smoking in the past year and perceived neighborhood air quality problems among adult Texans who smoke. Methods: In 2018, a cross-sectional multistage area probability design-based survey was administered to collect sociodemographic, behavioral, and health-related information from a representative sample of 2050 Texas residents. The current study included 486 adult respondents who reported smoking within the past 12 months. The association between attempts to quit smoking and perceived neighborhood air quality (measured by self-reported problems with neighborhood air quality) was examined using a population-weighted multivariable logistic regression analysis. Results: Overall, 60.7% of the 486 respondents attempted to quit cigarette smoking. The prevalence of attempting to quit was 74.6% for those reporting perceived neighborhood air quality problems. In the multivariable analysis, a higher likelihood of attempting to quit smoking was found among individuals with perceived neighborhood air quality problems (AOR: 1.906 [1.104-3.289]) and those who were married or living as married (AOR: 1.876 [1.161-3.033]). The likelihood of attempts to quit smoking was lower among males (AOR: 0.629 [0.397-0.995]) and decreased with age (AOR: 0.968 [0.951-0.984]). Discussion: The perceived neighborhood air quality problems were found to independently predict attempts to quit cigarette smoking in Texas. To encourage quitting smoking among individuals living in neighborhoods with poor air quality, such neighborhoods should receive tailored and evidence-based interventions to improve community education, social support, and healthcare professionals' assistance to quit smoking.
Assuntos
Características de Residência , Abandono do Hábito de Fumar , Humanos , Texas , Masculino , Feminino , Estudos Transversais , Adulto , Pessoa de Meia-Idade , Abandono do Hábito de Fumar/estatística & dados numéricos , Abandono do Hábito de Fumar/psicologia , Características de Residência/estatística & dados numéricos , Fumar Cigarros/epidemiologia , Poluição do Ar , Inquéritos e Questionários , Adulto Jovem , Adolescente , IdosoRESUMO
Research on the relationship between greenspace morphology and health is a growing field that informs the spatial design of greenspace to enhance health outcomes. This study reviews the current progress, methodologies, and knowledge gaps in this area. From a database search of 272â940 English articles and 39â053 Chinese articles up to April 18, 2024, we identified 22 and 7 studies on the topic for further evaluation. Predominantly cross-sectional and neighbourhood-scale analyses were conducted using land cover maps ranging from 0·25 to 100 meters in resolution. Six primary characteristics of greenspace morphology have been studied, including size, shape, fragmentation, connectedness, aggregation, and diversity. While associations between greenspace morphology and health outcomes have been observed, both their reliability and generalisability remain suggestive due to ecological study designs and heterogeneity among studies. Future research should prioritise individual-level prospective cohorts and intervention studies. Exploring mechanisms linking greenspace morphology and health, determining optimal map resolution, and distinguishing it from greenness magnitude in statistical analysis is essential. This evidence is crucial for health-promoting greenspace planning and should be routinely integrated into urban epidemiological research.
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Características de Residência , Humanos , Ambiente Construído , Parques RecreativosRESUMO
The food environment in school neighborhoods plays a crucial role in manipulating the food choices of schoolchildren. This study investigated the relationship between the food environment in neighborhoods and the dietary practices of government school students in a low socioeconomic setting in Sri Lanka. This cross-sectional study surveyed the neighborhood food environment of selected schools (n = 30) in the Monaragala District, Sri Lanka, using geographical information system (GIS) data and collected dietary information from a representative sample of schoolchildren (n = 603). Chi-square and Spearman correlation tests were performed using SPSS version 23.0 to estimate the associations between the food environment and BMI, while ArcGIS 10.4.1 was used to analyze the GIS data. The majority of the students (35.5%) were 15 years old, and approximately 51% were females. The mean BMI of the study participants was 18.14 (±3.28). More than 90% of outlets within proximity sold unhealthy foods. Consumption of confectionaries was 72.3% of the students, whereas healthy food choices ranged from 5% to 12%. A positive correlation between consuming unhealthy food and distance to outlets from school was observed (p<0.05). The risk of consuming low-nutrition food doubled (OR = 2.47, 95% CI: 1.52-3.89) among the students studying in schools where a larger proportion of energy-dense food was sold in closer proximity. In conclusion, the density and proximity of outlets that sell food with low nutrients in the school neighborhood environment were positively associated with students' unhealthy food item choices.
