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

{"title":"Do Rental Assistance Programs Relieve Overcrowding for Children?","authors":"Frank Zhu, Andrew Fenelon, Penelope Schlesinger, Danya E Keene","doi":"10.1007/s11524-025-00979-8","DOIUrl":"10.1007/s11524-025-00979-8","url":null,"abstract":"<p><p>Crowded living conditions are associated with negative health outcomes, particularly for children. Federal rental assistance may reduce household crowding by improving access to affordable housing for low-income families. We leveraged NHANES data linked with HUD administrative rental assistance records to examine relationships between different forms of HUD rental assistance and multiple measures of crowding for households with children. We found a statistically significant reduction in the odds of crowding for those currently receiving HUD assistance compared to a control group who entered rental assistance within 2 years of their NHANES interview (95% CI, 0.39 to 0.93). The specific relationships between rental assistance and crowding and the magnitude of these associations varied by rental assistance type (public housing, multi-family, and vouchers). Fewer than 1 in 4 eligible households receive rental assistance. Our findings suggest that expanding access to this resource can reduce household crowding and its adverse impacts on health and well-being.</p>","PeriodicalId":49964,"journal":{"name":"Journal of Urban Health-Bulletin of the New York Academy of Medicine","volume":" ","pages":"511-519"},"PeriodicalIF":4.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12279653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081774","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":"Correction: Spatiotemporal Analysis of Fentanyl-Associated Overdose Deaths in Chicago, IL, USA.","authors":"Hyojung Kang, Kaylee Janakos, Csaba Varga","doi":"10.1007/s11524-025-00993-w","DOIUrl":"10.1007/s11524-025-00993-w","url":null,"abstract":"","PeriodicalId":49964,"journal":{"name":"Journal of Urban Health-Bulletin of the New York Academy of Medicine","volume":" ","pages":"640"},"PeriodicalIF":4.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12279655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530757","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 Price of Denial: Examining the Health Consequences of Mortgage Lending Bias in Michigan Metro Areas.","authors":"Jamison Koeman, Wenchu Pan, Alexa Eisenberg, Lu Wang, Roshanak Mehdipanah","doi":"10.1007/s11524-025-00985-w","DOIUrl":"10.1007/s11524-025-00985-w","url":null,"abstract":"<p><p>Anti-Black mortgage lending discrimination (MLD) has resulted in homeownership disparities among White and Black households. This study examines the association between MLD and health opportunities, based on various neighborhood determinants of health (e.g., employment, education, and housing status), in Michigan's three largest metropolitan areas. Multilevel models using data from the Home Mortgage Disclosure Act and Census from 2015 to 2019 were used to examine the Black-White odds ratio of mortgage denial. An association analysis was performed to examine the relationship between the Black-White odds ratio of mortgage denial and neighborhood health opportunities. Loan denial for Black mortgage applicants was 1.99 (95% CI1.87, 2.12) times more likely than for White applicants. Neighborhoods with greater anti-Black MLD had fewer harmful environmental exposures, greater health insurance coverage, and better housing and socio-economic conditions. Anti-Black MLD remains a common practice and supports the assertion that Black home-seekers experience greater MLD in neighborhoods with better opportunities for health compared to White home-seekers, who access these benefits more freely. Greater protections against MLD-including increasing oversight of the data reporting requirements and improving mortgage access for Black households-are needed to promote health equity.</p>","PeriodicalId":49964,"journal":{"name":"Journal of Urban Health-Bulletin of the New York Academy of Medicine","volume":" ","pages":"483-494"},"PeriodicalIF":4.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12279676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276473","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":"County-Level COVID-19 Policy Comprehensiveness and Adult Behavioral Health during 2021 : County-Level COVID-19 Policy and Adult Behavioral Health.","authors":"Emily Wright, Emily C Dore, Kaitlyn E Jackson, Guangyi Wang, Mark J Pletcher, Thomas W Carton, Rita Hamad","doi":"10.1007/s11524-025-00982-z","DOIUrl":"10.1007/s11524-025-00982-z","url":null,"abstract":"<p><p>Epidemiologic research has found worsening behavioral health in the USA since 2020. Local policies may have contributed to these patterns and associated disparities. However, scant research has systematically documented county-level COVID-19-era policymaking or empirically investigated its health impacts. To investigate this question, we linked the US COVID-19 County Policy Database-a novel database with weekly data from 2020 to 2021 on 26 policies for 309 primarily urban counties-to data on adult behavioral health from the cross-sectional 2021 National Survey on Drug Use and Health (N = 25,600). We created measures of policy comprehensiveness by aggregating individual policies into an overall score, and into three domains: containment/closure, economic response, and public health. Outcomes