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PubMed1996

The long-term effects of a cardiovascular disease prevention trial: the Stanford Five-City Project.

OBJECTIVES: This study examined long-term effects of a health-education intervention trial to reduce the risk of cardiovascular disease. METHODS: Surveys were conducted in California in two treatment and two control cities at baseline (1979/1980), after the 6-year intervention (1985/1986), and 3 years later at follow-up (1989/1990). Net treatment/control differences in risk-factor change were assessed for women and men 25 to 74 years of age. RESULTS: Blood pressure improvements observed in all cities from baseline to the end of the intervention were maintained during the follow-up in treatment but not control cities. Cholesterol levels continued to decline in all cities during follow-up. Smoking rates leveled out or increased slightly in treatment cities and continued to decline in control cities but did not yield significant net differences. Both coronary heart disease and all-cause mortality risk scores were maintained or continued to improve in treatment cities while leveling out or rebounding in control cities. CONCLUSIONS: These findings suggest that community-based cardiovascular disease prevention trials can have sustained effects. However, the modest net differences in risk factors suggest the need for new designs and interventions that will accelerate positive risk-factor change.

Analysis of Variance↗
PubMed2001

Elevated incidence of type 2 diabetes in San Antonio, Texas, compared with that of Mexico City, Mexico.

OBJECTIVE: To compare the incidence of type 2 diabetes between low-income Mexican-Americans residing in San Antonio, Texas, and low-income residents in Mexico City, Mexico. RESEARCH DESIGN AND METHODS: Using data from the San Antonio Heart Study and the Mexico City Diabetes Study, we compared the incidence of type 2 diabetes in 35- to 64-year-old low-income Mexican-American residents of San Antonio with similarly aged low-income residents of Mexico City. Because of the different follow-up times in the two studies, Poisson regression was used to compare the rates of diabetes. Potential risk factors for diabetes were also analyzed to determine whether they explained or contributed to a difference in incidence. RESULTS: The age- and sex-adjusted incidence of type 2 diabetes was significantly higher in San Antonio (RR 2.01) compared with Mexico City. This difference was seen primarily in the oldest age group (55-64 years of age) and remained statistically significant after adjusting for a number of diabetes risk factors, including demographic, anthropometric, and metabolic variables. Follow-up rates were similar in both cities. CONCLUSIONS: We conclude that there was a higher incidence of type 2 diabetes in San Antonio than in Mexico City, and that difference occurred primarily in individuals in the oldest age group. The potential mediating factors we examined did not account for this difference. Other factors, such as exercise and diet, which were not available for analysis in this study, in addition to a cohort effect, may have contributed to the difference in incidence of type 2 diabetes in the two cities. In addition, there was no evidence of a higher case fatality among diabetic individuals from Mexico City compared with San Antonio.

Adult↗
PubMed2000

[Evaluation of the operation of supporting programs for social activity of the elderly by city, town, village governments in Japan].

OBJECTIVES: The aim of this study is to clarify the operative situation of the supporting programs for social activity of the elderly by city, town, village governments in 1997. METHODS: We conducted a study of 3,255 of cities, towns and villages in Japan using a mailed questionnaire, which had been developed to assess the activities of supporting programs for social activity of the elderly. The questionnaire asks government officers whether they had each of the 33 programs in 1997. Each one of these programs belongs to one of the four different aspects of social activities: 1. employment, 2. social participation/volunteering, 3. education/training, 4. individual activities. For each program, the frequency of regions having the program were counted in total, as well as for each of four levels on governments scale: 1. ordinance-designated city, 2. city, 3. town, 4. village. The number of programs operated by the municipality were also evaluated. The main results were as follows One thousand six hundred (49.2%) of cities, towns and villages responded to our questionnaire. 1. Four programs, the promotion of clubs for elderly people, class/lecture meetings for the elderly, sporting events/athletic meetings for the elderly, and a respect-for-age congratulatory gift/money, were put into operation by over 80% of cities, towns and village governments. 2. The number of programs in total or for each of the three aspects of social activities except for social participation/volunteering tended to be high for the large scale governments. There were wide gaps in the number of programs among the regions even of the same level of the government scale. 3. The regions having supporting programs for employment consisted mainly of cities. Seventy-five percent of villages had no supporting program for employment. CONCLUSION: The operational situation of the supporting programs for social activity of the elderly by city, town, village governments was clarified. Furthermore, results obtained by this study can be used for self-assessment of operational situations by municipalities and can contribute to the activation of their supporting programs.

Aged↗
PubMed2001

[Analysis of factors related to the high incidence of tuberculosis in the city of Wakayama--analysis according to age groups, and sputum test results].