Assuntos
Preferências Alimentares , Sistemas de Informação Geográfica , Humanos , Sri Lanka , Feminino , Masculino , Adolescente , Estudos Transversais , Criança , Instituições Acadêmicas , Estudantes/psicologia , Estudantes/estatística & dados numéricos , Características de Residência , Fatores Socioeconômicos , Índice de Massa Corporal , Comportamento AlimentarRESUMO
Background: The evidence on the association of fine particulate matter with an aerodynamic diameter of 2.5 µm or less (PM2.5) with pulmonary tuberculosis (PTB) retreatment is limited. There are no data on whether greenness exposure protects air pollution-related PTB retreatment in patients with prior PTB. Objective: In a population-based retrospective study, we aimed to investigate the influence of PM2.5 and residential greenness on the risk of PTB retreatment. Methods: A total of 26,482 patients with incident PTB, registered in a mandatory web-based reporting system between 2012 and 2019 in Zhengzhou, China, were included in the analysis. The exposure to PM2.5 was assessed based on the China High Air Pollutants dataset, and the level of greenness was estimated using the Normalized Difference Vegetation Index (NDVI) values. The associations of PTB retreatment with exposure to PM2.5 and greenness were evaluated, respectively, considering the local socioeconomic level indicated by the nighttime light index. Results: Among the 26,482 patients (mean age 46.86, SD 19.52 years) with a median follow-up time of 1523 days per patient, 1542 (5.82%) PTB retreatments were observed between 2012 and 2019. Exposure to PM2.5 was observed to be significantly associated with the increased risk of PTB retreatment in fully adjusted models with a hazard ratio of 1.97 (95% CI 1.34-2.83) per 10 µg/m3 increase in PM2.5. Patients living in the regions with relatively high quartiles of NDVI values had a 45% lower risk of PTB retreatment than those living in the regions with the lowest quartile for the 500 m buffers (hazard ratio 0.55, 95% CI 0.40-0.77). Such a protective effect of residential greenness was more pronounced among patients living in lower nighttime light areas. The strength of the association between PM2.5 exposure and the risk of PTB retreatment was attenuated by greenness. No significant association was observed between NDVI and the incidence of drug resistance. Conclusions: Long-term exposure to PM2.5 might be a risk factor for PTB retreatment, while an increased level of residential greenness was found to be associated with reduced risks of PTB retreatment. Our results suggest strengthening the control of ambient air pollution and improving residential greenness may contribute to the reduction of PTB retreatment.
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Material Particulado , Tuberculose Pulmonar , Humanos , Estudos Retrospectivos , Material Particulado/análise , Material Particulado/efeitos adversos , Pessoa de Meia-Idade , Feminino , Tuberculose Pulmonar/epidemiologia , Tuberculose Pulmonar/tratamento farmacológico , Masculino , China/epidemiologia , Adulto , Poluição do Ar/efeitos adversos , Poluição do Ar/análise , Exposição Ambiental/efeitos adversos , Exposição Ambiental/estatística & dados numéricos , Retratamento/estatística & dados numéricos , Idoso , Fatores de Risco , Características de Residência/estatística & dados numéricosRESUMO
Importance: There are consistent data demonstrating that socioeconomic disadvantage is associated with risk of premature mortality, but research on the relationship between neighborhood socioeconomic factors and premature mortality is limited. Most studies evaluating the association between neighborhood socioeconomic status (SES) and mortality have used a single assessment of SES during middle to older adulthood, thereby not considering the contribution of early life neighborhood SES. Objective: To investigate the association of life course neighborhood SES and premature mortality. Design, Setting, and Participants: This cohort study included Black and White participants of the multicenter Atherosclerosis Risk in Communities Study, a multicenter study conducted in 4 US communities: Washington County, Maryland; Forsyth County, North Carolina; Jackson, Mississippi; and the northwestern suburbs of Minneapolis, Minnesota. Participants were followed up for a mean (SD) of 18.8 (5.7) years (1996-2020). Statistical analysis was performed from March 2023 through May 2024. Exposure: Participants' residential addresses during childhood, young adulthood, and middle adulthood were linked with US Census-based socioeconomic indicators to create summary