Can housing improvements cure or prevent the onset of health conditions over time in deprived areas?

Background: There is a need for more evidence linking particular housing improvements to changes in specific health conditions. Research often looks at generic works over short periods. Methods: We use a longitudinal sample (n = 1933) with a survey interval of 2–5 years. Multivariate logistic regression is used to calculate the odds ratios of developing or recovering from six health conditions according to receipt of four types of housing improvements. Results: Receipt of fabric works was associated with higher likelihood of recovery from mental health problems and circulatory conditions. Receipt of central heating was also associated with higher likelihood of recovery form circulatory conditions. No evidence was found for the preventative effects of housing improvements. Conclusions: Health gain from housing improvements appears most likely when targeted at those in greatest health need. The health impacts of area-wide, non-targeted housing improvements are less clear in our study

Household car adoption and financial distress in deprived urban communities: A case of forced car ownership?

This paper explores the relationship between car ownership and financial circumstances for people living in disadvantaged urban communities. Assumptions about cars signifying status and income are problematised by an examination of the characteristics of those who adopt cars. We consider the possibility that, despite low incomes and financial problems, cars may be a necessity for some urban dwellers. Patterns of car ownership and adoption are analysed using cross-sectional and longitudinal survey data collected from communities in Glasgow, between 2006 and 2011, before, during and after the recession. Car ownership rates increased, as more people adopted a car than relinquished vehicles. The likelihood of household car adoption was influenced by changes in household size, increased financial difficulties in relation to housing costs, and where householders gained work. A small but growing proportion of households (up to 8.5% by 2011) are deemed ‘forced car owners’ by virtue of owning a car despite also reporting financial difficulties: three-quarters of this group maintain a car despite financial problems whilst a quarter adopt a car despite financial problems. Findings suggest that poor households are reluctant to relinquish their cars to ease money problems when under financial stress and that, for some, acquiring a car may be seen as necessary to better their circumstances. In neither case can we see evidence that the sustainable transport agenda is reaching disadvantaged communities and there are concerns that regeneration strategies are failing to promote mobility and accessibility for poor communities via transport policies

Housing improvements, fuel payment difficulties and mental health in deprived communities

This paper examines the effect of warmth interventions on self-reported difficulties affording fuel bills against a backdrop of rising mental health problems, using a longitudinal sample in Glasgow, UK. Following a period of rising fuel prices and stagnating wages, fuel poverty is high on the political agenda and is a particular issue for those living in deprived communities who may be most affected by rising fuel bills and reductions in employment, wages and incomes in the recent period of recession and austerity. Since 2006, the reporting of difficulties paying for fuel bills has been rising in the study population. Alongside fuel prices and income, energy efficiency is the third key driver of fuel poverty. As such the research seeks to establish whether warmth interventions, designed to improve the energy efficiency of homes can provide protection against worsening financial difficulties and lead to better mental health outcomes for residents. Results suggest that those who report greater frequency of financial difficulty also report worsening mental health. There is limited impact of energy efficiency improvements on perceived fuel affordability difficulties, and where there is an effect, central heating is related to more frequent financial hardships

Occupant behaviour as a fourth driver of fuel poverty (aka warmth & energy deprivation)

A conceptual framework for occupant behaviour as a driver of fuel poverty is presented, comprising: housing and use of the home; heating and energy arrangements and thermal comfort; household structure and dynamics; health and well-being; household finances; and social activity and relations. This framework informs longitudinal analysis of movements into and out of fuel poverty among households in deprived communities in Glasgow. Household surveys across ten years yielded a longitudinal sample of 3297 cases where initial and subsequent fuel poverty status was recorded using an experiential measure. A third of households changed their fuel poverty status over time: 18% moving out of fuel poverty and 16% moving in. Factors strongly associated with movements into fuel poverty included: being a single parent (OR 2.27); experiencing a mental health problem (OR 2.74); and remaining out of work (OR 1.89). Movement out of fuel poverty was less likely among those with infrequent family contact (OR 0.55) and who moved home (OR 0.66); home improvements had no effect upon the experience of fuel poverty. It is argued that the policy problem should be considered one of ‘warmth and energy deprivation’, accompanied by a broader interpretation of vulnerability to as well as from fuel poverty

Understanding the prevalence and drivers of food bank use: evidence from deprived communities in Glasgow

This article provides quantitative analysis of a self-reported measure of food bank use in the UK, adding to a sparse evidence base. Evidence from fifteen deprived communities in Glasgow is used to examine the scale of food bank use and to consider its relationship with socio-demographic, health, and financial variables. Being affected by welfare reforms was found to increase the likelihood of food bank use. Young men and those with mental health problems were found to be more likely than others to have used a food bank. Food banks appear to be used by groups who are being under-served by the welfare state and suffering the most acute impacts of austerity. The very low prevalence of food bank use among those who struggle to afford food points to their inadequacy as a response to food insecurity

Can walking habits be encouraged through area-based regeneration and relocation? A longitudinal study of deprived communities in Glasgow, UK

This paper examines changes to the walkability of the built environment and associated changes in walking behaviour following area regeneration or relocation in Glasgow, UK. The aim is to contribute to longitudinal evidence of links between the built environment and walking behaviour. Most studies to date have been cross-sectional and the evidence they provide that changing the built environment will lead to changes in walking behaviour is weak. Our study examines how changes in neighbourhood walkability influence levels of walking in the local area. We use household survey data from deprived neighbourhoods in Glasgow undergoing housing-led and area regeneration at two time points, 2011 and 2015. Measures of walkability were calculated for each year as a product of intersection density (connectivity) and dwelling density and attached to survey data. Relationships between changes in walkability and repeated measures of walking frequency are examined. We compare changes in walking between those who move house compared with those who experience changes to the built environment in their existing home location. Those who relocate (‘movers’) are more likely to increase their frequency of walking in the neighbourhood, but this is not necessarily as a result of changes in the built environment as measured using walkability metrics. Prior walking habits are a strong influence, with those who walk at baseline being more likely to increase their walking later. Environmental improvements through renewal programmes are often of insufficient quality or extent to stimulate increased walking. It is likely that area regeneration needs to be combined with people-based and social interventions to produce ‘behavioural spillovers’ that encourage walking habits

