Pandemic-Related Business Assistance, July 2021

The CARES Act is the largest stimulus package passed in the United States to date. On 12/27/2020, the Consolidated Appropriations Act was passed, providing $900 billion in stimulus relief for the pandemic. Another 1.4 trillion in spending helped plan the 2021 federal fiscal year. On 3/11/2021, the American Rescue Plan was passed providing an additional$1.9 trillion in economic stimulus to further aid the country through the ongoing pandemic. The pandemic has caused an unprecedented increase in unemployment, the closing or suspension of operations for many businesses, a drastic reduction in the capacity to produce many goods and services, and a significant reduction of disposable household income. To assist with these economic emergencies, federal, state, and local governments have passed legislation to aid households and businesses, including some programs for nonprofits. The timeline illustrates various programs developed on the federal, state, and local levels (Cuyahoga County and Cleveland) initiated after the pandemic started. This brief groups the actions of all levels of government into four categories: general business support, small business support, industry-specific support, and unemployment benefits for individuals. The subsequent sections offer a summary of each program and a link to their full description. The timeline covers a period of time from March 2020 to June 2021 and shows which programs continue beyond September 2021

Pandemic-Related Housing Assistance, July 2021

On 12/27/2020, the Consolidated Appropriations Act was passed, providing $900 billion in stimulus relief. Another 1.4 trillion in spending helped plan the 2021 federal fiscal year. On 3/11/2021, the American Rescue Plan passed providing an additional$1.9 trillion in economic stimulus to further aid the country through the ongoing pandemic. The pandemic has damaged not only health systems, but social and economic systems as well. One effect of COVID-19 has been mass housing instability, which is predominantly due to evictions. Many people have lost their jobs, in part or altogether, due to COVID-19, leaving residents with little income to pay their bills, including rent or mortgage and utilities, and forcing them to face consequences such as eviction or utility shutoffs. As a result of these housing issues, federal, state, and local governments have all passed legislation to mitigate housing instability. The timelines displays how the Federal Government, the State of Ohio, Cuyahoga County, and the City of Cleveland responded to housing issues during the COVID-19 pandemic. The timeline covers a period of time from March 2020 to June 2021 and shows which programs continue beyond September 2021

Environmental Profile of a Community’s Health (EPOCH): An Ecometric Assessment of Measures of the Community Environment Based on Individual Perception

Background Public health research has turned towards examining upstream, community-level determinants of cardiovascular disease risk factors. Objective measures of the environment, such as those derived from direct observation, and perception-based measures by residents have both been associated with health behaviours. However, current methods are generally limited to objective measures, often derived from administrative data, and few instruments have been evaluated for use in rural areas or in low-income countries. We evaluate the reliability of a quantitative tool designed to capture perceptions of community tobacco, nutrition, and social environments obtained from interviews with residents in communities in 5 countries. Methodology/ Principal Findings Thirteen measures of the community environment were developed from responses to questionnaire items from 2,360 individuals residing in 84 urban and rural communities in 5 countries (China, India, Brazil, Colombia, and Canada) in the Environmental Profile of a Community’s Health (EPOCH) study. Reliability and other properties of the community-level measures were assessed using multilevel models. High reliability (>0.80) was demonstrated for all community-level measures at the mean number of survey respondents per community (n = 28 respondents). Questionnaire items included in each scale were found to represent a common latent factor at the community level in multilevel factor analysis models. Conclusions/ Significance Reliable measures which represent aspects of communities potentially related to cardiovascular disease (CVD)/risk factors can be obtained using feasible sample sizes. The EPOCH instrument is suitable for use in different settings to explore upstream determinants of CVD/risk factors

Availability, aff ordability, and consumption of fruits and vegetables in 18 countries across income levels: fi ndings from the Prospective Urban Rural Epidemiology (PURE) study

