المؤلفون: Ivana Stankov, Jose D. Meisel, Olga Lucia Sarmiento, Xavier Delclòs-Alió, Dario Hidalgo, Luis A. Guzman, Daniel A. Rodriguez, Ross A. Hammond, Ana V. Diez Roux

المصدر: International Journal of Behavioral Nutrition and Physical Activity, Vol 21, Iss 1, Pp 1-15 (2024)

مصطلحات موضوعية: Complex systems, Agent-based model, Transportation policy, Health inequities, Time scarcity, Physical activity, Nutritional diseases. Deficiency diseases, RC620-627, Public aspects of medicine, RA1-1270

الوصف: Abstract Background Transportation policies can impact health outcomes while simultaneously promoting social equity and environmental sustainability. We developed an agent-based model (ABM) to simulate the impacts of fare subsidies and congestion taxes on commuter decision-making and travel patterns. We report effects on mode share, travel time and transport-related physical activity (PA), including the variability of effects by socioeconomic strata (SES), and the trade-offs that may need to be considered in the implementation of these policies in a context with high levels of necessity-based physical activity. Methods The ABM design was informed by local stakeholder engagement. The demographic and spatial characteristics of the in-silico city, and its residents, were informed by local surveys and empirical studies. We used ridership and travel time data from the 2019 Bogotá Household Travel Survey to calibrate and validate the model by SES. We then explored the impacts of fare subsidy and congestion tax policy scenarios. Results Our model reproduced commuting patterns observed in Bogotá, including substantial necessity-based walking for transportation. At the city-level, congestion taxes fractionally reduced car use, including among mid-to-high SES groups but not among low SES commuters. Neither travel times nor physical activity levels were impacted at the city level or by SES. Comparatively, fare subsidies promoted city-level public transportation (PT) ridership, particularly under a ‘free-fare’ scenario, largely through reductions in walking trips. ‘Free fare’ policies also led to a large reduction in very long walking times and an overall reduction in the commuting-based attainment of physical activity guidelines. Differential effects were observed by SES, with free fares promoting PT ridership primarily among low-and-middle SES groups. These shifts to PT reduced median walking times among all SES groups, particularly low-SES groups. Moreover, the proportion of low-to-mid SES commuters meeting weekly physical activity recommendations decreased under the 'freefare' policy, with no change observed among high-SES groups. Conclusions Transport policies can differentially impact SES-level disparities in necessity-based walking and travel times. Understanding these impacts is critical in shaping transportation policies that balance the dual aims of reducing SES-level disparities in travel time (and time poverty) and the promotion of choice-based physical activity.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1479-5868Test

الوصول الحر: https://doaj.org/article/d390d56b189644ca811e3d93a130e95dTest

المؤلفون: Mónica Serena Perner, Andrés Trotta, Usama Bilal, Binod Acharya, Harrison Quick, Natalia Pacífico, Romina Berazategui, Marcio Alazraqui, Ana V. Diez Roux

المصدر: International Journal for Equity in Health, Vol 22, Iss 1, Pp 1-11 (2023)

مصطلحات موضوعية: COVID-19, Spatial analysis, Urban health, Social inequalities, Small areas, Public aspects of medicine, RA1-1270

