Objectives
This program evaluation examines the outcomes of a multicomponent urban home‐based asthma program implemented through a city health department in a large Midwestern city. The purpose of ...the program was to improve asthma outcomes by controlling indoor asthma triggers in the home environment.
Design and Sample
This was a pre‐post evaluation study. Participants received home‐based education from a public health nurse or a health educator, cleaning and other supplies, and physical home interventions such as mold abatement and pest control. Asthma outcomes, caregiver quality of life, trigger‐related activities, and asthma management activities at baseline and 6 months following the intervention were evaluated using survey data. A total of 115 participants for whom baseline and follow‐up data were available were included in this analysis.
Measures
This study used parent self‐reported quantitative and qualitative data which were collected through baseline and follow‐up surveys administered by program staff.
Results
Significant reduction in asthma symptom days, nighttime awakenings, days with activity limitation, and albuterol use were observed. Emergency department visits, missed school days, and caregiver missed work days also were significantly reduced, and caregiver quality of life improved.
Conclusions
This multifaceted home‐based intervention decreased asthma triggers and improved asthma outcomes in children, and improved the quality of life of their caregivers.
Illicit and prescription drug use disorders are two to four times more prevalent among Aboriginal peoples in North America than the general population. Research suggests Aboriginal cultural ...participation may be protective against substance use problems in rural and remote Aboriginal communities. As Aboriginal peoples continue to urbanize rapidly around the globe, the role traditional Aboriginal beliefs and practices may play in reducing or even preventing substance use problems in cities is becoming increasingly relevant, and is the focus of the present study. Mainstream acculturation was also examined. Data were collected via in-person surveys with a community-based sample of Aboriginal adults living in a mid-sized city in western Canada (N = 381) in 2010. Associations were analysed using two sets of bootstrapped linear regression models adjusted for confounders with continuous illicit and prescription drug problem scores as outcomes. Psychological mechanisms that may explain why traditional culture is protective for Aboriginal peoples were examined using the cross-products of coefficients mediation method. The extent to which culture served as a resilience factor was examined via interaction testing. Results indicate Aboriginal enculturation was a protective factor associated with reduced 12-month illicit drug problems and 12-month prescription drug problems among Aboriginal adults in an urban setting. Increased self-esteem partially explained why cultural participation was protective. Cultural participation also promoted resilience by reducing the effects of high school incompletion on drug problems. In contrast, mainstream acculturation was not associated with illicit drug problems and served as a risk factor for prescription drug problems in this urban sample. Findings encourage the growth of programs and services that support Aboriginal peoples who strive to maintain their cultural traditions within cities, and further studies that examine how Aboriginal cultural practices and beliefs may promote and protect Aboriginal health in an urban environment.
•This study provides much needed information about the protective role of traditional Aboriginal culture in cities.•Aboriginal cultural participation was protective against prescription and illicit drug problems for urban-based Aboriginal.•Increased self-esteem partially explained why cultural participation was protective for Aboriginal peoples.•Aboriginal culture also promoted resilience.•Mainstream acculturation was not associated illicit drug problems and was a risk factor for prescription drug problems.
Urban climate policy offers a significant opportunity to promote improved public health. The evidence around climate and health cobenefits is growing but has yet to translate into widespread ...integrated policies. This article presents two systematic reviews: first, looking at quantified cobenefits of urban climate policies, where transportation, land use, and buildings emerge as the most studied sectors; and second, looking at review papers exploring the barriers and enablers for integrating these health cobenefits into urban policies. The latter reveals wide agreement concerning the need to improve the evidence base for cobenefits and consensus about the need for greater political will and leadership on this issue. Systems thinking may offer a way forward to help embrace complexity and integrate health cobenefits into decision making. Knowledge coproduction to bring stakeholders together and advance policy-relevant research for urban health will also be required. Action is needed to bring these two important policy agendas together.
Public open space (POS) plays a significant role in fostering human health and wellbeing in cities. A major limitation of current research on POS and health is that there is little attention on the ...role of various urban features on people's mental health, in different urban context. This study employed wearable sensors (a wearable camera, Empatica 4 wristband and a GPS device) to measure human physiological responses to urban indicators, objectively. To do this, we selected six kinds of public open space (water area, transit area, green area, commercial area, motor traffic area and mixed office and residential area) and recruited 86 participants for an experimental study. Next, we detected urban features by using Microsoft Cognitive Services (MCS) and calculated a change score to assess human physiological stress responses based on galvanic skin response (GSR) and skin temperature from the wristband. Lastly, we applied random effect model and geographically weighted regression analysis to examine the relationship between urban indicators and human physiological stress responses. The findings show that urban flow (vehicles, bikes and people), waterbodies, greenery and places to sit are associated with the changes of human physiological stress response. The findings indicate that the type of urban context may confound the effect of green and blue urban features; i.e., the effect on physiological stress response can be positive or negative depending on the context. The paper highlights the relevance of considering urban context in research on associations between urban features and stress response.
