An Evaluation of Pregnancy-associated Morbidity among Georgia\u27s USDA Designated Food Deserts, 2009-2010

Objective: To assess the affect of pregnant women residing in a USDA designated food desert on the development of pregnancy-associated morbidities Results: Living in a USDA food desert is not significantly associated with the development of pregnancy-associated morbidity [OR=0.973; CI: 0.835-1.134; p-value=0.728]. Backward stepwise regression showed all proposed potential confounders were significantly associated with the development of pregnancy-associated morbidity. These potential confounders include maternal age, regular exercise routine or previous diagnosis of diabetes or hypertension (p-values \u3c 0.02). Conclusion: Residing in a USDA designated food desert is not associated with the development of pregnancy-related morbidity. This analysis suggests other sociodemographic risk factors, such as maternal age or exercise routine, as indicators of morbidity rather than food accessibility

The Impact of Built Environment on Pedestrian Crashes and the Identification of Crash Clusters on an Urban University Campus

Objectives: Motor vehicle-pedestrian crash is a significant public health concern. The urban campus of Georgia State University poses unique challenges due to a large number of students and university employees. The objectives of this study are twofold: (1) to examine the correlation between specific features of the built environment on and around the University campus and pedestrian crashes; and (2) to identify crash clusters in the study area using network-based geospatial techniques.Methods: We obtained pedestrian crash data (n=119) from 2003 to 2007 from Georgia Department of Transportation and evaluated environmental features pertaining to the road infrastructure, pedestrian infrastructure and streetscape for each road segment and intersection. Prevalence rate of each feature with pedestrian crashes present was calculated. We used network-based Kernel Density Estimation to identify the high density road segments and intersections, then used network-based K-function to examine the clustering of pedestrian crashes.Results: Over 50% of the crosswalk signs, pedestrian signals, public transit, and location branding signs (more than three) at intersections involved pedestrian crashes. More than half of wider streets (greater than 29 feet), two-way streets, and streets in good condition had pedestrian crashes present. Crashes occurred more frequently in road segments with strong street compactness and mixed land use present and were significantly (p<0.05) clustered in these high-density zones.Conclusions: Findings can be used to understand the correlation between built environment and pedestrian safety, to prioritize the high-density zones for intervention efforts, and to formulate research hypotheses for investigating pedestrian crashes. [West J Emerg Med. 2010; 11(3): 295-302.

The Urban Health Index: A Handbook for its Calculation and Use

The Urban Health Index (UHI) is a single metric that can be used to measure and map the disparities in health determinants and outcomes in urban areas. This Handbook is primarily intended for those who want to calculate the UHI for a particular geographic area of interest

Urban Health Indicators and Indices- Current Status,

Though numbers alone may be insufficient to capture the nuances of population health, they provide a common language of appraisal and furnish clear evidence of disparities and inequalities. Over the past 30 years, facilitated by high speed computing and electronics, considerable investment has been made in the collection and analysis of urban health indicators, environmental indicators, and methods for their amalgamation. Much of this work has been characterized by a perceived need for a standard set of indicators. We used publication databases (e.g. Medline) and web searches to identify compilations of health indicators and health metrics. We found 14 long-term large-area compilations of health indicators and determinants and seven compilations of environmental health indicators, comprising hundreds of metrics. Despite the plethora of indicators, these compilations have striking similarities in the domains from which the indicators are drawn—an unappreciated concordance among the major collections. Research with these databases and other sources has produced a small number of composite indices, and a number of methods for the amalgamation of indicators and the demonstration of disparities. These indices have been primarily used for large-area (nation, region, state) comparisons, with both developing and developed countries, often for purposes of ranking. Small area indices have been less explored, in part perhaps because of the vagaries of data availability, and because idiosyncratic local conditions require flexible approaches as opposed to a fixed format. One result has been advances in the ability to compare large areas, but with a concomitant deficiency in tools for public health workers to assess the status of local health and health disparities. Large area assessments are important, but the need for small area action requires a greater focus on local information and analysis, emphasizing method over prespecified content

Spatial variations in the incidence of breast cancer and potential risks associated with soil dioxin contamination in Midland, Saginaw, and Bay Counties, Michigan, USA

