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At least 487 records · Page 27Linked to original sources
PubMed2005

The short-term effects of air pollution on daily mortality in four Australian cities.

OBJECTIVE: To examine the short-term health effects of air pollution on daily mortality in four Australian cities (Brisbane, Melbourne, Perth and Sydney), where more than 50% of Australians reside. METHODS: The study used a similar protocol to APHEA2 (Air Pollution and Health: A European Approach) study and derived single-city and pooled estimates. RESULTS: The results derived from the different approaches for the 1996-99 period showed consistent results for different statistical models used. There were significant effects on total mortality, (RR = 1.0284 per 1 unit increase in nephelometry [10(-4).m(-1)], RR = 1.0011 per 1ppb increase in NO2), and on respiratory mortality (RR = 1.0022 per 1ppb increase in O3). No significant differences between cities were found, but the NO2 and particle effects may refer to the same impacts. Meta-analyses carried out for three cities yielded estimates for the increase in the daily total number of deaths of 0.2% (-0.8% to 1.2%) for a 10 microg/m3 increase in PM10 concentration, and 0.9% (-0.7% to 2.5%) for a 10 microg/m3 increase in PM2.5 concentration. CONCLUSIONS: Air pollutants in Australian cities have significant effects on mortality.

Aged↗
PubMed2005

Chronic heart failure beyond city limits.

INTRODUCTION: Chronic heart failure (CHF) develops in frail elderly individuals who have suffered an acute or sustained insult to the structural efficiency of the heart due to the presence of underlying heart disease and/or hypertension. It is also more common in individuals with disproportionately high levels of cardiac disease or its risk factors, for example lower socioeconomic status. As such, this epidemic is particularly significant for older people, males and Aboriginal people; groups who comprise a greater proportion of the population in rural and remote Australia. The aim of this study is to determine if the rates of CHF differ between urban and rural Australia. METHOD: CHF prevalence rates derived from well validated international CHF prevalence data were applied to the Australian Bureau of Statistics Census data for 2001 and weighted to reflect the proportion of Aboriginal people in each geographical stratum. RESULTS: Australia wide, the estimated prevalence of CHF was 17.87 per 1000, ranging from 13.98/1000 in the Australian Capital Territory to 29.50/1000 in rural Northern Territory. Overall, CHF was more prevalent in rural and remote regions (19.84/1000) and large urban centres (19.01/1000) than in capital cities (16.94/1000) (p<0.001). High prevalence rates were also noted in the idyllic rural locations favoured by retirees. In Victoria, Western Australia, South Australia and the Australian Capital Territory over 70% of the estimated individual cases were located in capital cities. In New South Wales, Queensland, Tasmania and the Northern Territory the highest proportion of cases occurred outside capital cities. CONCLUSION: The main significance of these findings is that while a majority of heart failure may occur among people living in cities (because that is where most people live), a disproportionate number of cases occur among people living outside these cities (due to age and other socio-demographic risk factors) where services may be fewer and less accessible.

Adult↗
PubMed2006

[Nutrition and feeding situation of Chinese 0- 5 years old infants and children in 8 provinces, cities and villages in 2004].

OBJECTIVE: To investigate and analyze present nutrition and feeding situation of 0 - 5 years old infants and children in Chinese cities and villages and to understand main problems existed during Chinese infants and children's develop-growing period in order to provide a basis for further drafting measures of nutrition amelioration. METHODS: To utilize an "Investigation to Nutrition Situation of 0 - 5 Years Old Infants & Children" which is opened in Chinese 8 provinces, cities and villages in 2004 by Social Women Dept. of Ministry of Public Health, P. R. China to proceed measurement of height and body weight for 17081 infants and children of 0 - 5 years of age in 8 provinces, cities and villages, also with Questionnaire form to proceed an investigation to parents of above said infants and children about their feeding situation. RESULTS: The develop-growing difference between cities and villages' infants and children appears to begin in April, a high occurrence period for 1 - 2 years old infants and children in villages with long period chronicle malnutrition as main cause that Chinese western area villages' nutrition rate is 20% above to be higher than Chinese middle and eastern areas. Infants and children's mother milk feeding rate is higher than whole nation's children nutrition monitoring result in 2000 with villages obviously higher than cities. In adding infants' supplementary foods there obviously existed unscientific and unreasonable problem of adding time, adding quality and quantity of supplementary foods. To analyze cause it is besides economic factors there existed obvious relation with shortage of knowledge in nutrition and health care by infants and children's parents.

