Journal of urban health : bulletin of the New York Academy of Medicine
-
Sanitation delivery in the urban areas of sub-Saharan African countries has been a chronic issue, particularly difficult to tackle. Under the Millennium Development Goals, the sanitation target in urban sub-Saharan Africa was missed by a wide margin and witnessed almost no improvement. After 2 years of review, the WHO/UNICEF Joint Monitoring Programme published a new measure of access to sanitation as a baseline for the Sustainable Development Goals. ⋯ In sum, it is not a surprise that a Working Group recommended that the measure should be changed to include some shared facilities. Following the Working Group's recommendation would have avoided the adverse consequences of continued reliance on a key component of the methodology used for monitoring sanitation improvements under the Millennium Development Goals. The paper discusses the limitations of this methodology in the context of urban sub-Saharan Africa, where current sanitation conditions are seriously lacking, and the significant future urban population growth will add more pressure for the delivery of vital sanitation services.
-
The USA has very high rates of homicide by police compared to other high-income countries, with approximately 1000 civilians killed annually. The overwhelming majority of these police homicides are fatal shootings. Over the past 5 years, several comprehensive, real-time, data repositories, drawn largely from news reporting, have kept track of incidents in which civilians die during an encounter with the police and have become widely available. ⋯ Explanatory ecologic variables in our models include the violent crime rate, the percentage of the state population that is non-White, poverty rate, and urbanization, along with a validated proxy for firearm prevalence. We find that rates of police shooting deaths are significantly and positively correlated with levels of household gun ownership, even after accounting for the other explanatory variables. The association is stronger for the shooting of armed (with a gun) rather than unarmed victims.
-
This paper underscores the need for detailed data on health and disaster risks for sub-Saharan African cities, particularly for their informal settlements. Systems that should contribute to the information base on health and health risks in each locality are rarely functional. In most cities, there is a lack of data on health risks, health outcomes, and health determinants; where data are available, they are usually too aggregated to be useful to urban governments. ⋯ The second is from data collected by slum/shack dweller federations, which offer qualitative and quantitative findings on health, disasters, and other health determinants in informal settlements. Our conclusion reflects upon the need for additional data on multiple risks to advance urban health and well-being and support the 2030 Agenda for Sustainable Development. It also highlights the need to strengthen accountable urban governance in sub-Saharan Africa.
-
The digital neighborhood is the amalgamation of the spaces online where youth connect with others. Just as Black and Hispanic youth live in neighborhoods that influence their health, they are also influenced by online digital neighborhoods. Youth are exposed to social media content featuring substance use, sexual risk, and violence, yet little is known about the extent to which youth engage with such content. ⋯ Users reported lower levels of engagement with risk-related content (on an engagement continuum), ranging from passive exposure to dissemination. While negative risks may be amplified in the digital neighborhood, youth appear to strategically limit their engagement with that content. However, because risk behavior messaging is common in these digital neighborhoods, these spaces provide opportunities for health promotion interventions.
-
This report documents a successful intervention by a community-based naloxone distribution program in San Francisco. The program and its partner organizations, working with participants who use drugs, first identified the appearance of illicitly made fentanyl and increased outreach and naloxone distribution. Distribution of naloxone and reported use of naloxone to reverse opioid-involved overdoses increased significantly while the number of opioid-involved and fentanyl-involved overdose deaths did not. Community-based programs that provide training and naloxone to people who use drugs can serve as an early warning system for overdose risk and adaptively respond to the rapidly changing overdose risk environment.