The Impact of Neighborhood Conditions and Psychological Distress on Preterm Birth in African‐American Women

ObjectivePrior research suggests that adverse neighborhood conditions are related to preterm birth. One potential pathway by which neighborhood conditions increase the risk for preterm birth is by increasing women’s psychological distress. Our objective was to examine whether psychological distress mediated the relationship between neighborhood conditions and preterm birth.Design and SampleOne hundred and one pregnant African‐American women receiving prenatal care at a medical center in Chicago participated in this cross‐sectional design study.MeasuresWomen completed the self‐report instruments about their perceived neighborhood conditions and psychological distress between 15–26 weeks gestation. Objective measures of the neighborhood were derived using geographic information systems (GIS). Birth data were collected from medical records.ResultsPerceived adverse neighborhood conditions were related to psychological distress: perceived physical disorder (r = .26, p = .01), perceived social disorder (r = .21, p = .03), and perceived crime (r = .30, p = .01). Objective neighborhood conditions were not related to psychological distress. Psychological distress mediated the effects of perceived neighborhood conditions on preterm birth.ConclusionsPsychological distress in the second trimester mediated the effects of perceived, but not objective, neighborhood conditions on preterm birth. If these results are replicable in studies with larger sample sizes, intervention strategies could be implemented at the individual level to reduce psychological distress and improve women’s ability to cope with adverse neighborhood conditions.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/137507/1/phn12305_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/137507/2/phn12305.pd

Relationship between area mortgage foreclosures, homeownership, and cardiovascular disease risk factors: The Hispanic Community Health Study/Study of Latinos

Abstract Background The risk of mortgage foreclosure disproportionately burdens Hispanic/Latino populations perpetuating racial disparities in health. In this study, we examined the relationship between area-level mortgage foreclosure risk, homeownership, and the prevalence of cardiovascular disease risk factors among participants of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Methods HCHS/SOL participants were age 18–74 years when recruited from four U.S. metropolitan areas. Mortgage foreclosure risk was obtained from the U.S. Department of Housing and Urban Development. Homeownership, sociodemographic factors, and cardiovascular disease risk factors were measured at baseline interview between 2008 and 2011. There were 13,856 individuals contributing to the analysis (median age 39 years old, 53% female). Results Renters in high foreclosure risk areas had a higher prevalence of hypertension and hypercholesterolemia but no association with smoking status compared to renters in low foreclosure risk areas. Renters were more likely to smoke cigarettes than homeowners. Conclusion Among US Hispanic/Latinos in urban cities, area foreclosure and homeownership have implications for risk of cardiovascular disease

Social and individual subjective wellbeing and capabilities in Chile

The notion of social belongingness has been applied to different scales, from individual to social processes, and from subjective to objective dimensions. This article seeks to contribute to this multidimensional perspective on belongingness by drawing from the capabilities and subjective wellbeing perspectives. The specific aim is to analyze the relationships between capabilities—including those related to social belongingness—and individual and social subjective wellbeing. The hypotheses are: (H1–H2) There is a relationship between capabilities (measured as evaluation and functioning) and (H1) individual and (H2) social subjective wellbeing; (H3) The set of capabilities associated to individual subjective wellbeing differs from the set correlated to social subjective wellbeing; (H4) The intensity and significance of the correlation between subjective wellbeing and capabilities depends on whether the latter is measured as evaluation or functioning; and (H5) The relationships between capabilities and subjective wellbeing are complex and non-linear. Using a nationally representative survey in Chile, multiple linear (H1–H5) and dose response matching (H1–H5) regressions between capabilities and subjective wellbeing outcomes are estimated, confirming all hypotheses. Subjective evaluations and effective functionings of some capabilities (“basic needs,” “social ties,” “feeling recognized and respected;” “having and deploying a life project”) are consistently correlated with both subjective wellbeing outcomes. Others capabilities are correlated with both subjective wellbeing outcomes only when measured as functionings (contact with nature), do not display a systematic pattern of correlation (“health,” “pleasure,” “participation,” and “human security”) or are not associated with subjective wellbeing (“self-knowledge” and “understanding the world”). When observed, correlations are sizable, non-linear, and consistent across estimation methods. Moreover, capabilities related to social belongingness such as “social ties” and “feeling recognized and respected” are important by themselves but also are positively correlated to both social and individual subjective wellbeing. These findings underscore the need of a multidimensional perspective on the relationships between capabilities and subjective wellbeing, considering both subjective and objective, as well as individual and social aspects that are relevant to belongingness. These findings also have practical and policy implications, and may inform public deliberation processes and policy decisions to develop capabilities, promote subjective wellbeing, and ultimately promote positive belongingness

Diet And Perceptions Change With Supermarket Introduction In A Food Desert, But Not Because Of Supermarket Use.

