Journal of urban health : bulletin of the New York Academy of Medicine
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Randomized Controlled Trial
Cash Transfers and After-School Programs: A Randomized Controlled Trial for Young Men at Risk of Violence Exposure in Wilmington, Delaware.
We conducted a randomized controlled trial to determine whether an after-school program paired with a cash transfer (a conditional cash transfer) or a cash transfer alone (an unconditional cash transfer) can help improve health and economic outcomes for young men between the ages of 14 and 17 whose parents have low incomes and who live in neighborhoods with high crime rates. We find that receiving the cash transfer alone was associated with an increase in healthy behaviors (one of our primary outcome composite measures) and that the cash transfer paired with after-school programming was associated with an improvement in the financial health of participants (one of our secondary outcome composite measures). ⋯ Neither the cash transfer alone nor the programming plus cash transfer had statistically significant effects on our other primary composite measures (physical and mental health or school attendance and disciplinary actions), or our other secondary composite measures (criminal justice engagement or social supports) but in most cases, confidence intervals were too large to rule out meaningful effects. Results suggest that cash transfers hold promise to improve the health of youth without any indication of any adverse effects.
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Civilian injuries caused during contact with law enforcement personnel erode community trust in policing, impact individual well-being, and exacerbate existing health inequities. We assessed the relationship between ZIP code-level rates of civilian injuries caused during legal interventions and community-level sociodemographic characteristics using Illinois hospital data from 2016 to 2022. We developed multivariable Poisson regression models to examine whether legal intervention injury rates differed by race-ethnicity and community economic disadvantage across three geographic regions of Illinois representing different levels of urbanization. ⋯ Communities with the highest injury rates involving non-Hispanic white residents were significantly more economically unequal and disadvantaged. While the injury rates were consistently and substantially higher among non-Hispanic Black residents throughout the state, the findings illustrate that the association between overall civilian injuries caused during contact with law enforcement and community sociodemographic characteristics varied across regions. Data on local law enforcement agency policies and procedures are needed to better identify appropriate interventions.
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Mass shootings (incidents with four or more people shot in a single event, not including the shooter) are becoming more frequent in the United States, posing a significant threat to public health and safety in the country. In the current study, we intended to analyze the impact of state-level prevalence of gun ownership on mass shootings-both the frequency and severity of these events. We applied the negative binomial generalized linear mixed model to investigate the association between gun ownership rate, as measured by a proxy (i.e., the proportion of suicides committed with firearms to total suicides), and population-adjusted rates of mass shooting incidents and fatalities at the state level from 2013 to 2022. ⋯ Specifically, our model indicated that for every 1-SD increase-that is, for every 12.5% increase-in gun ownership, the rate of mass shooting fatalities increased by 34% (p value < 0.001). However, no significant association was found between gun ownership and rate of mass shooting incidents. These findings suggest that restricting gun ownership (and therefore reducing availability to guns) may not decrease the number of mass shooting events, but it may save lives when these events occur.
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We assess the effectiveness of paid ads on social media platforms as a research recruitment tool with Latino men who have sex with men (LMSM). We deployed four paid ad campaigns July-September 2022 in English and Spanish on Meta and Grindr featuring happy or risqué images of LMSM, documenting engagement and cost metrics. ⋯ Comparing platforms, Meta had higher engagement metrics than Grindr, while Grindr had higher proportions of those who completed the screener (57.9%) and were eligible (26.3%) than Meta (52.6% and 21.0%, respectively). Challenges to using paid ads as an LMSM recruitment tool included intersecting pandemics (Mpox, COVID-19), and limited connection between platforms and staff for study enrollment.
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Implementing the 15-min city and chrono-urbanism aims to improve sustainability and quality of life by ensuring residents' proximity to essential services. The 15-min city model is gaining global traction, with localized adaptations to suit communities' needs. Beyond environmental motivations, 15-min cities can benefit public health through enhanced walkability, social cohesion, and universal accessibility. ⋯ Recommendations to integrate 15-min cities into planning activities include conducting comprehensive baseline assessments, aligning goals with sustainability, economic development, flexible zoning, inclusive public spaces, and diverse community engagement tactics. We recommend interventions targeting marginalized communities and developing standardized measurement tools for comparison, monitoring, and evaluation. A nuanced, equitable approach to implementing 15-min cities can help urban plans support health equity across diverse populations.