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Evans C, Li W, Matskiv G, Brogly S. Epidemiology and association of neighbourhood marginalisation on violent knife assaults in Ontario: a population-based case-control study. Inj Prev 2024:ip-2023-045156. [PMID: 39033021 DOI: 10.1136/ip-2023-045156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 05/26/2024] [Indexed: 07/23/2024]
Abstract
BACKGROUND Violent knife assaults ('stabbings') are underappreciated as a source of morbidity and mortality. The two objectives of this study were to describe the epidemiology of stabbing injuries in the population of Ontario, Canada and to assess the associations between two measures of neighbourhood marginalisation-material deprivation and housing instability, and the risk of stabbing injury. METHODS We conducted a population-based case-control study over 2004-18 using linked administrative data. Cases suffered a stabbing injury resulting in an emergency department visit, hospitalisation or death. Four age and sex-matched controls were matched to each case. Multivariate logistic regression was used to assess the associations between neighbourhood material deprivation as well as housing instability and the risk of injury. Mean annualised injury incidences were estimated using the number of cases identified divided by the total population of Ontario for that year. RESULTS We identified 26 657 individuals with a stabbing injury, of which 724 (2.7%) were fatal. The mean annualised incidence was 13.4 per 100 000 (95% CI: 12.7 to 15.9). Victims were disproportionately young (median age 25 years; IQR: 20-37 years) males (84.1%), from large urban centres (77.5%), and in the lowest income quintile (39.3%). In multivariate models, neighbourhood material deprivation (OR 1.45, 95% CI: 1.43 to 1.47) and housing instability (OR 1.4, 95% CI: 1.22 to 1.26) were associated with risk of injury. CONCLUSIONS Stabbing injuries are a substantial public health problem that affects individuals of all ages and demographics but disproportionately affects younger men in urban settings. There is a weak association between residence in marginalised neighbourhoods and the risk of stabbing injury. Future studies should aim to better understand the nature of this association and consider opportunities for public health interventions to reduce the burden of violent knife injuries.
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Affiliation(s)
- Christopher Evans
- Emergency Medicine, Queen's University, Kingston, Ontario, Canada
- ICES Queen's, Kingston, Ontario, Canada
| | - Wenbin Li
- ICES Queen's, Kingston, Ontario, Canada
| | - George Matskiv
- Emergency Medicine, Queen's University, Kingston, Ontario, Canada
| | - Susan Brogly
- ICES Queen's, Kingston, Ontario, Canada
- Surgery, Queen's University, Kingston, Ontario, Canada
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2
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Vulliamy P, Hancorn K, Glasgow S, West A, Davenport RA, Brohi K, Griffiths MP. Age-related injury patterns resulting from knife violence in an urban population. Sci Rep 2022; 12:15250. [PMID: 36163382 PMCID: PMC9512781 DOI: 10.1038/s41598-022-17768-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 07/30/2022] [Indexed: 12/01/2022] Open
Abstract
Interpersonal violence involving knives is a major public health problem. The majority of patients are young people in urban areas, but little is known about age-specific patterns of injury and recent trends in injury characteristics. We performed a retrospective cohort study of all patients presenting to an urban major trauma centre with stab injuries resulting from assault between 2012 and 2018. A total of 3583 patients were included. Young people (age under 25) were more likely to have sustained multiple stab wounds compared to older people (43% vs 35%, p < 0.001) and had significantly higher rates of stab injuries involving the lower limbs, groin and buttocks. The annual number of injuries increased steadily during the study period in patients aged under 25 (r2 = 0.82, p = 0.005) and those over 25 (r2 = 0.95, p < 0.001). Over time, limb and junctional injuries accounted for an increasing proportion of stab wounds in young people, overtaking torso injuries as most common pattern of injury by the end of the study period. These findings illustrate the influence of age on injury patterns resulting from knife violence, and support the expansion of outreach initiatives promoting bystander-delivered haemorrhage control of extremity wounds.
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Affiliation(s)
- P Vulliamy
- Centre for Trauma Sciences, Blizard Institute, Queen Mary University of London, London, E1 2AT, UK
| | - K Hancorn
- The Royal London Hospital Major Trauma Centre, Barts Health NHS Trust, Whitechapel, E1 1FR, UK
| | - S Glasgow
- Centre for Trauma Sciences, Blizard Institute, Queen Mary University of London, London, E1 2AT, UK
| | - A West
- The Royal London Hospital Major Trauma Centre, Barts Health NHS Trust, Whitechapel, E1 1FR, UK
| | - R A Davenport
- Centre for Trauma Sciences, Blizard Institute, Queen Mary University of London, London, E1 2AT, UK.,The Royal London Hospital Major Trauma Centre, Barts Health NHS Trust, Whitechapel, E1 1FR, UK
| | - K Brohi
- Centre for Trauma Sciences, Blizard Institute, Queen Mary University of London, London, E1 2AT, UK.,The Royal London Hospital Major Trauma Centre, Barts Health NHS Trust, Whitechapel, E1 1FR, UK
| | - M P Griffiths
- The Royal London Hospital Major Trauma Centre, Barts Health NHS Trust, Whitechapel, E1 1FR, UK.
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3
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Ginzburg SL, Lemon SC, Rosal M. Neighborhood characteristics and ataque de nervios: the role of neighborhood violence. Transcult Psychiatry 2022; 59:438-447. [PMID: 32693690 DOI: 10.1177/1363461520935674] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Ataque de nervios is a Latina/o idiom of distress that may occur as a culturally sanctioned response to acute stressful experiences, particularly relating to grief, threat, family conflict, and a breakdown in social networks. The contextual factors associated with ataque de nervios have received little attention in research. This study examined the association between neighborhood factors and the experience of ataque de nervios among a sample of Latinas/os participating in the Latino Health and Well-Being Project in the northeastern United States. We examined the association between neighborhood cohesion, safety, trust, and violence and ataque de nervios. In multivariate logistic regression models, neighborhood violence was associated with ataque de nervios (p = .02), with each unit increase in the neighborhood violence scale being associated with 1.36 times greater odds of experiencing ataque de nervios. None of the other neighborhood variables were significantly associated with ataque de nervios. The positive association between neighborhood violence and the experience of ataque de nervios makes a further case for policy efforts and other investments to reduce neighborhood violence.
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Abstract
In a context where epidemiologic research has been heavily influenced by a biomedical and individualistic approach, the naming of “social epidemiology” allowed explicit emphasis on the social production of disease as a powerful explanatory paradigm and as critically important for interventions to improve population health. This review briefly highlights key substantive areas of focus in social epidemiology over the past 30 years, reflects on major advances and insights, and identifies challenges and possible future directions. Future opportunities for social epidemiology include grounding research in theoretically based and systemic conceptual models of the fundamental social drivers of health; implementing a scientifically rigorous yet realistic approach to drawing conclusions about social causes; using complementary methods to generate valid explanations and identify effective actions; leveraging the power of harmonization, replication, and big data; extending interdisciplinarity and diversity; advancing emerging critical approaches to understanding the health impacts of systemic racism and its policy implications; going global; and embracing a broad approach to generating socially useful research. Expected final online publication date for the Annual Review of Public Health, Volume 43 is April 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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Affiliation(s)
- Ana V. Diez Roux
- Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
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5
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Donnelly KA, Badolato GM, Goyal MK. Determining Intentionality of Pediatric Firearm Injuries by International Classification of Disease Code. Pediatr Emerg Care 2022; 38:e306-e309. [PMID: 33105466 DOI: 10.1097/pec.0000000000002272] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Firearm injuries are a leading cause of serious injury and death in childhood. The accuracy of International Classification of Disease (ICD) codes to assign intent is unclear. The objective of this study was to assess the validity of documented ICD codes for firearm injury intent compared with chart review. METHODS We performed a retrospective cohort study of children (<= 18 years) presenting to a tertiary care level 1 pediatric trauma center with firearm injuries between 2006 and 2017. We compared agreement between ICD codes and intent of injury determined by medical record review using Cohen κ. Intent for medical record review was assigned via the injury spectrum of intentionality (suicide attempt, accidental firing, mistaken target, firearm assault and unknown). For comparison with ICD codes, all medical record review cases marked as mistaken target were classified as accidental. A sensitivity analysis was then performed, coding all mistaken targets as assault. RESULTS There were 122 cases identified over the study period. The most common intent by ICD code was assault (n = 80, 65.6%). Medical record review categorized most injuries as mistaken targets. When mistaken target was categorized as accidental, most firearm injuries were coded as accidental (n = 89, 72.9%) Similar results were seen when mistaken target was categorized as assault, most injuries were categorized as assault (n = 79, 79.5%) Cohen κ was 0.15 when mistaken targets were categorized as accident and 0.30 when categorized as assault. CONCLUSIONS The ICD codes do not fully describe the intent of firearm injury. Revising ICD codes to account for mistaken targets could help to improve the validity of ICD codes for intent.
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Affiliation(s)
- Katie A Donnelly
- From the Children's National Hospital, George Washington University, Washington, DC
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6
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Does the Mass Public Transport System Cover the Social Transport Needs? Targeting SDG 11.2 in Guadalajara, Mexico. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11167709] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This paper analyses how SITEUR, the Mass Public Transport System (MPTS) in the Guadalajara Metropolitan Area (GMA), covers transport social needs, contributing to achieve Sustainable Development Goals (SDG) 11.2. In order to facilitate this, an Index of Mass Transport Provision (IMTP) was measured through proximity, frequency, and capacity. Then, an Index of Social Transport Needs (ISTN) was calculated by means of transport disadvantage indicators. Finally, the Index of Social Transport Needs Covered (ICSTN) was calculated. The calculations used geographic information systems and principal component analysis in 1834 geographic sections. Findings highlight that 50.3% of the inhabitants have a very high level of social transport needs, while only 6.8% of the population have very low social transport needs. Results show that SITEUR promotes advancement in public transport systems within the GMA relative to quality, security, and reliability and it also contributes to tackling social exclusion in the GMA. A proposal related to transport systems integration is included, to address an important aspect of social exclusion in the city.