Background Several international guidelines recommend the consumption of two servings of fruits and three servings of vegetables per day, but their intake is thought to be low worldwide. We aimed to determine the extent to which such low intake is related to availability and aff ordability. Methods We assessed fruit and vegetable consumption using data from country-specifi c, validated semi-quantitative food frequency questionnaires in the Prospective Urban Rural Epidemiology (PURE) study, which enrolled participants from communities in 18 countries between Jan 1, 2003, and Dec 31, 2013. We documented household income data from participants in these communities; we also recorded the diversity and non-sale prices of fruits and vegetables from grocery stores and market places between Jan 1, 2009, and Dec 31, 2013. We determined the cost of fruits and vegetables relative to income per household member. Linear random eff ects models, adjusting for the clustering of households within communities, were used to assess mean fruit and vegetable intake by their relative cost. Findings Of 143 305 participants who reported plausible energy intake in the food frequency questionnaire, mean fruit and vegetable intake was 3·76 servings (95% CI 3·66–3·86) per day. Mean daily consumption was 2·14 servings (1·93–2·36) in low-income countries (LICs), 3·17 servings (2·99–3·35) in lower-middle-income countries (LMICs), 4·31 servings (4·09–4·53) in upper-middle-income countries (UMICs), and 5·42 servings (5·13–5·71) in highincome countries (HICs). In 130 402 participants who had household income data available, the cost of two servings of fruits and three servings of vegetables per day per individual accounted for 51·97% (95% CI 46·06–57·88) of household income in LICs, 18·10% (14·53–21·68) in LMICs, 15·87% (11·51–20·23) in UMICs, and 1·85% (–3·90 to 7·59) in HICs (ptrend=0·0001). In all regions, a higher percentage of income to meet the guidelines was required in rural areas than in urban areas (p<0·0001 for each pairwise comparison). Fruit and vegetable consumption among individuals decreased as the relative cost increased (ptrend=0·00040). Interpretation The consumption of fruit and vegetables is low worldwide, particularly in LICs, and this is associated with low aff ordability. Policies worldwide should enhance the availability and aff ordability of fruits and vegetables

Environmental Profile of a Community’s Health (EPOCH): An Ecometric Assessment of Measures of the Community Environment Based on Individual Perception

Background: Public health research has turned towards examining upstream, community-level determinants of cardiovascular disease risk factors. Objective measures of the environment, such as those derived from direct observation, and perception-based measures by residents have both been associated with health behaviours. However, current methods are generally limited to objective measures, often derived from administrative data, and few instruments have been evaluated for use in rural areas or in low-income countries. We evaluate the reliability of a quantitative tool designed to capture perceptions of community tobacco, nutrition, and social environments obtained from interviews with residents in communities in 5 countries. Methodology/Principal Findings: Thirteen measures of the community environment were developed from responses to questionnaire items from 2,360 individuals residing in 84 urban and rural communities in 5 countries (China, India, Brazil, Colombia, and Canada) in the Environmental Profile of a Community’s Health (EPOCH) study. Reliability and other properties of the community-level measures were assessed using multilevel models. High reliability (>0.80) was demonstrated for all community-level measures at the mean number of survey respondents per community (n = 28 respondents). Questionnaire items included in each scale were found to represent a common latent factor at the community level in multilevel factor analysis models. Conclusions/ Significance: Reliable measures which represent aspects of communities potentially related to cardiovascular disease (CVD)/risk factors can be obtained using feasible sample sizes. The EPOCH instrument is suitable for use in different settings to explore upstream determinants of CVD/risk factors

Environmental Profile of a Community\u27s Health (EPOCH): An Instrument to Measure Environmental Determinants of Cardiovascular Health in Five Countries