Body Height↗
PubMed1984

City differences in racial occupational differentiation: a note on the use of odds ratios.

This note considers whether city differences in racial occupational distribution are best investigated using measures of nominal differentiation or measures of inequality, and argues that measures of inequality are better suited for testing the prevailing theories of race differences in occupation distribution. It also defends the Index of Net Difference and the Index of Dissimilarity (and other measures of inequality used in previous research) from the criticism that they are flawed because they are sensitive to city differences in occupational structure. Additionally, it explores a new approach for investigating city differences in occupational inequality within the log-linear framework. The logical and empirical arguments offered support the conclusions that racial occupation differences reflect racial stratification, and that variation in racial occupation differences across cities is best understood as the product of city differences in the severity of racial stratification. Thus, future research in this area should continue to focus on measures of inequality rather than measures of nominal differentiation until there are sound theoretical and empirical reasons for conceptualizing race differences in occupational distribution in terms of nominal differentiation.

Black or African American↗
PubMed1982

Morbidity and mortality associated with the July 1980 heat wave in St Louis and Kansas City, Mo.

The morbidity and mortality associated with the 1980 heat wave in St Louis and Kansas City, Mo, were assessed retrospectively. Heat-related illness and deaths were identified by review of death certificates and hospital, emergency room, and medical examiners' records in the two cities. Data from the July 1980 heat wave were compared with data from July 1978 and 1979, when there were no heat waves. Deaths from all causes in July 1980 increased by 57% and 64% in St Louis and Kansas City, respectively, but only 10% in the predominantly rural areas of Missouri. About one of every 1,000 residents of the two cities was hospitalized for or died of heat-related illness. Incidence rates (per 100,000) of heatstroke, defined as severe heat illness with documented hyperthermia, were 26.5 and 17.6 for St Louis and Kansas City, respectively. No heatstroke cases occurred in July 1979. Heatstroke rates were ten to 12 times higher for persons aged 65 years or older than for those younger than 65 years. The ratios of age-adjusted heatstroke rates were approximately 3:1 for nonwhite v white persons and about 6:1 for low v high socioeconomic status. Public health preventive measures in future heat waves should be directed toward the urban poor, the elderly, and persons of other-than-white races.

Adult↗
PubMed1982

Changing families and changing mobility: their impact on the central city.

Urban scholars and planners look to evidence of recent gains in the number of nontraditional households as a potential source of increase to the population sizes and tax bases of declining central cities. While it is now well established that substantial gains in the numbers of small, nontraditional households have occurred since the 1950s, it has not been demonstrated that: (a) these households are more likely to relocate in the city than traditional family households (husband-wife with children under 18); or (b) their cityward relocation patterns will significantly alter trends toward smaller city household populations. This paper addresses these questions by examining changes in city-suburb migration stream rates by household type over periods 1955-60, 1965-70 and 1970-75 for large metropolitan areas, and assesses their implications for potential changes in the aggregate sizes of city household populations.

Adolescent↗
PubMed1995

Factors related to immunization status among inner-city Latino and African-American preschoolers.

