Journal of Urban Health-Bulletin of the New York Academy of Medicine最新文献

{"title":"Neighborhood Socioeconomic Disadvantage and Frailty among Mid-to-Older-Aged Adults in Australia: Cross-Sectional and Longitudinal Associations.","authors":"Takumi Abe, Takemi Sugiyama, Alison Carver, Manoj Chandrabose, Gavin Turrell","doi":"10.1007/s11524-025-01018-2","DOIUrl":"https://doi.org/10.1007/s11524-025-01018-2","url":null,"abstract":"<p><p>This study examined the cross-sectional and longitudinal associations between neighborhood socioeconomic disadvantage and frailty in middle-to-older-aged adults. Data were obtained from a cohort study conducted in Brisbane, Australia, with 3966 participants (mean age 58.2 years; female 57.6%) included in cross-sectional analysis and 2846 in longitudinal analysis (3-year follow-up). A frailty index (FI), a composite score consisting of 32 items, was used continuously (range 0-1) and categorized into frail (FI > 0.35) and non-frail. Neighborhood disadvantage was measured using the Index of Relative Socioeconomic Disadvantage, an area-level composite index, and was categorized into tertiles. Two-level mixed-effects linear and logistic regression models were fitted, accounting for area-level clustering through random intercepts for areas and adjusting for demographic variables and individual-level socioeconomic status. In the cross-sectional analysis, 11% of participants were frail. Compared to residents of low disadvantage neighborhoods, those in middle and high disadvantage neighborhoods had higher levels of frailty and greater odds of being frail (OR = 1.54 [95% CI 1.13, 2.09] and OR = 2.86 [2.11, 3.88], respectively). In the longitudinal analysis, residing in middle and high disadvantage neighborhoods was significantly associated with increases in FI scores, relative to low disadvantage neighborhoods. Incident frailty was observed in 5% of participants at the follow-up. Residing in high disadvantage neighborhoods showed significantly higher odds of incident frailty (OR = 1.75 [1.08, 2.86]). Mid-to-older-aged residents of disadvantaged neighborhoods are more likely to be frail and to become frail over 3 years, compared to those in advantaged neighborhoods. Community-level interventions to reduce frailty should target disadvantage neighborhoods.</p>","PeriodicalId":49964,"journal":{"name":"Journal of Urban Health-Bulletin of the New York Academy of Medicine","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145330793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Housing Discrimination and Health of Public Housing Residents in Korea: An Examination of Gender Heterogeneity.","authors":"Haitao Du, Gum-Ryeong Park","doi":"10.1007/s11524-025-01009-3","DOIUrl":"https://doi.org/10.1007/s11524-025-01009-3","url":null,"abstract":"<p><p>While research has highlighted discrimination and its health impacts, whether and how housing-related discrimination is related to the health of public housing residents remains understudied. This paper places discrimination in the public housing context to disentangle the relationship between discrimination and health outcomes, and the moderating role of gender in such a link to fill knowledge gaps. Using an individual-level longitudinal dataset in Seoul, Korea, this paper employed individual fixed effects models and also included interaction terms to estimate how such associations differ by gender. First, about 7% of public housing residents experience housing discrimination. Second, individuals who experience housing-related discrimination report significantly higher levels of stress. Discrimination is linked to an increase in unhealthy behaviors, including smoking initiation and alcohol drinking. Also, the effect of discrimination on stress is significantly greater for women. In contrast, there are no significant gender differences in the effect of discrimination on smoking initiation or the frequency of alcohol consumption. This paper not only confirmed the negative effect of housing discrimination on stress and unhealthy behaviors but also gender differences in the negative association between housing discrimination and stress. The findings highlight the need for gender-sensitive interventions to address the health impacts of discriminatory housing experiences.</p>","PeriodicalId":49964,"journal":{"name":"Journal of Urban Health-Bulletin of the New York Academy of Medicine","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"U.S. Highway 71 and Social Determinants of Health: Long-Term Disparities in Earnings, Economic Mobility, Incarceration, and Teen Birth in Kansas City.","authors":"Byunggu Kang, Yi-Fang Lu","doi":"10.1007/s11524-025-01014-6","DOIUrl":"https://doi.org/10.1007/s11524-025-01014-6","url":null,"abstract":"<p><p>A growing body of research has revisited the social costs of U.S. interstate highways. In Kansas City, U.S. Highway 71 (Bruce R. Watkins Drive) was built through the city's East Side over nearly two decades, displacing residents, destroying community institutions, and raising safety and health concerns. Using Opportunity Atlas data, we compare long-term outcomes-income, economic mobility, incarceration, and teen birth-for the 1978-1983 cohorts by childhood residence: census tracts along the Highway 71 corridor versus other tracts in Kansas City. At age 35, those who grew up along the Highway 71 corridor had approximately 45% lower household incomes and 29% lower individual incomes than those from other parts of the city. They were more than twice as likely to be incarcerated and had substantially higher teenage birth rates. Disparities persisted in subgroup analyses of children from low-income families and remained statistically significant after adjusting for pre-existing neighborhood characteristics.