Urban Heat Islets: Street Segments, Land Surface Temperatures, and Medical Emergencies During Heat Advisories.

Objectives. To examine the relationships among environmental characteristics, temperature, and health outcomes during heat advisories at the geographic scale of street segments.Methods. We combined multiple data sets from Boston, Massachusetts, including remotely sensed measures of temperature and associated environmental characteristics (e.g., canopy cover), 911 dispatches for medical emergencies, daily weather conditions, and demographic and physical context from the American Community Survey and City of Boston Property Assessments. We used multilevel models to analyze the distribution of land surface temperature and elevated vulnerability during heat advisories across streets and neighborhoods.Results. A substantial proportion of variation in land surface temperature existed between streets within census tracts (38%), explained by canopy, impervious surface, and albedo. Streets with higher land surface temperature had a greater likelihood of medical emergencies during heat advisories relative to the frequency of medical emergencies during non-heat advisory periods. There was no independent effect of the average land surface temperature of the census tract.Conclusions. The relationships among environmental characteristics, temperature, and health outcomes operate at the spatial scale of the street segment, calling for more geographically precise analysis and intervention. (Am J Public Health. Published online ahead of print May 21, 2020: e1-e8. doi:10.2105/AJPH.2020.305636).

Exposure to infection when accessing groceries reveals racial and socioeconomic inequities in navigating the pandemic.

Disasters often create inequitable consequences along racial and socioeconomic lines, but a pandemic is distinctive in that communities must navigate the ongoing hazards of infection exposure. We examine this for accessing essential needs, specifically groceries. We propose three strategies for mitigating risk when accessing groceries: visit grocery stores less often; prioritize generalist grocery stores; seek out stores whose clientele have lower infection rates. The study uses a unique combination of data to examine racial and socioeconomic inequities in the ability to employ these strategies in the census block groups of greater Boston, MA in April 2020, including cellphone-generated GPS records to observe store visits, a resident survey, localized infection rates, and demographic and infrastructural characteristics. We also present an original quantification of the amount of infection risk exposure when visiting grocery stores using visits, volume of visitors at each store, and infection rates of those visitors' communities. Each of the three strategies for mitigating exposure were employed in Boston, though differentially by community. Communities with more Black and Latinx residents and lower income made relatively more grocery store visits. This was best explained by differential use of grocery delivery services. Exposure and exposure per visit were higher in communities with more Black and Latinx residents and higher infection rates even when accounting for strategies that diminish exposure. The findings highlight two forms of inequities: using wealth to transfer risk to others through grocery deliveries; and behavioral segregation by race that makes it difficult for marginalized communities to avoid hazards.

Intrasexual peer aggression and dating behavior during adolescence: an evolutionary perspective.

It has been suggested that the use of intrasexual aggression is a form of competition associated with reproductive opportunities. Here the authors investigated the relationship between retrospective dating and flirting behavior and peer aggression and victimization during middle and high school. Results indicate that the use of peer aggression was associated with adaptive dating outcomes in both sexes, whereas experiencing peer victimization was correlated with maladaptive dating behaviors among females only. Females who perpetrated high levels of indirect (i.e. nonphysical) aggression reported that they began dating at earlier ages in comparison to their peers, whereas aggressive males reported having more total dating partners. Experiencing female-female peer victimization was correlated with a later onset of dating behavior, more total dating partners, and less male flirtation while growing up. This report strengthens the connection between adolescent peer aggression and reproductive competition, suggesting a potential functionality to adolescent peer aggression in enhancing one's own mating opportunities at the expense of rivals.

Community violence and academic achievement: High-crime neighborhoods, hotspot streets, and the geographic scale of "community".

