As gentrification continues in New York City as well as other urban areas, residents of lower socioeconomic status maybe at higher risk for residential displacement. Yet, there have been few ...quantitative assessments of the health impacts of displacement. The objective of this paper is to assess the association between displacement and healthcare access and mental health among the original residents of gentrifying neighborhoods in New York City.
We used 2 data sources: 1) 2005-2014 American Community Surveys to identify gentrifying neighborhoods in New York City, and 2) 2006-2014 Statewide Planning and Research Cooperative System. Our cohort included 12,882 residents of gentrifying neighborhoods in 2006 who had records of emergency department visits or hospitalization at least once every 2 years in 2006-2014. Rates of emergency department visits and hospitalizations post-baseline were compared between residents who were displaced and those who remained.
During 2006-2014, 23% were displaced. Compared with those who remained, displaced residents were more likely to make emergency department visits and experience hospitalizations, mainly due to mental health (Rate Ratio = 1.8, 95% confidence interval = 1.5, 2.2), after controlling for baseline demographics, health status, healthcare utilization, residential movement, and the neighborhood of residence in 2006.
These findings suggest negative impacts of displacement on healthcare access and mental health, particularly among adults living in urban areas and with a history of frequent emergency department visits or hospitalizations.
Because it is difficult to objectively measure population-level physical activity levels, self-reported measures have been used as a surveillance tool. However, little is known about their validity ...in populations living in dense urban areas. We aimed to assess the validity of self-reported physical activity data against accelerometer-based measurements among adults living in New York City and to apply a practical tool to adjust for measurement error in complex sample data using a regression calibration method. We used 2 components of data: 1) dual-frame random digit dialing telephone survey data from 3,806 adults in 2010-2011 and 2) accelerometer data from a subsample of 679 survey participants. Self-reported physical activity levels were measured using a version of the Global Physical Activity Questionnaire, whereas data on weekly moderate-equivalent minutes of activity were collected using accelerometers. Two self-reported health measures (obesity and diabetes) were included as outcomes. Participants with higher accelerometer values were more likely to underreport the actual levels. (Accelerometer values were considered to be the reference values.) After correcting for measurement errors, we found that associations between outcomes and physical activity levels were substantially deattenuated. Despite difficulties in accurately monitoring physical activity levels in dense urban areas using self-reported data, our findings show the importance of performing a well-designed validation study because it allows for understanding and correcting measurement errors.
For a sustainable human presence on the Moon, it is critical to develop technologies that could utilise the locally available resources (a.k.a. in situ resource utilisation or ISRU) for habitat ...construction. As the surface soil is one of the most widely available resources at the Moon, we have investigated the viability of microwave heating of a lunar soil simulant (JSC-1A). JSC-1A was thermally treated in a bespoke microwave apparatus using 2.45 GHz frequency, using five different microwave powers in the range of 250 W to 1000 W. The structural properties of the resulting products were analysed to determine whether their microstructures and mechanical strengths differ under different input powers; and whether input power plays a crucial role in triggering thermal runaway, for identifying the optimum power for developing a microwave-heating. Our key findings are: (i) the higher input powers (800 W and 1000 W) generate the highest yields and microstructures with the greatest mechanical strengths, at the shortest fabrication times, and (ii) thermal runaway improves the microwave heating efficiency despite the rapid increase in temperature, once it is triggered. Our findings are of key importance for developing a microwave-heating payload for future lunar ISRU demonstration missions, contributing towards 3D printing-based extra-terrestrial construction processes.
To achieve a sustainable human presence on the Moon, it is critical to develop technologies utilising the local resources (a.k.a. in-situ resource utilisation or ISRU) for construction and resource ...extraction. In this study, we investigate the viability of microwave heating of two lunar soil simulants (JSC-1A and OPRH3N) under vacuum conditions, to simulate a lunar surface environment compared to previous studies performed at atmospheric pressure. All simulants are thermally treated in a bespoke 2.45 GHz microwave apparatus using three input powers: 1000 W, 600 W and 250 W. The microstructures and mechanical properties of the microwaved samples are analysed to identify their potential applications. Our key findings are: (i) higher input powers generate materials in shorter fabrication times with higher mechanical strengths and higher yields despite the same total energy input; (ii) the microstructures of the microwaved samples under vacuum are very different from those under atmospheric conditions due to the widespread vesicles/bubbles; and (iii) different heating rates caused by different input powers can be utilised for specific ISRU purposes: higher input powers for extra-terrestrial construction and lower input powers for resource extraction. Findings from this study have significant implications for developing a microwave-heating payload for lunar ISRU demonstration missions.