OBJECTIVE: To identify factors associated with undervaccination at 3 months and 24 months among low-income, inner-city Latino and African-American preschool children. DESIGN: Interviews with a representative sample of inner-city families using a cross-sectional, multi-stage, cluster-sample design combined with a replicated quota sampling approach. SETTING: South Central and East Los Angeles areas in inner-city Los Angeles. POPULATION: Eight hundred seventeen Latino and 387 African-American families with children between 12 and 36 months of age. MAIN OUTCOME VARIABLES: Being fully immunized or up-to-date (UTD) at 3 months (1 diphtheria-tetanus-pertussis vaccine and 1 oral polio vaccine) and 24 months of age (4 diphtheria-tetanus-pertussis vaccines, 3 oral polio vaccines, and 1 measles-mumps-rubella vaccine). METHODS: Logistic regressions of UTD immunization status at 3 and 24 months by population and health care system factors. RESULTS: Seventy percent of Latino children and 53% of African-American children were UTD at 3 months of age. At 24 months of age, 42% of Latino children and 26% of African-American children were UTD on their immunizations. Receipt of the first immunizations by 3 months was associated with smaller family size, and evidence of connection to prenatal care. Latino children were less likely to be UTD at 24 months if they obtained well child care from private providers versus public clinics (odds ratio [OR] = 0.45, 95% confidence interval [CI] = 0.26, 0.79). There was also a trend for Latino children to be less well immunized if they were in health maintenance organizations versus public clinics (0.31, 0.05 < P < .1). African-American children were more likely to be UTD at 24 months if they were UTD at 3 months (OR = 5.56, 95% CI = 1.43, 21.6), had more health visits (OR = 1.13, 95% CI = 1.01, 1.27), and were less likely to be UTD at 24 months if they were on Medicaid versus private insurance (OR = 0.26, 95% CI = 0.08, 0.90). IMPLICATIONS: Both African-American and Latino children in inner-city Los Angeles have low immunization rates at 3 and 24 months. Prenatal care and family size are strongly associated with being UTD by 3 months; however, family and child characteristics are relatively unimportant predictors of being UTD at 24 months of age. Important risk factors for underimmunization at 2 years of age in the inner-city, low-income communities studied include type of health insurance and source of well child care, with the public sector having higher rates than private doctors' offices or health maintenance organization/managed care plans.

Black or African American↗
PubMed1995

Attitudes and behaviors of African-American and Mexican-American women delivering newborns in inner-city Los Angeles.

To study some of the factors relating to the care of mothers and newborns in an inner-city hospital, three sources of information were reviewed: an obstetric database including information on prenatal care and perinatal mortality, a database of all admissions to the hospital neonatal intensive care unit over the past 5 years, and a detailed questionnaire concerning attitudes and behaviors of recently delivered women. While analyses from these hospital-based data are not conclusive, the results add evidence for the following propositions: 1) Optimal prenatal care is infrequently obtained by mothers delivering at inner-city hospitals. Lack of prenatal care is clearly associated with increased perinatal mortality. While the need for prenatal care is appreciated by 98% of the mothers in this sample, the most frequent reasons why prenatal care is not obtained earlier or more frequently involve knowledge about and access to prenatal care. 2) Inner-city mothers, in general, manifest attitudes and behaviors that promote the welfare of their pregnancies and newborns. These attitudes and behaviors are in stark contrast to those that are frequently attributed to inner-city women by the media. 3) Acute perinatal medical and nursing care are perceived by many postpartum women as suboptimal, particularly in terms of the lack of respect shown to patients by nurses and doctors. 4) Improved acute obstetric and neonatal care improves perinatal morbidity and mortality of infants delivered at inner-city hospitals.

Adult↗
PubMed1994

Multidrug-resistant tuberculosis in a hospital--Jersey City, New Jersey, 1990-1992.