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Baeza F, Vives Vergara A, González F, Orlando L, Valdebenito R, Cortinez-O’Ryan A, Slesinski C, Diez Roux AV. The Regeneración Urbana, Calidad de Vida y Salud - RUCAS project: a Chilean multi-methods study to evaluate the impact of urban regeneration on resident health and wellbeing. BMC Public Health 2021; 21:728. [PMID: 33858373 PMCID: PMC8047526 DOI: 10.1186/s12889-021-10739-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 03/30/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The available evidence of the health effects of urban regeneration is scarce In Latin America, and there are no studies focused on formal housing that longitudinally evaluate the impact of housing and neighborhood interventions on health. The "Regeneración Urbana, Calidad de Vida y Salud" (Urban Regeneration, Quality of Life, and Health) or RUCAS project is a longitudinal, multi-method study that will evaluate the impact of an intervention focused on dwellings, built environment and community on the health and wellbeing of the population in two social housing neighborhoods in Chile. METHODS RUCAS consists of a longitudinal study where inhabitants exposed and unexposed to the intervention will be compared over time within the study neighborhoods (cohorts), capitalizing on interventions as a natural experiment. Researchers have developed a specific conceptual framework and identified potential causal mechanisms. Proximal and more distal intervention effects will be measured with five instruments, implemented pre- and post-interventions between 2018 and 2021: a household survey, an observation tool to evaluate dwelling conditions, hygrochrons for measuring temperature and humidity inside dwellings, systematic observation of recreational areas, and qualitative interviews. Survey baseline data (956 households, 3130 individuals) is presented to describe sociodemographics, housing and health characteristics of both cohorts, noting that neighborhoods studied show worse conditions than the Chilean population. DISCUSSION RUCAS' design allows for a comprehensive evaluation of the effects that the intervention could have on various dimensions of health and health determinants. RUCAS will face some challenges, like changes in the intervention process due to adjustments of the master plan, exogenous factors -including COVID-19 pandemic and associated lockdowns- and lost to follow-up. Given the stepped wedge design, that the study capitalizes on within household changes over time, the possibility of adjusting data collection process and complementarity of methods, RUCAS has the flexibility to adapt to these circumstances. Also, RUCAS' outreach and retention strategy has led to high retention rates. RUCAS will provide evidence to inform regeneration processes, highlighting the need to consider potential health effects of regeneration in designing such interventions and, more broadly, health as a key priority in urban and housing policies.
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Affiliation(s)
- Fernando Baeza
- Department of Public Health, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, 8330077 Santiago, Chile
- Institute of Geography, Pontificia Universidad Católica de Chile, Vicuña Mackenna 4860, 7820436 Santiago, Chile
| | - Alejandra Vives Vergara
- Department of Public Health, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, 8330077 Santiago, Chile
- Centre for Sustainable Urban Development (CEDEUS), Los Navegantes 1963, 7520246 Santiago, Chile
| | - Francisca González
- Department of Public Health, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, 8330077 Santiago, Chile
| | - Laura Orlando
- Department of Public Health, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, 8330077 Santiago, Chile
| | - Roxana Valdebenito
- Department of Public Health, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, 8330077 Santiago, Chile
| | - Andrea Cortinez-O’Ryan
- Department of Public Health, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, 8330077 Santiago, Chile
- Department of Physical Education, Sports and Recreation, Universidad de La Frontera, Moneda 673, 8320216 Santiago, Chile
| | - Claire Slesinski
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, 3215 Market St, Philadelphia, PA 19104 USA
| | - Ana V. Diez Roux
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, 3215 Market St, Philadelphia, PA 19104 USA
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8
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Transport Poverty with Special Reference to Sustainability: A Systematic Review of the Literature. SUSTAINABILITY 2021. [DOI: 10.3390/su13031451] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of this work is to analyse the state of the art of scientific research related to transport poverty with special reference to sustainability and to identify new research needs. To this end, a methodology has been used in line with the objective set out, choosing the systematic review of the literature as the most suitable method. The results show that transport poverty is an under-exploited issue and is not well articulated by researchers, and there are great differences between the different areas of knowledge studied. The subjects related to health and medicine have more publications, almost 58%, with the rest distributed among 11 different subjects. Of the works analysed, only 26.69% refer to the topic of sustainability, and therefore this is a branch which is little studied in the literature in this field. Another relevant finding is that all the articles analysed highlight the vulnerability and inequality of the groups affected by transport poverty, with the elderly being the least studied in the research work.
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9
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Bossio JC, Sanchis I, Herrero MB, Armando GA, Arias SJ. Mortalidad infantil y desigualdades sociales en Argentina, 1980-2017. Rev Panam Salud Publica 2020; 44:e127. [PMID: 33165396 PMCID: PMC7603357 DOI: 10.26633/rpsp.2020.127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 05/01/2020] [Indexed: 11/24/2022] Open
Abstract
Objetivo. Estimar la tendencia de la mortalidad infantil, de la desigualdad entre jurisdicciones y de la desigualdad asociada a las condiciones sociales en Argentina entre 1980 y 2017. Métodos. Estudio ecológico y de serie temporal de la mortalidad infantil y de su desigualdad. Se obtuvieron los datos oficiales de mortalidad infantil, de nacimientos y de necesidades básicas insatisfechas; se calculó la tasa de mortalidad infantil, el índice de Gini y el índice de concentración. También se analizó la tendencia con un modelo de regresión lineal y se calculó el coeficiente de regresión y su significación estadística. Resultados. La mortalidad infantil se redujo 71,2% (de 32,41 a 9,34 por 1 000 nacidos vivos). La desigualdad por jurisdicción también se redujo y el índice de Gini pasó de 0,163 a 0,09. La desigualdad asociada a las condiciones sociales también mostró una reducción, y el índice de concentración disminuyó de -0,153 a -0,079. Si bien la mortalidad infantil se redujo en todo el período, este descenso no siempre se acompañó de una reducción del índice de Gini y del índice de concentración. Conclusiones. La tendencia de la tasa de mortalidad infantil fue al descenso mientras que la desigualdad en su distribución por jurisdicción y la desigualdad asociada a las condiciones sociales no siempre acompañaron esa reducción.
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Affiliation(s)
- Juan Carlos Bossio
- Instituto Nacional de Enfermedades Respiratorias “Emilio Coni”, Santa Fe, Argentina
| | - Iván Sanchis
- Universidad Nacional del Litoral, Santa Fe, Argentina
| | - María Belén Herrero
- Facultad Latinoamericana de Ciencias Sociales (FLACSO), Buenos Aires, Argentina
| | | | - Sergio Javier Arias
- Instituto Nacional de Enfermedades Respiratorias “Emilio Coni”, Santa Fe, Argentina
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10
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Stankov I, Garcia LMT, Mascolli MA, Montes F, Meisel JD, Gouveia N, Sarmiento OL, Rodriguez DA, Hammond RA, Caiaffa WT, Diez Roux AV. A systematic review of empirical and simulation studies evaluating the health impact of transportation interventions. ENVIRONMENTAL RESEARCH 2020; 186:109519. [PMID: 32335428 PMCID: PMC7343239 DOI: 10.1016/j.envres.2020.109519] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 04/08/2020] [Accepted: 04/10/2020] [Indexed: 06/11/2023]
Abstract
Urban transportation is an important determinant of health and environmental outcomes, and therefore essential to achieving the United Nation's Sustainable Development Goals. To better understand the health impacts of transportation initiatives, we conducted a systematic review of longitudinal health evaluations involving: a) bus rapid transit (BRT); b) bicycle lanes; c) Open Streets programs; and d) aerial trams/cable cars. We also synthesized systems-based simulation studies of the health-related consequences of walking, bicycling, aerial tram, bus and BRT use. Two reviewers screened 3302 unique titles and abstracts identified through a systematic search of MEDLINE (Ovid), Scopus, TRID and LILACS databases. We included 39 studies: 29 longitudinal evaluations and 10 simulation studies. Five studies focused on low- and middle-income contexts. Of the 29 evaluation studies, 19 focused on single component bicycle lane interventions; the rest evaluated multi-component interventions involving: bicycle lanes (n = 5), aerial trams (n = 1), and combined bicycle lane/BRT systems (n = 4). Bicycle lanes and BRT systems appeared effective at increasing bicycle and BRT mode share, active transport duration, and number of trips using these modes. Of the 10 simulation studies, there were 9 agent-based models and one system dynamics model. Five studies focused on bus/BRT expansions and incentives, three on interventions for active travel, and the rest investigated combinations of public transport and active travel policies. Synergistic effects were observed when multiple policies were implemented, with several studies showing that sizable interventions are required to significantly shift travel mode choices. Our review indicates that bicycle lanes and BRT systems represent promising initiatives for promoting population health. There is also evidence to suggest that synergistic effects might be achieved through the combined implementation of multiple transportation policies. However, more rigorous evaluation and simulation studies focusing on low- and middle-income countries, aerial trams and Open Streets programs, and a more diverse set of health and health equity outcomes is required.
