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1.
Artigo em Inglês | MEDLINE | ID: mdl-35270488

RESUMO

Neighborhoods play a central role in health and mental health, particularly during disasters and crises such as the COVID-19 pandemic. We examined changes in psychological distress following the pandemic, and the potential role of neighborhood conditions among 244 residents of New Orleans, Louisiana. Using modified linear regression models, we assessed associations between neighborhood characteristics and change in psychological distress from before to during the pandemic, testing effect modification by sex and social support. While higher density of offsite alcohol outlets (ß = 0.89; 95% CI: 0.52, 1.23), assault rate (ß = 0.14; 95% CI: 0.03, 0.24), and walkable streets (ß = 0.05; 95% CI: 0.02, 0.07) in neighborhoods were associated with an increase in distress, access to neighborhood parks (ß = -0.03; 95% CI: -0.05, -0.01), collective efficacy (ß = -0.23; 95% CI: -0.35, -0.09), and homicide rate (ß = -1.2; 95% CI: -1.8, -0.6) were associated with reduced distress related to the pandemic. These relationships were modified by sex and social support. Findings revealed the important but complicated relationship between psychological distress and neighborhood characteristics. While a deeper understanding of the neighborhoods' role in distress is needed, interventions that target neighborhood environments to ameliorate or prevent the residents' distress may be important not only during crisis situations.


Assuntos
COVID-19 , Pandemias , COVID-19/epidemiologia , Humanos , Características de Residência , SARS-CoV-2 , Apoio Social
2.
Sci Total Environ ; 825: 153801, 2022 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-35151745

RESUMO

The use of bio-indicators is an emerging, cost-effective alternative approach to identifying air pollution and assessing the need for additional air monitoring. This community science project explores the use of moss samples as bio-indicators of the distribution of metal air particulates in two residential neighborhoods of the industrial Duwamish Valley located in Seattle, WA (USA). We applied geographically weighted regression to data from 61 youth-collected samples to assess the location-specific area-level spatial predictors of the concentrations of 25 elements with focus on five heavy metals of concern due to health and environmental considerations. Spatial predictors included traffic volume, industrial land uses, major roadways, the airport, dirt roads, the Duwamish River, impervious surfaces, tree canopy cover, and sociodemographics. Traffic volume surrounding sample locations was the most consistent positive predictor of increasing heavy metal concentration. Greater distance from the heavy-industry corridor surrounding the Duwamish River predicted lower concentrations of all metals, with statistically significant associations for chromium and lead in some areas. As the distance from dirt roads increased, the concentration of arsenic and chromium decreased significantly. Percent tree canopy within 200 m of sample locations was a significant protective factor for cadmium concentrations. In addition, percent people of color was significantly positively associated with increasing lead, chromium and nickel concentrations. Our findings underscore the potential influence of heavy industry and mobile sources on heavy metal concentrations, the buffering potential of trees in local environments, and persistent opportunity to improve environmental justice.


Assuntos
Poluentes Atmosféricos , Briófitas , Metais Pesados , Adolescente , Poluentes Atmosféricos/análise , Cromo , Monitoramento Ambiental , Humanos , Metais Pesados/análise
3.
Artigo em Inglês | MEDLINE | ID: mdl-35206224

RESUMO

Green spaces have been proposed as equigenic factors, potentially mitigating health disparities. We used data from the 3887 participants residing in Philadelphia who participated in the Public Health Management Corporation's Southeastern Pennsylvania Household Health Survey in 2014-2015 to assess whether socioeconomic disparities in hypertension are modified by availability of neighborhood-level green spaces. Socioeconomic status (SES) was measured using individual-level education and neighborhood-level median household income. Green space availability was measured using surrounding percent tree canopy cover, mean normalized difference vegetation index (NDVI), and proximity to nearest park. Using logistic regression models adjusted for age, sex, and race/ethnicity, we found that adults with higher educational attainment had significantly lower levels of hypertension (OR = 0.63, 0.57, and 0.36 for high school, some college, and college graduates, respectively, as compared to those with less than high school education), and this pattern was similar for median household income (higher prevalence in lower income areas). We found no significant interaction between education and percent tree canopy cover (p = 0.83), meaning that educational disparities in hypertension were similar across all levels of green space availability. These results held when using mean NDVI or distance to nearest park as availability measures, or when considering neighborhood-level median household income as the socioeconomic measure, although the specific patterns and significance of interactions varied by exposure and modifier. While socioeconomic disparities in hypertension are strong for adults residing in Philadelphia, green spaces did not seem to modify them.