Over the last 20 years, the decrease in the incidence of Tuberculosis (TB) in Japan has slowed down. As of 1999, the incidence rate was 34.6 per 100,000 population in Japan, which was higher than that of the other developed countries, and the incidence rate in the city of Wakayama, one of the prefectural capital cities in Japan, during the same period was 42.9 per 100,000 population. We investigated the causes of this high incidence rate of TB in Wakayama City according to the analysis by age groups and sputum test results when patients are newly registered. Comparing our data during the period from 1.1.1998 to 12.31.1999 with data during the same period in the whole country and the rest of Wakayama Pref., the following results were obtained. Observing by age-groups, the incidence of TB in Wakayama City as well as in the rest of Wakayama Pref. and in the whole country was highest in the age-group above 70 years of age, though the rate of Wakayama City was significantly higher (146.2 per 100,000 population) than that in the rest of Wakayama Pref. (98.5 per 100,000 population) and that in the whole country (90.3 per 100,000 population). Furthermore, the incidence rate of cases diagnosed as TB without bacteriological proof in Wakayama City (57.1 per 100,000 population) was significantly higher than that of the whole country (33.7 per 100,000 population). Therefore, we concluded that one of the causes of high incidence of TB in Wakayama City was due to inappropriate method of diagnosing TB. More extensive use of sputum examination and strict evaluation of cases without bacteriological proof are desirable to increase the accuracy of TB diagnosis in Wakayama City.

Adolescent↗
PubMed1988

[Urbanization, the growth of big cities, and some of their problems].

The system of cities in developing countries (which usually are ex-colonial countries) is commonly characterized by primate city domination. The presence of big cities are often felt as parasitic, rather than being economically constructive. Rapid population growth in big cities is often accompanied by 1) shortages of productive employment opportunities, urban housing, and public services; and 2) emergence of squatter settlements, environmental pollution, and sociopsychological stress. In 1985, the urban population of Indonesia had reached 43 million, or 26.2% of the total population. So far, the growth of Indonesia's urban population is concentrated in its metropolitan cities. Even though the pattern of primacy is not striking, a tendency exists for the city-size distribution to deviate more from rank-size rule distribution. Distorted patterns of spatial development have restricted the development of small and middle range cities. In the year 2000, the urban population of Indonesia is estimated to become more than twice its number in 1985. Therefore, national urban policies need to focus more on promoting the development of intermediate and small cities.

Asia↗
PubMed1990

Changes in the population of larger cities of the USSR, 1979-1989.

"An overview of the dynamics of Soviet cities of over 100,000 population for the period 1979-1989 is presented, based largely on maps and tables depicting five key 'subsets' or city groupings: (a) cities increasing by over 100,000 inhabitants; (b) the fastest growing cities in percentage terms; (c) their comparison with fastest growing cities, 1959-1979; (d) the slowest growing cities in percentage terms; and (e) their comparison with slowest growing cities, 1959-1979. The paper, by focusing on these parameters and utilizing extensively graphic and cartographic methods of data presentation, provides...insights into city growth trends...."

Demography↗
PubMed1990

Growth of small and intermediate cities in Korea, 1975-1980.

"This paper examines the urban growth of 33 small and intermediate Korean cities during 1975-1980 from the ecological perspective. Using the multiple regression analysis, population growth of a city is measured by variables such as industrial structure, distance from a metropolitan city, and educational level of residents in a corresponding city. At the present development stage in Korea, those cities whose industrial structure is more specialized in the transformative sector rather than other sectors have grown more rapidly. The closeness to a metropolitan city and the educational level of residents for each city strongly influence urban growth of small cities."

Asia↗
PubMed1998

Tooth loss and periodontal bone level in individuals of Jönköping County. A comparison between two adult populations living in the city and in the surrounding area.