Numerous studies have demonstrated a negative relationship between community violence and youth academic achievement, but they have varied in their geographic definition of "community," especially as it relates to proximity to students' residences. We extend this by considering the independent relationships between academic achievement and violent events (from 911 dispatches; e.g., gun shots) at the neighborhood (i.e., census tract) and street-block levels. We use data from standardized Math and English Language Arts (ELA) tests from Boston, MA for 2011-2013. Exposure to community violence was partially independent between streets and tracts, with some students living on low-crime streets in high-crime neighborhoods or high-crime streets in low-crime neighborhoods. Initial regression models found that differences in a neighborhood's violent crime predicted up to a 3% difference in test scores on both Math and ELA tests. Students living on high-crime streets scored an additional 1% lower than neighbors on safer streets. Subsequent models with student-level fixed effects, however, eliminated these relationships, except for the effect of neighborhood-level violence on Math scores. These findings suggest that future work should consider community violence at both geographic scales, but that in this case the impacts were only consistent at the neighborhood level and associations at the street level were seemingly due to spatial segregation of households.

Vaccination intentions generate racial disparities in the societal persistence of COVID-19.

We combined survey, mobility, and infections data in greater Boston, MA to simulate the effects of racial disparities in the inclination to become vaccinated on continued infection rates and the attainment of herd immunity. The simulation projected marked inequities, with communities of color experiencing infection rates 3 times higher than predominantly White communities and reaching herd immunity 45 days later on average. Persuasion of individuals uncertain about vaccination was crucial to preventing the worst inequities but could only narrow them so far because 1/5th of Black and Latinx individuals said that they would never vaccinate. The results point to a need for well-crafted, compassionate messaging that reaches out to those most resistant to the vaccine.

Broken (windows) theory: A meta-analysis of the evidence for the pathways from neighborhood disorder to resident health outcomes and behaviors.

The criminological "broken windows" theory (BWT) has inspired public health researchers to test the impact of neighborhood disorder on an array of resident health behaviors and outcomes. This paper identifies and meta-analyzes the evidence for three mechanisms (pathways) by which neighborhood disorder is argued to impact health, accounting for methodological inconsistencies across studies. A search identified 198 studies (152 with sufficient data for meta-analysis) testing any of the three pathways or downstream, general health outcomes. The meta-analysis found that perceived disorder was consistently associated with mental health outcomes, as well as substance abuse, and measures of overall health. This supported the psychosocial model of disadvantage, in which stressful contexts impact mental health and related sequelae. There was no consistent evidence for disorder's impact on physical health or risky behavior. Further examination revealed that support for BWT-related hypotheses has been overstated owing to data censoring and the failure to consistently include critical covariates, like socioeconomic status and collective efficacy. Even where there is evidence that BWT impacts outcomes, it is driven by studies that measured disorder as the perceptions of the focal individual, potentially conflating pessimism about the neighborhood with mental health.

Effect of addition of chin strap on PAP compliance, nightly duration of use, and other factors.

STUDY OBJECTIVES: A chinstrap is potentially useful to reduce unintentional air leak by preventing mouth opening during PAP treatment. This study examines whether the addition of a chinstrap to PAP therapy has any effect on adherence, nightly duration of use, air leak, and residual AHI. METHODS: This was a retrospective study performed at an AASM-accredited VAMC sleep center. Clinical sleep data of veterans (n = 124) prescribed PAP therapy for sleep apnea was evaluated, and the effect of chinstrap use vs non-use on the above parameters was assessed. RESULTS: Chinstrap users had significantly greater PAP adherence, longer nightly duration of PAP use, lower residual AHI and lower leak compared to chinstrap non-users at first follow up visit. CONCLUSIONS: The addition of a chin strap to PAP therapy is a simple and inexpensive method of increasing PAP adherence.

Handgrip strength and socially dominant behavior in male adolescents.

Handgrip strength (HGS) is highly heritable and a good overall measure of strength and muscle function. Indicative of blood testosterone levels and fat-free body mass, HGS is also highly sexually dimorphic. Recent psychological research shows that HGS is correlated with a number of social variables, but only in males. We conducted three studies to further investigate the relationship between HGS and measures of aggression and social competition among adolescents. Consistent with previous reports, correlations were almost exclusive to males, but this was only visible during late adolescence (i.e., high school). These findings support evolutionary hypotheses regarding grip strength in male-male competition and suggest that similar to measures of testosterone, HGS is a measure that is predictive of social behavior in older adolescent males.