Assuntos
Hipertensão , Parques Recreativos , Adulto , Estudos Transversais , Humanos , Hipertensão/epidemiologia , Philadelphia/epidemiologia , Características de Residência , Fatores Socioeconômicos
4.
Am J Community Psychol ; 69(1-2): 46-58, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-34333789

RESUMO

Unmaintained vacant land in urban areas is associated with a number of negative outcomes for residents of urban areas, including mental and physical health, safety, and quality of life. Community programs which promote land parcel maintenance in urban neighborhoods have been found to reverse some of the effects that unmaintained land has on nearby residents. We explored how land parcel maintenance is associated with mental health outcomes using data collected in Flint, MI in 2017-2018. Trained observers assessed the maintenance of approximately 7200 land parcels and surveyed 691 residents (57% Female, 53% Black, M age = 51). We aggregated resident and parcel rating data to 463 street segments and compared three structural equation models (SEM) to estimate the mediating effects of fear of crime on the association of parcel qualities on mental distress for residents. We found that fear of crime mediated the association between parcel maintenance values and mental distress indicating that poor maintenance predicted more fear of crime which was associated with mental distress. Our findings add to our understanding about the mechanism by which vacant lot improvements may operate to enhance psychological well-being of residents who live on streets with vacant and unkept lots.


Assuntos
Crime , Qualidade de Vida , Crime/psicologia , Medo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Características de Residência
5.
Sci Total Environ ; 806(Pt 2): 150564, 2022 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-34582859

RESUMO

Prescribed fire is an increasingly important tool in restoring ecological conditions and reducing uncontrolled wildfire. Prescribed burn techniques could reduce public health impacts associated with wildfire smoke exposure. However, there have been few assessments of the health impacts of prescribed burning, and potential vulnerabilities among populations exposed to smoke from prescribed fires. Our study area focused on counties in and near U.S. National Forests - a set of lands distributed across the U.S. In county-level analyses, we compared the sociodemographic and health characteristics of areas that were exposed with those that were not exposed to prescribe burns during the years 2010-2019 on a national level and within three regions. In addition, using spatial error regression models, we looked for associations between prescribed fire exposure and health behaviors and outcomes while controlling for spatial autocorrelation. On a national level, we found disproportionate prescribed fire exposure in rural counties with higher percentage mobile home and vacant housing units, and higher percentage African-American and white populations. Regionally, we found evidence of disproportionate exposure to prescribed burns among counties with lower percentage white population, higher percentage Hispanic population and mobile homes in the southern region, and to high poverty counties with high vacancy in the western region. These findings could indicate that vulnerable populations face potential health risks from prescribed burning smoke exposure, but also that they are not missing out on the benefits of prescribed burning, which could involve considerably lower smoke exposure compared to uncontrolled wildfire. In addition, in regression analyses, we found no evidence of disproportionate health burden in exposed compared to unexposed counties. Awareness of these patterns could influence both large-scale or institutional polices about prescribed burning practice, and could be used to build decision-making factors into modeling tools and smoke management plans, as well as community-engagement around wildfire risk reduction.


Assuntos
Queimaduras , Incêndios , Demografia , Florestas , Humanos , Fumaça
6.
J Urban Health ; 98(6): 812-821, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34750735

RESUMO

Maintained green space in underserved urban neighborhoods may be an important environmental pathway to improving community health and safety, though effects may vary across population subgroups and by time of day. We examined survey responses from 442 participants (178 men and 264 women), living near vacant lots in a cluster-randomized controlled trial of a cleaning and greening intervention, on perceived safety during the day and at night. At the intervention sites after the intervention, only men reported feeling less unsafe during the day. Women reported more fear, and men reported less fear, after the intervention, although these results and tests for effect modification were not statistically significant. The clean-and-green intervention may have allayed fears for men during the day and supported their ease of movement throughout their neighborhoods. However, at night, it may have had the opposite effect on women. Though our study was under-powered, not designed to test associations stratified by gender, directions and magnitudes of associations differed substantially, indicating a need for further investigations into potential gender differences in the benefits of green space, to inform and better tailor interventions to improve perceived safety for all.


