An Equity-focused Assessment of the City of Richmond’s RVAgreen 2050 Planning Process

Local climate action and sustainability initiatives are often critiqued for their inattention to issues of equity and justice. In response, an increasing number of cities are now attempting to respond to this critique by making equity a more explicit goal of their climate action plans: Richmond Virginia is among those cities. The City of Richmond\u27s Office of Sustainability committed to prioritizing equity in the RVAGreen 2050 plan by recognizing how Richmond’s history of racism and structural inequalities have exacerbated climate concerns for largely Black and Latinx communities and centering historically marginalized communities of color in the engagement process. Students in URSP 637 Sustainable Community Development were asked to provide an external evaluation of the RVAGreen 2050 planning process. This report summarizes the findings of this evaluation and highlights recommendations for how to improve equity-centered engagement processed moving forward

Sex-Specific Computed Tomography Coronary Plaque Characterization and Risk of Myocardial Infarction.

OBJECTIVES: This study was designed to investigate whether coronary computed tomography angiography assessments of coronary plaque might explain differences in the prognosis of men and women presenting with chest pain. BACKGROUND: Important sex differences exist in coronary artery disease. Women presenting with chest pain have different risk factors, symptoms, prevalence of coronary artery disease and prognosis compared to men. METHODS: Within a multicenter randomized controlled trial, we explored sex differences in stenosis, adverse plaque characteristics (positive remodeling, low-attenuation plaque, spotty calcification, or napkin ring sign) and quantitative assessment of total, calcified, noncalcified and low-attenuation plaque burden. RESULTS: Of the 1,769 participants who underwent coronary computed tomography angiography, 772 (43%) were female. Women were more likely to have normal coronary arteries and less likely to have adverse plaque characteristics (p 4% (41% vs. 59%; p < 0.001). Over a median follow-up of 4.7 years, myocardial infarction (MI) occurred in 11 women (1.4%) and 30 men (3%). In those who had MI, women had similar total, noncalcified, and low-attenuation plaque burdens as men, but men had higher calcified plaque burden. Low-attenuation plaque burden predicted MI (hazard ratio: 1.60; 95% confidence interval: 1.10 to 2.34; p = 0.015), independent of calcium score, obstructive disease, cardiovascular risk score, and sex. CONCLUSIONS: Women presenting with stable chest pain have less atherosclerotic plaque of all subtypes compared to men and a lower risk of subsequent MI. However, quantitative low-attenuation plaque is as strong a predictor of subsequent MI in women as in men. (Scottish Computed Tomography of the HEART Trial [SCOT-HEART]; NCT01149590)