neighborhood SES scores for each of these life epochs. Neighborhood SES scores were categorized into distribution-based tertiles. Main Outcomes and Measures: Premature death was defined as all-cause mortality occurring before age 75 years. Multivariable-adjusted Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% CIs. Results: Among 12â¯610 study participants, the mean (SD) age at baseline was 62.6 (5.6) years; 3181 (25.2%) were Black and 9429 (74.8%) were White; and 7222 (57.3%) were women. The lowest, compared with the highest tertile, of neighborhood SES score in middle adulthood was associated with higher risk of premature mortality (HR, 1.28; 95% CI, 1.07-1.54). Similar associations were observed for neighborhood SES in young adulthood among women (HR, 1.25; 95% CI, 1.00-1.56) and neighborhood SES in childhood among White participants (HR, 1.25; 95% CI, 1.01-1.56). Participants whose neighborhood SES remained low from young to middle adulthood had an increased premature mortality risk compared with those whose neighborhood SES remained high (HR, 1.25; 95% CI, 1.05-1.49). Conclusions and Relevance: In this study, low neighborhood SES was associated with premature mortality. The risk of premature mortality was greatest among individuals experiencing persistently low neighborhood SES from young to middle adulthood. Place-based interventions that target neighborhood social determinants of health should be designed from a life course perspective that accounts for early-life socioeconomic inequality.
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Mortalidade Prematura , Humanos , Feminino , Masculino , Mortalidade Prematura/tendências , Pessoa de Meia-Idade , Características da Vizinhança , Idoso , Adulto , Fatores Socioeconômicos , Classe Social , Características de Residência/estatística & dados numéricos , Estudos de Coortes , Estados Unidos/epidemiologia , População Branca/estatística & dados numéricos , Fatores de Risco , Disparidades Socioeconômicas em SaúdeRESUMO
BACKGROUND: The physical and the social environment are important predictors of healthy weight, especially in low socioeconomic position (SEP) neighborhoods. Many Dutch municipalities have implemented a healthy weight approach (HWA). Yet, there is room for improvement. This system science study examined what influences the utilization of HWA facilities and activities, and what aspects can help to achieve a desired systems change (also called leverage point themes (LPTs)) in the HWA system as perceived by citizens living in low SEP neighborhoods. METHOD: All research phases were performed with four citizens co-researchers. Forty-seven citizens living in low SEP neighborhoods were semi-structurally interviewed about the neighborhood HWA facilities and municipal HWA activities. A rapid coding qualitative analysis approach was applied per topic. The topics were citizens' healthy living description, personal circumstances, and satisfaction with foot and cycle paths, sports facilities, playgrounds, green spaces, museums and theaters, community centers, churches, healthcare, school, food supplies, contact with neighborhood, unfamiliar and/or unused activities, familiar and used activities, unavailable but desired (lacking) activities, and reaching citizens. RESULTS: The utilization of HWA facilities and activities was influenced by the overarching themes of social cohesion, familiarity, reaching citizens, maintenance, safety, physical accessibility, financial accessibility, social accessibility, fit with personal context, and fit with the neighborhood's specific needs. Different overarching themes stood out across different facilities and activities. LPTs indicated the overarching themes needed in combination with one another for a specific activity or facility to increase utilization. For example, the LPT regarding foot and cycle paths was "accessible, safe, and maintained foot and cycle paths". The LPTs regarding familiar and used activities were "customized activities; information provision (e.g., about possibilities to join without paying); social contact, meeting others, and everyone feels included". CONCLUSION: Conducting inclusive qualitative research from a systems perspective among citizens living in low SEP neighborhoods has contributed valuable insights into their needs. This enables practical implementation of HWAs by providing a deeper understanding of the LPTs within the HWA system. LPTs can help HWA stakeholders to further develop current HWAs toward systems approaches. Future research could study the leverage points that may contribute to LPT implementation.
