Urban Public Health, a Multidisciplinary Approach
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ABSTRACT:
SUBMITTER: Battisti A
PROVIDER: S-EPMC7362667 | biostudies-literature | 2020 Jan
REPOSITORIES: biostudies-literature
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Project description:BackgroundUrban green spaces are important for human health, but they may expose visitors to tick-borne diseases. This not only presents a potential public health challenge but also undermines the expected public health gains from urban green spaces. The aim of this study is to assess the public health risk of tick-borne diseases in an urban green space used for recreation in Stockholm, Sweden.MethodsWe used a mixed method approach identifying both the magnitude of the tick hazard and the extent of the human exposure to tick-borne diseases. At six entry points to an urban green space, we sampled ticks and documented microhabitat conditions from five randomly assigned 2 m × 2 m plots. Surrounding habitat data was analyzed using geographical information system (GIS). Nymphs and adult ticks were tested for Borrelia burgdorferi sensu lato and Anaplasma phagocytophilum using TaqMan qPCR. Positive B. burgdorferi (s.l.) ticks were further analyzed by nested PCR amplification and sequence analysis. Population census data and visitor count data were used to estimate the degree of human exposure to tick-borne diseases. To further understand the degree to which visitors get in contact with infected ticks we also conducted interviews with visitors to green spaces.ResultsHigh tick densities were commonly found in humid broadleaved forest with low field vegetation. High pathogen prevalence was significantly correlated with increasing proportions of artificial areas. Integrating the tick hazard with human exposure we found that the public health risk of tick-borne diseases was moderate to high at most of the studied entry points. Many of the visitors frequently used urban green spaces. Walking was the most common activity, but visitors also engaged in activities with higher risk for tick encounters. Individual protective measures were connected to specific recreational activities such as picking berries or mushrooms.ConclusionsThe number of visitors can be combined with tick inventory data and molecular analyses of pathogen prevalence to make crude estimations of the public health risk of tick-borne diseases in urban green spaces. The risk of encountering infected ticks is omnipresent during recreational activities in urban green spaces, highlighting the need for public health campaigns to reduce the risk of tick-borne diseases.
| S-EPMC11015579 | biostudies-literature
Project description:Spatial equality analysis is useful for urban designers and policy makers to produce and/or adapt urban services provision, while supporting the pursuit of the public interest in the urban design process. This research focuses on urban public facilities (UPFs), the most relevant physical elements serving the public interest, and proposes a multi-scale methodology from a practical perspective to understand and foster the spatial equality of UPFs. Using Shenzhen to test the approach, this research first investigates the density and aggregation of UPFs at the district level to recognize how developing differentiations and social context act on the spatial patterns in UPFs. Second, the accessibility of different types of UPF are measured at the sub-district level which emphasizes the spatial impedance between demand and supply and the availability of services. Then, we draw location-specific design strategies for better spatial equality at a site scale. The results show "cross-district impact" plays an important role in influencing overall spatial equality. Also, sufficient transportation networks, road configurations, and the diversity of UPFs could significantly improve service capacity and impact the achievement of spatial equality. This paper draws attention to the improvement of spatial equality and can contribute new insights to the interpretation and measurement of the spatial equality in urban design debates.
| S-EPMC10382298 | biostudies-literature
Project description:Public health benefits are often a key political driver of urban sanitation investment in developing countries, however, pathogen flows are rarely taken systematically into account in sanitation investment choices. While several tools and approaches on sanitation and health risks have recently been developed, this research identified gaps in their ability to predict faecal pathogen flows, to relate exposure risks to the existing sanitation services, and to compare expected impacts of improvements. This paper outlines a conceptual approach that links faecal waste discharge patterns with potential pathogen exposure pathways to quantitatively compare urban sanitation improvement options. An illustrative application of the approach is presented, using a spreadsheet-based model to compare the relative effect on disability-adjusted life years of six sanitation improvement options for a hypothetical urban situation. The approach includes consideration of the persistence or removal of different pathogen classes in different environments; recognition of multiple interconnected sludge and effluent pathways, and of multiple potential sites for exposure; and use of quantitative microbial risk assessment to support prediction of relative health risks for each option. This research provides a step forward in applying current knowledge to better consider public health, alongside environmental and other objectives, in urban sanitation decision making. Further empirical research in specific locations is now required to refine the approach and address data gaps.
| S-EPMC5858256 | biostudies-literature
Project description:Over the early twentieth century, urban centers adopted full-time public health departments. We show that opening full-time administration had little observable impact on mortality. We then attempt to determine why health departments were ineffective. Our results suggest that achievements in public health occurred regardless of health department status. Further, we find that cities with and without a full-time health department allocated similar per capita expenditures towards health administration. This health department funding also better predicts infant mortality declines. Our conclusions indicate that specific campaigns, public health systems, and funding may have been more meaningful for local health over this era.