Assuntos
Características de Residência , Violência , Emoções , Medo , Feminino , Humanos , Masculino , Fatores Sexuais
7.
Inj Prev ; 2020 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-32792367

RESUMO

BACKGROUND: Alcohol-related vehicle crashes pose a significant challenge to public health in suburban communities. The Evesham Saving Lives programme operated between late 2015 and 2019 in two townships (Evesham and Voorhees) in New Jersey. The programme subsidised rideshare (eg, Uber) trips from bars and restaurants between the hours of 21:00 and 02:00 to prevent alcohol-related traffic injuries. METHODS: This study used data from the New Jersey Department of Transportation to examine changes to rates of injury crashes between 2010 and 2018. We used an ecological difference-in-difference design with Bayesian conditional autoregressive Poisson models to compare rates of injury crashes between participating municipalities (n=2) and non-participating municipalities (n=75). Sensitivity analyses included comparison with a weighted synthetic control series. RESULTS: The Evesham Saving Lives programme was associated with 18% fewer injury crashes overall (IRR=0.82, 95% credible interval (CrI): 0.76, 0.88). Reductions in crashes were estimated to be greatest at night (IRR=0.62, 95% CrI: 0.48, 0.79), with moderate reductions in the afternoon (IRR=0.80, 95% CrI: 0.72, 0.88). We estimate that around three lives were saved (95% CrI: 2, 5) and around 371 injuries were prevented (95% CrI: 204, 625), potentially making considerable savings in terms of medical and economic expenses. CONCLUSIONS: These findings support the claim that improving the convenience and reducing the costs of alternative night-time transportation can prevent road traffic injuries. Future studies should aim to replicate these analyses in programmes that have been implemented in other suburban communities across the US.

8.
Health Place ; 64: 102364, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32838890

RESUMO

There is increasing evidence that place-based interventions reduce crime and interpersonal violence in urban settings. However, evidence concerning the impacts of these neighborhood interventions on domestic crime (crime between intimate partners, family, or household members) is inconclusive. We used data from a New Orleans, Louisiana, place-based blighted property remediation intervention to test the hypothesis that the intervention was associated with changes in domestic crime. Because there is evidence that alcohol availability is related to domestic crime, we also assessed whether this association was moderated by alcohol outlet density. We assessed overall associations using a difference-in-difference approach and assessed moderation using a triple-difference approach. The analytic sample consisted of 204 remediated lots and 612 non-remediated matched control lots over 84 months (2011-2017), for a total of 68,544 lot-months. In difference-in-differences analyses, the place-based intervention was associated with additional domestic crime incidence (ß = 0.311, 95% CI: 0.016, 0.605; p = 0.039). In triple-difference analyses, on-premise bar density modified this association (ß = -0.119, 95%CI: -0.147, -0.092; p < 0.001): in areas with higher bar density, increases in domestic crime were lower near remediated lots compared with control lots. Place-based interventions to reduce blighted properties may have contributed to fewer domestic crime incidents in areas with more bars.


Assuntos
Crime , Violência , Humanos , Relações Interpessoais , Louisiana , Características de Residência
10.
Artigo em Inglês | MEDLINE | ID: mdl-32545651

RESUMO

Nature prescription programs have emerged to address the high burden of chronic disease and increasingly sedentary and screen-based lifestyles. This study examines the base of evidence regarding such programs. We conducted a narrative review of published literature using four electronic databases. We included case studies, research design articles, and empirical studies that discussed any type of outdoor exposure or activities initiated by a health-care provider from an outpatient clinic. We examined articles for information on target populations, health outcomes, and structural and procedural elements. We also summarized evidence of the effectiveness of nature prescription programs, and discussed needs and challenges for both practice and research. Eleven studies, including eight empirical studies, have evaluated nature prescription programs with either structured or unstructured formats, referring patients either to nearby parks or to formal outdoor activity programs. Empirical studies evaluate a wide variety of health behaviors and outcomes among the most at-risk children and families. Research is too sparse to draw patterns in health outcome responses. Studies largely tested program structures to increase adherence, or patient follow-through, however findings were mixed. Three published studies explore providers' perspectives. More research is necessary to understand how to measure and increase patient adherence, short and long-term health outcomes for patients and their families, and determinants of provider participation and participation impacts on providers' own health.