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Pesquisa Qualitativa , Características de Residência , Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Países Baixos , Promoção da Saúde/métodos , Idoso , Meio Social , Análise de Sistemas , Adulto Jovem , Entrevistas como AssuntoRESUMO
BACKGROUND: Despite recent advances in lung cancer therapeutics and improving overall survival, disparities persist among socially disadvantaged populations. This study aims to determine the effects of neighborhood deprivation indices (NDI) on lung cancer mortality. This is a multicenter retrospective cohort study assessing the relationship between NDI and overall survival adjusted for age, disease stage, and DNA methylation among biopsy-proven lung cancer patients. State-specific NDI for each year of sample collection were computed at the U.S. census tract level and dichotomized into low- and high-deprivation. RESULTS: A total of 173 non small lung cancer patients were included, with n = 85 (49%) and n = 88 (51%) in the low and high-deprivation groups, respectively. NDI was significantly higher among Black patients when compared with White patients (p = 0.003). There was a significant correlation between DNA methylation and stage for HOXA7, SOX17, ZFP42, HOXA9, CDO1 and TAC1. Only HOXA7 DNA methylation was positively correlated with NDI. The high-deprivation group had a statistically significant shorter survival than the low-deprivation group (p = 0.02). After adjusting for age, race, stage, and DNA methylation status, belonging to the high-deprivation group was associated with higher mortality with a hazard ratio of 1.81 (95%CI: 1.03-3.19). CONCLUSIONS: Increased neighborhood-level deprivation may be associated with liquid biopsy DNA methylation, shorter survival, and increased mortality. Changes in health care policies that consider neighborhood-level indices of socioeconomic deprivation may enable a more equitable increase in lung cancer survival.
Assuntos
Metilação de DNA , Neoplasias Pulmonares , Humanos , Neoplasias Pulmonares/mortalidade , Neoplasias Pulmonares/terapia , Neoplasias Pulmonares/patologia , Masculino , Feminino , Idoso , Estudos Retrospectivos , Pessoa de Meia-Idade , Características da Vizinhança , Carcinoma Pulmonar de Células não Pequenas/mortalidade , Carcinoma Pulmonar de Células não Pequenas/patologia , Carcinoma Pulmonar de Células não Pequenas/genética , Carcinoma Pulmonar de Células não Pequenas/terapia , Estados Unidos/epidemiologia , Fatores Socioeconômicos , Características de ResidênciaRESUMO
Background: Genetic and environmental factors contribute to psoriasis, but the impact of residential environments on this condition remains uncertain. We aimed to investigate the association of residential environments with psoriasis risk and explore its interaction with genes. Methods: We retrieved data on the spatial distribution of residential environments at 300 and 1000 m buffer zones from the UK Biobank, including the proportions of natural environments, domestic gardens, green spaces, and blue spaces within these zones. We then used Cox hazard models to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations between residential environments and psoriasis risk. Lastly, we constructed polygenic risk scores to determine genetic susceptibility and further analyse the interaction with residential environments. Results: Overall, 3755 incident cases of psoriasis were documented during a median follow-up of 12.45 years. Compared with the lowest exposure quantile (Q1), Q4 exposure to natural environments (1000 m buffer: HR = 1.16, 95% CI = 1.05-1.29; 300 m buffer: HR = 1.12, 95% CI = 1.02-1.24) and green spaces (1000 m buffer: HR = 1.16, 95% CI = 1.04-1.28; 300m buffer: HR = 1.10, 95% CI = 1.00-1.21) increased the risk of psoriasis, while Q4 exposure to domestic gardens (1000 m buffer: HR = 0.85, 95% CI = 0.77-0.93; 300m buffer: HR = 0.91, 95% CI = 0.83-1.00) and Q3 exposure to blue spaces (1000 m buffer: HR = 0.89, 95% CI = 0.81-0.98) were negatively associated with psoriasis risk. Among participants with a high genetic risk, those exposed to high levels of natural environments (1000 m buffer: HR = 1.49, 95% CI = 1.15-1.93; 300 m buffer: HR = 1.39, 95% CI = 1.10-1.77) and green spaces (300 m buffer: HR = 1.30, 95% CI = 1.04-1.64) had a higher risk of psoriasis, while those exposed to blue spaces (1000 m buffer: HR = 0.78, 95% CI = 0.63-0.98) had a lower risk of psoriasis. We also observed joint effects of genetic risk and residential environments and an antagonistic additive interaction between blue spaces and genetic risk (P = 0.011). Conclusions: We observed that residing in natural environments and green areas increased the risk of psoriasis in our sample, while proximity to blue spaces and domestic gardens was associated to reduced risks. The association of residential environments with psoriasis risk was modified by genetic susceptibility.