Cross-sectional and longitudinal studies were performed in the community (in this paper changed to city) of Jönköping, Sweden, over a period of 20 years to follow changes in oral health and oral health behaviour. To widen our knowledge about dental health and dental care among the adult population, we expanded the study in 1993 to cover the whole county. The specific aim of the present study was to describe tooth loss (excluding third molars) and periodontal bone level in adult residents of Jönköping County and to compare these two parameters in adults living in the city of Jönköping with the same in adults living in the rest of the county. Random samples of individuals 30, 40, 50, 60, and 70 years old were selected. A total of 484 persons from the city and 1219 subjects from the rest of the county were examined. A total of 32 (7%) and 27 (2%) persons were completely edentulous in the examined populations from the city and from the rest of the county, respectively. A majority belonged to the older age groups, 60 and 70 years, with 17% of the subjects in the city being edentulous compared with 13% in the rest of the county. The mean number of missing teeth in subjects in the city versus subjects in the rest of the county was 0.75/0.95, 1.37/1.60, 3.34/2.43, 6.34/7.40, and 9.95/10.26 in 30-, 40-, 50-, 60-, and 70-year-olds, respectively. Of all the different tooth types, the average number of molars per person decreased the most with increasing age from an average of 7.79/7.83 (city/county) to 3.06/3.09 (city/county) for 30- and 70-year-olds, respectively. The proportion of subjects without molars was higher in the older age groups in both the city and the rest of the county with 4.8/10.7% and 15.6/22.0% of the 60- and 70-year-olds, respectively, lacking molars. In both populations, the mean periodontal bone level decreased with age. It was concluded that no important differences in tooth loss and periodontal health could be seen between the two populations. When organising dental care, dental health administrators could apply the findings from the population in the city to the entire county.

Adult↗
PubMed2005

Radium equivalent activity concentrations in concrete building blocks in eight cities in Southwestern Nigeria.

The radioactivity concentrations of (226)Ra, (232)Th and (40)K were measured by using gamma ray spectroscopy in 130 concrete building blocks collected from block making sites in eight cities in Southwestern Nigeria. The results were used to compute the radium equivalent activity concentration for each city. The values of the concentrations of the primordial radionuclides varied widely within each city and among the cities. The weighted means for the cities range between 13.3 and 18.4, 28.2 and 71.6, and 176.2 and 336.8 Bq/kg for (226)Ra, (232)Th and (40)K, respectively. The city weighted means of radium equivalent activity concentrations for the eight cities range from 81 to 145 with a mean of 101 Bq/kg. The maximum for external hazard index was determined as 0.39. All the values are within the safety limits recommended by UNSCEAR [United Nations Scientific Committee on the Effects of Atomic Radiation 1982. Report to the General Assembly, with annexes. New York, United Nations.].

Cities↗
PubMed1999

Volumetric ragweed pollen data for eight cities in the continental United States.

BACKGROUND: A previous report presented volumetric ragweed pollen data for 23 cities in the continental United States. Although helpful, it did not represent all areas of the country. OBJECTIVE: The purpose of this present communication is to furnish ragweed pollen data for eight additional cities. METHODS: Ragweed pollen data were obtained from eight pollen sampling facilities in the continental United States. These data were analyzed to determine the length of the season in each city and its peak date. RESULTS: The ragweed pollen season was typically 2 or 3 months in duration. Ragweed pollen counts reached their annual maximum in late August or early September in cities in Minnesota, Nebraska, and South Dakota. The peak was achieved in late September or early October for two cities in Texas. The annual maximums for three remaining cities in Colorado, Utah and Alabama occurred in late August, early September and mid-September, respectively. CONCLUSIONS: The findings of this investigation were consistent with previous reports about the north-south nature of the ragweed pollen season. These data, when combined with the results of the 23-city investigation, indicate when source avoidance is most critical in many areas.

Alabama↗
PubMed1995

Fatal injuries after cocaine use as a leading cause of death among young adults in New York City.

BACKGROUND: Cocaine intoxication can lead to fatal cardiovascular and cerebrovascular events. In addition, the neurobehavioral effects of cocaine may increase the likelihood that a user will receive violent fatal injuries. Since New York City is a center for the importation and distribution of cocaine, we sought to determine the extent of cocaine use among city residents with fatal injuries. METHODS: Among a total of 14,843 residents of New York City who received fatal injuries from 1990 through 1992, we determined the proportion who used cocaine shortly before their deaths. We also determined the population-based rates of fatal injuries that were known to follow cocaine use and the proportion of all deaths of New York City residents that was represented by these cases for each demographic stratum. For adults 15 to 44 years of age, fatal injury after cocaine use was ranked with other causes of death as though it was a separate cause. RESULTS: Cocaine use, as measured by the detection of the metabolite benzoylecgonine in urine or blood, was found in 26.7 percent of all New York City residents receiving fatal injuries; free cocaine was detected in 18.3 percent. Approximately one third of deaths after cocaine use were the result of drug intoxication, but two thirds involved traumatic injuries resulting from homicides, suicides, traffic accidents, and falls. If fatal injury after cocaine use was considered as a separate cause of death, it would rank among the five leading causes of death among those 15 to 44 years of age in New York City. CONCLUSIONS: Fatal injuries among cocaine users account for a substantial proportion of all deaths among young adults in New York City.

Adolescent↗
PubMed2003

Indoor radon survey in dwellings of nine cities in the Eastern and the Western provinces of Saudi Arabia.