Assuntos
Pessoal de Saúde , Doença Crônica , Atenção à Saúde , Humanos , Projetos Piloto , Estudos Prospectivos
11.
Lancet Planet Health ; 4(4): e149-e157, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32353295

RESUMO

BACKGROUND: Cities across the world are undertaking ambitious projects to expand tree canopy by increasing the number of trees planted throughout public and private spaces. In epidemiological studies, greenspaces in urban environments have been associated with physical and mental health benefits for city dwellers. Greenworks Philadelphia is a plan to increase tree cover across Philadelphia (PA, USA) by the year 2025. We aimed to assess whether an increase in tree canopy or greenspace in Philadelphia could decrease mortality. METHODS: We did a greenspace health impact assessment to estimate the annual premature mortality burden for adult residents associated with projected changes in tree canopy cover in Philadelphia between 2014 and 2025. Using up-to-date exposure-response functions, we calculated the number of preventable annual premature deaths city-wide, and for areas of lower versus higher socioeconomic status, for each of three tree canopy scenarios: low, moderate and ambitious. The ambitious scenario reflected the city's goal of 30% tree canopy cover in each of the city's neighbourhoods; and low and moderate scenarios were based on the varying levels of plantable space across neighbourhoods. FINDINGS: We estimated that 403 (95% interval 298-618) premature deaths overall, including 244 (180-373) premature deaths in areas of lower socioeconomic status, could be prevented annually in Philadelphia if the city were able to meet its goal of increasing tree canopy cover to 30%. INTERPRETATION: Bringing all of Philadelphia, and particularly its poorer neighbourhoods, up to the 30% goal of tree canopy cover is not without challenge. Nevertheless, policies are warranted that value urban greening efforts as health-promoting and cost-saving measures. FUNDING: Spanish Ministry of Science, Innovation and Universities, and Generalitat de Catalunya.

12.
PLoS One ; 15(2): e0229258, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32092111

RESUMO

Runoff from heavy precipitation events can lead to microbiological contamination of source waters for public drinking water supplies. Philadelphia is a city of interest for a study of waterborne acute gastrointestinal illness (AGI) because of frequent heavy precipitation, extensive impervious landcover, and combined sewer systems that lead to overflows. We conducted a time-series analysis of the association between heavy precipitation and AGI incidence in Philadelphia, served by drinking water from Delaware River and Schuylkill River source waters. AGI cases on each day during the study period (2015-2017) were captured through syndromic surveillance of patients' chief complaint upon presentation at local emergency departments. Daily precipitation was represented by measurements at the Philadelphia International Airport and by modeled precipitation within the watershed boundaries, and we also evaluated stream flowrate as a proxy of precipitation. We estimated the association using distributed lag nonlinear models, assuming a quasi-Poisson distribution of the outcome variable and with adjustment for potential confounding by seasonal and long-term time trends, ambient temperature, day-of-week, and major holidays. We observed an association between heavy precipitation and AGI incidence in Philadelphia that was primarily limited to the spring season, with significant increases in AGI that peaked from 8 to 16 days following a heavy precipitation event. For example, the increase in AGI incidence related to airport precipitation above the 95th percentile (vs no precipitation) during spring reached statistical significance on lag day 7, peaked on day 16 (102% increase, 95% confidence interval: 16%, 252%), and declined while remaining significantly elevated through day 28. Similar associations were observed in analyses of watershed-specific precipitation in relation to AGI cases within the populations served by drinking water from each river. Our results suggest that heavy precipitation events in Philadelphia result in detectable local increases in waterborne AGI.