•Integrate wearable camera, wristband and GPS device for individual-level research in the built environment.•Assess the association between urban indicators and human physiological stress response in the different urban contexts.•Further understanding of how urban features influence mental health in the built environment.•Indicate that the type of urban context may confound the effect of urban features.
Background This study aimed to describe COVID-19 health literacy in urban and rural communities in Nigeria. Methods A descriptive cross-sectional design was used to enroll adults from households in ...rural and urban communities in Akure, South-west Nigeria. Nine questions were asked on respondents’ health literacy, each arranged on a scale of “1” implying “very difficult” to “7” implying “very easy’. We defined good health literacy as cumulative scores ≥50 points, and poor health literacy as scores 40 years had nearly two times odds of having good COVID-19 health literacy (AOR = 1.640, 95%CI = 0.769-3.495, p = 0.200). In rural communities, people >40 years had nearly four times odds of having good COVID-19 health literacy (AOR = 3.523, 95%CI= 1.420 – 8.742, p = 0.017). Conclusion COVID-19 health education should be integrated into national health programs to address urban-rural differences in COVID-19 health literacy.
•Exposome approaches can aid the development of comprehensive public health measures.•Exposomic tools can be integrated in infectious diseases surveillance/monitoring in urban areas.•The exposome ...could aid in risk assessment, preparedness and response to events of public health impact.
The COVID-19 pandemic placed public health measures against infectious diseases at the core of global health challenges, especially in cities where more than half of the global population lives. SARS-CoV-2 is an exposure agent recently added to the network of exposures that comprise the human exposome, i.e. the totality of all environmental exposures throughout one’s lifetime. At the same time, the application of measures to tackle SARS-CoV-2 transmission leads to changes in the exposome components and in characteristics of urban environments that define the urban exposome, a complementary concept to the human exposome, which focuses on monitoring urban health. This work highlights the use of a comprehensive systems-based approach of the exposome for better capturing the population-wide and individual-level variability in SARS-CoV-2 spread and its associated urban and individual exposures towards improved guidance and response. Population characteristics, the built environment and spatiotemporal features of city infrastructure, as well as individual characteristics/parameters, socioeconomic status, occupation and biological susceptibility need to be simultaneously considered when deploying non-pharmacological public health measures. Integrating individual and population characteristics, as well as urban-specific parameters is the prerequisite in urban exposome studies. Applications of the exposome approach in cities/towns could facilitate assessment of health disparities and better identification of vulnerable populations, as framed by multiple environmental, urban design and planning co-exposures. Exposome-based applications in epidemics control and response include the implementation of exposomic tools that have been quite mature in non-communicable disease research, ranging from biomonitoring and surveillance to sensors and modeling. Therefore, the exposome can be a novel tool in risk assessment and management during epidemics and other major public health events. This is a unique opportunity for the research community to exploit the exposome concept and its tools in upgrading and further developing site-specific public health measures in cities.
China has one of the highest rates of caesarean delivery in the world. Of the 16 million babies born in 2010, approximately half were by caesarean, with 107,330 in Shanghai alone. Understanding the ...reasons underlying this practice preference in China may provide insight into factors influencing caesarean rates in other countries.
The intent of this study was to determine whether there are differences in disaster preparedness between urban and rural community hospitals across New York State.
Descriptive and analytical ...cross-sectional survey study of 207 community hospitals; thirty-five questions evaluated 6 disaster preparedness elements: disaster plan development, on-site surge capacity, available materials and resources, disaster education and training, disaster preparedness funding levels, and perception of disaster preparedness.
Completed surveys were received from 48 urban hospitals and 32 rural hospitals.There were differences in disaster preparedness between urban and rural hospitals with respect to disaster plan development, on-site surge capacity, available materials and resources, disaster education and training, and perception of disaster preparedness. No difference was identified between these hospitals with respect to disaster preparedness funding levels.
The results of this study provide an assessment of the current state of disaster preparedness in urban and rural community hospitals in New York. Differences in preparedness between the two settings may reflect differing priorities with respect to perceived threats, as well as opportunities for improvement that may require additional advocacy and legislation. (Disaster Med Public Health Preparedness. 2019;13:424-428).
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