Arts and Culture: A Necessary Component to Address Unmet Social Needs and Advance Individual and Community Well-Being.

U.S. healthcare institutions increasingly integrate screenings for social needs into standard care, and help meet those needs by referring patients to community-based resources. However, community arts/culture assets are not commonly included among those resources. Given growing evidence of the positive health impacts of arts/culture, and given that access to these benefits remains inequitable, this article argues for the integration of arts/culture resources into healthcare referral networks. It highlights two early models, the CultureRx initiative in Massachusetts and Creative Forces, both of which piloted this integration with promising results. It also offers suggestions for better utilizing local arts/culture assets, emphasizing that these existing community resources can and should be applied to advance whole-person strategies and better address social drivers of health.

Domestic Violence Police Reporting and Resources During the 2020 COVID-19 Stay-at-Home Order in Chicago, Illinois.

Importance: Domestic violence (DV) has become a growing public health concern during the COVID-19 pandemic because individuals may be sheltering in place with abusers and facing mounting economic and health-related stresses. Objective: To analyze associations of the 2020 COVID-19 stay-at-home (SH) order with DV police reporting and resource availability, including differences by community area racial/ethnic composition. Design, Setting, and Participants: This longitudinal cohort study assessed DV police reports (January-June 2020) obtained from the Chicago, Illinois, Police Department and DV resource availability (March and August 2020) obtained from the NowPow community resource database, both for 77 community areas in Chicago. Data were analyzed July through December 2020. Exposures: The COVID-19 SH order effective March 21, 2020. Main Outcomes and Measures: Monthly rates of DV police reports and DV resource availability per 100 000 persons. Results: Of 77 community areas in Chicago, 28 (36.4%) were majority Black, 19 (24.7%) majority Hispanic/Latinx, 18 (23.4%) majority White, and 12 (15.6%) a different or no majority race/ethnicity, representing an estimated population of 2 718 555 individuals. For each community area, the SH order was associated with a decrease in the rate of DV police reports by 21.8 (95% CI, -30.48 to -13.07) crimes per 100 000 persons per month relative to the same months in 2019. Compared with White majority community areas, Black majority areas had a decrease in the rate of DV police reports by 40.8 (95% CI, -62.93 to -18.75) crimes per 100 000 persons per month relative to the same months in 2019. The SH order was also associated with a decrease in DV resource availability at a rate of 5.1 (95% CI, -7.55 to -2.67) resources per 100 000 persons, with the largest decreases for mental health (-4.3 [95% CI, -5.97 to -2.66] resources per 100 000 persons) and personal safety (-2.4 [95% CI, -4.40 to -0.41] resources per 100 000 persons). The Black majority south side of Chicago had a larger decrease in resource availability (-6.7 [95% CI, -12.92 to -0.46] resources per 100 000 persons) than the White majority north side. Conclusions and Relevance: In this longitudinal cohort study, the rate of DV police reports decreased after the SH order was implemented in Chicago. This decrease was largely observed in Black majority communities, whereas there was no significant change in White majority communities. These findings may reflect decreased DV incidence but may also reflect an exacerbation of underreporting. In addition, DV resource availability decreased disproportionately on the predominantly Black south side of Chicago.

Embedding research recruitment in a community resource e-prescribing system: lessons from an implementation study on Chicago's South Side.

OBJECTIVE: The study sought to implement and assess the CommunityRx e-prescribing system to recruit research participants from a predominantly non-Hispanic Black community on Chicago's South Side. MATERIALS AND METHODS: CommunityRx integrates with electronic medical record systems to generate a personalized list of health-promoting community resources (HealtheRx). Between December 2015 and December 2016, HealtheRxs distributed at outpatient visits to adults with asthma or chronic obstructive pulmonary disease also incentivized participation in a pulmonary research registry. Usual practices for registry recruitment continued in parallel. RESULTS: Focus groups established acceptability and appropriateness among the target population. Pulmonary research registry recruitment information was included on 13 437 HealtheRxs. Forty-one (90% non-Hispanic Black) patients responded with willingness to participate and 9 (8 non-Hispanic Black) returned a signed consent required to enroll. Usual recruitment practices enrolled 4 registrants (1 non-Hispanic Black). DISCUSSION: Automating research recruitment using a community e-prescribing system is feasible. CONCLUSIONS: Implementation of an electronic medical record-integrated, community resource referral tool promotes enrollment of eligible underrepresented research participants; however, enrollment was low.

Sexuality and Cognitive Status: A U.S. Nationally Representative Study of Home-Dwelling Older Adults.

OBJECTIVES: To determine patterns and prevalence of sexual behavior, problems, and attitudes in individuals with different cognitive status. DESIGN: We used data from the National Social Life, Health, and Aging Project to describe the relationship between sexual behavior, function, and cognitive status (normal, mild cognitive impairment, dementia), classified using an adapted Montreal Cognitive Assessment (MoCA) (0-30 points). SETTING: U.S. home-dwelling older adults. PARTICIPANTS: Nationally representative probability sample of 3,196 adults (1,682 women, 1,514 men) aged 62 to 91 (mean 72). MEASUREMENTS: Cognitive status and sexual activity, problems, and attitudes. RESULTS: The weighted response rate was 74%. Mean MoCA score was 22.7. Of partnered people with dementia, 59% of men and 51% of women were sexually active, including 41% of those aged 80 to 91; 46% of all men (95% confidence interval (CI)=37.8-53.2%) and 18% of all women (95% CI=13.6-21.5%) with dementia were sexually active. The rate of sexual function problems was high across gender and cognitive groups (77%). Having sex primarily out of obligation was similar across cognitive groups for women (12%) and higher in men with dementia (17%) than other men (2-5%; P <.001). The majority of people were having sex less often than they would like. Few men (17%) or women (1%) with dementia talked with a doctor about sex. CONCLUSION: Many home-dwelling men and women with dementia are sexually active. Although the rate of sexual function problems was uniformly high, people with lower cognitive function infrequently discussed sex with a physician.