included any past-30-day use and frequency of use of multiple substances (alcohol, binge alcohol, cigarettes, marijuana, non-marijuana illicit drug use, and vaping) and past-30-day psychological distress. Models adjusted for individual covariates, county fixed effects, and time-varying county-level COVID-19 covariates. We found that increases in overall policy comprehensiveness-and comprehensiveness in each of three domains-over time were not associated with the behavioral health outcomes assessed. Meanwhile, stratified models found some variability in associations across sex, racial/ethnic, education, and urban subgroups. This study established the feasibility, utility, and potential challenges of linking newly available COVID-19-related county policy data with health data to examine county-level policy influences on behavioral health. Further research is needed to inform responses to current behavioral health needs and future public health emergencies.</p>","PeriodicalId":49964,"journal":{"name":"Journal of Urban Health-Bulletin of the New York Academy of Medicine","volume":" ","pages":"713-725"},"PeriodicalIF":4.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12279665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024353","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":"Pharmacy Homeless Outreach Engagement Non-medical Independent Prescribing Rx (PHOENIx) Community Pharmacy-Based Pilot Randomized Controlled Trial.","authors":"Richard Lowrie, Vibhu Paudyal, Andrew McPherson, Helena Heath, Jane Moir, Natalie Allen, Nigel Barnes, Hugh Hill, Adnan Araf, Cian Lombard, Steven Ross, Sarah Tearne, Parbir Jagpal, Versha Cheed, Lee Middleton, Shabana Akhtar, George Provan, Jennifer Hislop, Andrea Williamson, Frances S Mair","doi":"10.1007/s11524-025-00981-0","DOIUrl":"10.1007/s11524-025-00981-0","url":null,"abstract":"<p><p>Randomized controlled trials (RCTs) aiming to address the multiple health and social challenges of people experiencing homelessness (PEH) are lacking. Here we report the findings from a multicenter, open, pilot RCT. The intervention involved independent prescriber pharmacist from the National Health Service working on outreach in partnership with dedicated workers from Homeless Voluntary Charity or Social Enterprises (HVCSEs) (Pharmacist and third sector charity worker integrated Homeless Outreach Engagement Non-medical Independent prescriber Rx'-PHOENIx) in low threshold HVCSE venues or temporary accommodation addressing PEH participants' health and wider needs through repeated outreach. The trial aimed to investigate whether sufficient numbers of participants could be recruited, retained, the intervention delivered as planned, and sufficient data collected to inform a subsequent definitive RCT. Clinical outcomes were also collected at follow-up (6 months). Participants were recruited from five community pharmacies and nearby venues in urban centers of Glasgow-Scotland and Birmingham-England, then randomized one-to-one into PHOENIx intervention in addition to usual care (UC) or UC only. A priori progression criteria were achieved: 55% of those assessed as eligible were recruited; at 6 months, 72% remained in the study, 91% had emergency department and mortality data available, and 72% completed questionnaire booklets. Fifty-three percent of participants received at least 50% of the planned PHOENIx intervention consultations (in-person or phone) at 6 months. Signs of improvement in clinical outcomes in the PHOENIx group included fewer ambulance call-outs, ED visits, and hospitalizations; higher outpatient attendances; and higher scores on self-reported health-related quality of life. A definitive RCT is merited.</p>","PeriodicalId":49964,"journal":{"name":"Journal of Urban Health-Bulletin of the New York Academy of Medicine","volume":" ","pages":"540-563"},"PeriodicalIF":4.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12279658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259253","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":"Association Between Recent Criminal Legal Involvement and Functional Status Among US Adults with Diabetes: 2015-2019.","authors":"Laura C Hawks, Rebekah J Walker, Leonard E Egede","doi":"10.1007/s11524-024-00894-4","DOIUrl":"10.1007/s11524-024-00894-4","url":null,"abstract":"<p><p>Diabetes is a significant public health concern with significant implications for health equity. Functional disability undermines disease control and may be associated with the relationship between criminal legal involvement and poor chronic disease outcomes, but this relationship has not been studied. This study examined the association between recent criminal legal involvement and functional disability among a nationally representative sample of US adults with diabetes. Adult respondents to the National Survey of Drug Use and Health (2015-2019) who reported a diagnosis of diabetes were included in this analysis examining the association between three forms of recent criminal legal involvement (past year arrest, or supervision on probation or parole) and functional disability, as measured by the World Health Organization Disability Assessment Score 2.0. In multivariate linear regression analyses adjusted for relevant socio-demographic and clinical confounders, the functional disability score increased by 2.7 (95% CI, 1.6-3.9) for those with past year arrest compared to no past year arrest; 1.2 (95% CI, -0.1, 2.6) for those with past year probation compared to no past year probation; and 0.4 (95% CI, -1.1, 1.8) for those with past year parole compared to no past year parole. Recent criminal legal involvement, specifically past year arrest, is associated with greater functional disability, which may serve as an important mediator for poor health outcomes in patients with diabetes. Future research should examine this pathway and prioritize interventions to improve both functional disability and glycemic control among individuals with diabetes and recent criminal legal involvement.