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Affiliation(s)
- Ivana Stankov
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, 3600 Market St, 7th Floor, Philadelphia, PA, 19104, USA.
| | - Leandro M T Garcia
- UKCRC Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | | | - Felipe Montes
- Department of Industrial Engineering, Social and Health Complexity Center, Universidad de Los Andes, Bogotá, Colombia
| | - José D Meisel
- Facultad de Ingeniería, Universidad de Ibagué, Carrera 22 Calle 67, Ibagué, 730001, Colombia
| | - Nelson Gouveia
- Department of Preventive Medicine, University of São Paulo Medical School, São Paulo, Brazil
| | - Olga L Sarmiento
- School of Medicine, Universidad de Los Andes, Cra 1 # 18a-10, Bogotá, Colombia
| | - Daniel A Rodriguez
- University of California, Berkeley, USA; Department of City and Regional Planning and Institute for Transportation Studies, University of California, Berkeley, USA
| | - Ross A Hammond
- Center on Social Dynamics and Policy, The Brookings Institution, 1775 Massachusetts Ave NW, Washington, DC, 20036, USA; Brown School at Washington University in St. Louis, One Brookings Drive, St Louis, MO, 36130, USA
| | - Waleska Teixeira Caiaffa
- Observatory for Urban Health in Belo Horizonte, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Ana V Diez Roux
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, 3600 Market St, 7th Floor, Philadelphia, PA, 19104, USA
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11
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Henson RM, Ortigoza A, Martinez-Folgar K, Baeza F, Caiaffa W, Vives Vergara A, Diez Roux AV, Lovasi G. Evaluating the health effects of place-based slum upgrading physical environment interventions: A systematic review (2012-2018). Soc Sci Med 2020; 261:113102. [PMID: 32739786 PMCID: PMC7611465 DOI: 10.1016/j.socscimed.2020.113102] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 05/28/2020] [Accepted: 05/31/2020] [Indexed: 11/04/2022]
Abstract
Rapid urbanization in low- and middle-income countries (LMIC) is associated with increasing population living in informal settlements. Inadequate infrastructure and disenfranchisement in settlements can create environments hazardous to health. Placed-based physical environment upgrading interventions have potential to improve environmental and economic conditions linked to health outcomes. Summarizing and assessing evidence of the impact of prior interventions is critical to motivating and selecting the most effective upgrading strategies moving forward. Scientific and grey literature were systematically reviewed to identify evaluations of physical environment slum upgrading interventions in LMICs published between 2012 and 2018. Thirteen evaluations that fulfilled inclusion criteria were reviewed. Quality of evaluations was assessed using an adapted Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. Findings were then pooled with those published prior to 2012. Narrative analysis was performed. Of thirteen evaluations, eight used a longitudinal study design (“primary evaluations”). All primary evaluations were based in Latin America and included two housing, two transportation, and four comprehensive intervention evaluations. Three supporting evaluations assessed housing interventions in Argentina and South Africa; two assessed a comprehensive intervention in India. Effects by intervention-type included improvements in quality of life and communicable diseases after housing interventions, possible improvements in safety after transportation and comprehensive interventions, and possible non-statistically significant effects on social capital after comprehensive interventions. Effects due to interventions may vary by regional context and intervention scope. Limited strong evidence and the diffuse nature of comprehensive interventions suggests a need for attention to measurement of intervention exposure and analytic approaches to account for confounding and selection bias in evaluation. In addition to health improvements, evaluators should consider unintended health consequences and environmental impact. Understanding and isolating the effects of place-based interventions can inform necessary policy decisions to address inadequate living conditions as rapid urban growth continues across the globe.
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Affiliation(s)
- Rosie Mae Henson
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, 3600 Market Street, 7th Floor, Philadelphia, PA, USA, 19104.
| | - Ana Ortigoza
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, 3600 Market Street, 7th Floor, Philadelphia, PA, USA, 19104
| | - Kevin Martinez-Folgar
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, 3600 Market Street, 7th Floor, Philadelphia, PA, USA, 19104; Instituto de Nutrición de Centroamérica y Panamá (INCAP), Guatemala
| | - Fernando Baeza
- Departamento de Salud Pública, Escuela de Medicina, Pontificia Universidad Católica de Chile, Chile
| | - Waleska Caiaffa
- Observatório de Saúde Urbana de Belo Horizonte, Universidade Federal de Minas Gerais, Brazil
| | - Alejandra Vives Vergara
- Departamento de Salud Pública, Escuela de Medicina, Pontificia Universidad Católica de Chile, Chile; Centro de Desarrollo Urbano Sustentable (CEDEUS), Pontificia Universidad Católica de Chile, Chile
| | - Ana V Diez Roux
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, 3600 Market Street, 7th Floor, Philadelphia, PA, USA, 19104
| | - Gina Lovasi
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, 3600 Market Street, 7th Floor, Philadelphia, PA, USA, 19104
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12
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Matzopoulos R, Bloch K, Lloyd S, Berens C, Bowman B, Myers J, Thompson ML. Urban upgrading and levels of interpersonal violence in Cape Town, South Africa: The violence prevention through urban upgrading programme. Soc Sci Med 2020; 255:112978. [PMID: 32330747 DOI: 10.1016/j.socscimed.2020.112978] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 04/01/2020] [Accepted: 04/05/2020] [Indexed: 11/15/2022]
Abstract
Violence Prevention through Urban Upgrading applies second generation crime prevention through environmental design, which includes built environment interventions alongside social programmes and community participation initiatives in Khayelitsha, one of South Africa's poorest and most violent suburbs. We conducted a retrospective population-based study using survey data from 3625 geo-located households collected between 2013 and 2015 and mapped alcohol outlets to assess the association between the intervention and reported experience of violence. The analysis used generalised linear models to estimate and compare selfreported experience of violence adjusting for known confounders, which included area and household deprivation as well as alcohol outlet density. Living in close proximity to the upgraded urban infrastructure was associated with a 34% reduced exposure to interpersonal violence after adjusting for confounders. This association was consistent across age and gender. Access to additional social programmes alongside the urban upgrading intervention was not associated with further reduction in risk. The association between urban-upgrading and reduced exposure to interpersonal violence supports its inclusion among interventions in national and local crime prevention policies to address social and structural environments.
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Affiliation(s)
- Richard Matzopoulos
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa; Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa.
| | - Kim Bloch
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Sam Lloyd
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa; Institute of Science, Technology and Policy and Center for Security Studies, ETH Zürich, Switzerland
| | | | - Brett Bowman
- School of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Jonny Myers
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Mary Lou Thompson
- Department of Biostatistics, School of Public Health and Community Medicine, University of Washington, USA
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13
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Urban Crime Occurrences in Association with Built Environment Characteristics: An African Case with Implications for Urban Design. SUSTAINABILITY 2020. [DOI: 10.3390/su12073056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Empirically, the physical spatial arrangement of places provides us with a clue about the likelihood for crime opportunities based on the principles of crime prevention through environmental design (CPTED). Although we know that the quality of the urban built environment influences people’s behavior, its measurement as a variable is not an easy task. In this study, we present and develop a set of urban built environment indicators (UBEIs) based on two datasets: building footprints and road networks at the neighborhood level in the city of Praia, Cape Verde. We selected the four most relevant UBEIs to create a single urban built environment indicator (CUBEI), and then, explored their relationships with five types of crime (i.e., burglary, robbery, mugging, residential robbery, and crimes involving weapons) using correlation and regression analysis. Our results showed a consistent and statistically significant relationship between different types of crimes with both the UBEIs and CUBEI, suggesting that a poor urban built environment is associated with an increase of all types of crimes investigated in this study. Thus, to minimize crime incidents, urban planners should rehabilitate or design neighborhoods from the earlier stage, considering the principles of CPTED and broken window theory (BWT).
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Sarmiento OL, Higuera-Mendieta D, Wilches-Mogollon MA, Guzman LA, Rodríguez DA, Morales R, Méndez D, Bedoya C, Linares-Vásquez M, Arévalo MI, Martínez-Herrera E, Montes F, Meisel JD, Useche AF, García E, Triana CA, Medaglia AL, Hessel P, Arellana J, Moncada C, King AC, Diez Roux AV. Urban Transformations and Health: Methods for TrUST-a Natural Experiment Evaluating the Impacts of a Mass Transit Cable Car in Bogotá, Colombia. Front Public Health 2020; 8:64. [PMID: 32211367 PMCID: PMC7075807 DOI: 10.3389/fpubh.2020.00064] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 02/20/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Cable cars provide urban mobility benefits for vulnerable populations. However, no evaluation has assessed cable cars' impact from a health perspective. TransMiCable in Bogotá, Colombia, provides a unique opportunity to (1) assess the effects of its implementation on the environmental and social determinants of health (microenvironment pollution, transport accessibility, physical environment, employment, social capital, and leisure time), physical activity, and health outcomes (health-related quality of life, respiratory diseases, and homicides); and (2) use citizen science methods to identify, prioritize, and communicate the most salient negative and positive features impacting health and quality of life in TransMiCable's area, as well as facilitate a consensus and advocacy-building change process among community members, policymakers, and academic researchers. Methods: TrUST (In Spanish: Transformaciones Urbanas y Salud: el caso de TransMiCable en Bogotá) is a quasi-experimental study using a mixed-methods approach. The intervention group includes adults from Ciudad Bolívar, the area of influence of TransMiCable. The control group includes adults from San Cristóbal, an area of future expansion for TransMiCable. A conceptual framework was developed through group-model building. Outcomes related to environmental and social determinants of health as well as health outcomes are assessed using questionnaires (health outcomes, physical activity, and perceptions), secondary data (crime and respiratory outcomes) use of portable devices (air pollution exposure and accelerometry), mobility tracking apps (for transport trajectories), and direct observation (parks). The Stanford Healthy Neighborhood Discovery Tool is being used to capture residents' perceptions of their physical and social environments as part of the citizen science component of the investigation. Discussion: TrUST is innovative in its use of a mixed-methods, and interdisciplinary research approach, and in its systematic engagement of citizens and policymakers throughout the design and evaluation process. This study will help to understand better how to maximize health benefits and minimize unintended negative consequences of TransMiCable.