الوصف: Abstract Background The COVID-19 pandemic has shown how intraurban inequalities are likely to reinforce health and social inequalities. Studies at small area level help to visualize social inequialities hidden in large areas as cities or regions. Aim To describe the spatial patterning of COVID-19 death rates in neighborhoods of the medium-sized city of Bariloche, Argentina, and to explore its relationship with the socioeconomic characteristics of neighborhoods. Methods We conducted an ecological study in Bariloche, Argentina. The outcome was counts of COVID-19 deaths between June 2020 and May 2022 obtained from the surveillance system and georeferenced to neighborhoods. We estimated crude- and age-adjusted death rates by neighborhood using a Bayesian approach through a Poisson regression that accounts for spatial-autocorrelation via Conditional Autoregressive (CAR) structure. We also analyzed associations of age-adjusted death rates with area-level socioeconomic indicators. Results Median COVID-19 death rate across neighborhoods was 17.9 (10th/90th percentile of 6.3/35.2) per 10,000 inhabitants. We found lower age-adjusted rates in the city core and western part of the city. The age-adjusted death rate in the most deprived areas was almost double than in the least deprived areas, with an education-related relative index of inequality (RII) of 2.14 (95% CI 1.55 to 2.96). Conclusion We found spatial heterogeneity and intraurban variability in age-adjusted COVID-19 death rates, with a clear social gradient, and a higher burden in already deprived areas. This highlights the importance of studying inequalities in health outcomes across small areas to inform placed-based interventions.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1475-9276Test

الوصول الحر: https://doaj.org/article/0f5adcf44d1c4a8d8b5ad75da40676e3Test

المؤلفون: Anne Dorothée Slovic, Katherine Indvik, Lucas Soriano Martins, Josiah L. Kephart, Sandra Swanson, D. Alex Quistberg, Mika Moran, Maryia Bakhtsiyarava, Carol Zavaleta-Cortijo, Nelson Gouveia, Ana V. Diez Roux

المصدر: Climate Risk Management, Vol 45, Iss , Pp 100625- (2024)

مصطلحات موضوعية: Climate change, Climate hazards, Risk perception, Latin America, Urban, Adaptation, Meteorology. Climatology, QC851-999

الوصف: Climate hazards threaten the health and wellbeing of people living in urban areas. This study characterized reported climate hazards, adaptation action, and barriers to adaptation in 124 Latin American cities, and associations of climate hazards with urban social and built environment characteristics. We examined cities that responded to a global environmental disclosure system and that were included in the Urban Health in Latin America (SALURBAL) Project database.The cities studied reported a median of three climate hazards. The most reported hazards were storms (61%) water scarcity (57%) extreme temperature (52%) and wildfires (51%). Thirty-eight percent of cities reported four or more distinct types of hazards. City size, density, GDP, and greenness were related to hazard reports, and although most cities reported taking actions to reduce vulnerability to climate change, 23% reported no actions at all. The most frequently reported actions were hazard mapping and modeling (47%) and increasing vegetation or greenspace coverage (45%). Other actions, such as air quality initiatives and urban planning, were much less common (8% and 3%, respectively). In terms of challenges in adapting to climate change, 35% of cities reported no challenges. The most frequently reported challenges were urban environment and development (43%) and living conditions (35%). Access to data, migration, public health, and safety/security were rarely reported as challenges. Our results suggest that climate hazards are recognized, but that adaptation responses are limited and that many important challenges to response action are not fully recognized.This study contributes to understanding of local priorities, ongoing actions, and required support for urban climate vulnerability assessment and adaptation responses. Findings suggest the need for future research documenting local perceptions of climate hazards and comparison with documented climate hazards.

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S2212096324000421Test; https://doaj.org/toc/2212-0963Test

الوصول الحر: https://doaj.org/article/9820f01927554e5cbee10baa8526d603Test

المؤلفون: Ariela Braverman-Bronstein, Dèsirée Vidaña-Pérez, Ana V. Diez Roux, Carolina Pérez Ferrer, Brisa N. Sánchez, Tonatiuh Barrientos-Gutiérrez

المصدر: BMC Public Health, Vol 23, Iss 1, Pp 1-10 (2023)

مصطلحات موضوعية: Adolescent pregnancy, Urban environment, Structural availability, Mexico, Public aspects of medicine, RA1-1270