</p>","PeriodicalId":49964,"journal":{"name":"Journal of Urban Health-Bulletin of the New York Academy of Medicine","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"What Good Is That?\"-Perspectives of Using Telehealth to Discuss Serious Illness with Urban-Dwelling Low-Income Older Adults in Assisted Living.","authors":"Kelseanne Breder, Christine Jacob, Daniel David","doi":"10.1007/s11524-025-01012-8","DOIUrl":"https://doi.org/10.1007/s11524-025-01012-8","url":null,"abstract":"<p><p>Telehealth offers an avenue for older adults to access providers, discuss care needs, and have serious illness conversations. However, telehealth is embraced by some and not by others. Urban-dwelling, low-income older adults have unique challenges in accessing continuous care, engaging with the healthcare system and receiving support to address serious illness care needs. To investigate telehealth acceptance in low-income older adults, we conducted individual semi-structured qualitative interviews with 46 residents of three Medicaid-funded assisted living facilities (MALFs) which provide social, functional, and clinical support to underserved populations. Interview transcripts were analyzed using conventional content analysis. Four qualitative themes describing telehealth acceptance in low-income assistant living communities were identified. Benefit: Telehealth offers convenience-participants highlighted how telehealth facilitates access to healthcare appointments, making it easier to receive care. Barrier: Technology fluency and access is not universal-many described physical and technological barriers that limit their ability to use telehealth effectively. Preference: general distaste for telehealth-this theme captures participants' overall attitudes and gut reactions to telehealth, ranging from enthusiasm to skepticism. Concern: mistrust in clinical connection-patients expressed concerns about trust, security, and the ability to build meaningful connections with providers through telehealth. While telehealth can make care more convenient, telehealth encounters may hinder trust in the therapeutic relationship between urban-dwelling low-income older adults and providers. For telehealth conversations discussing serious illness, additional efforts are needed to support engagement, foster trust, and provide patient-centered care in populations that have been historically marginalized.</p>","PeriodicalId":49964,"journal":{"name":"Journal of Urban Health-Bulletin of the New York Academy of Medicine","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare and Social Needs of Older Adults in Underserved Urban Communities: Insights from Community Health Workers.","authors":"Arkers Kwan Ching Wong, Tianyi Liu, Luna Ziqi Liu, Jonathan Bayuo, Xingjuan Tao, Frances Kam Yuet Wong","doi":"10.1007/s11524-025-01011-9","DOIUrl":"https://doi.org/10.1007/s11524-025-01011-9","url":null,"abstract":"<p><p>As populations age globally, ensuring equitable healthcare access and social support for older adults in underserved urban areas has become increasingly critical. Elderly residents in low-income districts face challenges, including poor living conditions, social isolation, and healthcare access barriers. Community health workers (CHWs) are vital in bridging these gaps, yet their effectiveness is often Limited by resources and training. This qualitative study explores the healthcare and social needs of elderly residents receiving community services, identifies gaps in support systems, and examines the challenges faced by CHWs in delivering care in an underserved urban district. The study took place in Sham Shui Po, a district in Hong Kong with a high concentration of economically disadvantaged elderly residents. Data were collected through 17 semi-structured interviews with older residents and non-governmental organization (NGO) staff, alongside three focus group discussions with CHWs, and were analyzed using thematic analysis. The results showed that senior residents faced poor living conditions, chronic illnesses, and mobility issues, exacerbated by financial constraints and limited healthcare access. Long wait times, transportation challenges, and language barriers hindered medical service use. Many struggled with digital healthcare tools, limiting their ability to manage health independently. CHWs provided vital support but encountered physical strain, inadequate training, and logistical difficulties, highlighting the need for structured training and better resources. Addressing elderly care challenges requires integrated healthcare models, expanded financial and digital literacy programs, and enhanced CHW training and support. Strengthening these areas can improve health outcomes and well-being for aging populations in low-income urban settings.