Equity at the ballot box: Health as a resource for political participation among low-income workers in two United States cities.
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ABSTRACT:
SUBMITTER: McGuire CM
PROVIDER: S-EPMC8494427 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Examining the distributional equity of urban tree canopy cover (UTCC) has increasingly become an important interdisciplinary focus of ecologists and social scientists working within the field of environmental justice. However, while UTCC may serve as a useful proxy for the benefits provided by the urban forest, it is ultimately not a direct measure. In this study, we quantified the monetary value of multiple ecosystem services (ESD) provisioned by urban forests across nine U.S. cities. Next, we examined the distributional equity of UTCC and ESD using a number of commonly investigated socioeconomic variables. Based on trends in the literature, we predicted that UTCC and ESD would be positively associated with the variables median income and percent with an undergraduate degree and negatively associated with the variables percent minority, percent poverty, percent without a high school degree, percent renters, median year home built, and population density. We also predicted that there would be differences in the relationships between each response variable (UTCC and ESD) and the suite of socioeconomic predictor variables examined because of differences in how each response variable is derived. We utilized methods promoted within the environmental justice literature, including a multi-city comparative analysis, the incorporation of high-resolution social and environmental datasets, and the use of spatially explicit models. Patterns between the socioeconomic variables and UTCC and ESD did not consistently support our predictions, highlighting that inequities are generally not universal but rather context dependent. Our results also illustrated that although the variables UTCC and ESD had largely similar relationships with the predictor variables, differences did occur between them. Future distributional equity research should move beyond the use of proxies for environmental amenities when possible while making sure to consider that the use of ecosystem service estimates may result in different patterns with socioeconomic variables of interest. Based on our findings, we conclude that understanding and remedying the challenges associated with inequities requires an understanding of the local social-ecological system if larger sustainability goals are to be achieved.
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Project description:[This corrects the article DOI: 10.1371/journal.pone.0228499.].
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Project description:ImportanceHealth equity is an often-cited goal of public health, included among the 4 overarching goals of the Department of Health and Human Services' Healthy People 2020. Yet it is difficult to find summary assessments of national progress toward this goal.ObjectivesTo identify variation in several measures of health equity from 1993 to 2017 in the United States and to test whether there are significant time trends.Design, setting, and participantsSurvey study using 25 years of data, from January 1, 1993, to December 31, 2017, from the Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System to assess trends in health equity and health justice by race/ethnicity, sex, and income in 3 categories by year.Main outcomes and measuresHealth equity was assessed separately for each of 2 health constructs: healthy days-the average of physical and mental healthy days over the previous 30 days-and general health in 5 categories, rescaled to approximate a continuous variable. For each health construct, average health was calculated along with 4 measures of health equity: disparities across 3 income groups; black-white disparities; health justice-a measure of the correlation of health outcomes with income, race/ethnicity and sex; and a summary health equity metric.ResultsAmong the 5 456 006 respondents, the mean (SD) age was 44.5 (12.7) years; 3 178 688 (58.3%) were female; 4 163 945 (76.3%) were non-Latinx white; 474 855 (8.7%) were non-Latinx black; 419 542 (7.7%) were Latinx; and 397 664 (7.3%) were of other race/ethnicity. The final sample included 5 456 006 respondents for self-reported health and 5 349 527 respondents for healthy days. During the 25-year period, the black-white gap showed significant improvement (year coefficient: healthy days, 0.021; 97.5% CI, 0.012 to 0.029; P < .001; self-reported health, 0.030; 97.5% CI, 0.025 to 0.035; P < .001). The health equity metric for self-reported health showed no significant trend. For healthy days, the Health Equity Metric declined over time (year coefficient: healthy days, -0.025; 97.5% CI, -0.033 to -0.017; P < .001). Health justice declined over time (year coefficient: healthy days, -0.045; 97.5% CI, -0.053 to -0.038; P < .001; self-reported health, -0.035; 97.5% CI, -0.046 to-0.023; P < .001), and income disparities worsened (year coefficient: healthy days, -0.060; 97.5% CI, -0.076 to -0.044; P < .001; self-reported health, -0.029; 97.5% CI, -0.046 to -0.012; P < .001).Conclusions and relevanceResults of this analysis suggest that there has been a clear lack of progress on health equity during the past 25 years in the United States. Achieving widely shared goals of improving health equity will require greater effort from public health policy makers, along with their partners in medicine and the sectors that contribute to the social determinants of health.