Assuntos
Água Potável/efeitos adversos , Gastroenteropatias/etiologia , Chuva , Doença Aguda , Humanos , Incidência , Dinâmica não Linear , Philadelphia , Rios , Estações do Ano , Poluição da Água , Abastecimento de Água
13.
Environ Int ; 134: 105237, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31677802

RESUMO

Exposure to natural outdoor environments (NOE) has been shown in population-level studies to reduce anxiety and psychological distress. This study investigated how exposure to one's everyday natural outdoor environments over one week influenced mood among residents of four European cities including Barcelona (Spain), Stoke-on-Trent (United Kingdom), Doetinchem (The Netherlands) and Kaunas (Lithuania). Participants (n = 368) wore a smartphone equipped with software applications to track location and mood (using mobile ecological momentary assessment (EMA) software), for seven consecutive days. We estimated random-effects ordered logistic regression models to examine the association between mood (positive and negative affect), and exposure to green space, represented by two binary variables indicating exposure versus no exposure to NOE using GPS tracking and satellite and aerial imagery, 10 and 30 min prior to participants' completing the EMA. Models were adjusted for home city, day of the week, hour of the day, EMA survey type, residential NOE exposure, and sex, age, education level, mental health status and neighbourhood socioeconomic status. In addition, we tested for heterogeneity of effect by city, sex, age, residential NOE exposure and mental health status. Within 10 min of NOE exposure, compared to non-exposure, we found that overall there was a positive relationship with positive affect (OR: 1.39, 95% CI: 1.06, 1.81) of EMA surveys, and non-significant negative association with negative affect (OR: 0.80, 95% CI: 0.58, 1.10). When stratifying, associations were consistently found for Stoke-on-Trent inhabitants and men, while findings by age group were inconsistent. Weaker and less consistent associations were found for exposure 30 min prior to EMA. Our findings support increasing evidence of psychological and mental health benefits of exposure to natural outdoor environments, especially among urban populations such as those included in our study.


Assuntos
Afeto , Cidades , Humanos , Lituânia , Masculino , Países Baixos , Espanha , Reino Unido
14.
Health Aff (Millwood) ; 38(10): 1687-1694, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31589538

RESUMO

Violence is a leading cause of death and disability in the United States and abroad, with far-reaching consequences for individuals and communities. Interventions that address environmental and social contexts have the potential for greater populationwide effects, yet research has been slow to identify and rigorously evaluate these types of interventions to reduce violence. Several urban communities across the US are conducting experimental and quasi-experimental community-based research to examine the effect of place-based interventions on violence. Using examples from Philadelphia, Pennsylvania; Flint, Michigan; Youngstown, Ohio; and New Orleans, Louisiana, we describe how place-based interventions that remediate vacant land and abandoned buildings work to reduce violence. These examples support the potential for place-based interventions to create far-reaching and sustainable improvements in the health and safety of communities that experience significant disadvantage. These interventions warrant the attention of community stakeholders, funders, and policy makers.


Assuntos
Nível de Saúde , Habitação , Características de Residência/estatística & dados numéricos , Segurança , Reforma Urbana/estatística & dados numéricos , Violência/estatística & dados numéricos , Humanos , Estados Unidos , Violência/tendências
15.
Am J Public Health ; 109(10): 1371-1378, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31415211

RESUMO

Across the United States, physicians are prescribing patients nature. These "Nature Rx" programs promote outdoor activity as a measure to combat health epidemics stemming from sedentary lifestyles. Despite the apparent novelty of nature prescription programs, they are not new. Rather, they are a reemergence of nature-based therapeutics that characterized children's health programs in the late 19th and early 20th centuries. These historic programs were popular among working-class urban families, physicians, and public health officials. By contrast, adherence is a challenge for contemporary programs, especially in socially disadvantaged areas. Although there are differences in nature prescription programs and social context, historical antecedents provide important lessons about the need to provide accessible resources and build on existing social networks. They also show that nature-and its related health benefits-does not easily yield itself to precise scientific measurements or outcomes. Recognizing these constraints may be critical to nature prescription programs' continued success and support from the medical profession.


Assuntos
Meio Ambiente , Exercício Físico/fisiologia , Exercício Físico/psicologia , Promoção da Saúde/história , Pediatria/história , Terapias Complementares/história , Terapias Complementares/métodos , Características Culturais , Promoção da Saúde/organização & administração , História do Século XIX , História do Século XX , História do Século XXI , Humanos , Relações Interpessoais , Pediatria/organização & administração , Saúde Pública , Tempo de Tela , Comportamento Sedentário , Fatores Socioeconômicos , Estados Unidos
16.
Artigo em Inglês | MEDLINE | ID: mdl-31261862