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Predisposição Genética para Doença , Psoríase , Características de Residência , Humanos , Psoríase/genética , Psoríase/epidemiologia , Masculino , Feminino , Estudos Prospectivos , Pessoa de Meia-Idade , Adulto , Reino Unido/epidemiologia , Idoso , Análise Espacial , Meio Ambiente , Fatores de Risco , Interação Gene-AmbienteRESUMO
The increased usage of navigation technologies has caused conflicts in local traffic management, resulting in congested residential areas among other challenges for residents. This paper uses content analysis to investigate such negative social externalities within local communities and neighbourhoods. Through a corpus of 90 news articles about traffic incidents caused by navigation technologies, we identified negative traffic and safety-related externalities, including congestion, damage, pollution, and accidents. We also report on countermeasures by local communities and governments, including street closures, speed limit reduction, and turn bans. Based on our results, we discuss the implications for designing mobile navigation technologies that reduce negative social externalities.
Assuntos
Sistemas de Informação Geográfica , Humanos , Acidentes de Trânsito/prevenção & controle , Condução de Veículo , Segurança , Características de ResidênciaRESUMO
BACKGROUND: Studies investigating the impact of racial segregation on health have reported mixed findings and tended to focus on the racial composition of neighborhoods. These studies use varying racial composition measures, such as census data or investigator-adapted questions, which are currently limited to assessing one dimension of neighborhood racial composition. OBJECTIVE: This study aims to develop and validate a novel racial segregation measure, the Pictorial Racial Composition Measure (PRCM). METHODS: The PRCM is a 10-item questionnaire of pictures representing social environments across adolescence and adulthood: neighborhoods and blocks (adolescent and current), schools and classrooms (junior high and high school), workplace, and place of worship. Cognitive interviews (n=13) and surveys (N=549) were administered to medically underserved patients at a primary care clinic at the Barnes-Jewish Hospital. Development of the PRCM occurred across pilot and main phases. For each social environment and survey phase (pilot and main), we computed positive versus negative pairwise comparisons: mostly Black versus all other categories, half Black versus all other categories, and mostly White versus all other categories. We calculated the following validity metrics for each pairwise comparison: sensitivity, specificity, correct classification rate, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, false positive rate, and false negative rate. RESULTS: For each social environment, the mostly Black and mostly White dichotomizations generated better validity metrics relative to the half Black dichotomization. Across all 10 social environments in the pilot and main phases, mostly Black and mostly White dichotomizations exhibited a moderate-to-high sensitivity, specificity, correct classification rate, positive predictive value, and negative predictive value. The positive likelihood ratio values were >1, and the negative likelihood ratio values were close to 0. The false positive and negative rates were low to moderate. CONCLUSIONS: These findings support that using either the mostly Black versus other categories or the mostly White versus other categories dichotomizations may provide accurate and reliable measures of racial composition across the 10 social environments. The PRCM can serve as a uniform measure across disciplines, capture multiple social environments over the life course, and be administered during one study visit. The PRCM also provides an added window into understanding how structural racism has impacted minoritized communities and may inform equitable intervention and prevention efforts to improve lives.