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Affiliation(s)
| | | | - Maria A Wilches-Mogollon
- School of Medicine, Universidad de Los Andes, Bogotá, Colombia.,Department of Industrial Engineering, School of Engineering, Universidad de Los Andes, Bogotá, Colombia
| | - Luis A Guzman
- Department of Civil and Environmental Engineering, School of Engineering, Universidad de Los Andes, Bogotá, Colombia
| | - Daniel A Rodríguez
- College of Environmental Design and Institute for Transport Studies, University of California, Berkeley, Berkeley, CA, United States
| | - Ricardo Morales
- Department of Civil and Environmental Engineering, School of Engineering, Universidad de Los Andes, Bogotá, Colombia
| | - Daniela Méndez
- Department of Civil and Environmental Engineering, School of Engineering, Universidad de Los Andes, Bogotá, Colombia
| | - Claudia Bedoya
- School of Medicine, Universidad de Los Andes, Bogotá, Colombia.,Systems Engineering and Computing Department, School of Engineering, Universidad de Los Andes, Bogotá, Colombia
| | - Mario Linares-Vásquez
- Systems Engineering and Computing Department, School of Engineering, Universidad de Los Andes, Bogotá, Colombia
| | - Maria Isabel Arévalo
- Systems Engineering and Computing Department, School of Engineering, Universidad de Los Andes, Bogotá, Colombia
| | - Eliana Martínez-Herrera
- National School of Public Health, Research Group of Epidemiology, Universidad de Antioquia, Medellín, Colombia
| | - Felipe Montes
- Department of Industrial Engineering, School of Engineering, Universidad de Los Andes, Bogotá, Colombia
| | - Jose D Meisel
- Facultad de Ingeniería, Universidad de Ibagué, Ibagué, Colombia
| | - Andrés F Useche
- Department of Industrial Engineering, School of Engineering, Universidad de Los Andes, Bogotá, Colombia
| | - Elizabeth García
- School of Medicine, Universidad de Los Andes, Bogotá, Colombia.,Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Camilo A Triana
- School of Medicine, Universidad de Los Andes, Bogotá, Colombia
| | - Andrés L Medaglia
- Department of Industrial Engineering, School of Engineering, Universidad de Los Andes, Bogotá, Colombia
| | - Philipp Hessel
- School of Government, Universidad de Los Andes, Bogotá, Colombia
| | - Julian Arellana
- Department of Civil and Environmental Engineering, Universidad del Norte, Barranquilla, Colombia
| | - Carlos Moncada
- Facultad de Ingeniería, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Abby C King
- Department of Epidemiology & Population Health, Stanford University School of Medicine, Stanford, CA, United States.,Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA, United States
| | - Ana V Diez Roux
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States.,Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States
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15
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Sarmiento OL, Higuera-Mendieta D, Wilches-Mogollon MA, Guzman LA, Rodríguez DA, Morales R, Méndez D, Bedoya C, Linares-Vásquez M, Arévalo MI, Martínez-Herrera E, Montes F, Meisel JD, Useche AF, García E, Triana CA, Medaglia AL, Hessel P, Arellana J, Moncada C, King AC, Diez Roux AV. Urban Transformations and Health: Methods for TrUST-a Natural Experiment Evaluating the Impacts of a Mass Transit Cable Car in Bogotá, Colombia. Front Public Health 2020. [PMID: 32211367 DOI: 10.3389/fpubh.2020.0006410.3389/fpubh.2020.00064.s001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2023] Open
Abstract
Background: Cable cars provide urban mobility benefits for vulnerable populations. However, no evaluation has assessed cable cars' impact from a health perspective. TransMiCable in Bogotá, Colombia, provides a unique opportunity to (1) assess the effects of its implementation on the environmental and social determinants of health (microenvironment pollution, transport accessibility, physical environment, employment, social capital, and leisure time), physical activity, and health outcomes (health-related quality of life, respiratory diseases, and homicides); and (2) use citizen science methods to identify, prioritize, and communicate the most salient negative and positive features impacting health and quality of life in TransMiCable's area, as well as facilitate a consensus and advocacy-building change process among community members, policymakers, and academic researchers. Methods: TrUST (In Spanish: Transformaciones Urbanas y Salud: el caso de TransMiCable en Bogotá) is a quasi-experimental study using a mixed-methods approach. The intervention group includes adults from Ciudad Bolívar, the area of influence of TransMiCable. The control group includes adults from San Cristóbal, an area of future expansion for TransMiCable. A conceptual framework was developed through group-model building. Outcomes related to environmental and social determinants of health as well as health outcomes are assessed using questionnaires (health outcomes, physical activity, and perceptions), secondary data (crime and respiratory outcomes) use of portable devices (air pollution exposure and accelerometry), mobility tracking apps (for transport trajectories), and direct observation (parks). The Stanford Healthy Neighborhood Discovery Tool is being used to capture residents' perceptions of their physical and social environments as part of the citizen science component of the investigation. Discussion: TrUST is innovative in its use of a mixed-methods, and interdisciplinary research approach, and in its systematic engagement of citizens and policymakers throughout the design and evaluation process. This study will help to understand better how to maximize health benefits and minimize unintended negative consequences of TransMiCable.
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Affiliation(s)
| | | | - Maria A Wilches-Mogollon
- School of Medicine, Universidad de Los Andes, Bogotá, Colombia
- Department of Industrial Engineering, School of Engineering, Universidad de Los Andes, Bogotá, Colombia
| | - Luis A Guzman
- Department of Civil and Environmental Engineering, School of Engineering, Universidad de Los Andes, Bogotá, Colombia
| | - Daniel A Rodríguez
- College of Environmental Design and Institute for Transport Studies, University of California, Berkeley, Berkeley, CA, United States
| | - Ricardo Morales
- Department of Civil and Environmental Engineering, School of Engineering, Universidad de Los Andes, Bogotá, Colombia
| | - Daniela Méndez
- Department of Civil and Environmental Engineering, School of Engineering, Universidad de Los Andes, Bogotá, Colombia
| | - Claudia Bedoya
- School of Medicine, Universidad de Los Andes, Bogotá, Colombia
- Systems Engineering and Computing Department, School of Engineering, Universidad de Los Andes, Bogotá, Colombia
| | - Mario Linares-Vásquez
- Systems Engineering and Computing Department, School of Engineering, Universidad de Los Andes, Bogotá, Colombia
| | - Maria Isabel Arévalo
- Systems Engineering and Computing Department, School of Engineering, Universidad de Los Andes, Bogotá, Colombia
| | - Eliana Martínez-Herrera
- National School of Public Health, Research Group of Epidemiology, Universidad de Antioquia, Medellín, Colombia
| | - Felipe Montes
- Department of Industrial Engineering, School of Engineering, Universidad de Los Andes, Bogotá, Colombia
| | - Jose D Meisel
- Facultad de Ingeniería, Universidad de Ibagué, Ibagué, Colombia
| | - Andrés F Useche
- Department of Industrial Engineering, School of Engineering, Universidad de Los Andes, Bogotá, Colombia
| | - Elizabeth García
- School of Medicine, Universidad de Los Andes, Bogotá, Colombia
- Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Camilo A Triana
- School of Medicine, Universidad de Los Andes, Bogotá, Colombia
| | - Andrés L Medaglia
- Department of Industrial Engineering, School of Engineering, Universidad de Los Andes, Bogotá, Colombia
| | - Philipp Hessel
- School of Government, Universidad de Los Andes, Bogotá, Colombia
| | - Julian Arellana
- Department of Civil and Environmental Engineering, Universidad del Norte, Barranquilla, Colombia
| | - Carlos Moncada
- Facultad de Ingeniería, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Abby C King
- Department of Epidemiology & Population Health, Stanford University School of Medicine, Stanford, CA, United States
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA, United States
| | - Ana V Diez Roux
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States
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Leventhal T, Dupéré V. Neighborhood Effects on Children's Development in Experimental and Nonexperimental Research. ACTA ACUST UNITED AC 2019. [DOI: 10.1146/annurev-devpsych-121318-085221] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Children's neighborhood contexts are defined by rising socioeconomic inequality and segregation. This article reviews several decades of research on how neighborhood socioeconomic conditions are associated with children's development. The nonexperimental literature suggests that the most salient neighborhood socioeconomic condition depends on the outcome—disadvantage for social, emotional, and behavioral outcomes and advantage for achievement-related outcomes. Moreover, children's cumulative exposure to neighborhood socioeconomic conditions over the first two decades of life, and possibly especially in childhood, may matter most for later development. These findings are partially supported by the few experimental studies available, and across study designs, neighborhood effects are typically modest. In order to improve our understanding of this topic, we recommend methodologically rigorous designs—experimental and nonexperimental—and comparative approaches, particularly ones addressing the complexities of development in neighborhood contexts. To guide this research, we provide an integrated framework that captures a broad and dynamic perspective including macro forces, neighborhood social processes and resources, physical features, spatial dynamics, and individual differences.
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Affiliation(s)
- Tama Leventhal
- Eliot-Pearson Department of Child Study and Human Development, Tufts University, Medford, Massachusetts 02155, USA
| | - Veronique Dupéré
- École de Psychoéducation, Université de Montréal, Outremont, Québec H2V 2S9, Canada
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Sanjuán Marín JF, Medina R, Botache Capera WF, Montoya F, Ruiz G, García Marín AF, Badiel M, Ordoñez Delgado CA. Tendencia de los años perdidos de vida potencial por trauma en Colombia: análisis de un periodo de nueve años. REVISTA COLOMBIANA DE CIRUGÍA 2019. [DOI: 10.30944/20117582.513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Introducción. El trauma es reconocido como una epidemia global que varía según las regiones donde se presenta. Una parte de la carga de la enfermedad está determinada por los años perdidos de vida potencial, la cual es una estimación de amplio uso para la vigilancia en salud pública; sin embargo, existe poca información disponible en relación a esto. El objetivo de este estudio fue determinar la tendencia de los años perdidos de vida potencial por el trauma en un período de nueve años. Métodos. La información se obtuvo del Instituto Nacional de Medicina Legal y Ciencias Forenses en un período de nueve años (2007-2015). La población de referencia se determinó con base en las proyecciones del Departamento Administrativo Nacional de Estadística, que indicaron una expectativa de vida de 75 años. Resultados. En el 2015, a las lesiones por traumatismos en Colombia les correspondieron 1.920,7 años perdidos de vida potencial por cada 100.000 personas. Durante el período de estudio, las principales causas fueron los homicidios (rango, 51 a 68 %) y los accidentes de tránsito (rango, 19 a 28 %); la relación entre hombres y mujeres fue de 7:1, y la tendencia estadística fue hacia la disminución de los años perdidos de vida potencial. Conclusiones. Los homicidios siguen aportando el mayor número de lesiones por trauma y años perdidos de vida potencial. Los hombres jóvenes continuaron siendo la población mayormente afectada. Se conceptúa la necesidad de incrementar los esfuerzos para mejorar la vigilancia en salud pública y ahondar en las intervenciones oportunas relacionadas con el trauma.