الوصف: Abstract Background The association of the built environment and the structural availability of services/amenities with adolescent birth rates (ABR) has been overlooked in Latin America. We investigated the association of the availability, and changes in the availability, of services/amenities with ABR in 92 Mexican cities. Methods We estimated ABR using data on live birth registration linked to municipality of residence at the time of birth from 2008–2017. The number of services/amenities were obtained from the National Statistical Directory of Economic Units in 2010, 2015, and 2020 and grouped as follows: education, health care, pharmacies, recreation, and on- and off-premises alcohol outlets. Data were linearly interpolated to obtain yearly estimates. We estimated densities per square km by municipality. We fitted negative binomial hybrid models, including a random intercept for municipality and city, and adjusted for other social environment variables. Results After adjustment a 1-unit increase in the density of recreation facilities, pharmacies, and off-premises alcohol outlets within municipalities was associated with a 5%, 4% and 12% decrease in ABR, respectively. Municipalities with higher density of education, recreational and health care facilities had a lower ABR; in contrast, municipalities with a higher density of on-premises alcohol experienced a higher ABR. Conclusion Our findings highlight the importance of economic drivers and the need to invest in infrastructure, such as pharmacies, medical facilities, schools, and recreation areas and limit the availability of alcohol outlets to increase the impact of current adolescent pregnancy prevention programs.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1471-2458Test

الوصول الحر: https://doaj.org/article/57d9076a83b64922a120bfde53dc00bcTest

المؤلفون: Sofía Baquero, Felipe Montes, Ivana Stankov, Olga L. Sarmiento, Pablo Medina, S. Claire Slesinski, Francisco Diez-Canseco, Maria F. Kroker-Lobos, Waleska Teixeira Caiaffa, Alejandra Vives, Marcio Alazraqui, Tonatiuh Barrientos-Gutiérrez, Ana V. Diez Roux

المصدر: Scientific Reports, Vol 13, Iss 1, Pp 1-13 (2023)

مصطلحات موضوعية: Medicine, Science

الوصف: Abstract The SALURBAL (Urban Health in Latin America) Project is an interdisciplinary multinational network aimed at generating and disseminating actionable evidence on the drivers of health in cities of Latin America. We conducted a temporal multilayer network analysis where we measured cohesion over time using network structural properties and assessed diversity within and between different project activities according to participant attributes. Between 2017 and 2020 the SALURBAL network comprised 395 participants across 26 countries, 23 disciplines, and 181 institutions. While the cohesion of the SALURBAL network fluctuated over time, overall, an increase was observed from the first to the last time point of our analysis (clustering coefficient increased [0.83–0.91] and shortest path decreased [1.70–1.68]). SALURBAL also exhibited balanced overall diversity within project activities (0.5–0.6) by designing activities for different purposes such as capacity building, team-building, research, and dissemination. The network’s growth was facilitated by the creation of new diverse collaborations across a range of activities over time, while maintaining the diversity of existing collaborations (0.69–0.75 between activity diversity depending on the attribute). The SALURBAL experience can serve as an example for multinational research projects aiming to build cohesive networks while leveraging heterogeneity in countries, disciplines, career stage, and across sectors.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2045-2322Test

الوصول الحر: https://doaj.org/article/c3c7217e86024d39ad2a4cdfd00de684Test

المؤلفون: Leah H Schinasi, Maryia Bakhtsiyarava, Brisa N. Sanchez, Josiah L. Kephart, Yang Ju, Sarav Arunachalam, Nelson Gouveia, Waleska Teixeira Caiaffa, Marie S. O'Neill, Iryna Dronova, Ana V. Diez Roux, Daniel A. Rodriguez

المصدر: Environment International, Vol 180, Iss , Pp 108230- (2023)

مصطلحات موضوعية: Green space, Vegetation, NDVI, Urban heat, Ambient temperature, Climate change, Environmental sciences, GE1-350