</p>","PeriodicalId":49964,"journal":{"name":"Journal of Urban Health-Bulletin of the New York Academy of Medicine","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: The Association of Exposure to Urban Greenspace and Depression in Women.","authors":"Esmat Taheri, Arian Faramarziniya, Razieh Khosrorad, Moslem Lari Najafi, Hamid Joveini, Mohammad Khamirchi, Hafez Heydari, Leila Haghighi Kaffash, Alireza Ghorbani, Fatemeh Niko, Faeze Sadat Shobeyri, Mohsen Yazdani Aval, Mohamad Sedigh Mirzaie, Mohammad Miri","doi":"10.1007/s11524-025-00994-9","DOIUrl":"10.1007/s11524-025-00994-9","url":null,"abstract":"","PeriodicalId":49964,"journal":{"name":"Journal of Urban Health-Bulletin of the New York Academy of Medicine","volume":" ","pages":"952"},"PeriodicalIF":4.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12484480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144734973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender Differences in Social Determinants of Hypertension Among Older Brazilian Adults Residing in Urban Areas: A Multilevel Approach from the ELSI-Urbe.","authors":"Débora Moraes Coelho, Amanda Cristina de Souza Andrade, Bruno de Souza Moreira, Luciana de Souza Braga, Maria Fernanda Lima-Costa, Waleska Teixeira Caiaffa","doi":"10.1007/s11524-025-00998-5","DOIUrl":"10.1007/s11524-025-00998-5","url":null,"abstract":"<p><p>Despite growing interest in the social determinants of hypertension, nationally representative studies examining intra-urban effects of individual and contextual socioeconomic conditions within unequal urban areas, such as those in Latin America, remain scarce. This study describes gender disparities in the association of individual and contextual socioeconomic conditions with hypertension among older adults residing in urban areas of Brazil. We analyzed data from 6,767 participants from the baseline (2015-2016) of the Brazilian Longitudinal Study of Aging (ELSI-Brazil), a nationally representative cohort of community-dwelling adults aged ≥ 50years. Analyses were conducted as part of the ELSI-Urbe project, which integrates individual-level ELSI-Brazil data with contextual urban information. Hypertension was self-reported. The measure of socioeconomic condition was education, and the contextual measure was the Brazilian Deprivation Index (IBP; acronym in Portuguese) of the census tract of the participant's residence. Multilevel logistic regression models (individuals and census tracts), adjusted for age and stratified by gender, were used. The prevalence of hypertension by education and the IBP differed between men and women. In women, higher education (≥9 years versus ≤4 years of schooling) was associated with a lower chance of hypertension (odds ratio [OR] = 0.62; 95% confidence interval [CI] = 0.52-0.74), and residing in census tracts with higher deprivation was associated with a higher chance of hypertension (OR per standard deviation [SD] = 1.04; 95%CI = 1.01-1.09). In men, there was no significant association between education or IBP and hypertension. Our findings suggest that public policies in middle- and low-income countries, such as Brazil, should be gender-sensitive context-specific to effectively address the burden of this disease.</p>","PeriodicalId":49964,"journal":{"name":"Journal of Urban Health-Bulletin of the New York Academy of Medicine","volume":" ","pages":"905-916"},"PeriodicalIF":4.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12484455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Cumulative Burden of Housing Insecurity among Children in the USA from Birth to Adolescence.","authors":"Audrey Renson, Matthew Z Fowle, Sarah Pachman, Giselle Routhier","doi":"10.1007/s11524-025-01005-7","DOIUrl":"10.1007/s11524-025-01005-7","url":null,"abstract":"<p><p>Housing insecurity is a key social determinant of a wide range of health outcomes, subject to large racial inequities, and with a likely sensitive period in childhood. Housing insecurity can manifest in multiple ways and change over time, but previous studies have primarily focused on single dimensions or a single time point. This study examines cumulative exposure to multiple forms of housing insecurity from birth to adolescence, overall, and by race in large US cities. Using data from the Future of Families and Child Wellbeing Study (FFCWS), we estimated cumulative incidence and mean cumulative count of several forms of housing insecurity, accounting for missing data (due primarily to gaps between waves) using lower bounds and a mixed modeling approach. Between 45% (lower bound) and 71% (modeled) of children experienced at least one housing insecurity event by age 15. The average number of events among children who had any event was between 2.63 (lower bound) and 6.11 (modeled). Children of non-Hispanic Black and Hispanic mothers, compared to non-Hispanic White mothers, were more likely to experience an initial event, but once experienced, had similar numbers of events. We find a massive and cyclical burden of housing insecurity during childhood. Large racial differences in incidence of first events, but not repeated events, suggest that preventive interventions would most effectively mitigate racial inequities in housing insecurity.</p>","PeriodicalId":49964,"journal":{"name":"Journal of Urban Health-Bulletin of the New York Academy of Medicine","volume":" ","pages":"930-939"},"PeriodicalIF":4.