<p>Abstract</p> <p>Background</p> <p>High levels of dioxins in soil and higher-than-average body burdens of dioxins in local residents have been found in the city of Midland and the Tittabawassee River floodplain in Michigan. The objective of this study is threefold: (1) to evaluate dioxin levels in soils; (2) to evaluate the spatial variations in breast cancer incidence in Midland, Saginaw, and Bay Counties in Michigan; (3) to evaluate whether breast cancer rates are spatially associated with the dioxin contamination areas.</p> <p>Methods</p> <p>We acquired 532 published soil dioxin data samples collected from 1995 to 2003 and data pertaining to female breast cancer cases (<it>n </it>= 4,604) at ZIP code level in Midland, Saginaw, and Bay Counties for years 1985 through 2002. Descriptive statistics and self-organizing map algorithm were used to evaluate dioxin levels in soils. Geographic information systems techniques, the Kulldorff's spatial and space-time scan statistics, and genetic algorithms were used to explore the variation in the incidence of breast cancer in space and space-time. Odds ratio and their corresponding 95% confidence intervals, with adjustment for age, were used to investigate a spatial association between breast cancer incidence and soil dioxin contamination.</p> <p>Results</p> <p>High levels of dioxin in soils were observed in the city of Midland and the Tittabawassee River 100-year floodplain. After adjusting for age, we observed high breast cancer incidence rates and detected the presence of spatial clusters in the city of Midland, the confluence area of the Tittabawassee, and Saginaw Rivers. After accounting for spatiotemporal variations, we observed a spatial cluster of breast cancer incidence in Midland between 1985 and 1993. The odds ratio further suggests a statistically significant (<it>α </it>= 0.05) increased breast cancer rate as women get older, and a higher disease burden in Midland and the surrounding areas in close proximity to the dioxin contaminated areas.</p> <p>Conclusion</p> <p>These findings suggest that increased breast cancer incidences are spatially associated with soil dioxin contamination. Aging is a substantial factor in the development of breast cancer. Findings can be used for heightened surveillance and education, as well as formulating new study hypotheses for further research.</p

Space-Time Surveillance of Negative Emotions after Consecutive Terrorist Attacks in London

Terrorist attacks pose significant threats to mental health. There is dearth information about the impact of consecutive terrorist attacks on space-time concentrations of emotional reactions. This study collected (1) Twitter data following the two terrorist attacks in London in March and June of 2017, respectively, and (2) deprivation data at small areal levels in the United Kingdom. The space-time permutation model was used to detect the significant clusters of negative emotions, including fear, sadness, and anger in tweets. Logistic regression models were used to examine the social deprivation of communities associated with negative tweeting. The results reported two significant clusters after the March attack, one was in London, ten days after the attack, and the other was far from the attack site between Manchester and Birmingham, three days after the attack. Attention to the reoccurring attack in June diminished quickly. The socially deprived communities experienced double disadvantage&mdash;sending fewer tweets but expressing more negative emotions than their counterparts. The findings suggest that terrorism can affect public emotions far and broad. There is a potential for surveillance to rapidly identify geographically concentrated emotions after consecutive or prolonged disasters using social media data

Geographic disparities in accessibility to food stores in southwest Mississippi

Disparities in accessibility to healthy food are a critical public-health concern. Poor access to reasonably priced, nutritious, and good-quality food may lead to poor diet and increase the risks of health problems such as obesity, diabetes, and cardiovascular diseases. This research advances the popular two-step floating catchment area (2SFCA) method by incorporating a kernel density (KD) function to form the ‘KD2SFCA method’. The study applies the method to measure the spatial access to food stores in southwest Mississippi, and examines the interaction between the spatial access and nonspatial factors. The research shows that neighborhoods with higher scores of urban socioeconomic disadvantage actually have better spatial accessibility to food stores; but higher percentages of carless households and lower income in some neighborhoods may compromise overall accessibility. Neighborhoods with stronger cultural barriers tend to be associated with poorer spatial accessibility. The study clearly differentiates spatial and nonspatial factors in access inequalities, and thus helps policy makers to design corresponding remedial strategies.

Spatiotemporal Agglomeration of Real-Estate Industry in Guangzhou, China

Real estate development is critical to healthy economic growth and regional development. Using real-estate data in Guangzhou, China from the 1970s to 2015, we examined the spatiotemporal agglomeration and evolution of Guangzhou’s real estate industry with spatial and spatiotemporal techniques. This study shows that real estate businesses were initially agglomerated in the city center with socioeconomic advantages, and later spread into suburbs as new growth foundations. We also found that different business types, depending on their functions, evolved and agglomerated in different time periods. The findings provide valuable support to the formulation of effective government policy and the management of real estate enterprises in China