الوصف: Green vegetation may protect against heat-related death by improving thermal comfort. Few studies have investigated associations of green vegetation with heat-related mortality in Latin America or whether associations are modified by the spatial configuration of green vegetation. We used data from 323 Latin American cities and meta-regression models to estimate associations between city-level greenness, quantified using population-weighted normalized difference vegetation index values and modeled as three-level categorical terms, and excess deaths from heat (heat excess death fractions [heat EDFs]). Models were adjusted for city-level fine particulate matter concentration (PM2.5), social environment, and country group. In addition to estimating overall associations, we derived estimates of association stratified by green space clustering by including an interaction term between a green space clustering measure (dichotomized at the median of the distribution) and the three-level greenness variable. We stratified analyses by climate zone (arid vs. temperate and tropical combined). Among the 79 arid climate zone cities, those with moderate and high greenness levels had modestly lower heat EDFs compared to cities with the lowest greenness, although protective associations were more substantial in cities with moderate versus high greenness levels and confidence intervals (CI) crossed the null (Beta: −0.41, 95% CI: −1.06, 0.25; Beta −0.23, 95% CI: −0.95, 0.49, respectively). In 244 non-arid climate zone cities, associations were approximately null. We did not observe evidence of effect modification by green space clustering. Our results suggest that greenness may offer modest protection against heat-related mortality in arid climate zone Latin American cities.

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S0160412023005032Test; https://doaj.org/toc/0160-4120Test

الوصول الحر: https://doaj.org/article/6f7694b958f742a29275814c23d8e8daTest

المؤلفون: Herney Rengifo-Reina, Tonatiuh Barrientos-Gutiérrez, Nancy López-Olmedo, Brisa N. Sánchez, Ana V. Diez Roux

المصدر: International Journal of Public Health, Vol 68 (2023)

مصطلحات موضوعية: Colombia, older adults, urban areas, migration, frailty, neighborhoods, Public aspects of medicine, RA1-1270

الوصف: Objective: We investigated the association between the density of internal human migration, in the urban neighborhood, on frailty in the older adult population in Colombia.Methods: The data used in this study are from four Colombian population surveys. We analyzed 633 census tracts with a sample of 2,194 adults 60 years and over for frailty (measured using the Fried criteria). We considered the proportion of inhabitants in a census tract with a history of internal migration as the exposure variable considering three temporalities. For contextual forced migration, we identified two types: 5-year, and 1-year. Poisson multivariable regression models with two hierarchical levels (individual and census tracts) were estimated.Results: The prevalence of pre-fragile/frailty was 80.63% [CI 95%: 77.67, 83.28]. The prevalence ratio were significantly higher for the older adults who live in neighborhoods where a higher proportion of internal migrants reside.Conclusion: We conclude that older adults who lived in neighborhoods with a high proportion of internal migrants experience more frailty. Potential explanations are that neighborhoods with high internal migration could experience social (l increase in cultural heterogeneity, in the perception of insecurity, violence and physical conditions (pressure on local economies and services, leading elderly residents to compete for neighborhood resources), translated into social stress.

وصف الملف: electronic resource

العلاقة: https://www.ssph-journal.org/articles/10.3389/ijph.2023.1605379/fullTest; https://doaj.org/toc/1661-8564Test

الوصول الحر: https://doaj.org/article/3387e64947bc4f0788cc8b37dcd1664cTest

المؤلفون: Marianela Castillo-Riquelme, Goro Yamada, Ana V. Diez Roux, Tania Alfaro, Sandra Flores-Alvarado, Tonatiuh Barrientos, Camila Teixeira Vaz, Andrés Trotta, Olga L. Sarmiento, Mariana Lazo

المصدر: BMC Public Health, Vol 22, Iss 1, Pp 1-14 (2022)

مصطلحات موضوعية: Self-reported health, Aging, Latin-America, Multilevel analysis, Urban health, Gender, Public aspects of medicine, RA1-1270