Assuntos
Meio Social , Humanos , Masculino , Feminino , Inquéritos e Questionários , Adulto , Pessoa de Meia-Idade , Adolescente , Grupos Raciais/estatística & dados numéricos , Grupos Raciais/psicologia , Características de Residência/estatística & dados numéricos , Reprodutibilidade dos Testes , IdosoRESUMO
INTRODUCTION: People with low income have worse outcomes throughout the cancer care continuum; however, little is known about income and the diagnostic interval. We described diagnostic pathways by neighborhood income and investigated the association between income and the diagnostic interval. METHODS: This was a retrospective cohort study of colon cancer patients diagnosed 2007-2019 in Ontario using routinely collected data. The diagnostic interval was defined as the number of days from the first colon cancer encounter to diagnosis. Asymptomatic pathways were defined as first encounter with a colonoscopy or guaiac fecal occult blood test not occurring in the emergency department and were examined separately from symptomatic pathways. Quantile regression was used to determine the association between neighborhood income quintile and the conditional 50th and 90th percentile diagnostic interval controlling for age, sex, rural residence, and year of diagnosis. RESULTS: A total of 64,303 colon cancer patients were included. Patients residing in the lowest income neighborhoods were more likely to be diagnosed through symptomatic pathways and in the emergency department. Living in low-income neighborhoods was associated with longer 50th and 90th-percentile symptomatic diagnostic intervals compared to patients living in the highest income neighborhoods. For example, the 90th percentile diagnostic interval was 15 days (95% CI 6-23) longer in patients living in the lowest income neighborhoods compared to the highest. CONCLUSION: These findings reveal income inequities during the diagnostic phase of colon cancer. Future work should determine pathways to reducing inequalities along the diagnostic interval and evaluate screening and diagnostic assessment programs from an equity perspective.
Assuntos
Neoplasias do Colo , Renda , Humanos , Feminino , Masculino , Neoplasias do Colo/diagnóstico , Neoplasias do Colo/epidemiologia , Estudos Retrospectivos , Idoso , Pessoa de Meia-Idade , Renda/estatística & dados numéricos , Ontário/epidemiologia , Detecção Precoce de Câncer/estatística & dados numéricos , Fatores de Tempo , Colonoscopia/estatística & dados numéricos , Colonoscopia/economia , Sangue Oculto , Idoso de 80 Anos ou mais , Características de Residência , AdultoRESUMO
Background: Walkable neighborhoods are closely related to an increase in walking frequency and the strengthening of social cohesion. These factors, in turn, contribute to lower BMI and other positive health-related outcomes. However, with a rapid increase in aging populations in China and the fact that women are facing more challenges than men as they age, especially mobility challenges because they tend to live longer leading to probabilities to become widowed. Nevertheless, less attention has been paid to understanding the gender difference between these relationships. Methods: Based on a survey of 533 older adults in Dalian, China, this study tried to investigate the intertwined relationship between perceived walkability, social cohesion, walking frequency, and BMI. A Structural Equation Model (SEM) and multiple-group analysis were applied to test the proposed framework. Results: First, results show that gender differences existed among the above interrelationships, and the most substantial gender gap was found in effects of social cohesion on BMI. Second, perceived walkability only has a direct effect (0.149) on walking frequencies for female seniors. Third, although the relationships between perceived walkability and BMI are not directly related in both male and female models, the indirect connection (-0.053) is substituted for female seniors. Besides, the inhibiting effect of walking on BMI, which is -0.511, is also valid for female seniors. Finally, in terms of the role of social cohesion, both the positive impacts of perceived walkability on it (0.225 for males and 0.325 for females) and its promoting effects on walking have been confirmed in male (0.142) and female models (0.103). The negative direct effect of social cohesion on BMI (-0.083) is only confirmed in male seniors. Conclusion: Insights derived from this analysis can help bring forward gender-specific interventions to build a more inclusive walkable and social environment to improve the mobility and physical health of older adults.