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12484506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Urban Green on Population Health in Sub-Saharan Africa: A Scoping Review.","authors":"Ebenezer Oduro Antiri, Hilary Konadu Awuah, Promise Salu, John Adoripore, Anthony Edward Boakye, Edward Wilson Ansah","doi":"10.1007/s11524-025-00995-8","DOIUrl":"10.1007/s11524-025-00995-8","url":null,"abstract":"<p><p>Sub-Saharan Africa's (SSA) rapid urbanization and climate change have resulted in habitat loss, deforestation, and reduction in urban green spaces. Urban greenness is vital for biodiversity, public health, and climate resilience. Urban green spaces have several health advantages, including lowering urban heat stress and enhancing mental and physical well-being of the population. However, little is known about the accessibility, use, and effects of urban greenness on population health in the region. This scoping review maps the evidence on urban green space availability, utilization, and population health impacts in SSA. The review also identifies the barriers and facilitators that strengthen and contribute to sustainability and urban health. In accordance with the JBI scoping review framework and PRISMA-ScR criteria, this study screened 10,683 records from major databases, grey literature, and reference checks. Initial title and abstract screening produced 118 records for full-text screening, from which 72 records were incorporated into the final analysis, which mapped the evidence using thematic analysis and narrative synthesis. It was found that urban green spaces in SSA are characterized by significant disparities in availability and accessibility, with such areas frequently falling short of international standards. Poor maintenance, corruption, safety issues, and socioeconomic disparities are factors that limit urban green space utilization, while proximity facilitates usage. Stress reduction, increased physical activity, and lower risk of non-communicable diseases, including obesity and hypertension, are identified benefits of the usage of urban green spaces. However, lack of green spaces and neglect of these spaces increase the risk of respiratory problems and vector-borne diseases. Strategic investments in urban green spaces, policy reforms, and community-led greening initiatives are required to improve access and utilization, especially in green-depleted areas. Future research needs to concentrate on experimental and longitudinal methods to demonstrate causal links between urban green space and health outcomes, enhancing sustainable urban planning and health equity in SSA to achieve Sustainable Development Goals 3 and 13.</p>","PeriodicalId":49964,"journal":{"name":"Journal of Urban Health-Bulletin of the New York Academy of Medicine","volume":" ","pages":"830-847"},"PeriodicalIF":4.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12484461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergency Hospital Admissions for Cardiovascular Causes Attributable to Air Pollution and Extreme Temperatures in Spain: Influence of Economic and Demographic Factors in a Nationwide Study.","authors":"J A López-Bueno, J Díaz, M Iriso, R Ruiz-Páez, M A Navas-Martín, C Linares","doi":"10.1007/s11524-025-01006-6","DOIUrl":"10.1007/s11524-025-01006-6","url":null,"abstract":"<p><p>Using generalised linear models (GLMs) with a Poisson link, this study analysed the short-term effect of NO₂, ozone, PM₁₀ and PM_2.5 on the daily number of emergency hospital admissions due to cardiovascular disease (CVD), acute cerebrovascular disease, acute myocardial infarction (AMI) and ischaemic heart disease (IHD). The impact of the minimum daily temperature in cold waves and maximum daily temperature in heat waves was likewise analysed. Specific dose-response functions were calculated for each province and cause of admission considered. We used random effects mixed models to analyse the relationship between the percentage of admissions in each province and the following provincial variables: income level; number of inhabitants; population percentage aged 65 years and over and percentage of women. Our results indicated that in Spain there were 10,167 (95%CI: 3.679, 16.554) emergency CVD-related annual admissions attributable to the variables considered, which accounted for 7.7% of total annual CVD-related admissions in Spain and broke down as follows: 6.9% attributable to air pollution in general, and NO₂ and O₃ in particular, and 0.8% attributable to extreme temperatures, especially during cold waves. A similar pattern could be observed for the specific causes. With respect to the percentage of CVD-related admissions attributable to air pollution, higher income level was a protective element and age over 65 years was a risk factor for the percentage of the population concerned. Air pollution is a risk factor for short-term emergency hospital admissions due to CVD in Spain, with the effect NO₂ and O₃ being especially noteworthy, in terms of all CVD-related causes and the specific causes considered. The impact of extreme temperatures is of a lower order of magnitude than that of air pollution, and the effect of the maximum daily temperature in heat waves on CVD is extremely small.</p>","PeriodicalId":49964,"journal":{"name":"Journal of Urban Health-Bulletin of the New York Academy of Medicine","volume":" ","pages":"813-829"},"PeriodicalIF":4.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12484484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144975915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}