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Dias MADS, Friche AADL, Costa DADS, Freire FM, Oliveira VBD, Caiaffa WT. Homicídios em Belo Horizonte, MG: um retrato das iniquidades nas cidades. SAUDE E SOCIEDADE 2019. [DOI: 10.1590/s0104-12902019181034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Resumo Os homicídios no Brasil são um dos indicadores mais sensíveis da desigualdade social nas cidades. Assim, políticas de proteção social integradas nos territórios podem impactar esse evento em saúde. Este artigo objetiva descrever os homicídios em Belo Horizonte à luz de um modelo conceitual, parte de um processo avaliativo de um projeto de reurbanização na cidade. A partir da revisão da literatura, construiu-se um modelo conceitual para a compreensão dos homicídios e sua vinculação com o viver nas cidades. Realizou-se um estudo descritivo dos homicídios a partir de dados do Sistema de Informação sobre Mortalidade (SIM) relativos ao período de 2002 a 2012. O modelo conceitual reforça que os homicídios encontram nas cidades seus mais expressivos determinantes vinculados à desigualdade e à exclusão, junto a valores de uma cultura de força e preconceitos. Os homicídios em Belo Horizonte apresentam taxas elevadas na cidade formal, sendo de três a seis vezes maiores nas favelas. Morrem mais negros, jovens homens, de baixa escolaridade, nas vias públicas e nos territórios vulneráveis. Os homicídios são a síntese das desvantagens urbanas, especialmente em tais áreas. Retrata-se em Belo Horizonte o que se vê no Brasil, denunciando a desigualdade e sua perversidade no viver e morrer nas cidades.
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What Does Urban Transformation Look Like? Findings from a Global Prize Competition. SUSTAINABILITY 2019. [DOI: 10.3390/su11174653] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Different disciplines are grappling with the concept of ‘urban transformation’ reflecting its planetary importance and urgency. A recent systematic review traces the emergence of a normative epistemic community that is concerned with helping make sustainable urban transformation a reality. Our contribution to this growing body of work springs out of a recent initiative at the World Resources Institute, namely, the WRI Ross Prize for Cities, a global award for transformative projects that have ignited sustainable changes in their city. In this paper we explain the competition-based approach that was used to source transformative initiatives and relate our findings to existing currents in urban transformation scholarship and key debates. We focus on one of the questions at the heart of the normative urban transformation agenda: what does urban transformation look like in practice? Based on an analysis of the five finalists, we describe urban transformation as encompassing a plurality of contextual and relative changes, which may progress and accelerate positively, or regress over time. An evaluative approach that considers varying ‘degrees’ and ‘types’ of urban transformation is proposed to establish meaning within single cases and across several cases of urban transformation.
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Quistberg DA, Diez Roux AV, Bilal U, Moore K, Ortigoza A, Rodriguez DA, Sarmiento OL, Frenz P, Friche AA, Caiaffa WT, Vives A, Miranda JJ. Building a Data Platform for Cross-Country Urban Health Studies: the SALURBAL Study. J Urban Health 2019; 96:311-337. [PMID: 30465261 PMCID: PMC6458229 DOI: 10.1007/s11524-018-00326-0] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Studies examining urban health and the environment must ensure comparability of measures across cities and countries. We describe a data platform and process that integrates health outcomes together with physical and social environment data to examine multilevel aspects of health across cities in 11 Latin American countries. We used two complementary sources to identify cities with ≥ 100,000 inhabitants as of 2010 in Argentina, Brazil, Chile, Colombia, Costa Rica, El Salvador, Guatemala, Mexico, Nicaragua, Panama, and Peru. We defined cities in three ways: administratively, quantitatively from satellite imagery, and based on country-defined metropolitan areas. In addition to "cities," we identified sub-city units and smaller neighborhoods within them using census hierarchies. Selected physical environment (e.g., urban form, air pollution and transport) and social environment (e.g., income, education, safety) data were compiled for cities, sub-city units, and neighborhoods whenever possible using a range of sources. Harmonized mortality and health survey data were linked to city and sub-city units. Finer georeferencing is underway. We identified 371 cities and 1436 sub-city units in the 11 countries. The median city population was 234,553 inhabitants (IQR 141,942; 500,398). The systematic organization of cities, the initial task of this platform, was accomplished and further ongoing developments include the harmonization of mortality and survey measures using available sources for between country comparisons. A range of physical and social environment indicators can be created using available data. The flexible multilevel data structure accommodates heterogeneity in the data available and allows for varied multilevel research questions related to the associations of physical and social environment variables with variability in health outcomes within and across cities. The creation of such data platforms holds great promise to support researching with greater granularity the field of urban health in Latin America as well as serving as a resource for the evaluation of policies oriented to improve the health and environmental sustainability of cities.
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Affiliation(s)
| | - Ana V. Diez Roux
- Urban Health Collaborative, Drexel University, Philadelphia, PA USA
- Nesbitt Hall, 3215 Market St, 2nd Floor, Philadelphia, PA 19104 USA
| | - Usama Bilal
- Urban Health Collaborative, Drexel University, Philadelphia, PA USA
| | - Kari Moore
- Urban Health Collaborative, Drexel University, Philadelphia, PA USA
| | - Ana Ortigoza
- Urban Health Collaborative, Drexel University, Philadelphia, PA USA
| | - Daniel A. Rodriguez
- Department of City & Regional Planning, University of California - Berkeley, Berkeley, CA USA
| | - Olga L. Sarmiento
- Department of Epidemiology, Universidad de los Andes, Bogota, Colombia
| | - Patricia Frenz
- School of Public Health, Universidad de Chile, Santiago, Chile
| | - Amélia Augusta Friche
- Departament of Preventive and Social Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
| | - Waleska Teixeira Caiaffa
- Departament of Preventive and Social Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
| | - Alejandra Vives
- School of Medicine, Pontifica Universidad Católica de Chile, Santiago, Chile
| | - J. Jaime Miranda
- School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - the SALURBAL Group
- Urban Health Collaborative, Drexel University, Philadelphia, PA USA
- Nesbitt Hall, 3215 Market St, 2nd Floor, Philadelphia, PA 19104 USA
- Department of City & Regional Planning, University of California - Berkeley, Berkeley, CA USA
- Department of Epidemiology, Universidad de los Andes, Bogota, Colombia
- School of Public Health, Universidad de Chile, Santiago, Chile
- Departament of Preventive and Social Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
- School of Medicine, Pontifica Universidad Católica de Chile, Santiago, Chile
- School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
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21
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de Salles Dias MA, de Lima Friche AA, Mingoti SA, da Silva Costa DÁRA, de Souza Andrade AC, Freire FM, de Oliveira VB, Teixeira Caiaffa W. Mortality from Homicides in Slums in the City of Belo Horizonte, Brazil: An Evaluation of the Impact of a Re-Urbanization Project. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E154. [PMID: 30626068 PMCID: PMC6338920 DOI: 10.3390/ijerph16010154] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 12/21/2018] [Accepted: 12/28/2018] [Indexed: 12/02/2022]
Abstract
Background: Homicide rates in Brazil are among the highest worldwide. Although not exclusive to large Brazilian cities, homicides find their most important determinants in cities' slums. In the last decade, an urban renewal process has been initiated in the city of Belo Horizonte, in Brazil. Named Vila Viva project, it includes structuring urban interventions such as urban renewal, social development actions and land regularization in the slums of the city. This study evaluates the project's effect on homicide rates according to time and interventions. Methods: Homicide rates were analyzed comparing five slums with interventions (S1⁻S5) to five grouped non-intervened slums (S0), with similar socioeconomic characteristics from 2002 to 2012. Poisson regression model estimates the effect of time of observation and the effect of time of exposure (in years) to a completed intervention, besides the overall risk ratio (RR). Results: Using the time of observation in years, homicide rates decreased in the studied period and even more if considered cumulative time of exposure to a completed intervention for S1, S2, S3 and S4, but not for S5. Conclusions: Although the results of the effect of the interventions are not repeated in all slums, a downward trend in homicide rates has been found, which is connected to the interventions. New approaches could be necessary in order to verify the nexus between slum renewal projects and the reduction of homicide rates.
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Affiliation(s)
- Maria Angélica de Salles Dias
- Observatory for Urban Health in Belo Horizonte (OSUBH), School of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte 30130100, Brazil.
- Public Health Post-Graduation Program, School of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte 30130100, Brazil.
| | - Amélia Augusta de Lima Friche
- Observatory for Urban Health in Belo Horizonte (OSUBH), School of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte 30130100, Brazil.
- Public Health Post-Graduation Program, School of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte 30130100, Brazil.
| | - Sueli Aparecida Mingoti
- Department of Statistics, Institute of Exact Sciences, Federal University of Minas Gerais (UFMG), Belo Horizonte 30130100, Brazil.
| | - D Á Rio Alves da Silva Costa
- Observatory for Urban Health in Belo Horizonte (OSUBH), School of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte 30130100, Brazil.
| | - Amanda Cristina de Souza Andrade
- Observatory for Urban Health in Belo Horizonte (OSUBH), School of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte 30130100, Brazil.
- Department of Public Health, Federal University of Mato Grosso (UFMT), Belo Horizonte 30130100, Brazil.
| | | | - Veneza Berenice de Oliveira
- Observatory for Urban Health in Belo Horizonte (OSUBH), School of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte 30130100, Brazil.
| | - Waleska Teixeira Caiaffa
- Observatory for Urban Health in Belo Horizonte (OSUBH), School of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte 30130100, Brazil.
- Public Health Post-Graduation Program, School of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte 30130100, Brazil.