The results of a first phase of an indoor radon survey in a total of 1610 dwellings distributed in nine cities of the Eastern and the Western provinces of Saudi Arabia are presented. The objective of this radon survey was to obtain representative indoor radon data for seven cities in the Eastern province. Khafji, Hafr Al-Batin, Abqaiq, Qatif, Al-Ahsa, Dammam and Khobar and to compare this with two cities in the Western province, Madina and Taif. So far, detailed radon data is not available for Saudi Arabia: therefore, this radon survey provides a base line for Saudi Arabia in the Radon World Atlas. On average, 200 indoor radon dosemeters were distributed in each city and placed for a period of one year starting from May 2001 to May 2002. The total number of collected dosemeters was 847. A total of 724 houses and 98 schools were covered in this survey. The results of the survey in the cities showed that the overall minimum, maximum and average radon concentrations were 1, 137 and 22 Bq m(-3), respectively. Geometric mean and geometric standard deviations of the radon distribution were found to be 18 and 1.92, respectively. In one of the dwellings in Qatif city, radon concentration, measured by a passive system and then confirmed by an active system, was found to be 535 +/- 23 and 523 +/- 22 Bq m(-3), respectively. The result of a radon survey in 98 schools showed that the minimum, maximum and average radon concentrations were 1, 70 and 19 Bq m(-3), respectively. The average radon concentration for each city was also determined. The lowest average radon concentration (8 Bq m(-3)) was found in Al-Ahsa while the highest average concentration (40 Bq m(-3)) was found in Khafji.

Air Pollutants, Radioactive↗
PubMed2005

Internet-based health promotion and disease control in the 8 cities: successes, barriers, and future plans.

OBJECTIVES: The objective of this paper is to provide a detailed description of Internet-based sexually transmitted disease/human immunodeficiency virus prevention in the 8 US cities most affected by syphilis in men who have sex with men. GOAL: By reviewing the efforts under way in these 8 cities, we will understand the barriers and facilitators associated with Internet-based prevention efforts. STUDY: This is a review of Internet activities taking place in 8 major US cities. RESULTS: Efforts in the 8 cities vary, with some cities reporting little or no Internet-based prevention activities. Other cities have attempted banner advertising, online outreach, online partner notification, online laboratory slips for syphilis testing, and auditorium-style chat sessions. CONCLUSION: Though a number of policy-related barriers prevent some cities from engaging in Internet-based prevention, these activities are clearly important to the overall prevention effort. In order to surmount local policy barriers, it is essential to obtain evaluation data from the programs initiated.

Cities↗
PubMed2002

Suicide among New York City police officers, 1977-1996.

OBJECTIVE: The authors assessed the suicide rates of New York City police officers during a recent period. METHOD: The authors reviewed death certificates of active New York City police officers who died from 1977 through 1996 (N=668); age-, gender-, and race-specific suicide rates among New York City police officers and the city's residents were determined. RESULTS: The police suicide rate was 14.9 per 100,000 person-years, compared with a demographically adjusted suicide rate of New York City residents of 18.3 per 100,000 person-years. Suicide rates among male police officers were comparable to their reference population. Female police officers had a higher risk of suicide than female residents of New York, but the number of suicides of female police officers was small. CONCLUSIONS: The rate of suicide among New York City police officers is equal to, or even lower than, the suicide rate of the city's resident population.

Adult↗
PubMed2002

A tale of two cities: effects of air pollution on hospital admissions in Hong Kong and London compared.

The causal interpretation of reported associations between daily air pollution and daily admissions requires consideration of residual confounding, correlation between pollutants, and effect modification. If results obtained in Hong Kong and London--which differ in climate, lifestyle, and many other respects--were similar, a causal association would be supported. We used identical statistical methods for the analysis in each city. Associations between daily admissions and pollutant levels were estimated using Poisson regression. Nonparametric smoothing methods were used to model seasonality and the nonlinear dependence of admissions on temperature, humidity, and influenza admissions. For respiratory admissions (> or = 65 years of age), significant positive associations were observed with particulate matter < 10 microm in aerodynamic diameter (PM(10), nitrogen dioxide, sulfur dioxide, and ozone in both cities. These associations tended to be stronger at shorter lags in Hong Kong and at longer lags in London. Associations were stronger in the cool season in Hong Kong and in the warm season in London, periods during which levels of humidity are at their lowest in each city. For cardiac admissions (all ages) in both cities, significant positive associations were observed for PM(10), NO(2), and SO(2) with similar lag patterns. Associations tended to be stronger in the cool season. The associations with NO(2) and SO(2) were the most robust in two-pollutant models. Patterns of association for pollutants with ischemic heart disease were similar in the two cities. The associations between O(3) and cardiac admissions were negative in London but positive in Hong Kong. We conclude that air pollution has remarkably similar associations with daily cardiorespiratory admissions in both cities, in spite of considerable differences between cities in social, lifestyle, and environmental factors. The results strengthen the argument that air pollution causes detrimental short-term health effects.