Since 1986 (the first full year following implementation of the revised tuberculosis [TB] surveillance case definition), the reported rate of TB per 100,000 persons in New Jersey increased from 9.5 cases to 12.6 cases in 1992. Of the 984 cases reported to CDC from New Jersey in 1992, 108 (11.0%) were reported from Jersey City (1990 population: 230,300)--the city ranked second in number of TB cases reported and fourth in rate of TB (46.9 per 100,000) in the state. In addition, in 1992, the rate of multidrug-resistant TB (MDR-TB) (i.e., Mycobacterium tuberculosis isolates resistant to at least isoniazid [INH] and rifampin [RIF]) among TB patients in New Jersey was 5%; the rate in Jersey City was 13%. To characterize the epidemiologic features of persons with drug-resistant TB, the New Jersey Department of Health and the Infectious Diseases Division of the Jersey City Medical Center conducted a study among patients treated at that hospital during 1990-1992. This report presents the findings of the study and compares the hospital's rates of drug-resistant TB with previously reported rates, rates for other cities in New Jersey, and rates for the state.

Adolescent↗
PubMed1996

Seroprevalence of antibody against poliovirus in inner-city preschool children. Implications for vaccination policy in the United States.

OBJECTIVES: To assess susceptibility to poliomyelitis in selected inner-city preschool children in the United States and to estimate the contribution of secondary spread of live attenuated oral poliovirus vaccine virus to type-specific immunity. DESIGN: Cross-sectional seroprevalence study. METHODS: Serum neutralizing antibody levels against poliovirus types 1, 2, and 3 were analyzed according to vaccination status, age, and other sociodemographic variables. SETTING: Hospital and satellite clinics serving inner-city populations in Houston, Tex, and Detroit, Mich, 1990 to 1991. PARTICIPANTS: A total of 526 children aged 12 to 47 months seeking medical care were enrolled in the seroprevalence study; 144 children aged 12 to 35 months without a history of previous oral poliovirus vaccination were enrolled in the secondary spread study. RESULTS: Seropositive rates were similar in children in both cities, ranging from about 80% for types 1 and 3 in 12- to 23-month-old children to more than 90% in those aged 36 to 47 months. The most important predictor of seropositivity was the number of doses of oral poliovirus vaccine received (P < .01), with levels approximately 90% for all 3 serotypes among children who had received 3 or more doses. In children likely to have been unvaccinated, seropositive rates ranged from 9% to 18% for poliovirus types 1 and 3 and from 29% to 42% for type 2; secondary spread of vaccine virus appeared to have occurred among children who had previously received 1 dose or less but not those with 2 or more doses. CONCLUSIONS: Levels of immunity to poliovirus among inner-city preschoolers are high and may be predicted by the number of doses of oral poliovirus vaccine received. Secondary spread of the vaccine virus plays a modest role in increasing polio immunity in inner-city populations, especially against types 1 and 3. This role will decrease in importance if the recently attained high levels of immunization coverage in the United States are sustained and if the risk of importation of wild poliovirus continues to diminish.

Antibodies, Viral↗
PubMedDate not supplied

Papanicolaou test status among inner-city adolescent girls.

BACKGROUND: The English medical literature for the past decade lacks any reports on Papanicolaou (Pap) test status among inner-city adolescent girls. Our objectives were (1) to assess the pattern of Pap test status among inner-city adolescent girls and (2) to ascertain the association of the Pap test status with their knowledge, beliefs, and behaviors. METHODS: All 3,980 inner-city senior high school adolescent female students in two cities in New Jersey were included in the survey. Response rate was 84%; 89% of respondents were minority adolescents. RESULTS: The factors that significantly increased the probability of obtaining a Pap smear were physician recommendation for Pap test, being knowledgeable of Pap test, awareness that other family members had obtained Pap tests, family income and parents' education levels. The age of initiation of first Pap test almost always was before 18 years of age; 13% of sexually active girls were smokers. The major barriers for never having had a Pap test were lack of physician's recommendation, ignorance about the Pap test, cost of the test, lack of information on how and where to obtain it, belief that they were not at risk for cancer, and embarrassment over requesting the test. CONCLUSION: Inner-city predominantly minority adolescent girls who have considerable sexual activity, multiple sex partners, initiation of intercourse at an early age, and smoking are at high risk for cervical cancer. It makes sense to initiate Pap screening for such high-risk adolescents. Individualized Pap test educational intervention programs adopted to the adolescents' barriers to undergoing Pap testing and physicians' recommendations for this preventive care are needed to encourage high-risk adolescent girls to undergo regular Pap tests and appropriate follow-up.

