Colorado Immersion Training in Community Engagement: Because You Can't Study What You Don't Know.

BACKGROUND: Community engagement (CE)has become a major element in medical research. In alliance with the goals of the Clinical and Translational Sciences Award program, Colorado Immersion Training in Community Engagement (CIT) is a community-campus partnership that aims to introduce an expanded pool of researchers to community-based participatory research (CBPR) and CE. OBJECTIVES: To describe CIT components and preliminary results. METHODS: CIT attempts to support a change in the research trajectory of academic health researchers, program developers, and graduate students toward CE. The program occurs on campus and in six community settings: Urban African American, urban Asian and refugee, urban Latino, urban American Indian/Alaska Native, rural northeast Colorado, and rural San Luis Valley. Components include a 4-week Directed Reading, a seminar on CBPR, 4-day community immersion, reflection, and 6-month support. Evaluation describes recruitment, implementation, and participants' understanding of CBPR and skills post-training. RESULTS: Fifty-eight people have participated. A comprehensive curriculum was developed to address (1) principals of CBPR, (2) health disparities, (3) listening to community, (4) self-reflection, and (5) engagement tools. Community immersions expose participants to a community's culture and opportunities to discuss health issues with a range of community members. Local "community guides" enhance participants' experience. Of the first two cohorts, 90% changed the way they plan to approach their research, 94% changed how they viewed community involvement in research, and 77% learned new skills to help engage communities in research. CONCLUSIONS: CIT applies to and positively impacts researchers from a variety of disciplines. CIT creates opportunities for long lasting partnerships between researchers and communities.

The wire and urban health education.

As urban health has emerged as a distinct field, experts have collaborated to develop models for interdisciplinary education to train health professionals. Interdisciplinary learning is an important yet challenging imperative for urban health education. This paper explores lessons learned from a 2010 speaker series at the Johns Hopkins Bloomberg School of Public Health. The television show, The Wire, was used as a teaching tool to illustrate the context of health disparities in American cities and to explore the complex factors perpetuating urban health outcomes. We suggest that individuals interested in developing interdisciplinary teaching models can learn from both the form and the content of The Wire. As a popular televised serial narrative, The Wire prompts an investigation into the forms and circulation of academic research in a fractured and specialized media landscape. The formal narrative structure of the show provides mental scaffolding from which epidemiological, historical, geographical, anthropological, and other relevant disciplinary learning can build. The Wire encourages critical reflection among public health professionals about the forces that shape public health training, research, and practice and offers creative expansions to existing urban health educational efforts.

Urban health and primary care at Johns Hopkins: urban primary care medical home resident training programs.

Johns Hopkins University recently implemented two novel urban health residency training programs (UHR). The programs include increased access programs, community health worker-delivered care, substance abuse screening and treatment, community psychiatry/ mental health programs, case and disease management teams, and interprofessional training. These programs are designed to create well-trained physicians who competently provide care for the underserved inner-city patient.

"The law has no feeling for poor folks like us!" Everyday responses to legal compulsion in England's working-class communities, 1871-1904.

During the late Victorian period, the role of the state increased dramatically in England's working-class urban communities. New laws on labor, health, and education, enforced by a growing bureaucracy of elected and appointed officials, extended the reach of public authority into daily life on an unprecedented scale. Everyday negotiations between these officials and working-class men and women, I argue, were key moments for determining the practical impact of new social welfare policies. This was particularly true in the contestation over children's compulsory school attendance, as I demonstrate through a close examination of the daily encounters between parents and education officials. Despite the growing size and authority of the Victorian state, working-class parents effectively mitigated the impact of the compulsory education laws on their families. They were able to do so because the categories that governed the level of enforcement­age, household economic status, health, and labor­were themselves determined through daily dialogues between parents and education officials. Parents' familiarity with the law and with the dynamics of the public education bureaucracy were key factors in these negotiations, as were internal fractures within the Victorian state itself. Working-class parents, and mothers in particular, also countered officials' moral policy justifications with their own discourse of right and wrong, which focused on the legitimacy of parental authority, an insistence on just treatment, and the elevation of household needs over the laws' requirements.

Spatial variations in US poverty: beyond metropolitan and non-metropolitan.

Because poverty in rural and urban areas of the US often has different causes, correlates and solutions, effective anti-poverty policies depend on a thorough understanding of the ruralness or urbanness of specific places. This paper compares several widely used classification schemes and the varying magnitudes of poverty that they reveal in the US. The commonly used 'metropolitan/non-metropolitan' distinction obscures important socioeconomic differences among metropolitan areas, making our understanding of the geography of poverty imprecise. Given the number and concentration of poor people living in mixed-rural and rural counties in metropolitan regions, researchers and policy-makers need to pay more nuanced attention to the opportunities and constraints such individuals face. A cross-classification of the Office of Management and Budget's metro system with a nuanced RUDC scheme is the most effective for revealing the geographical complexities of poverty within metropolitan areas.

Urban policy engagement with social sustainability in metro Vancouver.

This article presents an analysis of social sustainability in comparative theoretical context and as a challenge to the post-political interpretation of sustainability in policy practice at the urban and regional scales. Metro Vancouver provides a case study for improving our understanding of the meaning of social sustainability as a framework for social policy in that it is among the handful of cities around the world currently working to define and enact social sustainability in governance terms. Results of this participant research provide evidence that some cities are politically engaging alternative development pathways using the concept of social sustainability. For sustainable development to retain its promise as an alternative policy framework for cities, social sustainability must be at the forefront.

Land rent and housing policy: a case study of the San Francisco Bay area rental housing market.

In the San Francisco Bay Area, where residential rent is among the highest in the United States, an analysis of data from several sources demonstrates that high rent cannot be accounted for by higher quality, higher operating costs, or higher construction costs. At least one-third of the total rent paid is land rent. Despite increases in real incomes, very-low-income tenants in the Bay Area today have less income remaining after payment of rent than tenants did in 1960. High land rent is a long-term feature of the Bay Area rental market that results mostly from its geography, the density of its urban centers, and a strong economy, rather than from regulatory barriers to new multifamily construction. Deregulation is not a sufficient response to the effects of land rent on low-income tenants. Government should subsidize non-profit housing organizations, particularly land trusts that remove residential land from the market. Taxes on land rent would be a particularly appropriate funding source.