Adolescent↗
PubMed2003

Distance from roads and cities as a predictor of habitat loss and fragmentation in the caatinga vegetation of Brazil.

Roads and cities represent huge sources of degradation for adjacent ecosystems regarding nutrient cycling, energy, water flow and species composition. In this study we test the hypothesis that distance from roads and cities is associated with habitat loss and fragmentation in the caatinga vegetation--a dry forest to scrub vegetation that covers ca. 736,000 km2 of northeast Brazil. The study site comprised a 2,828.8 km2 piece (64 km x 44.2 km) of Xingó region (09 degrees 36'S, 37 degrees 50'W), which is located between the States of Alagoas and Sergipe. Based on satellite imagery we mapped the remaining vegetation, 145 km of paved roads and the seven small-sized cities set in the study site. A positive correlation was found between the combined distance from roads and cities and the percentage of remaining vegetation as it dropped from 18% at 12 km distant to 5.9% at 1 km distant from cities and roads. Thus, remaining vegetation was reduced by one third near cities and roads. A positive correlation was also found between distance from cities and roads and the percentage of fragments larger than 200 ha, which ranged from 3.6% (within 3 km distance class) to 23.3% (15 km distance class) of all fragments. Our results suggest a road/city-effect zone of 12 to 15 km width, over which habitat loss and fragmentation extend throughout the caatinga vegetation. These findings should be considered in the regional polices for biodiversity conservation and economic development of the caatinga region.

Brazil↗
PubMed1987

Home care in New York City: providers, payers, and clients.

Estimates based on 1980 data indicate that almost two-thirds of the disabled elderly in New York City receive care only from informal sources. Another one-fifth use a combination of informal and formal sources of care. Thus, only about 15 percent are exclusively dependent on various agencies and programs that constitute the formal home care system. Over 200 organizations in 1986 offered some form of home care service in New York City. Among these were at least 100 proprietary businesses, 61 nonprofit personal care agencies, and 36 nonprofit certified home health agencies. In 1984, 166,739 different New York City residents received home care services provided by the four largest types of formal providers of care: certified home health agencies; Long Term Home Health Care Programs; Human Resources Administration home attendant agencies and homemaker/housekeeper agencies; and Department for Aging homemaker/housekeeper programs. While women age 65 and older living alone are the largest client group for home care services, persons below age 65 account for approximately one-fourth of program caseloads of the four major home care providers in New York City. An estimate of one-day home care use in 1984 shows that the four major types of providers served 59,554 persons with total annual expenditures of $499.3 million, while nursing homes cared for 36,072 persons with annual expenditures of almost $1.4 billion. It is thus evident that more people are receiving organized, extended care at home on a given day in New York City than in nursing homes. Medicaid, the major payer for home care in New York City, spent $412.4 million on home care services in 1984, accounting for 82.6 percent of total publicly funded expenditures for home care services. Of this amount, 89 percent was for personal care services provided through the Human Resources Administration's personal care program. More details on home care in New York City follow, along with a discussion of policy perspectives surrounding the provision of and payment for home care services in the future.

Aged↗
PubMed2003

Epidemiology and control of tuberculosis in Western European cities.

SETTING: Major cities of Western Europe. OBJECTIVE: To describe major variations in the epidemiology and control of tuberculosis in large Western European Cities. DESIGN: Postal survey using contacts identified through the EURO-TB surveillance network. RESULTS: Twenty cities responded. In most cities, notification rates were substantially higher than national rates. Rates ranged from less than 10 per 100,000 in Reykjavik and Belfast to over 70 per 100,000 in Lisbon. MDR-TB ranged from less than 1% of cases in many cities to over 5% in Rome and Milan. The proportion of patients estimated to be HIV-positive ranged from less than 5% in many countries to over 20% in Milan. These variations in epidemiology were accompanied by major variations in control policy, particularly in approaches to new entrant screening and BCG vaccination. CONCLUSION: In Western Europe, tuberculosis is primarily a problem of large cities. Some of these cities have very high rates of tuberculosis. There is little consensus about the best approaches to control. The evidence base for the effectiveness of different aspects of TB control needs to be strengthened.

Antitubercular Agents↗