Journal of urban health : bulletin of the New York Academy of Medicine
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Review
Urban Environments, Health, and Environmental Sustainability: Findings From the SALURBAL Study.
Despite the relevance of cities and city policies for health, there has been limited examination of large numbers of cities aimed at characterizing urban health determinants and identifying effective policies. The relatively few comparative studies that exist include few cities in lower and middle income countries. The Salud Urbana en America Latina study (SALURBAL) was launched in 2017 to address this gap. ⋯ Beyond these aims SALURBAL, has an overarching goal of supporting collaborative policy relevant research and capacity -building that engages individuals and institutions from across Latin America. In this review we provide an update on the SALURBAL data resource and collaborative approach and summarize key findings from the first aim of the study. We also describe key elements of our approach, challenges we have faced and how we have overcome them, and identify key opportunities to support policy relevant evidence generation in urban health for the future.
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Studies investigating the potential health effects of floor of residence have reported conflicting results. In the Rotterdam Study, we examined associations between floor and mortality among elderly residents of a neighborhood of Rotterdam, the Netherlands. ⋯ Compared to floors 13 and above, adjusted hazard ratios [95% confidence interval] were: 1.31 [0.89-1.95] (floors 1-2), 1.52 [1.04-2.22] (floors 3-4), 1.07 [0.73-1.57] (floors 5-6), 1.12 [0.76-1.66] (floors 7-8), 1.45 [0.96-2.18] (floors 9-10), and 1.04 [0.69-1.58] (floors 11-12). In this prospective population-based cohort of elderly adults in Rotterdam, the Netherlands, a nonlinear association was observed between floor level of residence and mortality, with stronger associations observed at lower floors compared to the highest floors.
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A growing number of studies have associated walkability and greenspace exposure with greater physical activity (PA) in women during pregnancy. However, most studies have focused on examining women's residential environments and neglected exposure in locations outside the home neighborhood. Using 350 person-days (N = 55 participants) of smartphone global positioning system (GPS) location and accelerometer data collected during the first and third trimesters and 4-6 months postpartum from 55 Hispanic pregnant women from the Maternal and Developmental Risks from Environmental and Social Stressors (MADRES) study, we examined the day-level effect of women's exposure to walkability and greenspace on their PA outcomes during pregnancy and in the early postpartum period. ⋯ Results showed that women engaged in 23% more MVPA minutes on days when they had some versus no exposure to parks and open spaces in activity spaces (b = 1.23; 95%CI: 1.02-1.48). In addition, protective effects of daily greenspace and walkability exposure on MVPA were stronger in the first and third trimesters, among first-time mothers, and among women who had high pre-pregnancy body mass index (BMI) and lived in least-safe neighborhoods. Our results suggest that daily greenspace and walkability exposure are important for women's PA and associated health outcomes during pregnancy and early postpartum.
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Evidence has documented the effects of place on perinatal outcomes, but less is known about the sociopolitical mechanisms, such as gentrification, that shape neighborhood context and produce spatialized inequities in adverse birth outcomes. Leveraging a diverse sample in California, we assessed the associations between gentrification and birth outcomes: preterm birth, small-for-gestational-age, and low birth weight. Gentrification was measured using the Freeman method and the Displacement and Gentrification Typology. ⋯ While Displacement and Gentrification Typology-measured gentrification was consistently associated with greater odds of adverse outcomes, Freeman-measured gentrification was associated with slightly lower odds of small-for-gestational-age and low birth weight. Furthermore, gentrification was associated with birth outcome odds across multiple racial and ethnic groups, but the directions and magnitudes of the associations varied depending on the gentrification assessment methodology and the outcome assessed. Results demonstrate that gentrification plays a role in shaping adverse birth outcomes in California.
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Mortgage discrimination alters the distribution of investment, opportunity, and economic advantage-key contributors of health disparities. Leveraging Home Mortgage Disclosure Act data, we assessed mortgage denial risk in 380 U. ⋯ This approach borrows information through spatial and non-spatial smoothing, resulting in stable estimates in the presence of sparse data. The method, publicly accessible, allows researchers to apply our approach, fostering deeper insights into mortgage lending discrimination and systematic neighborhood disinvestment.