الوصف: Abstract Background Understanding how urban environments influence people’s health, especially as individuals age, can help identify ways to improve health in the rapidly urbanizing and rapidly aging populations. Objectives To investigate the association between age and self-reported health (SRH) in adults living in Latin-American cities and whether gender and city-level socioeconomic characteristics modify this association. Methods Cross-sectional analyses of 71,541 adults aged 25–97 years, from 114 cities in 6 countries (Argentina, Brazil, Colombia, Chile, El Salvador, and Guatemala), as part of the Salud Urbana en America Latina (SALURBAL) Project. We used individual-level age, gender, education, and self-reported health (SRH) data from harmonized health surveys. As proxies for socioeconomic environment we used a city-level socioeconomic index (SEI) calculated from census data, and gross domestic product (GDP) per-capita. Multilevel Poisson models with a robust variance were used to estimate relative risks (RR), with individuals nested in cities and binary SRH (poor SHR vs. good SRH) as the outcome. We examined effect modification by gender and city-level socioeconomic indicators. Results Overall, 31.4% of the sample reported poor SRH. After adjusting for individual-level education, men had a lower risk of poor SRH (RR = 0.76; CI 0.73–0.78) compared to women, and gender modified the association between age and poor SRH (p-value of interaction

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1471-2458Test

الوصول الحر: https://doaj.org/article/39a59ad472d84f3c81c2c65f75cdb740Test

المؤلفون: Angela D'Adamo, Alina Schnake-Mahl, Pricila H. Mullachery, Mariana Lazo, Ana V. Diez Roux, Usama Bilal

المصدر: SSM: Population Health, Vol 21, Iss , Pp 101314- (2023)

مصطلحات موضوعية: Health inequities, Influenza, Pandemic, Social class, Ethnic groups, Public aspects of medicine, RA1-1270, Social sciences (General), H1-99

الوصف: Objective: The COVID-19 pandemic has exacerbated existing health disparities. To provide a historical perspective on health disparities for pandemic acute respiratory viruses, we conducted a scoping review of the public health literature of health disparities in influenza outcomes during the 1918, 1957, 1968, and 2009 influenza pandemics. Methods: We searched for articles examining socioeconomic or racial/ethnic disparities in any population, examining any influenza-related outcome (e.g., incidence, hospitalizations, mortality), during the 1918, 1957, 1968, and 2009 influenza pandemics. We conducted a structured search of English-written articles in PubMed supplemented by a snowball of articles meeting inclusion criteria. Results: A total of 29 articles met inclusion criteria, all but one focusing exclusively on the 1918 or 2009 pandemics. Individuals of low socioeconomic status, or living in low socioeconomic status areas, experienced higher incidence, hospitalizations, and mortality in the 1918 and 2009 pandemics. There were conflicting results regarding racial/ethnic disparities during the 1918 pandemic, with differences in magnitude and direction by outcome, potentially due to issues in data quality by race/ethnicity. Racial/ethnic minorities had generally higher incidence, mortality, and hospitalization rates in the 1957 and 2009 pandemics. Conclusion: Individuals of low socioeconomic status and racial/ethnic minorities have historically experienced worse influenza outcomes during pandemics. These historical patterns can inform current research to understand disparities in the ongoing COVID-19 pandemic and future pandemics.

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S2352827322002932Test; https://doaj.org/toc/2352-8273Test

الوصول الحر: https://doaj.org/article/573e2027aeb442e09da0e227ea3f769dTest

المؤلفون: Sofía Baquero, Felipe Montes, Ivana Stankov, Olga L. Sarmiento, Pablo Medina, S. Claire Slesinski, Francisco Diez-Canseco, Maria F. Kroker-Lobos, Waleska Teixeira Caiaffa, Alejandra Vives, Marcio Alazraqui, Tonatiuh Barrientos-Gutiérrez, Ana V. Diez Roux

المصدر: Scientific Reports, Vol 13, Iss 1, Pp 1-1 (2023)

مصطلحات موضوعية: Medicine, Science

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2045-2322Test

الوصول الحر: https://doaj.org/article/b6043363b6b944298d61a93efb3b6e40Test