RESUMO

Health benefits have been linked to spending time outdoors in nature and green space. However, there is some evidence of inequities to accessing safe outdoor space, particularly in low-resource communities. The primary aim of this study is to assess attitudes towards nature and use of green space in urban areas. A secondary aim is to describe perceptions of physician-initiated nature prescriptions that target local pediatric populations. We conducted six focus group interviews with 42 residents who were guardians or caretakers of children living in low-resource neighborhoods in Philadelphia, PA. We analyzed interview data using a conventional content analysis approach. Three major themes emerged: (1) perceived benefits of being in nature (physical and mental health benefits), (2) barriers to time spent in nature (unsafe and undesirable conditions of local parks), and (3) desired features of outdoor green spaces (amenities that would increase park use). Additionally, we describe participants' reactions to the idea of a pediatrician-delivered prescription for outdoor green space exposure for a child in their care. Adherence to nature prescriptions programs may hinge on local green space resources, as well as experiential and perceptual barriers and facilitators to nature and park accessibility among caregivers tasked with fulfilling a nature prescription for a child in their care.


Assuntos
Parques Recreativos , Características de Residência , Adolescente , Adulto , Idoso , Atitude , Exercício Físico , Feminino , Grupos Focais , Humanos , Masculino , Saúde Mental , Pessoa de Meia-Idade , Philadelphia , População Urbana , Adulto Jovem
17.
Sci Total Environ ; 668: 760-767, 2019 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-30865906

RESUMO

Despite reported health benefits of urban greenspace (gs), the epidemiological evidence is less clear for allergic disease. To address a limitation of previous research, we examined the associations of medium- and high-resolution residential gs measures and tree and/or grass canopies with allergic outcomes for children enrolled in the longitudinal cincinnati childhood allergy and air pollution study (ccaaps). We estimated residential gs based on 400 m radial buffers around participant addresses (n = 478) using the normalized differential vegetation index (ndvi) and land cover-derived urban greenspace (ugs) (tree and grass coverage, combined and separate) at 30 m and 1.5-2.5 m resolution, respectively. Associations between outdoor aeroallergen sensitization and allergic rhinitis at age 7 and residential gs measures at different exposure windows were examined using multivariable logistic regression models. A 10% increase in ugs-derived grass coverage was associated with an increased risk of sensitization to grass pollens (adjusted odds ratio [aor]: 1.27; 95% confidence interval = 1.02-1.58). For each 10% increase in ugs-derived tree canopy coverage, nonstatistically significant decreased odds were found for grass pollen sensitization, tree pollen sensitization, and sensitization to either (aor range = 0.87-0.94). Results similar in magnitude to ugs-tree canopy coverage were detected for ndvi and allergic sensitizations. High-resolution (down to 1.5 m) gs measures of grass- and tree-covered areas showed associations in opposite directions for different allergy outcomes. These data suggest that measures strongly correlated with tree canopy (e.g., ndvi) may be insufficient to detect health effects associated with proximity to different types of vegetation or help elucidate mechanisms related to specific gs exposure pathways.


Assuntos
Poluição do Ar/estatística & dados numéricos , Alérgenos/análise , Exposição Ambiental/estatística & dados numéricos , Rinite Alérgica/epidemiologia , Criança , Feminino , Humanos , Estudos Longitudinais , Masculino , Razão de Chances , Pólen , Desenvolvimento Sustentável/tendências , Árvores
18.
Artigo em Inglês | MEDLINE | ID: mdl-30889810

RESUMO

Epidemiological studies consistently show an association between wildfire-related smoke exposure and adverse respiratory health. We conducted a systematic review of evidence in published literature pertaining to heterogeneity of respiratory effects from this exposure in North America. We calculated the within-study ratio of relative risks (RRR) and 95% confidence intervals (CI) to examine heterogeneity of effect by population subgroup, and then summarized the RRRs using meta-analysis. We found evidence of a greater effect of wildfire smoke on respiratory health among females relative to males for asthma (RRR: 1.035, 95% CI: 1.013, 1.057) and chronic obstructive pulmonary disease (RRR: 1.018, 95% CI: 1.003, 1.032). There was evidence of a lower relative risk for all respiratory outcomes among youth compared to adults (RRR: 0.976, 95% CI: 0.963, 0.989). We also found wildfire smoke effects stratified by income, race, education, health behaviors, access to care, housing occupancy, geographic region, and urban/rural status. However, data were insufficient to quantitatively evaluate effect modification by these characteristics. While we found evidence that certain demographic subgroups of the population are more susceptible to respiratory health outcomes from wildfire smoke, it is unclear whether this information can be used to inform policy aimed to reduce health impact of wildfires.