Adolescent↗
PubMed1997

A tale of two New Jersey cities.

Judging from the social and health measures considered in this article, Newark and Jersey City face similar challenges as other large cities. For Newark, the challenges are more extreme. The high rates of poverty and violence, coupled with a low rate of high school graduation and a large number of single parent households bode ill for the city. The hospitals in Newark and Jersey City have undergone major changes in meeting the needs of their communities. They have adjusted their size, shortened their lengths of stay, and provided more intensive care services and outpatient services. Of special concern for New Jersey's hospitals is the reliance on Medicaid financing. If dramatic changes are made to the Medicaid program, Newark hospitals should be on high alert. Legislatures need to tread carefully in designing policies that address the needs of New Jersey's large cities. The state is undergoing major changes in its health care system. The demise of the all-payer rate setting system, the establishment of the Health Care Subsidy Fund to finance uncompensated care and subsidize insurance for low and middle-income families, modifications to the community rating system for private insurance, and changes to the welfare system that affect eligibility for Medicaid all require legislators to consider the context in which these programs operate.

Adolescent↗
PubMed1995

Putting prevention into practice. Impact of a multifaceted physician education program on preventive services in the inner city.

BACKGROUND: Physicians' prevention practices often differ from guidelines published by national authorities. Effective preventive services are most needed in inner city settings that suffer disproportionately from preventable diseases. This study examined the impact of a multifaceted physician prevention education program on the provision of preventive services in an inner city municipal hospital. METHODS: The study used a controlled intervention comparative design at two inner city municipal hospitals--Harlem Hospital Center, New York, NY (intervention site) and Kings County Hospital, Brooklyn, NY (comparison site)--serving predominantly African-American patient populations. The intervention site received prototype materials for physicians, patients, and the office setting from the US Public Health Service's Put Prevention Into Practice campaign and a series of prevention lectures from November 1991 through April 1992. Change in physician prevention practices and knowledge was assessed by self-administered questionnaires and change in patients' reports of preventive services received was assessed by structured interviews. RESULTS: Physicians at Harlem Hospital Center reported a greater postintervention increase in prevention practices and demonstrated a greater increase in prevention knowledge in comparison with physicians at Kings County Hospital. Patients at Harlem Hospital Center reported receiving increased preventive services from physicians after the intervention, while patients at Kings County Hospital did not report any significant change in preventive services received. CONCLUSIONS: A multifaceted physician education program using prototype materials from the Put Prevention Into Practice campaign with prevention lectures significantly increased the prevention knowledge and practices reported by physicians and the preventive services reported received by patients at an inner city municipal hospital.

Adult↗
PubMed1994

Cancer mortality in Chinese immigrants to New York City. Comparison with Chinese in Tianjin and with United States-born whites.

BACKGROUND: Cancer rates in immigrant populations are frequently found to be intermediate between the country of origin and the adopted country. Such observations play an important role in establishing the environmental origin of cancer. Chinese now constitute the third largest group immigrating to New York City. METHODS: Cancer deaths in New York City (1986-90) among 706 male and 412 female foreign-born Chinese were compared using proportional cancer mortality ratios (PCMR) with Chinese who died of cancer in Tianjin, China (19,461 deaths, 1983-87), and with United States-born whites in New York City (32,293 deaths). RESULTS: Cancer sites were divided into those for which the age-adjusted PCMR were significantly higher in Tianjin Chinese (TC) compared with New York City whites (NYW), and those for which PCMR were significantly lower in TC compared with NYW. PCMR for Chinese immigrants usually fell between those of TC and NYW, but some were closer to those of TC (e.g., liver, gallbladder, female lung) whereas other sites were closer to those of NYW (e.g., esophagus, colon, rectum). CONCLUSIONS: These data provide additional support for the concept that much cancer originates with and can be modified by environmental factors.