</p>","PeriodicalId":49964,"journal":{"name":"Journal of Urban Health-Bulletin of the New York Academy of Medicine","volume":" ","pages":"379-388"},"PeriodicalIF":4.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12032083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523515","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":"Neighborhood Factors as Correlates of Alcohol Use in the N2 Cohort Study of Black Sexually Minoritized Men and Transgender Women.","authors":"Tyrone Moline, Dustin T Duncan, Justin Knox, Seann Regan, Christina A Mehranbod, Cho-Hee Shrader, John A Schneider, Byoungjun Kim","doi":"10.1007/s11524-024-00942-z","DOIUrl":"10.1007/s11524-024-00942-z","url":null,"abstract":"<p><p>Sexually minoritized men (SMM), transgender women (TW), and particularly Black SMM and Black TW may be disproportionately impacted by alcohol-related problems. Few studies have empirically examined neighborhood factors that may contribute to alcohol use, specifically among these populations. Using data from the N2 longitudinal cohort study in Chicago, IL, survey data from the second wave of longitudinal assessment (n = 126) and GPS mobility data from enrollment were used to evaluate neighborhood alcohol outlet availability, neighborhood disorder, and neighborhood poverty as correlates of individual alcohol use. Neighborhood exposures were measured using 200-m-derived activity space areas, created from GPS data, using publicly accessible geospatial contextual data. Separate multivariable quasi-poison regression models tested for association between neighborhood alcohol outlet density (AOD), measured separately for on-premise (e.g., bars) and off-premise consumption outlets (e.g., liquor stores), neighborhood poverty (defined as the percentage of neighborhood areas at 150% or greater of the US poverty line), exposure to vacant buildings, and neighborhood violent crime density. Separate analytical models found no significant effect between alcohol use and exposure to on-premise consumption venue AOD (risk ratio (RR) = 0.99, p = 0.57), off-premise consumption AOD (RR = 0.94, p = 0.56), neighborhood poverty (RR = 1.04, p = 0.07), or neighborhood violent crime (RR = 1.00, p = 0.94). Exposure to higher levels of vacant buildings (RR = 1.03, p = 0.04) was found to be significantly associated with increased alcohol use. Among this population, opposed to geospatial access, neighborhood measurements indicative of disorder may have a greater influence on shaping alcohol use.</p>","PeriodicalId":49964,"journal":{"name":"Journal of Urban Health-Bulletin of the New York Academy of Medicine","volume":" ","pages":"400-412"},"PeriodicalIF":4.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12031704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865802","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 Different Greenspace Metrics on Cardiovascular Disease Incidence in Urban Settings: A Comparative Analysis.","authors":"Ruoyu Dong, Hong Yuan, Gang Xu, Yuchen Li, Yanqing Xu, Cong Fu","doi":"10.1007/s11524-025-00971-2","DOIUrl":"10.1007/s11524-025-00971-2","url":null,"abstract":"<p><p>Cardiovascular diseases (CVDs) are the leading cause of global mortality, and urban greenspace can reduce CVDs risk. However, the evidence relating various greenspace metrics to CVDs risk is inconclusive. To enhance the understanding of the correlation between greenspace and CVDs, we compared three greenspace indicators-street view-based greenspace (SVG), normalized difference vegetation index (NDVI), and green cover rate (GCR). We used a large sample of 36,504 CVDs hospitalization records with precise residential addresses from 2017 to 2022 in Jingzhou, China. Employing the geographically weighted regression (GWR) model, we investigated the association between greenspace and CVDs incidence at the population level. We found significant negative associations between NDVI/SVG and CVDs incidence (SVG: β = - 1.64; 95% CI, [- 2.12, - 1.15]; NDVI: β = - 8.57; 95% CI, [- 9.81, - 7.33]), with NDVI exhibiting a more substantial protective effect. However, no significant relationship was found in GCR (p = 0.161). The impacts varied by age, but not by gender, with younger individuals benefiting more than the elderly, and SVG showed no significant relationship with CVDs incidence in individuals over 65 years. Our findings suggested the importance of the presence of greenspace in CVDs prevention. Consequently, in urban greenspace planning, priority should be given to the vegetation quantity in residential areas over the size of greenspace facilities located distant from residences.</p>","PeriodicalId":49964,"journal":{"name":"Journal of Urban Health-Bulletin of the New York Academy of Medicine","volume":" ","pages":"274-289"},"PeriodicalIF":4.