Assuntos
Exposição Ambiental/efeitos adversos , Doenças Respiratórias/etiologia , Fumaça/efeitos adversos , Incêndios Florestais , Feminino , Humanos , Masculino , América do Norte/epidemiologia , Doenças Respiratórias/epidemiologia , Risco , População Rural , Fatores Sexuais
19.
Accid Anal Prev ; 123: 123-131, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30476630

RESUMO

Bicycle lanes reduce real and perceived risks for bicycle vs. motor vehicle crashes, reducing the burden of traffic injuries and contributing to greater cycling participation. Previous research indicates that the effectiveness of bicycle lanes differs according to roadway characteristics, and that bicycle lane types are differentially associated with reduced crash risks. The aim of this study is to combine these perspectives and identify the types of on-road bicycle lanes that are associated with the greatest reductions in bicycle crashes given the presence of specific roadway characteristics. We compiled a cross sectional spatial dataset consisting of 32,444 intersection polygons and 57,285 street segment polygons representing the roadway network for inner Melbourne, Australia. The dependent measure was a dichotomous indicator for any bicycle crash (2014-2017). Independent measures were bicycle lanes (exclusive bicycle lanes, shared bicycle and parking lanes, marked wide kerbside lanes, and kerbside bicycle lanes) and other roadway characteristics (speed limit, bus routes, tram routes, bridges, one-way flow, traffic lane width). In Bayesian conditional autoregressive logit models, bicycle lanes of all types were associated with decreased crash odds where speeds were greater, bus routes and tram stops were present, and traffic lanes were narrower. Only exclusive bicycle lanes were associated with reduced crash odds (compared to the expected odds given the presence of the bicycle lane and the roadway conditions) in all these setting. The extent to which on-road bicycle lanes reduce crash risks depends on the bicycle lane type, the roadway conditions, and the combination of these two factors. Bicycle lanes that provide greater separation between cyclists and vehicular traffic are most consistently protective.


Assuntos
Acidentes de Trânsito/prevenção & controle , Ciclismo , Ambiente Construído/classificação , Acidentes de Trânsito/estatística & dados numéricos , Austrália , Teorema de Bayes , Ambiente Construído/estatística & dados numéricos , Estudos Transversais , Humanos , Veículos Automotores/estatística & dados numéricos , Fatores de Risco , Segurança , Análise Espacial
20.
Public Health Rep ; 133(6): 650-657, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30286299

RESUMO

OBJECTIVES: In 2005, Hurricane Katrina caused damage in New Orleans, Louisiana, and much of the land in low-resource neighborhoods became vacant and blighted. In 2014, New Orleans launched a program, Fight the Blight, which remediated properties in 6 neighborhoods. Our objective was to examine changes in crime rates near lots that were remediated (ie, debris removed and vegetation mowed). METHODS: We used a quasi-experimental design to test whether crime rates changed from preremediation (January 2013-October 2014) to postremediation (July 2016-March 2017) near 204 vacant lots that were remediated compared with 560 control vacant lots that were not remediated between October 2014 and July 2016. We also examined differences between remediated lots that received 1 treatment (n = 64) and those that received ≥2 treatments (n = 140). RESULTS: We found no significant differences between remediated and control lots in levels of violent, property, and domestic crimes from preremediation to postremediation. However, the number of drug crimes per square mile decreased significantly near all remediated lots (5.7% lower; P < .001) compared with control lots, largely driven by the significant decrease (6.4% lower; P < .001) in drug crimes found near lots that received ≥2 treatments. CONCLUSIONS: Investing in programs that improve neighborhood environments affected by high rates of physical disorder and vacancy may be a way to decrease violence. However, routine remediation may be needed to increase the public health impact of blight abatement programs in warmer climates, where weeds and vegetation grow rapidly.


Assuntos
Crime/estatística & dados numéricos , Reforma Urbana/estatística & dados numéricos , Humanos , Renda/estatística & dados numéricos , Nova Orleans , Pobreza/estatística & dados numéricos , Características de Residência/estatística & dados numéricos , Desemprego/estatística & dados numéricos , Violência/estatística & dados numéricos
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