Journal of urban health : bulletin of the New York Academy of Medicine
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There is considerable evidence demonstrating the positive impact of pedometers and walking programs for increasing physical activity and reducing risk for cardiovascular disease among diverse populations. However, no interventions have been targeted towards South Asian taxi drivers, a population that may be at high risk for developing cardiovascular disease. Supporting South Asian Taxi Drivers to Exercise through Pedometers (SSTEP) was a 12-week pilot study among South Asian taxi drivers to increase their daily step counts. ⋯ The SSTEP intervention resulted in a small increase in step counts among participants overall, and in a significant increase (>2,000 steps) among a subset ("Bigsteppers"). Drivers with higher baseline glucose values had significantly greater improvements in their step counts. Focused lifestyle interventions for drivers at high risk for cardiovascular disease may be particularly impactful.
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Comparative Study
A comparison of social and spatial determinants of health between formal and informal settlements in a large metropolitan setting in Brazil.
Urban informal settlements are often under-recognized in national and regional surveys. A lack of quality intra-urban data frequently contributes to a one-size-fits-all public health intervention and clinical strategies that rarely address the variegated socioeconomic disparities across and within different informal settlements in a city. The 2010 Brazilian census gathered detailed population and place-based data across the country's informal settlements. ⋯ Average per household income in informal settlement census tracts is less than one third that of non-informal tracts (US\$708 versus US\$2362). Even among informal settlements in different planning areas in the same city, there is marked variation in these characteristics. Public health interventions, clinical management, and urban planning policies aiming to improve the living conditions of the people residing in informal settlements, including government strategies currently underway, must consider the differences that exist between and within informal settlements that shape place-based physical and social determinants of health.
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The goal of this study was to assess the association between features of the built environment and levels of walking and cycling as forms of transportation in the city of Curitiba, Brazil. Data collection was conducted through a telephone survey in 2008. The International Physical Activity Questionnaire was used to identify walking or cycling as forms of transportation. ⋯ Higher access to bike paths (OR = 0.80, 95 % CI = 0.64-1.00) was inversely associated with walking at recommended levels (≥ 150 min/week). Higher-income areas (OR = 0.26, 95 % CI = 0.08-0.81), greater number of traffic lights (OR = 0.27, 95 % CI = 0.09-0.88), and higher land use mix (OR = 0.52, 95 % CI = 0.31-0.88) were inversely associated with cycling. The neighborhood built environment may affect active commuting among adults living in urban centers in middle-income countries.
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Harm reduction approaches endeavor to assist individuals with avoiding the most detrimental consequences of risk taking behaviors, but limited research has documented the outcomes of harm reduction substance abuse treatment. In total, 211 methamphetamine-using men who have sex with men (MSM) enrolled in two outcome studies of substance abuse treatment programs that were implementing an evidence-based, cognitive-behavioral intervention (i.e., the Matrix Model) from a harm reduction perspective. Study 1 (N = 123) examined changes in self-reported substance use, Addiction Severity Index (ASI) composite scores, and HIV care indicators over a 12-month follow-up. ⋯ Participants in both studies reported concurrent increases in marijuana use. Taken together, these studies are among the first to observe that clients may reduce stimulant use and concomitant sexual risk-taking behavior during harm reduction substance abuse treatment. Randomized controlled trials are needed to examine the differential effectiveness of harm reduction and abstinence-based approaches to substance abuse treatment.
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Heat waves can be lethal and routinely prompt public warnings about the dangers of heat. With climate change, extreme heat events will become more frequent and intense. However, little is known about public awareness of heat warnings or behaviors during hot weather. ⋯ Seniors in the focus groups did not perceive themselves to be at risk, and often did not identify AC as an important health protection strategy. While heat warnings are received by most New Yorkers, AC cost, risk perception problems, and a preference for staying home leave many at risk during heat waves. Improving AC access and risk communications will help better protect the most vulnerable during heat waves.