| S-EPMC6604079 | biostudies-literature
Project description:BackgroundDental therapists (DTs) are primary care dental providers, used globally, and were introduced in the United States (US) in 2005. DTs have now been adopted in 13 states and several Tribal nations.ObjectivesThe objective of this study is to qualitatively examine the drivers and outcomes of the US dental therapy movement through a health equity lens, including community engagement, implementation and dissemination, and access to oral health care.MethodsThe study compiled a comprehensive document library on the dental therapy movement including literature, grant documents, media and press, and gray literature. Key stakeholder interviews were conducted across the spectrum of engagement in the movement. Dedoose software was used for qualitative coding. Themes were assessed within a holistic model of oral health equity.FindingsHealth equity is a driving force for dental therapy adoption. Community engagement has been evident in diverse statewide coalitions. National accreditation standards for education programs that can be deployed in 3 years without an advanced degree reduces educational barriers for improving workforce diversity. Safe, high-quality care, improvements in access, and patient acceptability have been well documented for DTs in practice.ConclusionHaving firmly taken root politically, the impact of the dental therapy movement in the US, and the long-term health impacts, will depend on the path of implementation and a sustained commitment to the health equity principle.
| S-EPMC8428854 | biostudies-literature
Project description:Legislature directly impacts the practice of physicians across multiple specialties. The goal of our study is to investigate the political engagement and opinions of plastic surgery trainees, and how they perceive legislation impacts future practice.MethodsA 24-question survey was designed and distributed to all program directors and Resident Council members within the American Society of Plastic Surgeons. This initiative was driven by the board and directors and supported by the Resident Council. The Resident Council is a trainee-driven committee within the American Society of Plastic Surgeons that communicates with the Board of Directors.ResultsThis survey generated a 10.3% response rate with 118 responses out of 1143 trainees in ACGME accredited institutions. When asked in an open-ended fashion to list the most important reason why one planned to vote in the 2020 election, only 6.8% listed healthcare as a factor. Eighty-four percent of respondents believe that their vote impacts future legislation and regulation. Ninety-four percent strongly agree or agree that political legislation affects reimbursement.ConclusionsWith only 10.3% of trainees responding, there is a concern that political activity is not a priority for plastic surgery trainees. Plastic surgery trainees are attending summits, meeting with politicians, writing letters, and attending fundraisers. Respondents are overwhelmingly voting and planning to vote in elections, though few list healthcare as a reason. A future goal must be to motivate trainees to consider the intersection between healthcare and plastic surgery.
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Project description:Is there a relationship between family income inequality and income mobility across generations in the United States? As family income inequality rose in the United States, parental resources available for improving children's health, education, and care diverged. The amount and rate of divergence also varied across US states. Researchers and policy analysts have expressed concern that relatively high inequality might be accompanied by relatively low mobility, tightening the connection between individuals' incomes during childhood and adulthood. Using data from the Panel Study of Income Dynamics, the National Longitudinal Survey of Youth, and various government sources, this paper exploits state and cohort variation to estimate the relationship between inequality and mobility. Results provide very little support for the hypothesis that inequality shapes mobility in the United States. The inequality children experienced during youth had no robust association with their economic mobility as adults. Formal analysis reveals that offsetting effects could underlie this result. In theory, mobility-enhancing forces may counterbalance mobility-reducing effects. In practice, the results suggest that in the US context, the intergenerational transmission of income may not be very responsive to changes in inequality.
| S-EPMC4569595 | biostudies-literature
Project description:UnlabelledAn important issue of regional air quality management is to allocate air quality management funds to maximize environmental and human health benefits. In this study, we use an innovative approach to tackle this air quality management issue. We develop an innovative resource allocation model that allows identification of air pollutant emission control strategies that maximize mortality avoidances subject to a resource constraint. We first present the development of the resource allocation model and then a case study to show how the model can be used to identify resource allocation strategies that maximize mortality avoidances for top five Metropolitan Statistical Areas (MSAs) (i.e., New York, Los Angeles, Chicago, Dallas-Fort Worth, and Philadelphia) in the continental United States collectively. Given budget constraints in the U.S. Environmental Protection Agency's (EPA) Clean Air Act assessment, the results of the case study suggest that controls of sulfur dioxide (SO2) and primary carbon (PC) emissions from EPA Regions 2, 3, 5, 6, and 9 would have significant health benefits for the five selected cities collectively. Around 30,800 air pollution-related mortalities could be avoided during the selected 2-week summertime episode for the five cities collectively if the budget could be allocated based on the results of the resource allocation model. Although only five U.S. cities during a 2-week episode are considered in the case study, the resource allocation model can be used by decision-makers to plan air pollution mitigation strategies to achieve the most significant health benefits for other seasons and more cities over a region or the continental U.S.ImplicationsEffective allocations of air quality management resources are challenging and complicated, and it is desired to have a tool that can help decision-makers better allocate the funds to maximize health benefits of air pollution mitigation. An innovative resource allocation model developed in this study can help decision-makers identify the best resource allocation strategies for multiple cities collectively. The results of a case study suggest that controls of primary carbon and sulfur dioxides emissions would achieve the most significant health benefits for five selected cities collectively.
