Examining racial and ethnic heat exposure disparities in New York City (NYC) across different spatial and political scales through geographic effect measure modification.

Structural racism in the United States has resulted in neighborhoods with higher proportions of non-Hispanic Black (Black) or Hispanic/Latine residents having more features that intensify, and less that cool, the local-heat environment. This study identifies areas of New York City (NYC) where racial/ethnic heat exposure disparities are concentrated. We analyzed data from the 2013-2017 American Community Survey, U.S Landsat-8 Analysis Ready Data on summer surface temperatures, and NYC Land Cover Dataset at the census tract-level (n = 2098). Four cross-sectional regression modeling strategies were used to estimate the overall City-wide association, and associations across smaller intra-city areas, between tract-level percent of Black and percent Hispanic/Latine residents and summer day surface temperature, adjusting for altitude, shoreline, and nature-cover: overall NYC linear, borough-specific linear, Community District-specific linear, and geographically weighted regression models. All three linear regressions identified associations between neighborhood racial and ethnic composition and summer day surface temperatures. The geographically weighted regression models, which address the issue of spatial autocorrelation, identified specific locations (such as northwest Bronx, central Brooklyn, and uptown Manhattan) within which racial and ethnic disparities for heat exposures are concentrated. Through examining the overall effects and geographic effect measure modification across spatial scales, the results of this study identify specific geographic areas for intervention to mitigate heat exposure disparities experienced by Black and Hispanic/Latine NYC residents.

The CHANGE (Climate Health ANalysis Grading Evaluation) tool for weight of evidence reviews on climate change and health research.

BACKGROUND: Climate change has been identified as one of the biggest threats to human health. Despite this claim, there are no standardized tools that assess the rigor of published literature for use in weight of evidence (WOE) reviews. Standardized assessment tools are essential for creating clear and comparable WOE reviews. As such, we developed a standardized tool for evaluating the quality of climate change and health studies focused on evaluating studies that quantify exposure-response relationships and studies that implement and/or evaluate adaptation interventions. METHODS: The authors explored systematic-review methodology to enhance transparency and increase efficiency in summarizing and synthesizing findings from studies on climate change and health research. The authors adapted and extended existing WOE methods to develop the CHANGE (Climate Health ANalysis Grading Evaluation) tool. The resulting assessment tool has been refined through application and subsequent team input. RESULTS: The CHANGE tool is a two-step standardized tool for systematic review of climate change and health studies of exposure-response relationships and adaptation intervention studies. Step one of the CHANGE tool aims to classify studies included in weight-of-evidence reviews and step two assesses the quality and presence of bias in the climate change and health studies. CONCLUSION: The application of the CHANGE tool in WOE reviews of climate change and health will lead to increased comparability, objectivity, and transparency within this research area.

Environmental health perceptions of urban youth from low-income communities: A qualitative photovoice study and framework.

BACKGROUND: Children are amongst the most susceptible groups to environmental exposures, for both immediate and life-course health outcomes. Despite their increased susceptibility, children's knowledge, experiences and voices are understudied. A deeper understanding of children's environmental health perceptions has the potential to better inform policy, develop targeted interventions and improve public health outcomes. METHODS: In this study, our community-academic partnership used the Photovoice research method to examine how urban children from low-income communities perceive environmental influences on their health. Twenty children, ages 10-12, took photographs and participated in focus group interviews regarding their perspectives on how the environment influences their health. RESULTS: Qualitative analyses revealed five major thematic categories: environmental exposures, environmental health sentiments, environmental health outcomes, interest in environmental health and environmental health solutions. We used the findings to develop an environmental health perspective theoretical framework that can inform future work designed to promote the environmental health and well-being of children from low-income communities in urban communities. CONCLUSION: Photovoice enabled children from low-income communities to capture and communicate their environmental health perceptions. These findings have the potential to inform and identify potential targets and opportunities for environmental health interventions and promotion in their communities. PATIENT OR PUBLIC CONTRIBUTION: Partnerships with community-based organizations were central to the present study. By design, these community-based partners were involved in the conduct and procedures of the study.

The COVID-19 Pandemic as a Threat Multiplier for Childhood Health Disparities: Evidence from St. Louis, MO.

The COVID-19 pandemic has highlighted socioeconomic and racial health disparities in the USA. In this study, we examined the COVID-19 pandemic as a threat multiplier for childhood health disparities by evaluating health behavior changes among urban St. Louis, MO, children (ages 6-14) during the COVID-19 pandemic. From 27 October to 10 December 2020, 122 parents/guardians reported on their children's health behaviors (Eating, Sleeping, Physical activity, Time outside, Time with friends in-person, Time with friends remotely, Time using media for educational proposes, Time using media for non-educational proposes, and Social connectedness) prior to and during the COVID-19 pandemic. We ran K-means cluster analyses to identify distinct health behavior cluster profiles. Relative risks were determined to evaluate behavioral differences between the two clusters. Two distinct cluster profiles were identified: a High Impact profile (n = 49) and a Moderate Impact profile (n = 73). Children in the High Impact cluster had a greater risk of being diagnosed with COVID-19, developed worsened eating habits (RR = 2.10; 95% CI = 1.50-2.93), spent less time sleeping, and spent less time outdoors (RR = 1.55; 95% CI = 1.03-2.43) than the Moderate Impact cluster. The High Impact cluster was more likely to include Black children and children from single-adult households than the Moderate Impact cluster (both p < 0.05). Our findings suggest that the COVID-19 pandemic may be a threat multiplier for childhood health disparities. Further research is needed to better understand the long-term effects of the COVID-19 pandemic on children's health.

The impact of nature-based education on health-related quality of life among low-income youth: results from an intervention study.

