One strategy for increasing physical activity is to create and enhance access to park space. We assessed the literature on the relationship of parks and objectively measured physical activity in ...population-based studies in the United States (US) and identified limitations in current built environment and physical activity measurement and reporting. Five English-language scholarly databases were queried using standardized search terms. Abstracts were screened for the following inclusion criteria: 1) published between January 1990 and June 2013; 2) US-based with a sample size greater than 100 individuals; 3) included built environment measures related to parks or trails; and 4) included objectively measured physical activity as an outcome. Following initial screening for inclusion by two independent raters, articles were abstracted into a database. Of 10,949 abstracts screened, 20 articles met the inclusion criteria. Five articles reported a significant positive association between parks and physical activity. Nine studies found no association, and six studies had mixed findings. Our review found that even among studies with objectively measured physical activity, the association between access to parks and physical activity varied between studies, possibly due to heterogeneity of exposure measurement. Self-reported (vs. independently-measured) neighborhood park environment characteristics and smaller (vs. larger) buffer sizes were more predictive of physical activity. We recommend strategies for further research, employing standardized reporting and innovative study designs to better understand the relationship of parks and physical activity.
•We reviewed research on parks and objectively measured physical activity.•Measurement and reporting of park density and proximity is not standardized.•The association of parks and physical activity was inconsistent across studies.•Standardized measurement and reporting are needed for future meta-analyses.
Comprehensive community initiatives (CCI) are multi-issue, large-scale, often philanthropic investments in disadvantaged communities to comprehensively address community problems. We studied two ...sites of The California Endowment’s Building Healthy Communities Initiative, Richmond and East Oakland, to examine CCI implementation. Prior research offers best practices focused on cultivating existing community organizational and organizing infrastructure. We find that CCI success also requires an enabling local government context. Where political will aligns with the initiative’s goals, CCIs should support work to inform and improve local public policy and systems. Inadequate government resources necessitate CCI investment, but government has an important role in CCI success.
In the United States, health disparities in obesity and obesity-related illnesses have been the subject of growing concern. To better understand how obesity-related health disparities might relate to ...obesogenic built environments, the authors conducted a systematic review of the published scientific literature, screening for studies with relevance to disadvantaged individuals or areas, identified by low socioeconomic status, black race, or Hispanic ethnicity. A search for related terms in publication databases and topically related resources yielded 45 studies published between January 1995 and January 2009 with at least 100 participants or area residents that provided information on 1) the built environment correlates of obesity or related health behaviors within one or more disadvantaged groups or 2) the relative exposure these groups had to potentially obesogenic built environment characteristics. Upon consideration of the obesity and behavioral correlates of built environment characteristics, research provided the strongest support for food stores (supermarkets instead of smaller grocery/convenience stores), places to exercise, and safety as potentially influential for disadvantaged groups. There is also evidence that disadvantaged groups were living in worse environments with respect to food stores, places to exercise, aesthetic problems, and traffic or crime-related safety. One strategy to reduce obesity would involve changing the built environment to be more supportive of physical activity and a healthy diet. Based on the authors' review, increasing supermarket access, places to exercise, and neighborhood safety may also be promising strategies to reduce obesity-related health disparities.
Context: This article explores the relationship between metropolitan fragmentation, as defined by the total number of governmental units within a metropolitan statistical area (local municipalities, ...special service districts, and school districts), and racial disparities in mortality among blacks and whites in the 1990s. The presence of numerous governmental jurisdictions in large metropolitan areas in the United States can shape the geography of opportunity, with adverse consequences for health. Methods: We conducted a regression analysis using U.S. Census of Government data and Compressed Mortality File data for the country's largest 171 metropolitan statistical areas. Findings: We found a link between increased metropolitan area fragmentation and greater racial differences in mortality between blacks and whites for both children and working-age adults. Although increasing fragmentation is associated with a higher mortality rate for blacks, it is not associated with a higher mortality rate for whites. These findings suggest that research is needed to understand how governance can positively or negatively influence a population's health and create conditions that generate or exacerbate health disparities. Conclusions: We need to understand the extent to which metropolitan fragmentation contributes to racial segregation, whether racism contributes to both, and the role of poverty and antipoverty policies in reducing or exacerbating the consequences of metropolitan fragmentation. The exact pathways by which metropolitan fragmentation contributes to differences between blacks' and whites' mortality rates are unknown. Uncovering how institutions influence the social, economic, and environmental conditions, which in turn contribute to the current racial and ethnic health disparities in the largest metropolitan areas, is key. Understanding these "upstream" determinants of a population's health and the disparities in health between subgroups in the overall population must be at the core of any attempt to reduce disparities in health. Building bridges between urban planning and public health can be critical to these efforts.