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22
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Vulliamy P, Faulkner M, Kirkwood G, West A, O’Neill B, Griffiths MP, Moore F, Brohi K. Temporal and geographic patterns of stab injuries in young people: a retrospective cohort study from a UK major trauma centre. BMJ Open 2018; 8:e023114. [PMID: 30401726 PMCID: PMC6231558 DOI: 10.1136/bmjopen-2018-023114] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To describe the epidemiology of assaults resulting in stab injuries among young people. We hypothesised that there are specific patterns and risk factors for injury in different age groups. DESIGN Eleven-year retrospective cohort study. SETTING Urban major trauma centre in the UK. PARTICIPANTS 1824 patients under the age of 25 years presenting to hospital after a stab injury resulting from assault. OUTCOMES Incident timings and locations were obtained from ambulance service records and triangulated with prospectively collected demographic and injury characteristics recorded in our hospital trauma registry. We used geospatial mapping of individual incidents to investigate the relationships between demographic characteristics and incident timing and location. RESULTS The majority of stabbings occurred in males from deprived communities, with a sharp increase in incidence between the ages of 14 and 18 years. With increasing age, injuries occurred progressively later in the day (r2=0.66, p<0.01) and were less frequent within 5 km of home (r2=0.59, p<0.01). Among children (age <16), a significant peak in injuries occurred between 16:00 and 18:00 hours, accounting for 22% (38/172) of injuries in this group compared with 11% (182/1652) of injuries in young adults. In children, stabbings occurred earlier on school days (hours from 08:00: 11.1 vs non-school day 13.7, p<0.01) and a greater proportion were within 5 km of home (90% vs non-school day 74%, p=0.02). Mapping individual incidents demonstrated that the spike in frequency in the late afternoon and early evening was attributable to incidents occurring on school days and close to home. CONCLUSIONS Age, gender and deprivation status are potent influences on the risk of violent injury in young people. Stab injuries occur in characteristic temporal and geographical patterns according to age group, with the immediate after-school period associated with a spike in incident frequency in children. This represents an opportunity for targeted prevention strategies in this population.
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Affiliation(s)
- Paul Vulliamy
- Centre for Trauma Sciences, Queen Mary University of London, London, UK
| | | | - Graham Kirkwood
- Institute of Health and Society, Newcastle University, Newcastle-upon-Tyne, UK
| | - Anita West
- Trauma Service, The Royal London Hospital, Barts Health NHS Trust, London, London, UK
| | - Breda O’Neill
- Trauma Service, The Royal London Hospital, Barts Health NHS Trust, London, London, UK
| | - Martin P Griffiths
- Trauma Service, The Royal London Hospital, Barts Health NHS Trust, London, London, UK
| | - Fionna Moore
- South East Coast Ambulance Service NHS Foundation Trust, Crawley, UK
| | - Karim Brohi
- Centre for Trauma Sciences, Queen Mary University of London, London, UK
- Trauma Service, The Royal London Hospital, Barts Health NHS Trust, London, London, UK
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Vallejo K, Tapias J, Arroyave I. Trends of Rural/Urban Homicide in Colombia, 1992-2015: Internal Armed Conflict and Hints for Postconflict. BIOMED RESEARCH INTERNATIONAL 2018; 2018:6120909. [PMID: 30868066 PMCID: PMC6379862 DOI: 10.1155/2018/6120909] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 08/14/2018] [Accepted: 09/13/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To analyze the relationship between rural and urban homicide rates in Colombia between 1992 and 2015 and the fluctuations in these rates. METHODS Individual records of homicides and population aggregates in men and women aged 15-64 years were used. The adjusted rates of annual homicides were calculated for urban/rural areas and standardized by age. Rate Ratios (RRs) adjusted by region were calculated. A joinpoint analysis was performed to identify inflection points and the Annual Percentage Change (APC). RESULTS Four joinpoints were identified in rural and urban rates: after peaking in 1992, homicide rates fell until 1997, and then increased until 2002. From this point on there was a continuous reduction until 2015, although this reduction slowed down from 2005 onward. During almost the whole period, the rates of rural homicides were higher than those of urban homicides, although they equalized at the end of the period. CONCLUSIONS Unlike in other countries, during the study period Colombian homicide rates, which coincided with the dynamics of the armed conflict, were higher in rural than in urban areas. In recent years, a predominance of urban homicides committed by younger men has been identified, which could pose a challenge to postconflict in Colombia.
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Affiliation(s)
| | - Jose Tapias
- Faculty of Economic Sciences, Department of Economy, University of Antioquia, Medellin, Colombia
| | - Ivan Arroyave
- National School of Public Health, University of Antioquia, Medellin, Colombia
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Nussio E, Norza Céspedes E. Deterring delinquents with information. Evidence from a randomized poster campaign in Bogotá. PLoS One 2018; 13:e0200593. [PMID: 30024894 PMCID: PMC6053166 DOI: 10.1371/journal.pone.0200593] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 06/30/2018] [Indexed: 11/25/2022] Open
Abstract
In this article, we test whether an isolated information campaign can deter criminals by appealing to their apprehension risk perception. A randomized trial was conducted around 154 high crime housing blocks in Bogotá. With support of the Colombian Police, half of the blocks were exposed to a three month poster campaign reporting the number of “arrests around this street block” and half to a no-treatment control condition. The main outcome measure (total registered crime) and secondary outcome measures (calls to the emergency line for thefts and attacks, and minor wrongdoings) were provided by the Police. Additionally, trust in police, security perception, and police performance perception were measured among residents and workers in the treatment and control areas (N = 616) using a post-treatment survey. Measures were analyzed with linear regression analysis and two-sample t-tests. Over the course of the treatment period, premeditated crime was reduced, while spontaneous crime remained unchanged. Overall levels of crime were not significantly altered. Also, a moderate crime reduction is detectable during the first month of the treatment period. The posters were highly visible (93% of respondents in the treated areas recalled them) and positively received (67% “liked” them). Perceptions of security and police among locals improved, though not significantly. Inherent among residents of Bogotá is a pervasive feeling of impunity and low trust in authorities, making the city a hard test case for an offender-targeted advertising campaign. Initial reductions of crime and overall reductions of premeditated crime are thus noteworthy. These results align with key principles of apprehension risk updating theory.
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Affiliation(s)
- Enzo Nussio
- Center for Security Studies, ETH Zurich, Switzerland
- * E-mail:
| | - Ervyn Norza Céspedes
- Departamento de Ciencia Política, Universidad de los Andes, Bogotá, Colombia
- Facultad de Psicología, Universidad del Bosque, Bogotá, Colombia
- Observatorio del Delito, Policía Nacional de Colombia, Bogotá, Colombia
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Kondo MC, Andreyeva E, South EC, MacDonald JM, Branas CC. Neighborhood Interventions to Reduce Violence. Annu Rev Public Health 2018; 39:253-271. [PMID: 29328874 DOI: 10.1146/annurev-publhealth-040617-014600] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Violence is a widespread problem that affects the physical, mental, and social health of individuals and communities. Violence comes with an immense economic cost to its victims and society at large. Although violence interventions have traditionally targeted individuals, changes to the built environment in places where violence occurs show promise as practical, sustainable, and high-impact preventive measures. This review examines studies that use quasi-experimental or experimental designs to compare violence outcomes for treatment and control groups before and after a change is implemented in the built environment. The most consistent evidence exists in the realm of housing and blight remediation of buildings and land. Some evidence suggests that reducing alcohol availability, improving street connectivity, and providing green housing environments can reduce violent crimes. Finally, studies suggest that neither transit changes nor school openings affect community violence.
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Affiliation(s)
- Michelle C Kondo
- Northern Research Station, US Department of Agriculture (USDA) Forest Service, Philadelphia, Pennsylvania 19103, USA;
| | - Elena Andreyeva
- Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104-6021, USA
| | - Eugenia C South
- Department of Emergency Medicine, Center for Emergency Care Policy Research, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
| | - John M MacDonald
- Department of Criminology, School of Arts and Sciences, University of Pennsylvania, Philadelphia, Pennsylvania 19104-6286, USA
| | - Charles C Branas
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
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Riley C, Roy B, Harari N, Vashi A, Violano P, Greene A, Lucas G, Smart J, Hines T, Spell S, Taylor S, Tinney B, Williams M, Wang EA. Preparing for Disaster: a Cross-Sectional Study of Social Connection and Gun Violence. J Urban Health 2017; 94:619-628. [PMID: 28116587 PMCID: PMC5610120 DOI: 10.1007/s11524-016-0121-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Living in communities with persistent gun violence is associated with negative social, behavioral, and health outcomes, analogous to those of a natural disaster. Taking a disaster-preparedness approach may identify targets for community-based action to respond to on-going gun violence. We assessed the relevance of adapting a disaster-preparedness approach to gun violence and, specifically, the relationship between perceived collective efficacy, its subscales of social cohesion and informal social control, and exposure to gun violence. In 2014, we conducted a cross-sectional study using a community-based participatory research approach in two neighborhoods in New Haven, CT, with high violent crime rates. Participants were ≥18 years of age and English speaking. We measured exposure to gun violence by adapting the Project on Human Development in Chicago Neighborhoods Exposure to Violence Scale. We examined the association between perceived collective efficacy, measured by the Sampson Collective Efficacy Scale, and exposure to gun violence using multivariate modeling. We obtained 153 surveys (51% response rate, 14% refusal rate, and 35% non-response rate). Ninety-five percent reported hearing gunfire, 58% had friend or family member killed by gun violence, and 33% were physically present during a shooting. In the fully adjusted model, one standard deviation higher perceived collective efficacy was associated with lower reported exposure to gun violence (β = -0.91, p < 0.001). We demonstrated that it is possible to activate community members and local officials to engage in gun violence research. A novel, community-based approach adapted from disaster-preparedness literature may be an effective framework for mitigating exposure to gun violence in communities with persistent gun violence.