Placing full-service supermarkets in food deserts--areas with limited access to healthy food--has been promoted as a way to reduce inequalities in access to healthy food, improve diet, and reduce the risk of obesity. However, previous studies provide scant evidence of such impacts. We surveyed households in two Pittsburgh, Pennsylvania, neighborhoods in 2011 and 2014, one of which received a new supermarket in 2013. Comparing trends in the two neighborhoods, we obtained evidence of multiple positive impacts from new supermarket placement. In the new supermarket neighborhood we found net positive changes in overall dietary quality; average daily intakes of kilocalories and added sugars; and percentage of kilocalories from solid fats, added sugars, and alcohol. However, the only positive outcome in the recipient neighborhood specifically associated with regular use of the new supermarket was improved perceived access to healthy food. We did not observe differential improvement between the neighborhoods in fruit and vegetable intake, whole grain consumption, or body mass index. Incentivizing supermarkets to locate in food deserts is appropriate. However, efforts should proceed with caution, until the mechanisms by which the stores affect diet and their ability to influence weight status are better understood

Neighbourhood socioeconomic disadvantage and fruit and vegetable consumption:a seven countries comparison

BACKGROUND: Low fruit and vegetable consumption is a risk factor for poor health. Studies have shown consumption varies across neighbourhoods, with lower intakes in disadvantaged neighbourhoods. However, findings are inconsistent, suggesting that socio-spatial inequities in diet could be context-specific, highlighting a need for international comparisons across contexts. This study examined variations in fruit and vegetable consumption among adults from neighbourhoods of varying socioeconomic status (SES) across seven countries (Australia, Canada, Netherlands, New Zealand, Portugal, Scotland, US). METHODS: Data from seven existing studies, identified through literature searches and knowledge of co-authors, which collected measures of both neighbourhood-level SES and fruit and vegetable consumption were used. Logistic regression was used to examine associations between neighbourhood-level SES and binary fruit and vegetable consumption separately, adjusting for neighbourhood clustering and age, gender and education. As much as possible, variables were treated in a consistent manner in the analysis for each study to allow the identification of patterns of association within study and to examine differences in the associations across studies. RESULTS: Adjusted analyses showed evidence of an association between neighbourhood-level SES and fruit consumption in Canada, New Zealand and Scotland, with increased odds of greater fruit intake in higher SES neighbourhoods. In Australia, Canada, New Zealand and Portugal, those residing in higher SES neighbourhoods had increased odds of greater vegetable intake. The other studies showed no evidence of a difference by neighbourhood-level SES. CONCLUSIONS: Acknowledging discrepancies across studies in terms of sampling, measures, and definitions of neighbourhoods, this opportunistic study, which treated data in a consistent manner, suggests that associations between diet and neighbourhood-level socioeconomic status vary across countries. Neighbourhood socioeconomic disadvantage may differentially impact on access to resources in which produce is available in different countries. Neighbourhood environments have the potential to influence behaviour and further research is required to examine the context in which these associations arise

Comparing perception-based and geographic information systems (GIS) based characterizations of the local food environment