| S-EPMC9090227 | biostudies-literature
Project description:SARS CoV-2 WGS (Georgia Department of Public Health)
| PRJNA713775 | ENA
Project description:BackgroundGreenland struggles with a high prevalence of smoking, alcohol and drug abuse. In response to the increasing need for preventive initiatives, the first public health program Inuuneritta was introduced in 2007. Internationally, frameworks focus primarily on the implementation of a single, well-described intervention or program. However, with the increasing need and emergence of more holistic, integrated approaches, a need for research investigating the process of policy implementation from launch to action arises. This paper aims to augment the empirical evidence on the implementation of integrated health promotion programs within a governmental setting using the case of Inuuneritta II. In this study, the constraining and enabling determinants of the implementation processes within and across levels and sectors were examined.MethodsQualitative methods with a transdisciplinary approach were applied. Data collection consisted of six phases with different qualitative methods applied to gain a comprehensive overview and understanding of Inuuneritta II's implementation process. These methods included: observations and focus group discussions at the community health worker (CHW) conference, telephone interviews, document analysis, and a workshop on results dissemination.ResultsEnabling determinants influencing the implementation process of Inuuneritta II positively were high motivation among adopters, local prevention committees supporting community health workers, and the initiation of the central prevention committee. In contrast, constraining determinants were ambiguous program aims, high turnovers, siloed budgets and work environments, and an inconsistent and neglected central prevention committee.ConclusionInuuneritta II provided a substantial framework for an integrated health policy approach. However, having a holistic and comprehensive program enabling an integrated approach is not sufficient. Inuuneritta II's integrated approach does not harmonise with the government's inflexible organisational structure resulting in insufficient implementation.
| S-EPMC6286563 | biostudies-literature
Project description:Public transit, especially urban rail systems, plays a vital role in shaping commuting patterns. Compared with census data and survey data, large-scale and real-time big data can track the impacts of urban policy implementations at finer spatial and temporal scales. Therefore, this study proposed a multi-level analytical framework using transit smartcard data to examine urban commuting dynamics in response to rail transit upgrades. The study area was Shenzhen, one of the most highly urbanized and densely populated cities in China, which provides the opportunity to examine the effects of rail transit upgrades on commuting patterns in a rapidly developing urban context. Changes in commuting patterns were examined at three levels: city, region, and individual. At the city level, we considered the average commuting time, commuting speed, and commuting distance across the whole city. At the region level, we analyzed changes in the job accessibility of residential zones. Finally, this study evaluated the potential effects of rail transit upgrades on the jobs-housing relationship at the individual level. Difference-in-difference models were used for causal inference between rail transit upgrades and commuting patterns. In the very short term, the opening of new rail transit lines resulted in no significant changes in overall commuting patterns across the whole city; however, two effects of rail transit upgrades on commuting patterns were identified. First, rail transit upgrades enhanced regional connectivity between residential zones and employment centers, thus improving job accessibility. Second, rail transit improvement increased the commuting distances of individuals and contributed to the separation of workplaces and residences. This study provides meaningful insights into the effects of rail transit upgrades on commuting patterns.
| S-EPMC6797187 | biostudies-literature
Project description:We explored the interrelationships among diabetes, hypertension, and missing teeth among underserved racial/ethnic minority elders.Self-reported sociodemographic characteristics and information about health and health care were provided by community-dwelling ElderSmile participants, aged 50 years and older, who took part in community-based oral health education and completed a screening questionnaire at senior centers in Manhattan, New York, from 2010 to 2012.Multivariable models (both binary and ordinal logistic regression) were consistent, in that both older age and Medicaid coverage were important covariates when self-reported diabetes and self-reported hypertension were included, along with an interaction term between self-reported diabetes and self-reported hypertension.An oral public health approach conceptualized as the intersection of 3 domains-dentistry, medicine, and public health-might prove useful in place-based assessment and delivery of services to underserved older adults. Further, an ordinal logit model that considers levels of missing teeth might allow for more informative and interpretable results than a binary logit model.
| S-EPMC4455510 | biostudies-literature
Project description:BACKGROUND:Cities are investing millions in Cure Violence, a public health approach to reduce urban violence by targeting at-risk youth and redirecting conflict to nonviolent responses. The impact of such a program compared with criminal justice responses is unknown because experiments directly comparing criminal justice and public health approaches to violence prevention are infeasible with observational data. We simulated experiments to test the influence of two interventions on violence: (1) Cure Violence and (2) directed police patrol in violence hot spots. METHODS:We used an agent-based model to simulate a 5% sample of the New York City (NYC) adult population, with agents placed on a grid representing the land area of NYC, with neighborhood size and population density proportional to land area and population density in each community district. Agent behaviors were governed by parameters drawn from city data sources and published estimates. RESULTS:Under no intervention, 3.87% (95% CI, 3.84, 3.90) of agents were victimized per year. Implementing the violence interrupter intervention for 10 years decreased victimization by 13% (to 3.35% [3.32, 3.39]). Implementing hot-spots policing and doubling the police force for 10 years reduced annual victimization by about 11% (to 3.46% [3.42, 3.49]). Increasing the police force by 40% combined with implementing the violence interrupter intervention for 10 years decreased violence by 19% (to 3.13% [3.09, 3.16]). CONCLUSIONS:Combined investment in a public health, community-based approach to violence prevention and a criminal justice approach focused on deterrence can achieve more to reduce population-level rates of urban violence than either can in isolation. See video abstract at, http://links.lww.com/EDE/B298.
| S-EPMC5718925 | biostudies-literature
Project description: Not available
| S-EPMC1924940 | biostudies-literature