RESUMEN
We assessed the influence of supportive housing, incarceration, and health service use on markers of HIV infection for people living with HIV and serious mental illness or substance use disorder (SUD) participating in a New York City supportive housing program (NY III). Using matched administrative data from 2007 to 2014, we compared survivor time without AIDS, achievement of undetectable viral load, and maintenance of viral suppression between NY III tenants (n = 696), applicants placed in other supportive housing programs (n = 333), and applicants not placed in supportive housing (n = 268). Inverse probability of treatment weights were applied to Cox proportional hazards regression models to account for confounding of observed variables. Individuals not placed in supportive housing had a significantly greater risk of death or AIDS diagnosis than NY III tenants [adjusted hazard ratio = 1.84 (1.40, 2.44), p < 0.001]. Incarceration and outpatient SUD treatment were significantly associated with negative short-term outcomes (time to undetectable viral load) but positive long-term outcomes (time to death or AIDS diagnosis). Supportive housing, SUD treatment, and incarceration were associated with prolonged survival without AIDS among supportive housing applicants living with HIV.
Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/fisiopatología , Infecciones por VIH/tratamiento farmacológico , Personas con Mala Vivienda/estadística & datos numéricos , Vivienda Popular , Sobrevida , Carga Viral/efectos de los fármacos , Síndrome de Inmunodeficiencia Adquirida/psicología , Adulto , Femenino , Infecciones por VIH/psicología , Infecciones por VIH/virología , Vivienda , Humanos , Masculino , Trastornos Mentales/epidemiología , Trastornos Mentales/psicología , Persona de Mediana Edad , Ciudad de Nueva York , Trastornos Relacionados con Sustancias/epidemiología , Trastornos Relacionados con Sustancias/psicologíaRESUMEN
Neighborhood conditions influence people's health; sustaining healthy neighborhoods is a New York City (NYC) Health Department priority. Gentrification is characterized by rapid development in historically disinvested neighborhoods. The gentrification burden, including increased living expenses, and disrupted social networks, disproportionally impacts certain residents. To ultimately target health promotion interventions, we examined serious psychological distress time trends in gentrifying NYC neighborhoods to describe the association of gentrification and mental health overall and stratified by race and ethnicity. We categorized NYC neighborhoods as hypergentrifying, gentrifying, and not-gentrifying using a modified New York University Furman Center index. Neighborhoods with ≥100% rent growth were hypergentrifying; neighborhoods with greater than median and <100% rent growth were gentrifying; and neighborhoods with less than median rent growth were not-gentrifying. To temporally align neighborhood categorization closely with neighborhood-level measurement of serious psychological distress, data during 2000-2017 were used to classify neighborhood type. We calculated serious psychological distress prevalence among adult populations using data from 10 NYC Community Health Surveys during 2002-2015. Using joinpoint and survey-weighted logistic regression, we analyzed serious psychological distress prevalence time trends during 2002-2015 by gentrification level, stratified by race/ethnicity. Among 42 neighborhoods, 7 were hypergentrifying, 7 were gentrifying, and 28 were not gentrifying. In hypergentrifying neighborhoods, serious psychological distress prevalence decreased among White populations (8.1% to 2.3%, ß = -0.77, P = 0.02) and was stable among Black (4.6% to 6.9%, ß = -0.01, P = 0.95) and Latino populations (11.9% to 10.4%, ß = -0.16, P = 0.31). As neighborhoods gentrified, different populations were affected differently. Serious psychological distress decreased among White populations in hypergentrifying neighborhoods, no similar reductions were observed among Black and Latino populations. This analysis highlights potential unequal mental health impacts that can be associated with gentrification-related neighborhood changes. Our findings will be used to target health promotion activities to strengthen community resilience and to ultimately guide urban development policies.
Asunto(s)
Salud Mental , Segregación Residencial , Adulto , Humanos , Ciudad de Nueva York , Características de la Residencia , Estado de SaludRESUMEN
PURPOSE: To examine neighborhood-level disparities in SARS-CoV-2 molecular test percent positivity in New York City (NYC) by demographics and socioeconomic status over time to better understand COVID-19 inequities. METHODS: Across 177 neighborhoods, we calculated the Spearman correlation of neighborhood characteristics with SARS-CoV-2 molecular test percent positivity during March 1-July 25, 2020 by five periods defined by trend in case counts: increasing, declining, and three plateau periods to account for differential testing capacity and reopening status. RESULTS: Percent positivity was positively correlated with neighborhood racial and ethnic characteristics and socioeconomic status, including the proportion of the population who were Latino and Black non-Latino, uninsured, Medicaid enrollees, transportation workers, or had low educational attainment. Correlations were generally consistent over time despite increasing testing rates. Neighborhoods with high proportions of these correlates had median percent positivity values of 62.6%, 28.7%, 6.4%, 2.8%, and 2.2% in the five periods, respectively, compared with 40.6%, 11.7%, 1.7%, 0.9%, and 1.0% in neighborhoods with low proportions of these correlates. CONCLUSIONS: Disparities in SARS-CoV-2 molecular test percent positivity persisted in disadvantaged neighborhoods during multiple phases of the first few months of the COVID-19 epidemic in NYC. Mitigation of the COVID-19 burden is still urgently needed in disproportionately affected communities.
Asunto(s)
COVID-19 , SARS-CoV-2 , Hispánicos o Latinos , Humanos , Ciudad de Nueva York/epidemiología , Características de la Residencia , Factores SocioeconómicosRESUMEN
The electrical characteristics of quantum dots (QDs) can vary depending on the surface modulation, which can change the luminance and efficiency of electroluminescent devices. Thus, understanding surface ligand is essential in improving the performance of QDs-based light-emitting diodes (LEDs). We analyzed the performance of QDs-based LEDs with respect to the QD surface volume. On the QD surfaces, the 1.1 nm-long tryoctylphosphine oxide (TOPO) ligand with three neck-type structure was replaced with a 1.7 nm-long oleic acid (OA) ligand with a one neck-type structure to evaluate the dependence of the LED properties on the ligand length. With all other conditions being identical, the luminance and efficiency of the QDs-based LEDs with an OA ligand were approximately 1,000 cd/m2 greater and 1.5 times higher, respectively, than those of the QDs-based LEDs with a TOPO ligand. These results show that if the physical length of the surface ligand is relatively long, decreasing the surface area would result in increased injection of electrons and holes into the QDs, increasing the luminance and efficiency.