Measuring features of the local food environment has been a major challenge in studying the effect of the environment on diet. This study examined associations between alternate ways of characterizing the local food environment by comparing Geographic Information System (GIS)-derived densities of various types of stores to perception-based measures of the availability of healthy foods. Survey questions rating the availability of produce and low-fat products in neighborhoods were aggregated into a healthy food availability score for 5,774 residents of North Carolina, Maryland, and New York. Densities of supermarkets and smaller stores per square mile were computed for 1 mile around each respondent’s residence using kernel estimation. The number of different store types in the area was used to measure variety in the food environment. Linear regression was used to examine associations of store densities and variety with reported availability. Respondents living in areas with lower densities of supermarkets rated the selection and availability of produce and low-fat foods 17% lower than those in areas with the highest densities of supermarkets (95% CL, −18.8, −15.1). In areas without supermarkets, low densities of smaller stores and less store variety were associated with worse perceived availability of healthy foods only in North Carolina (8.8% lower availability, 95% CL, −13.8, −3.4 for lowest vs. highest small-store density; 10.5% lower 95% CL, −16.0, −4.7 for least vs. most store variety). In contrast, higher smaller store densities and more variety were associated with worse perceived healthy food availability in Maryland. Perception- and GIS-based characterizations of the environment are associated but are not identical. Combinations of different types of measures may yield more valid measures of the environment.http://deepblue.lib.umich.edu/bitstream/2027.42/58001/1/Comparing perception based and geographic informatin systems GIS based characterizations of the local food environment.pd

Neighborhood racial composition, neighborhood poverty, and food access in metropolitan Detroit: Geographic information systems and spatial analysis.

Inadequate access to a good selection of high-quality nutritious foods may be a barrier to healthy eating in impoverished, African-American neighborhoods and contribute to higher morbidity and mortality. In this study, I examined the spatial distribution of nutritional resources according to the racial and economic characteristics of neighborhoods in metropolitan Detroit. I first tested the extent to which large chain supermarkets are less accessible in neighborhoods with greater proportions of African-American residents using three spatially explicit measures (Manhattan Block distance to the nearest supermarket, number of supermarkets within a three-mile radius, and potential supermarket accessibility based on an inverse distance function) and whether neighborhood poverty mediates or moderates the association. Adjusting for spatial autocorrelation, the relationship between neighborhood racial composition and supermarket accessibility depends on neighborhood poverty level. For all three accessibility measures, supermarket accessibility is similar in low-poverty neighborhoods across the three tertiles of percentage African-American residents. Among the most impoverished neighborhoods, however, high African-American neighborhoods, on average, are 1.17 miles further from the nearest supermarket, have 2.95 fewer supermarkets within a three-mile radius, and have 0.70-units poorer potential supermarket accessibility when compared to predominately white neighborhoods. This study also compared the spatial distribution of several types of retail food stores (chain, large independent, mom-and-pop, specialty, convenience, and liquor) and the availability, selection, quality, and cost of fresh fruits and vegetables at these stores in four geographically-defined communities in and near Detroit: a poor, predominately African-American community; a poor, racially heterogeneous community; a middle-income, predominately African-American community; and a middle-income, racially heterogeneous community. The poor, predominately African-American community has particularly poor access to nutritional resources. It has considerably fewer large grocery stores, a smaller proportion of retail outlets selling fresh produce, and significantly lower quality produce than the middle-income, racially heterogeneous community, as well as the greatest number of liquor stores of the four communities. Overall, results of this study indicating unequal distribution of nutritional resources according to an interaction between the racial and economic characteristics of neighborhoods lend support for racial residential segregation and neighborhood poverty as fundamental causes of disease (Link and Phelan 1995) in metropolitan Detroit.Ph.D.Health and Environmental SciencesNutritionPublic healthSocial SciencesUrban planningUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/124228/2/3122085.pd

Investigating The Association Between Social Disorganization, Health-Related Quality Of Life, And Prostate Cancer Diagnoses In African American Men

Currently, Prostate cancer is the number one cancer among all men in Illinois with 42,773 identified cases between 2002 and 2006 for all races (Illinois Department of Public Heath (IDPH), Illinois Cancer Registry, 2008). Additionally, African American men living in Cook County have the highest rate for all racial groups at 227.1 per 100,000 between 2002 and 2006 (IDPH, Illinois Cancer Registry, 2008). This proposed research attempts to identify any influences of social disorganization on health-related quality of life (HRQL) in African American men living in south suburban cook county in Illinois with Prostate Cancer diagnosis using the International Classification of Functioning, Disability and Health (ICF) to measure and map disability by zip code using Geographic Information System (GIS). The proposed research attempts to identify preventable risk factors during phase one and in phase develop a community intervention for men at risk for prostate cancer, by increasing HRQL of African American men with current diagnosis of prostate cancer