Tens of billions of dollars-both public and private-flow to low-income communities each year, mostly for affordable housing. However, it is rare for the health effects of these investments to be ...assessed. In San Francisco, California, a collaborative effort is under way that aims to fill this research gap while helping residents of Sunnydale, the city's largest public housing project, where poverty, violence, and truancy are entrenched. The collaboration is in its earliest stages-with construction not scheduled to start for at least four years-but some early lessons have emerged. For example, researchers and community developers have found that their data collection needs and timeline expectations often don't match. Nevertheless, the collaborators intend to use the long period before groundbreaking to establish baseline measurements of residents' social and physical well-being, plan initiatives in collaboration with community members and stakeholders, and seek funding for the initiatives and a longitudinal evaluation of the community.
This paper is a conceptual analysis of the effects of racial residential segregation, which is a major contributor to racial and ethnic health disparities. Metropolitan segregation has had adverse ...health consequences for economically disadvantaged and minority populations because they are exposed to higher levels of environmental pollutants and have limited opportunities to gain a quality education, access to healthcare, and increase their economic opportunity. Based on our empirical and theoretical analysis we provide a holistic framework that takes an ecological systems approach to understand the affects of urban health and health disparities. We contend that in order to improve the urban/environmental health conditions for the most vulnerable urban populations, it will require comprehensive community and regional focused strategies that link local community development efforts to larger macro-level metropolitan regional strategies.
ABSTRACT
BACKGROUND
We gathered baseline data about student need of healthy, free school food, and if current school meal programming serves students in need of healthy free school food, in ...anticipation of the completion of a district‐wide kitchen infrastructure and educational farm project in a high‐poverty urban school district.
METHODS
We used mixed methods to assess student hunger, whether the school meal program met student needs, and to determine associations between presence of a cooking kitchen and perceptions of healthy food. Participants included 72 staff, 143 parents, and 6437 K‐5 students in the qualitative component, and 9078 parents and 1693 staff in the quantitative component.
RESULTS
Staff participants stated packaging and reheating food influenced student consumption. During observations, students at seven of nine high poverty sites with packaged reheated food did not eat school meals, but this was not true at four out of four high‐poverty sites with unpackaged fresh food. Parents (OR = 1.17, 95% CI 1.00‐1.39) and staff (OR = 1.58, 95% CI 1.15‐2.17) from schools with a cooking kitchen were more likely to perceive school lunch as healthy in adjusted models.
CONCLUSIONS
Food preparation and presentation appears to influence student consumption of school food and adult perception of school meal quality.
Across the US, vulnerable communities have been adversely affected by large-scale development led by universities, hospitals, and medical facilities. More often than not, much of the tension around ...university or hospital expansion has been around traffic congestion, rising land, and housing costs, displacement of lower income individuals, gentrification, and environmental pollution. Using interviews, focus groups, archival data and observant participation, this article analyzes how Jamaica Plain Neighborhood Development Corporation (JPNDC) and other nonprofit community-based organization partners were able to form a public-private partnership with local hospitals, medical facilities, and research organizations that led to a community-focused workforce development and community benefits program in Boston. In addition, this case study demonstrates how Boston became one of the first cities in the country to link development to community-based outcomes and investments aimed at helping some of Boston's most disadvantaged and vulnerable residents.
High-achieving African American students in California are not attending University of California (UC) campuses. Due to hyper-implementations of Proposition 209, which limited UC campuses' ability to ...use race as a significant admission criteria, the UC system and individual UC campus policies have scaled back their efforts to recruit high-achieving African American students from California. This article presents findings from the qualitative portion (n = 74) of a convergent mixed-method study of over 700 African American college-going students. Findings convey the critical role that access, outreach, diversity, and climate plays in the college choice process of African American high achievers. Drawing upon higher education and critical race literature, the findings further reveal the challenges and opportunities for states and elite universities in retaining its brightest students from diverse backgrounds. This research also conveys the potential of research to inform state, systemic, and institutional policies to increase access to selective public universities.
Urban Health Hutson, Malo; Moscovitz, Alex
Encyclopedia of Environmental Health,
2019
Book Chapter
Despite the urban challenges, over the last 30years there has been a precipitous increase in the number of initiatives led by international, state, and local government jurisdictions and nonprofit ...organizations to address urban health challenges and promote healthier cities. Moreover, many of these initiatives are centrally focused on urban health equity. This article explores how urban dwellers’ health is influenced by factors such as the quality of urban governance, employment, health services, economy, political system, education, social support networks, safety and security, and gender equality. In addition, the physical environment also plays a critical role in urban health equity. The physical environment such as toxic facilities and air quality, healthy housing, the transportation system and networks, access to clean water, wastewater and sanitation, and safe neighborhoods are important to improving a person’s quality of life, health, and well-being.
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