This study came to determine the prevalence of Early Childhood Carries (ECC) among preschoolers in a marginalized population and describe the influence of behavioral and social determinants on the ...development of ECC.
This is a cross-sectional study that was carried out in four random preschools in the Jerusalem Governorate of the Occupied Palestinian Territories. All children aged 3-5 years old in the selected schools were screened for ECC using the decayed, missing, and filled teeth index (dmft). Data on children's socio-economic, feeding habits, hygiene habits, access to care, parental level of stress, social support, and locus of control were collected by a validated questionnaire sent to the children's main caregivers. Descriptive statistics were generated and bivariable and multivariable analyses were used to explain the influence of different behavioral and social determinants on ECC levels.
Four hundred and fifty-seven preschoolers completed the questionnaire and the clinical screening. Ninety-seven percent (n = 447) had experienced dental decay, with an average dmft score of 6.6 ± 4.3. After accounting for potential confounding, parents' internal locus of control was associated with lower dental caries among children (IRR = 0.97, 95% CI = 0.97, 0.98). Having routine, preventive visits versus never seeing a dentist were associated with lower dmft scores (IRR = 0.42, 95% CI = 0.33, 0.52). Night feeding habits (putting things other than water in the baby bottle at night, having children sleep while being breastfed at night) were positively associated with children's dental caries (IRR = 1.06, 95% CI = 1.04, 1.09: IRR = 1.15, 95% CI = 1.03, 1.29, respectively). Not adding sugar to the bottle was negatively associated with children's dental caries (IRR = 0.86, 95% CI = 0.74, 1.00).
Preschoolers in this study suffered from high dental caries experience. Although infant feeding habits were key factors in explaining the elevated level of the disease, system and socio-psychological factors were also detrimental to ECC prevalence. Policies and interventions to alleviate the burden of ECC need to address socioeconomic determinants of health in addition to feeding and hygiene practices.
The future of human space exploration will inevitably involve longer-term stays and possibly permanent settlement on the surfaces of other planetary bodies. It will, therefore, be advantageous or ...perhaps even necessary to utilise local resources for building an infrastructure for human habitation on the destination planetary body. In this context human lunar exploration is the next obvious step. Lunar soil is regarded as an ideal feedstock for lunar construction materials. However, significant gaps remain in our knowledge and understanding of certain chemical and physical properties of lunar soil, which need to be better understood in order to develop appropriate construction techniques and materials for lunar applications.
This article reviews our current understanding of the dielectric behaviour of lunar soil in the microwave spectrum, which is increasingly recognised as an important topic of research in the Space Architecture field. Although the coupling between the lunar soil and microwave energy is already recognised, considerable challenges must be overcome before microwave processing could be used as a main fabrication method for producing robust structures on the Moon. We also review the existing literature on the microwave processing of lunar soil and identify three key research areas where future efforts are needed to make significant advances in understanding the potential of microwave processing of lunar soil for construction purposes.
Objectives. We investigate the association between perceived everyday discrimination and psychological distress among urban African-American women with young children (under 6 years) living in ...low-income neighborhoods. Specifically, we examine whether instrumental and emotional social support moderates the association between perceived everyday discrimination and psychological distress.
Design. The data come from the Detroit Dental Health Project, a two-stage area probability sample representative of low-income African-American children in the city of Detroit. The analysis focuses on 969 female caregivers of young children. A series of hierarchical regression analyses were performed to examine the role of social support in the link between perceived everyday discrimination and psychological distress, with appropriate adjustments for the complex sample design.
Results. Both moderate and high frequency levels of discrimination were associated with higher levels of psychological distress after controlling for age, education, income, and self-rated health. There was a main effect of emotional support so that availability of emotional support was associated with less psychological distress. Instrumental support exerted a buffering effect to mitigate the negative influence of moderate levels of perceived discrimination on psychological distress.
Conclusion. Findings suggest that instrumental social support provides some protection from everyday stress. Social support, however, does not offset the impact of acute stress caused by frequent perceptions of everyday discrimination.
Limited research has been conducted regarding the association between mental illness and dental caries. We studied the impact of emotional distress on current and new dental caries among low-income ...African-American caregivers in Detroit, Michigan and if this association was mediated by poor oral hygiene and sugar consumption and modified by a chronic health condition.