BACKGROUND: Nature experiences have been shown to promote physical, emotional, mental and overall health. However, low-income youth often face inequities in access to nature. The purpose of this study was to evaluate the impact of a 15-week nature-based education (NBE) intervention on health-related quality of life (HRQoL) of low-income youth. METHODS: A total of 362 low-income youth (ages 9-15) in St. Louis, MO, USA, participated in this study. Study participants completed a pre- and post-intervention survey that included validated measures of six HRQoL domains (Physical Activity, Emotional Health Functioning, School Functioning, Social Functioning, Family Functioning and overall HRQoL). Random effects analysis of covariance was used to test for significant differences in HRQoL scores between the intervention and control groups, after adjusting for school, age, previous nature exposure, and Science, Technology, Engineering and Mathematics capacity. RESULTS: After the intervention period, youth in the NBE intervention group experienced improvements in all HRQoL domain scores (P < 0.001), whereas youth in the control group experienced declines in HRQoL domain scores (P < 0.001). CONCLUSIONS: NBE may have a positive impact on the HRQoL of low-income youth. Further investigations examining the influence of nature-based activities on youth health outcomes are warranted.

Sex-Specific Depressive Symptom Trajectories Among Adolescents in Los Angeles County, 2013 to 2017.

Objective: After remaining stable for many years, the prevalence of depression among adolescents increased over the past decade, particularly among girls. In this study, we used longitudinal data from a cohort of high school students to characterize sex-specific trajectories of depressive symptoms during this period of increasing prevalence and widening gender gap in adolescent depression. Method: Using data from the Health and Happiness Cohort, a longitudinal 8-wave study of high school students residing in Los Angeles County from 2013 to 2017 (N = 3,393), we conducted a multiple-group, latent class growth analysis by sex to differentiate developmental trajectories in depressive symptoms scores measured by the Center for Epidemiological Studies- Depression (CES-D) scale (range, 0-60). Results: A 4-class solution provided the best model fit for both girls and boys. Trajectories among girls included low stable (35.1%), mild stable (42.8%), moderate decreasing (16.2%), and high arching (5.9%). Trajectories among boys included low stable (49.2%), mild increasing (34.7%), moderate decreasing (12.2%), and high increasing (3.9%). Average scores consistently exceeded or crossed the threshold for probable depression (≥16). Across comparable sex-specific trajectory groups, the average CES-D scores of girls were higher than those of boys, whose average scores increased over time. Conclusion: In a diverse cohort of students in Los Angeles County, depressive symptom trajectories were comparable to prior time periods but with a higher proportion of students in trajectories characterized by probable depression. Trajectories differed by sex, suggesting that future research should consider differential severity and onset of depression between boys and girls.

Growing up green: a systematic review of the influence of greenspace on youth development and health outcomes.

Youth growing up in places with more greenspaces have better developmental outcomes. The literature on greenspace and youth development is largely cross-sectional, thus limited in terms of measuring development and establishing causal inference. We conducted a systematic review of prospective, longitudinal studies measuring the association between greenspace exposure and youth development outcomes measured between ages two and eighteen. We searched Cochrane, PubMed, CINAHL, Scopus, and Environment Complete, and included prospective cohort, quasi-experimental, and experimental studies on greenspace and youth development. Study quality was assessed using a 10-item checklist adapted from a previously published review on greenspace and health. Twenty-eight studies met criteria for review and were grouped into five thematic categories based on reported outcomes: cognitive and brain development, mental health and wellbeing, attention and behavior, allergy and respiratory, and obesity and weight. Seventy-nine percent of studies suggest an association between greenspace and improved youth development. Most studies were concentrated in wealthy, Western European countries, limiting generalizability of findings. Key opportunities for future research include: (1) improved uniformity of standards in measuring greenspace, (2) improved measures to account for large latency periods between greenspace exposure and developmental outcomes, and (3) more diverse study settings and populations.

Overflowing Disparities: Examining the Availability of Litter Bins in New York City.

In the 1980s, activists' concerns about the disproportionate placements of landfills in low-income communities ignited the environmental justice movement. Today, similar issues of environmental injustice-the limited availability of litter bins across New York City (NYC) neighborhoods-remain unresolved. This study examines the association between NYC neighborhood income and litter bin availability. The NYC Department of Sanitation 2020 Litter Bin Inventory and archival measures of neighborhood composition and socioeconomic status were aggregated within NYC census tract neighborhoods. Multilevel Bayesian conditional autoregressive Poisson models estimated the prevalence rate ratio for counts of litter bins according to median household income in each census tract, accounting for spatial autocorrelation. Bivariate associations identified that census tracts with higher median household income had a greater prevalence of litter bins than census tracts with lower median household income; however, spatial autocorrelation attenuated the relationship between median household income and availability of litter bins. Further research is necessary to identify the spatially structured condition that accounted for the observed effect. The results warrant further investigation of both perceived and actual disparities in litter bin availability.

Place-based interventions and the epidemiology of violence prevention.

Purpose of review: Violence is a leading cause of death, disability, and health inequity in the United States. This review summarizes the scientific literature on place-based interventions and violence, describes study design challenges, and suggests future directions for this group of interventions. Recent findings: Violence prevention strategies commonly target high-risk individuals, but recent research has found that place-based interventions are practical, sustainable, and high-impact opportunities that benefit communities at large. This body of work has largely consisted of quasi-experimental studies of land and building place-based interventions and interpersonal violence. Summary: Current epidemiological evidence suggests that place-based interventions are cost-effective solutions for violence prevention. Future work is needed using mixed methods to better understand their mechanisms of action and to inform implementation efforts. There are opportunities for the broader development of implementation science to bring promising and established place-based interventions to scale and to extend these interventions to other types of violence.