Background The environment in which people live is known to be important in influencing diet, physical activity, smoking, psychosocial and other risk factors for cardiovascular (CV) disease. However no instrument exists that evaluates communities for these multiple environmental factors and is suitable for use across different communities, regions and countries. This report describes the design and reliability of an instrument to measure environmental determinants of CV risk factors. Method/Principal Findings The Environmental Profile of Community Health (EPOCH) instrument comprises two parts: (I) an assessment of the physical environment, and (II) an interviewer-administered questionnaire to collect residents\u27 perceptions of their community. We examined the inter-rater reliability amongst 3 observers from each region of the direct observation component of the instrument (EPOCH I) in 93 rural and urban communities in 5 countries (Canada, Colombia, Brazil, China and India). Data collection using the EPOCH instrument was feasible in all communities. Reliability of the instrument was excellent (Intraclass Correlation Coefficient - ICC&gt;0.75) for 24 of 38 items and fair to good (ICC 0.4–0.75) for 14 of 38 items. Conclusion This report shows data collection with the EPOCH instrument is feasible and direct observation of community measures reliable. The EPOCH instrument will enable further research on environmental determinants of health for population studies from a broad range of settings

Environmental Profile of a Community's Health (EPOCH): An Instrument to Measure Environmental Determinants of Cardiovascular Health in Five Countries

BACKGROUND: The environment in which people live is known to be important in influencing diet, physical activity, smoking, psychosocial and other risk factors for cardiovascular (CV) disease. However no instrument exists that evaluates communities for these multiple environmental factors and is suitable for use across different communities, regions and countries. This report describes the design and reliability of an instrument to measure environmental determinants of CV risk factors. METHOD/PRINCIPAL FINDINGS: THE ENVIRONMENTAL PROFILE OF COMMUNITY HEALTH (EPOCH) INSTRUMENT COMPRISES TWO PARTS: (I) an assessment of the physical environment, and (II) an interviewer-administered questionnaire to collect residents' perceptions of their community. We examined the inter-rater reliability amongst 3 observers from each region of the direct observation component of the instrument (EPOCH I) in 93 rural and urban communities in 5 countries (Canada, Colombia, Brazil, China and India). Data collection using the EPOCH instrument was feasible in all communities. Reliability of the instrument was excellent (Intraclass Correlation Coefficient--ICC>0.75) for 24 of 38 items and fair to good (ICC 0.4-0.75) for 14 of 38 items. CONCLUSION: This report shows data collection with the EPOCH instrument is feasible and direct observation of community measures reliable. The EPOCH instrument will enable further research on environmental determinants of health for population studies from a broad range of settings

City Know-How

Human health and planetary health are influenced by city lifestyles, city leadership, and city development. For both, worrying trends are leading to increasing concern and it is imperative that human health and environmental impacts become core foci in urban policy. Changing trajectory will require concerted action; the journal Cities & Health is dedicated to supporting the flow of knowledge, in all directions, to help make this happen. We wish to foster communication between researchers, practitioners, policy-makers, communities, and decision-makers in cities. This is the purpose of the City Know-how section of the journal. ‘Research for city practice’ disseminates lessons from research by explaining key messages for city leaders, communities, and the professions involved in city policy and practice. ‘City shorts’ provide glimpses of what is being attempted or achieved ‘on the ground’ and ’case studies’ are where you will find evaluations of interventions. Last, ‘Commentary and debate’ extends conversations we are having to develop and mobilize much needed new thinking. Join in these conversations. In order to strengthen the community of interest, we would like to include many and varied voices, including those from younger practitioners and researchers who are supporting health and health equity in everyday urban lives

Scientific Objectives of Einstein Telescope

The advanced interferometer network will herald a new era in observational astronomy. There is a very strong science case to go beyond the advanced detector network and build detectors that operate in a frequency range from 1 Hz-10 kHz, with sensitivity a factor ten better in amplitude. Such detectors will be able to probe a range of topics in nuclear physics, astronomy, cosmology and fundamental physics, providing insights into many unsolved problems in these areas.Comment: 18 pages, 4 figures, Plenary talk given at Amaldi Meeting, July 201