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Affiliation(s)
- Carley Riley
- Division of Critical Care, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 2005, Cincinnati, OH, 45229-3039, USA.
| | - Brita Roy
- Section of General Internal Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Nurit Harari
- Indian Health Service, Chinle Comprehensive Health Care Facility, Chinle, AZ, USA
| | - Anita Vashi
- Center for Innovation to Implementation, VA Palo Alto Healthcare System, Palo Alto, CA, USA
| | - Pina Violano
- Trauma Injury Prevention, Community Outreach & Research Department, Yale-New Haven Hospital, New Haven, CT, USA
| | - Ann Greene
- Robert Wood Johnson Foundation Clinical Scholars Program, Yale University School of Medicine, New Haven, CT, USA.,West River Community Resilience Team, New Haven, CT, USA
| | - Georgina Lucas
- Robert Wood Johnson Foundation Clinical Scholars Program, Yale University School of Medicine, New Haven, CT, USA
| | - Jerry Smart
- Transitions Clinic Network, New Haven, CT, USA.,Newhallville Community Resilience Team, New Haven, CT, USA
| | - Teresa Hines
- Newhallville Community Resilience Team, New Haven, CT, USA.,African American Affinity Group, Yale University, New Haven, CT, USA
| | - Stacy Spell
- West River Community Resilience Team, New Haven, CT, USA.,Project Longevity New Haven, New Haven, CT, USA
| | - Sharon Taylor
- School of Public Health, Yale University, New Haven, CT, USA
| | | | - Maurice Williams
- Yale Center for Clinical Investigation, Yale University School of Medicine, New Haven, CT, USA
| | - Emily A Wang
- Section of General Internal Medicine, Yale University School of Medicine, New Haven, CT, USA.,Robert Wood Johnson Foundation Clinical Scholars Program, Yale University School of Medicine, New Haven, CT, USA.,Transitions Clinic Network, New Haven, CT, USA
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Ranney ML, Fletcher J, Alter H, Barsotti C, Bebarta VS, Betz ME, Carter PM, Cerdá M, Cunningham RM, Crane P, Fahimi J, Miller MJ, Rowhani-Rahbar A, Vogel JA, Wintemute GJ, Shah MN, Waseem M. A Consensus-Driven Agenda for Emergency Medicine Firearm Injury Prevention Research. Ann Emerg Med 2017; 69:227-240. [PMID: 27998625 PMCID: PMC5272847 DOI: 10.1016/j.annemergmed.2016.08.454] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 08/17/2016] [Accepted: 08/22/2016] [Indexed: 12/14/2022]
Abstract
STUDY OBJECTIVE To identify critical emergency medicine-focused firearm injury research questions and develop an evidence-based research agenda. METHODS National content experts were recruited to a technical advisory group for the American College of Emergency Physicians Research Committee. Nominal group technique was used to identify research questions by consensus. The technical advisory group decided to focus on 5 widely accepted categorizations of firearm injury. Subgroups conducted literature reviews on each topic and developed preliminary lists of emergency medicine-relevant research questions. In-person meetings and conference calls were held to iteratively refine the extensive list of research questions, following nominal group technique guidelines. Feedback from external stakeholders was reviewed and integrated. RESULTS Fifty-nine final emergency medicine-relevant research questions were identified, including questions that cut across all firearm injury topics and questions specific to self-directed violence (suicide and attempted suicide), intimate partner violence, peer (nonpartner) violence, mass violence, and unintentional ("accidental") injury. Some questions could be addressed through research conducted in emergency departments; others would require work in other settings. CONCLUSION The technical advisory group identified key emergency medicine-relevant firearm injury research questions. Emergency medicine-specific data are limited for most of these questions. Funders and researchers should consider increasing their attention to firearm injury prevention and control, particularly to the questions identified here and in other recently developed research agendas.
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Affiliation(s)
- Megan L. Ranney
- Department of Emergency Medicine, Alpert Medical School, Brown University, Providence, RI
| | - Jonathan Fletcher
- Department of Emergency Medicine, Alpert Medical School, Brown University, Providence, RI
| | - Harrison Alter
- Department of Emergency Medicine, Highland Hospital-Alameda Health System, Oakland, CA
| | | | - Vikhyat S. Bebarta
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO
| | - Marian E. Betz
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO
| | - Patrick M. Carter
- Department of Emergency Medicine, University of Michigan School of Medicine, Ann Arbor, MI
| | - Magdalena Cerdá
- Department of Emergency Medicine, University of California, Davis, Sacramento, CA
| | - Rebecca M. Cunningham
- Department of Emergency Medicine, University of Michigan School of Medicine, Ann Arbor, MI; University of Michigan Injury Center, University of Michigan, Ann Arbor, MI
| | - Peter Crane
- Department of Emergency Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY
| | - Jahan Fahimi
- Department of Emergency Medicine, University of California, San Francisco, CA
| | - Matthew J. Miller
- Department of Health Sciences, Bouvé College of Health Sciences, Northeastern University, Boston, MA
| | - Ali Rowhani-Rahbar
- Department of Epidemiology and Harborview Injury Prevention & Research Center, University of Washington, Seattle, WA
| | - Jody A. Vogel
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO; Denver Health Medical Center, University of Colorado School of Medicine, Aurora, CO
| | - Garen J. Wintemute
- Department of Emergency Medicine, University of California, Davis, Sacramento, CA
| | - Manish N. Shah
- Berbee Walsh Department of Emergency Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI
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Glass TA, Bilal U. Are neighborhoods causal? Complications arising from the 'stickiness' of ZNA. Soc Sci Med 2016; 166:244-253. [PMID: 26830654 DOI: 10.1016/j.socscimed.2016.01.001] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Revised: 12/23/2015] [Accepted: 01/03/2016] [Indexed: 02/06/2023]
Abstract
Are neighborhoods causal? The answer remains elusive. Armed with new multilevel methods, enthusiasm for neighborhoods research surged at the turn of the century. However, a wave of skepticism has arisen based on the difficulty of drawing causal inferences from observational studies in which selection to neighborhoods is non-random. Researchers have sought answers from experimental and quasi-experimental studies of movers vs. stayers. We develop two related concepts in this essay in the hopes of shedding light on this problem. First, the inceptive environment into which persons are born (which we term ZNA for Zip code Nativity Area) exerts a potentially powerful causal impact on health. Detecting that causal effect is challenging for reasons similar that obtain in other fields (including genetics). Second, we explicate the problem of neighborhood 'stickiness' in terms of the persistence of neighborhood treatment assignment, and argue that under-appreciation of stickiness has led to systematic bias in causal estimates of neighborhoods proportional to the degree of stickiness. In sticky contexts, failure to account for the lasting influences of ZNA by adjusting for intermediate individual socioeconomic and health variables on the causal pathway can result in neighborhood effects estimates that are biased toward the null. We follow with an example drawn from evidence of neighborhood 'stickiness' and obesity. The stickiness of ZNA cautions us that experimental evidence may be insufficient or misleading as a solution to causal inference problems in neighborhood research.
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Affiliation(s)
- Thomas A Glass
- Johns Hopkins Bloomberg School of Public Health, United States.
| | - Usama Bilal
- Johns Hopkins Bloomberg School of Public Health, United States; Social and Cardiovascular Research Group, School of Medicine, University of Alcala, Madrid, Spain
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de Vocht F, Campbell R, Brennan A, Mooney J, Angus C, Hickman M. Propensity score matching for selection of local areas as controls for evaluation of effects of alcohol policies in case series and quasi case-control designs. Public Health 2015; 132:40-9. [PMID: 26718422 DOI: 10.1016/j.puhe.2015.10.033] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Revised: 10/23/2015] [Accepted: 10/29/2015] [Indexed: 01/25/2023]
Abstract
OBJECTIVES Area-level public health interventions can be difficult to evaluate using natural experiments. We describe the use of propensity score matching (PSM) to select control local authority areas (LAU) to evaluate the public health impact of alcohol policies for (1) prospective evaluation of alcohol policies using area-level data, and (2) a novel two-stage quasi case-control design. STUDY DESIGN Ecological. METHODS Alcohol-related indicator data (Local Alcohol Profiles for England, PHE Health Profiles and ONS data) were linked at LAU level. Six LAUs (Blackpool, Bradford, Bristol, Ipswich, Islington, and Newcastle-upon-Tyne) as sample intervention or case areas were matched to two control LAUs each using PSM. For the quasi case-control study a second stage was added aimed at obtaining maximum contrast in outcomes based on propensity scores. Matching was evaluated based on average standardized absolute mean differences (ASAM) and variable-specific P-values after matching. RESULTS The six LAUs were matched to suitable control areas (with ASAM < 0.20, P-values >0.05 indicating good matching) for a prospective evaluation study that sought areas that were similar at baseline in order to assess whether a change in intervention exposure led to a change in the outcome (alcohol related harm). PSM also generated appropriate matches for a quasi case-control study--whereby the contrast in health outcomes between cases and control areas needed to be optimized in order to assess retrospectively whether differences in intervention exposure were associated with the outcome. CONCLUSIONS The use of PSM for area-level alcohol policy evaluation, but also for other public health interventions, will improve the value of these evaluations by objective and quantitative selection of the most appropriate control areas.
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Affiliation(s)
- F de Vocht
- NIHR School for Public Health Research (SPHR), UK; School of Social and Community Medicine, University of Bristol, Bristol, UK.
| | - R Campbell
- NIHR School for Public Health Research (SPHR), UK; School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - A Brennan
- NIHR School for Public Health Research (SPHR), UK; ScHARR, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - J Mooney
- NIHR School for Public Health Research (SPHR), UK; ScHARR, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - C Angus
- NIHR School for Public Health Research (SPHR), UK; ScHARR, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - M Hickman
- NIHR School for Public Health Research (SPHR), UK; School of Social and Community Medicine, University of Bristol, Bristol, UK
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Mayne SL, Lee BK, Auchincloss AH. Evaluating Propensity Score Methods in a Quasi-Experimental Study of the Impact of Menu-Labeling. PLoS One 2015; 10:e0144962. [PMID: 26677849 PMCID: PMC4682980 DOI: 10.1371/journal.pone.0144962] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 11/25/2015] [Indexed: 11/18/2022] Open
Abstract
Background Quasi-experimental studies of menu labeling have found mixed results for improving diet. Differences between experimental groups can hinder interpretation. Propensity scores are an increasingly common method to improve covariate balance, but multiple methods exist and the improvements associated with each method have rarely been compared. In this re-analysis of the impact of menu labeling, we compare multiple propensity score methods to determine which methods optimize balance between experimental groups. Methods Study participants included adult customers who visited full-service restaurants with menu labeling (treatment) and without (control). We compared the balance between treatment groups obtained by four propensity score methods: 1) 1:1 nearest neighbor matching (NN), 2) augmented 1:1 NN (using caliper of 0.2 and an exact match on an imbalanced covariate), 3) full matching, and 4) inverse probability weighting (IPW). We then evaluated the treatment effect on differences in nutrients purchased across the different methods. Results 1:1 NN resulted in worse balance than the original unmatched sample (average standardized absolute mean distance [ASAM]: 0.185 compared to 0.171). Augmented 1:1 NN improved balance (ASAM: 0.038) but resulted in a large reduction in sample size. Full matching and IPW improved balance over the unmatched sample without a reduction in sample size (ASAM: 0.049 and 0.031, respectively). Menu labeling was associated with decreased calories, fat, sodium and carbohydrates in the unmatched analysis. Results were qualitatively similar in the propensity score matched/weighted models. Conclusions While propensity scores offer an increasingly popular tool to improve causal inference, choosing the correct method can be challenging. Our results emphasize the benefit of examining multiple methods to ensure results are consistent, and considering approaches beyond the most popular method of 1:1 NN matching.