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12031710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631010","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":"Barriers to Buprenorphine Treatment Among People Experiencing Homelessness: A Qualitative Study from the Provider Perspective.","authors":"Carmen L Masson, Kelly R Knight, Emily A Levine, Joseph A Spillane, Ya Chi Angelina Liang, Leslie W Suen, Maggie M Chen, Barry Zevin, Robert P Schwartz, Phillip O Coffin, James L Sorensen","doi":"10.1007/s11524-025-00967-y","DOIUrl":"10.1007/s11524-025-00967-y","url":null,"abstract":"<p><p>People experiencing homelessness (PEH) face a high risk of opioid-related deaths, yet there is limited qualitative data on the barriers encountered when accessing buprenorphine treatment for opioid use disorder (OUD). To address this gap, we interviewed 28 clinicians, outreach workers, and administrators from organizations serving PEH with OUD. Our goal was to understand the barriers and facilitators at the patient, clinic, and institutional levels and gather recommendations for improvement. Interviews, conducted via Zoom and analyzed through thematic analysis, revealed several barriers. At the patient level, themes related to barriers included knowledge and experience (e.g., limited knowledge about buprenorphine options; rejection of buprenorphine due to prior experience with precipitated withdrawal); concerns about the medication and its administration (e.g., distrust of injectable medications; concerns about treatment control, and a prolonged informed consent process for extended-release injectable buprenorphine); and challenges due to homelessness (e.g., identification requirement to access medication at pharmacies, difficulties managing buprenorphine while unsheltered). At the clinic level, themes centered around staffing (e.g., lack of training and experience in treating PEH and staffing shortages) and health care-related stigma (e.g., discriminatory attitudes toward PEH with OUD). Institutional-level themes included state-regulatory factors (e.g., practice regulations limiting clinical pharmacists' ability to prescribe buprenorphine) and access factors (e.g., stigmatization of buprenorphine prescribing, limited low-barrier buprenorphine access, and care system complexity). Recommendations included educational programs for patients and clinicians to increase understanding and reduce stigma, integrating buprenorphine treatment into non-traditional settings, and providing housing with treatment.</p>","PeriodicalId":49964,"journal":{"name":"Journal of Urban Health-Bulletin of the New York Academy of Medicine","volume":" ","pages":"465-475"},"PeriodicalIF":4.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12031702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732759","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":"A Home Disaster Preparedness Intervention Study with Korean American Residents in New York City.","authors":"Tara Heagele, JungMoon Hyun, So-Hyun Park, William Ellery Samuels, Jin Young Seo","doi":"10.1007/s11524-025-00974-z","DOIUrl":"10.1007/s11524-025-00974-z","url":null,"abstract":"<p><p>This study investigated the effectiveness of the Nurses Taking on Readiness Measures (N-TORM) intervention in improving disaster preparedness of Asian immigrant residents in New York City. N-TORM is an innovative, nurse-led, household disaster preparedness educational intervention provided to community members to help them create their disaster-related evacuation and communication plans, build disaster supply kits, and understand community resources available to assist residents before, during, and after disasters. The aims of this controlled before-after intervention study were to (a) pilot test the Korean translation of the Household Emergency Preparedness Instrument (K-HEPI), (b) evaluate the effectiveness of N-TORM to increase household disaster preparedness knowledge and behavior, and (c) describe the factors most necessary to maintain and expand N-TORM. Participants in the experimental group (N = 200) demonstrated significantly greater pre-to-post improvement in disaster preparedness compared to those in the control group (N = 199), as measured by the K-HEPI (effect on total General Preparedness scores, β = 1.66, SE = 0.105, p < .001). The Korean community organization that was involved in this study continues to offer N-TORM to its members, demonstrating the intervention's sustainability. Further testing of the K-HEPI and the intervention in longitudinal studies is recommended to explore potential associations between disaster preparedness and outcomes such as survival without rescue, prevention of injury, or acute exacerbations of chronic illnesses. Replicating the intervention across different immigrant populations is essential, and data from these studies can inform policy development to better address the needs of immigrant communities before, during, and after disasters. ClinicalTrials.gov Identifier: NCT0554478. Hunter College of City University of New York Protocol Record 2022-0542-Hunter, Korean Translation and Validation of the K-HEPI by a Phase 1 Feasibility Study in NYC, is registered and posted on the ClinicalTrials.gov website.</p>","PeriodicalId":49964,"journal":{"name":"Journal of Urban Health-Bulletin of the New York Academy of Medicine","volume":" ","pages":"332-343"},"PeriodicalIF":4.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12031703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755482","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}