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Project description:Despite calls for political consensus, there is growing evidence that the public response to the COVID-19 pandemic has been politicized in the US. We examined the extent to which this polarization exists among the US public across two national studies. In a representative US sample (N = 699, March 2020) we find that liberals (compared to conservatives) perceive higher risk, place less trust in politicians to handle the pandemic, are more trusting of medical experts such as the WHO, and are more critical of the government response. We replicate these results in a second, pre-registered study (N = 1000; April 2020), and find that results are similar when considering partisanship, rather than political ideology. In both studies we also find evidence that political polarization extends beyond attitudes, with liberals consistently reporting engaging in a significantly greater number of health protective behaviors (e.g., wearing face masks) than conservatives. We discuss the possible drivers of polarization on COVID-19 attitudes and behaviors, and reiterate the need for fostering bipartisan consensus to effectively address and manage the COVID-19 pandemic.
| S-EPMC8631569 | biostudies-literature
Project description:ImportanceLittle is known about support for and willingness to engage in political violence in the United States. Such violence would likely involve firearms.ObjectiveTo evaluate whether firearm owners' and nonowners' support for political violence differs and whether support among owners varies by type of firearms owned, recency of purchase, and frequency of carrying a loaded firearm in public.Design, setting, and participantsThis cross-sectional nationally representative survey study was conducted from May 13 to June 2, 2022, among US adult members of the Ipsos KnowledgePanel, including an oversample of firearm owners.ExposureFirearm ownership vs nonownership.Main outcomes and measuresMain outcomes concern (1) support for political violence, in general and to advance specific political objectives; (2) personal willingness to engage in political violence, by severity of violence and target population; and (3) perceived likelihood of firearm use in political violence. Outcomes are expressed as weighted proportions and adjusted prevalence differences, with P values adjusted for the false-discovery rate and reported as q values.ResultsThe analytic sample comprised 12 851 respondents: 5820 (45.3%) firearm owners, 6132 (47.7%) nonowners without firearms at home, and 899 (7.0%) nonowners with firearms at home. After weighting, 51.0% (95% CI, 49.9%-52.1%) were female, 8.5% (95% CI, 7.5%-9.5%) Hispanic, 9.1% (95% CI, 8.1%-10.2%) non-Hispanic Black, and 62.6% (95% CI, 61.5%-63.8%) non-Hispanic White; the mean (SD) age was 48.5 (18.0) years. Owners were more likely than nonowners without firearms at home to consider violence usually or always justified to advance at least 1 of 17 specific political objectives (owners: 38.8%; 95% CI, 37.3%-40.4%; nonowners: 29.8%; 95% CI, 28.5%-31.2%; adjusted difference, 6.5 percentage points; 95% CI, 4.5-9.3 percentage points; q < .001) but were not more willing to engage in political violence. Recent purchasers, owners who always or nearly always carry loaded firearms in public, and to a lesser extent, owners of assault-type rifles were more supportive of and willing to engage in political violence than other subgroups of firearm owners.Conclusions and relevanceIn this study of support for political violence in the United States, differences between firearm owners and nonowners without firearms at home were small to moderate when present. Differences were greater among subsets of owners than between owners and nonowners. These findings can guide risk-based prevention efforts.
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Project description:Mass shootings are becoming a more common occurrence in the United States. Data show that mass shootings increased steadily over the past nearly 50 years. Crucial is that the wide-ranging adverse effects of mass shootings generate negative mental health outcomes on millions of Americans, including fear, anxiety, and ailments related to such afflictions. This study extends previous research that finds a strong positive relationship between income inequality and mass shootings by examining the effect of household income as well as the interaction between inequality and income. To conduct our analyses, we compile a panel dataset with information across 3,144 counties during the years 1990 to 2015. Mass shootings was measured using a broad definition of three or more victim injuries. Income inequality was calculated using the post-tax version of the Gini coefficient. Our results suggest that while inequality and income alone are both predictors of mass shootings, their impacts on mass shootings are stronger when combined via interaction. Specifically, the results indicate areas with the highest number of mass shootings are those that combine both high levels of inequality and high levels of income. Additionally, robustness checks incorporating various measures of mass shootings and alternative regression techniques had analogous results. Our findings suggest that to address the mass shootings epidemic at its core, it is essential to understand how to stem rising income inequality and the unstable environments that we argue are created by such inequality.
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