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Affiliation(s)
- Stephanie L. Mayne
- Department of Epidemiology and Biostatistics, School of Public Health, Drexel University, Philadelphia, Pennsylvania, United States of America
- * E-mail:
| | - Brian K. Lee
- Department of Epidemiology and Biostatistics, School of Public Health, Drexel University, Philadelphia, Pennsylvania, United States of America
| | - Amy H. Auchincloss
- Department of Epidemiology and Biostatistics, School of Public Health, Drexel University, Philadelphia, Pennsylvania, United States of America
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Abstract
This paper reviews the magnitude and empirical findings of social epidemiological neighborhood effects research. An electronic keyword literature search identified 1369 empirical and methodological neighborhood effects papers published in 112 relevant journals between 1990 and 2014. Analyses of temporal trends were conducted by focus, journal type (e.g., epidemiology, public health, or social science), and specific epidemiologic journal. Select papers were then critically reviewed. Results show an ever-increasing number of papers published, notably since the year 2000, with the majority published in public health journals. The variety of health outcomes analyzed is extensive, ranging from infectious disease to obesity to criminal behavior. Papers relying on data from experimental designs are thought to yield the most credible results, but such studies are few and findings are inconsistent. Papers relying on data from observational designs and multilevel models typically show small statistically significant effects, but most fail to appreciate fundamental identification problems. Ultimately, of the 1170 empirically focused neighborhood effects papers published in the last 24 years, only a handful have clearly advanced our understanding of the phenomena. The independent impact of neighborhood contexts on health remains unclear. It is time to expand the social epidemiological imagination.
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Hatzenbuehler ML, Duncan D, Johnson R. Neighborhood-Level LGBT Hate Crimes and Bullying Among Sexual Minority Youths: A Geospatial Analysis. VIOLENCE AND VICTIMS 2015; 30:663-75. [PMID: 26160063 DOI: 10.1891/0886-6708.vv-d-13-00166] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
The goal of this study was to evaluate a novel measure of environmental risk factors for bullying among sexual minority youths. Data on lesbian, gay, bisexual, and transgender (LGBT) assault hate crimes were obtained from police records, geocoded, and then linked to individual-level data on bullying and sexual orientation from the 2008 Boston Youth Survey Geospatial Dataset (N = 1,292; 108 sexual minorities). Results indicated that sexual minority youths who reported relational and electronic bullying were more likely to reside in neighborhoods with higher LGBT assault hate crime rates. There was no asso- ciation between LGBT assault hate crimes and bullying among heterosexual youths, pro- viding evidence for specificity to sexual minority youth. Moreover, no relationships were observed between sexual minority bullying and neighborhood-level violent and property crimes, indicating that the results were specific to LGBT assault hate crimes.
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Trowbridge MJ, Pickell SG, Pyke CR, Jutte DP. Building Healthy Communities: Establishing Health And Wellness Metrics For Use Within The Real Estate Industry. Health Aff (Millwood) 2014; 33:1923-9. [DOI: 10.1377/hlthaff.2014.0654] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Matthew J. Trowbridge
- Matthew J. Trowbridge ( ) is an associate professor in emergency medicine and public health sciences at the University of Virginia School of Medicine, in Charlottesville
| | - Sarah Gauche Pickell
- Sarah Gauche Pickell is director of communications and development at the Institute for Advanced Studies in Culture at the University of Virginia
| | - Christopher R. Pyke
- Christopher R. Pyke is the vice president of research at the US Green Building Council, in Washington, D.C
| | - Douglas P. Jutte
- Douglas P. Jutte is an associate professor at the University of California, Berkeley, and executive director of the Build Healthy Places Network, in San Francisco
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Garcia L, Qi L, Rasor M, Clark CJ, Bromberger J, Gold EB. The relationship of violence and traumatic stress to changes in weight and waist circumference: longitudinal analyses from the study of women's health across the nation. JOURNAL OF INTERPERSONAL VIOLENCE 2014; 29:1459-76. [PMID: 24212978 PMCID: PMC3969450 DOI: 10.1177/0886260513507132] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
This article investigates the associations of violence and traumatic stress with changes in weight and waist circumference, hypothesizing that violence in midlife would be associated with increases or decreases in weight and waist circumference. The longitudinal cohort of the Study of Women's Health Across the Nation comprised the study sample, which included an ethnically/racially and socially diverse group of 2,870 women between the ages of 42 and 52 years at baseline. Women were followed annually for 10 years, and assessments included weight and waist circumference measures and data on violence, health outcomes, and confounders. At baseline, 8.6% Caucasian, 10.8% African American, 9.2% Chinese, and 5.0% Japanese women reported violence and traumatic stress. Reporting violence and traumatic stress during follow-up was significantly associated with weight gain (odds ratio [OR] = 2.39, 95% confidence interval [CI] = [1.28-4.47]), weight loss (OR = 3.54, 95% CI = [1.73-7.22]), and gain (OR = 2.44, 95% CI = [1.37-4.37]) or loss (OR = 2.66, 95% CI = [1.23-5.77]) in waist circumference, adjusting for age, race/ethnicity, education, marital status, and smoking. Violence and traumatic stress against midlife women were associated with gains or losses in weight and waist circumference.
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Cassidy T, Inglis G, Wiysonge C, Matzopoulos R. A systematic review of the effects of poverty deconcentration and urban upgrading on youth violence. Health Place 2013; 26:78-87. [PMID: 24412655 DOI: 10.1016/j.healthplace.2013.12.009] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Revised: 12/14/2013] [Accepted: 12/15/2013] [Indexed: 11/28/2022]
Abstract
Neighbourhood risk factors have been shown to be associated with youth violence and predictors of youth violence. This systematic review examined the existing evidence for youth violence interventions involving the deconcentration of poverty and urban upgrading. Search strategies combined related terms for youth, violence and a broad combination of terms for the intervention from a range of academic databases and websites. Abstracts were screened by two authors and appraised using a quantitative study assessment tool. Nine studies were included. No strong evidence was available to support diversification as an intervention, some evidence was identified in support of a variety of urban upgrading interventions, while the strongest study designs and demonstrated positive effects were shown for resettlement interventions. The small number of studies meeting the inclusion criteria was ascribed to the methodological complexity of inferring a causal association with 'upstream' interventions. No studies from low and middle income countries satisfied the inclusion criteria.
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Affiliation(s)
- Tali Cassidy
- School of Public Health and Family Medicine, University of Cape Town, South Africa.
| | - Gabrielle Inglis
- Gender Health and Justice Research Unit, University of Cape Town, South Africa
| | - Charles Wiysonge
- Centre for Evidence-based Health Care & Division of Community Health, Department of Interdisciplinary Health Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa
| | - Richard Matzopoulos
- School of Public Health and Family Medicine, University of Cape Town, South Africa; Burden of Disease Research Unit, Medical Research Council, South Africa
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Gawryszewski VP, Sanhueza A, Martinez-Piedra R, Escamilla JA, Souza MDFMD. Homicídios na região das Américas: magnitude, distribuição e tendências, 1999-2009. CIENCIA & SAUDE COLETIVA 2012; 17:3171-82. [DOI: 10.1590/s1413-81232012001200003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2012] [Accepted: 09/13/2012] [Indexed: 11/22/2022] Open
Abstract
O objetivo do estudo foi descrever a magnitude e a distribuição da mortalidade por homicídios nas Américas e analisar suas tendências. Foram analisados óbitos por homicídios (X85 a Y09 e Y35) de 32 países das Américas, período 1999-2009, registrados no Sistema de Informações de Mortalidade/Organização Pan Americana da Saúde. Utilizou-se modelo binomial negativo para estudar as tendências. Cerca de 121.297 mortes por homicídios (89% homens e 11% mulheres) ocorreram anualmente nas Américas, predominando as idades de 15 a 24 e de 25 a 39 anos. Em 2009, a taxa padronizada de homicídios da região foi 15,5/100.000. Os países com taxas/100.000 baixas foram Canadá (1,8), Argentina (4,4), Cuba (4,8), Chile (5,2) e Estados Unidos (5,8); e com taxas/100.000 altas foram El Salvador (62,9), Guatemala (51,2), Colômbia (42,5), Venezuela (33,2) e Porto Rico (25,8). Entre 1999-2009 as taxas da região permaneceram estáveis; aumentaram em nove países, como Venezuela (p < 0,001), Panamá (p < 0,001), El Salvador (p < 0,001) e Porto Rico (p < 0,001); diminuíram em quatro países, especialmente na Colômbia (p < 0,001); e permaneceram estáveis no Brasil, Estados Unidos, Equador e Chile. O aumento no México ocorreu no período mais recente. Apesar dos esforços empreendidos, diversos países têm taxas altas de homicídios e crescimento nas mesmas.
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Kaufman JS. Some models just can't be fixed. A commentary on Mortensen. Soc Sci Med 2012; 76:8-11. [PMID: 23149334 DOI: 10.1016/j.socscimed.2012.10.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2012] [Accepted: 10/16/2012] [Indexed: 10/27/2022]
Affiliation(s)
- Jay S Kaufman
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, 1020 Pine Ave West, Montreal, QC H3A 1A2, Canada.
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