Journal of urban health : bulletin of the New York Academy of Medicine
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HIV affects African American gay and bisexual men (AAGBM) more disproportionately than any other group in the USA. The Black Church, which has been a historic mainstay for African American empowerment and well-being, has the potential to be a public health partner for HIV prevention with AAGBM. ⋯ Public health should consider how thoughtful engagement, research, and interventions can support these approaches. Developing partnerships with the Black Church and African American clergy can promote effective HIV prevention efforts for AAGBM.
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In the early 1980s, men who have sex with men (MSM) in San Francisco were one of the first populations to be affected by the human immunodeficiency virus (HIV) epidemic, and they continue to bear a heavy HIV burden. Once a rapidly fatal disease, survival with HIV improved drastically following the introduction of combination antiretroviral therapy in 1996. As a result, the ability of HIV-positive persons to move into and out of San Francisco has increased due to lengthened survival. ⋯ The results suggest that the overall MSM population and all the MSM subpopulations studied decreased in size from 2006 to 2014. Further, there were differences in migration patterns by race and by HIV serostatus. The modeling methods outlined can be applied by others to determine how migration patterns contribute to HIV-positive population size and output from these models can be used in a transmission model to better understand how migration can impact HIV transmission.
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Black men who have sex with men (BMSM) are a population at the intersection of two minority statuses-racial minority and sexual minority. Membership in either group, compared to white or heterosexual group membership, may increase one's risk of negative childhood and adult experiences. Baseline data from an HIV intervention efficacy trial (the Black Men Evolving Study) were used to explore the prevalence of adverse childhood experiences (ACEs) among 536 BMSM and associations between ACEs and adult mental and physical health outcomes. ⋯ Findings revealed that ACE score was significantly associated with adult mental health (AOR = 1.21, 95% CI [1.12, 1.30]), but not with adult physical health. All ACEs were significantly associated with mental health, but only physical neglect and household substance abuse were significantly associated with physical health (AOR = 1.69, 95% CI [1.02, 2.74] and AOR = 1.57, 95% CI [1.03, 2.40], respectively). The findings support the need for interventions targeting improved adult health outcomes, particularly for minority groups, to consider the impact of early adversity on health and wellness.
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The China Healthy Cities initiative, a nationwide public health campaign, has been implemented for 25 years. As "Healthy China 2030" becomes the key national strategy for improving population health, this initiative is an important component. However, the effects of the initiative have not been well studied. ⋯ We found that the China Healthy Cities initiative was associated with increases in the proportion of urban domestic sewage treated (32 percentage points), the proportion of urban domestic garbage treated (30 percentage points), and the proportion of qualified farmers' markets (40 percentage points), all of which are statistically significant (P < 0.05). No significant change was found for increases in green coverage of urban built-up area (5 percentage points), green space per capita (2 square meter), and days with Air Quality Index/Air Pollution Index ≤ 100 (25 days). In conclusion, the China Healthy Cities initiative was associated with significant improved urban environment in terms of infrastructure construction, yet had little impact on green space and air quality.
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Research on residential segregation and health, primarily conducted in the USA, has chiefly employed city or regional measures of racial segregation. To test our hypothesis that stronger associations would be observed using local measures, especially for racialized economic segregation, we analyzed risk of fatal and non-fatal assault in Massachusetts (1995-2010), since this outcome is strongly associated with residential segregation. ⋯ For fatal assaults, comparing the bottom vs. top quintiles, the incidence rate ratio (and 95% confidence interval (CI)) in models using the census tract measures equaled 3.96 (95% CI 3.10, 5.06) for the ICE for racialized economic segregation, 3.26 (95% CI 2.58, 4.14) for the ICE for income, 3.14 (95% CI 2.47, 3.99) for poverty, 2.90 (95% CI 2.21, 3.81) for the ICE for race/ethnicity, and only 0.93 (95% CI 0.79, 1.11) for the Index of Dissimilarity; in models that included both census tract and city/town ICE measures, this risk ratio for the ICE for racialized economic segregation was higher at the census tract (3.29; 95% CI 2.43, 4.46) vs. city/town level (1.61; 95% CI 1.12, 2.32). These results suggest that, at least in the case of fatal and non-fatal assaults, research on residential segregation should employ local measures, including of racialized economic segregation, to avoid underestimating the adverse impact of segregation on health.