Response to Kestens et al. Comments on Melis et al. The effects of the Urban Built Environment on Mental Health: A Cohort Study in a Large Northern Italian City. Int J Environ Res Public Health 2015, 12, 14898-14915

The commentary from Kestens et al. [1] raises interesting issues about measuring contextual exposures and encourages new studies to incorporate them in their design: as a group of researchers, we strongly support their view and think that those useful reflections should be used as guidelines for future research.[...

Hispanic health in the USA: a scoping review of the literature

Hispanics are the largest minority group in the USA. They contribute to the economy, cultural diversity, and health of the nation. Assessing their health status and health needs is key to inform health policy formulation and program implementation. To this end, we conducted a scoping review of the literature and national statistics on Hispanic health in the USA using a modified social-ecological framework that includes social determinants of health, health disparities, risk factors, and health services, as they shape the leading causes of morbidity and mortality. These social, environmental, and biological forces have modified the epidemiologic profile of Hispanics in the USA, with cancer being the leading cause of mortality, followed by cardiovascular diseases and unintentional injuries. Implementation of the Affordable Care Act has resulted in improved access to health services for Hispanics, but challenges remain due to limited cultural sensitivity, health literacy, and a shortage of Hispanic health care providers. Acculturation barriers and underinsured or uninsured status remain as major obstacles to health care access. Advantageous health outcomes from the “Hispanic Mortality Paradox” and the “Latina Birth Outcomes Paradox” persist, but health gains may be offset in the future by increasing rates of obesity and diabetes. Recommendations focus on the adoption of the Health in All Policies framework, expanding access to health care, developing cultural sensitivity in the health care workforce, and generating and disseminating research findings on Hispanic health

The effects of health care reforms on health inequalities: a review and analysis of the European evidence base

Health care is widely considered to be an important determinant of health. The health care systems of Western Europe have recently experienced significant reforms, under pressure from economic globalization. Similarly, in Eastern Europe, health care reforms have been undertaken in response to the demands of the new market economy. Both of these changes may influence equality in health outcomes. This article aims to identify the mechanisms through which health care may affect inequalities. The authors conducted a literature review of the effects on health inequalities of European health care reforms. Particular reference was paid to interventions in the fields of financing and pooling, allocation, purchasing, and provision of services. The majority of studies were from Western Europe, and the outcomes most often examined were access to services or income distribution. Overall, the quality of research was poor, confirming the need to develop an appropriate impact assessment methodology. Few studies were related to pooling, allocation, or purchasing. For financing and purchasing, the studies showed that publicly funded universal health care reduces the impact of ill health on income distribution, while insurance systems can increase inequalities in access to care. Out-of-pocket payments increase inequalities in access to care and contribute to impoverishment. Decentralizing health services can lead to geographic inequalities in health care access. Nationalized, publicly funded health care systems are most effective at reducing inequalities in access and reducing the effects on health of income distribution

Urban health multidisciplinary actions promoting health in an urban environment

The crisis faced by the Western lifestyle model when dealing with problems associated with climate change and the new roles that cities and buildings must play in a world of globalisation fosters the rise of a new approach that marks a necessary turning point for our civilisation. For decades now, the fight against climate change has seen many of the world’s most important countries committing themselves to agreements—from the Kyoto Protocol of 1992 to the Paris COP21 in 2015—that are gradually getting better at establishing goals, strategies and actions for improving quality of life and protecting the entire planet, even if some venture doubts on the concrete possibility of achieving them

On hybrid model predictive control of sewer networks

Real-time control (RTC) of sewer-network systems plays an important role in meeting increasingly restrictive environmental regulations to reduce release of untreated wastewater to the environment. This chapter presents the application of hybrid model predictive control (HMPC) on sewer systems. It is known from the literature that HMPC has a computational complexity growing exponentially with the size of the system to be controlled. However, the average solution time of modern mixed integer program (MIP) solvers is often much better than the predicted worst-case-solution time. The problem is to know when the worst-case computational complexity appears. In addition to presenting the application, a secondary aim of the chapter is to discuss the limits of applicability due to real-time constraints on computation time when HMPC is applied on large-scale systems such as sewer networks. By using a case study of a portion of the Barcelona sewer system, it is demonstrated how the computational complexity of HMPC appears for certain state and disturbance combinations