Pathogens of skin and skin-structure infections in the UK and their susceptibility to antibiotics, including ceftaroline

Objectives: Bacterial skin and skin-structure infections (SSSIs) are frequent settings for antibiotic use. We surveyed their UK aetiology and pathogen susceptibility, including susceptibility to ceftaroline. Methods: Consecutive SSSI isolates were collected at 35 UK hospitals, to a maximum of 60/site, together with 15 ‘supplementary’ MRSA/site. Isolates were re-identified and BSAC susceptibility testing was performed, with parallel CLSI agar testing for ceftaroline. Results: Isolates (n¼1908) were collected from 1756 hospitalized patients, predominantly with surgical and traumatic infections, abscesses and infected ulcers and largely from general medicine and general surgery patients. They included 1271 Staphylococcus aureus (201 MRSA), 162 b-haemolytic streptococci, 269 Enterobacteriaceae, 138 Pseudomonas aeruginosa and 37 enterococci. Most (944/1756) patients had monomicrobial MSSA infections. Rates of resistance to quinolones, gentamicin and cephalosporins were ,20% in Enterobacteriaceae and ,10% in P. aeruginosa. MRSA rates varied greatly among hospitals and were 2.5-fold higher in general medicine than in general surgery patients. At breakpoint, ceftaroline inhibited: (i) all MSSA and 97.6% of MRSA, with MICs of 2 mg/L for the few resistant MRSA; (ii) all b-haemolytic streptococci; and (iii) 83% of Enterobacteriaceae. High-level ceftaroline resistance in Enterobacteriaceae involved ESBLs or AmpCenzymes. Ceftaroline MICs by CLSI methodology generally equalled those by BSAC or were 2-fold higher, but this differential was 4–16-fold for P. aeruginosa. Conclusions: Irrespective of patient group, SSSIs were dominated by S. aureus. Most pathogens were susceptible, but 15.8% of S. aureus were MRSA, with locally higher prevalence

Global Environmental Engineering for and with Historically Marginalized Communities

Marginalized communities lack full participation in social, economic, and political life, and they disproportionately bear the burden of environmental and health risks. This special issue of Environmental Engineering Science, the official journal of the Association of Environmental Engineering and Science Professors (AEESP), reports research on the unique environmental challenges faced by historically marginalized communities around the world. The results of community-based participatory research with an Afro-descendant community in Columbia, Native American communities in Alaska, United States, villagers in the Philippines, disadvantaged communities in California, United States, rural communities in Mexico and Costa Rica, homeless encampments in the San Diego River (United States) watershed entrepreneurs in Durban, South Africa, and remote communities in the island nation of Fiji are presented. The research reported in this special issue is transdisciplinary, bringing engineers together with anthropologists, sociologists, economists, and public health experts. In the 13 articles in this special issue, some of the topics covered include inexpensive technologies for water treatment, novel agricultural strategies for reversing biodiversity losses, and strategies for climate change adaptation. In addition, one article covered educational strategies for teaching ethics to prepare students for humanitarian engineering, including topics of poverty, sustainability, social justice, and engineering decisions under uncertainty. Finally, an article presented ways that environmental engineering professors can engage and promote the success of underrepresented minority students and enable faculty engaged in community-based participatory research

Faculty Recital

Program listing performers and works performe

Molecular Epidemiology of Staphylococcus aureus Skin and Soft Tissue Infections in the Lao People's Democratic Republic.

This is the first report of the molecular epidemiology of Staphylococcus aureus from skin and soft tissue infections (SSTI) in Laos. We selected a random sample of 96 S. aureus SSTI isolates received by the Microbiology Laboratory, Mahosot Hospital, Vientiane, between July 2012 and June 2014, including representation from seven referral hospitals. Isolates underwent susceptibility testing by Clinical and Laboratory Standards Institute methods, spa typing and DNA microarray analysis, with whole genome sequencing for rare lineages. Median patient age was 19.5 years (interquartile range 2-48.5 years); 52% (50) were female. Forty-three spa types, representing 17 lineages, were identified. Fifty-eight percent (56) of all isolates encoded Panton-Valentine leukocidin (PVL), representing six lineages: half of these patients had abscesses and three had positive blood cultures. The dominant lineage was CC121 (39; 41%); all but one isolate encoded PVL and 49% (19) were from children under five. Staphyococcus argenteus was identified in six (6%) patients; mostly adults > 50 years and with diabetes. Six isolates (6%) belonged to rare lineage ST2885; two possibly indicate cross-infection in a neonatal unit. One isolate from a previously undescribed lineage, ST1541, was identified. Antibiotic resistance was uncommon except for penicillin (93; 97%) and tetracycline (48; 50%). Seven (7%) isolates were methicillin-resistant S. aureus (MRSA), belonging to ST239-MRSA-III, CC59-MRSA-V(T) Taiwan Clone, ST2250-MRSA-IV, ST2885-MRSA-V and CC398-MRSA-V. Globally widespread CC5 and CC30 were absent. There are parallels in S. aureus molecular epidemiology between Laos and neighboring countries and these data highlight the prominence of PVL and suggest infiltration of MRSA clones of epidemic potential from surrounding countries