Data came from Detroit Dental Health Project, a prospective cohort study of low-income African American caregivers and their children. We focused on baseline (
= 1,021) and 4-year follow-up participants (
= 614). Dental caries were assessed using the International Caries Detection and Assessment System. The study outcomes included two baseline caries outcomes (counts of non-cavitated lesions, baseline counts of cavitated lesions) and two outcomes of new caries over 4 years (new cavitated lesions and new non-cavitated lesions). The exposure was emotional distress. We performed multivariable quasi-Poisson regression analysis to test the association between emotional distress and caries. We tested effect modification by stratifying data by chronic health conditions and performed causal mediation analysis to test an indirect effect of oral hygiene and sugar consumption.
Ninety six percent of the caregivers were female, and their average age was 28 years old. Thirteen percent reported emotional distress at baseline. After accounting for potential confounding, emotional distress was positively associated with cavitated lesions at baseline (IRR = 1.36, 95% CI = 1.08, 1.70). Among those with a chronic health condition, stronger association was observed (IRR = 1.73, 95% CI = 1.27, 2.35). After 4 years, those with emotional distress and chronic health conditions had an increased risk of developing non-cavitated carious lesions (IRR = 1.41, 95% CI = 1.06, 1.88). Poor oral hygiene explained 51% of the association between emotional distress and baseline cavitated lesions (natural indirect effect = 1.16, 95% CI = 1.02, 1.33), but there was no evidence for an indirect effect of sugar consumption.
In this group of young, African-American caregivers with low socioeconomic status, dental caries was associated with emotional distress. This association was explained by poor oral hygiene and strengthened among those who reported a chronic health condition.
A rapid increase of Medicaid expenditures has been a serious concern, and housing stability has been discussed as a means to reduce Medicaid costs. A program evaluation of a New York City supportive ...housing program has assessed the association between supportive housing tenancy and Medicaid savings among New York City housing program applicants with serious mental illness and chronic homelessness or dual diagnoses of mental illness and substance use disorder, stratified by distinctive Medicaid expenditure patterns.
The evaluation used matched data from administrative records for 2827 people. Sequence analysis identified 6 Medicaid expenditure patterns during 2 years prior to baseline among people placed in the program (n = 737) and people eligible but not placed (n = 2090), including very low Medicaid coverage, increasing Medicaid expenditure, low, middle, high, and very high Medicaid expenditure patterns. We assessed the impact of the program on Medicaid costs for 2 years post-baseline via propensity score matching and bootstrapping.
The housing program was associated with Medicaid savings during 2 years post-baseline (-$9526, 95% CI = -$19,038 to -$2003). Stratified by Medicaid expenditure patterns, Medicaid savings were found among those with very low Medicaid coverage (-$15,694, 95% CI = -$35,926 to -$7983), increasing Medicaid expenditures (-$9020, 95% CI = -$26,753 to -$1705), and high Medicaid expenditure patterns (-$14,450, 95% CI = -$38,232 to -$4454). Savings were largely driven by shorter psychiatric hospitalizations in the post-baseline period among those placed.
The supportive housing program was associated with Medicaid savings, particularly for individuals with very low Medicaid coverage, increasing Medicaid expenditures, and high Medicaid expenditures pre-baseline.
Both homelessness and incarceration are associated with housing instability, which in turn can disrupt continuity of HIV medical care. Yet, their impacts have not been systematically assessed among ...people living with HIV/AIDS (PLWHA).
We studied a retrospective cohort of 1,698 New York City PLWHA with both jail incarceration and homelessness during 2001-05 to evaluate whether frequent transitions between jail incarceration and homelessness were associated with a lower likelihood of continuity of HIV care during a subsequent one-year follow-up period. Using matched jail, single-adult homeless shelter, and HIV registry data, we performed sequence analysis to identify trajectories of these events and assessed their influence on engagement in HIV care and HIV viral suppression via marginal structural modeling.
Sequence analysis identified four trajectories; 72% of the cohort had sporadic experiences of both brief incarceration and homelessness, whereas others experienced more consistent incarceration or homelessness during early or late months. Trajectories were not associated with differential engagement in HIV care during follow-up. However, compared with PLWHA experiencing early bouts of homelessness and later minimal incarceration/homelessness events, we observed a lower prevalence of viral suppression among PLWHA with two other trajectories: those with sporadic, brief occurrences of incarceration/homelessness (0.67, 95% CI = 0.50,0.90) and those with extensive incarceration experiences (0.62, 95% CI = 0.43,0.88).
Housing instability due to frequent jail incarceration and homelessness or extensive incarceration may exert negative influences on viral suppression. Policies and services that support housing stability should be strengthened among incarcerated and sheltered PLWHA to reduce risk of adverse health conditions.
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