China↗
PubMed2004

The New York City Smoke-Free Air Act: second-hand smoke as a worker health and safety issue.

BACKGROUND: Despite the provisions of a Smoke-Free Air Act (SFAA) enacted in 1995, more than 415,000 non-smoking New York City workers reported exposure to second-hand smoke in the workplace all or most of the time in 2002. Continued exposure to second-hand smoke in New York City prompted a renewed debate about a broader smoke-free air law. METHODS: The approach taken by the New York City Department of Health and Mental Hygiene to make the case for workplace protection from second-hand smoke, counter the opposition's arguments, and ultimately win the support of policymakers and the public for comprehensive smoke-free workplace legislation is described. RESULTS: On December 30, 2002, New York City's Mayor signed the SFAA of 2002 into law, making virtually all workplaces, including restaurants and bars, smoke-free. CONCLUSIONS: Proponents for a stronger law prevailed by defining greater protection from second-hand smoke as a matter of worker health and safety. Efforts to enact smoke-free workplace laws will inevitably encounter strong opposition, with the most common argument being that smoke-free measures will harm businesses. These challenges, however, can be effectively countered and public support for these measures is likely to increase over time by focusing the debate on worker protection from second-hand smoke exposure on the job.

Air Pollution, Indoor↗
PubMed1981

The centralized prenatal genetics screening program of New York City: I. Developmental phase.

The increasing demand in New York City for prenatal diagnosis of genetic disorders has necessitated the development of a large-scale, centralized prenatal genetic screening program. The objective of this program is eventually to serve 3,000 to 4,000 at-risk New York City pregnant women annually. Through the teamwork of a task force comprising representatives from the New York Scientists' Committee for Public Information (SCPI), the Medical and Health Research Association of New York City Departments of Health, and five different advisory committees, the centralized Prenatal Diagnosis Laboratory of New York City (PDL) was designed and established. While this program aims to provide high quality, centralized laboratory service for the prenatal detection of chromosome abnormalities and open neural tube defects, it also emphasizes quality-controlled services in genetic counseling, aminocentesis, ultrasound monitoring, obstetric care, and patient follow-up. Genetic counseling by PDL-employed counselors is made available to patients whenever the participating hospital lacks such service or cannot handle their patient load. In addition, PDL has launched a vigorous public health education program. A detailed guideline for the program was prepared describing the highest standards of quality for each component. The initial step was th developmental phase that included establishing the advisory committees, searching for sponsors, preparing guidelines, developing the health education program, renovating the laboratory site, purchasing and installing equipment, and recruiting of staff. The experience gained from this endeavor will be of value in the development of similar large-scale prenatal diagnosis programs.

Amniocentesis↗
PubMed2004

Waste management in Guangdong cities: the waste management literacy and waste reduction preferences of domestic waste generators.

A questionnaire survey was conducted in 2002 on 1365 households in two prefectural-level cities in the Pearl River Delta, Jiangmen and Zhongshan. Three groups of issues are covered in this paper: 1) waste management literacy, concerns, and public participation; 2) waste recycling practices and the potential for waste avoidance; and 3) public environmental literacy. This study confirms findings from previous surveys and provides new information on important issues such as imposing monetary charges on waste and environmental activities, littering, source separation programs (SSPs), and public participation and expectations in local waste management. Saving up recyclable materials for redemption in waste depots is commonly practiced in mainland China regardless of the level of development of a city, although at the household level, high-income families tend to place less value on the revenues to be gained from redemption than lower income groups do. Data from the previous and the present studies indicate that such voluntary but largely economically driven waste recovery behavior diverts at least 10% of the household waste from the waste stream. Although uncompensated SSP is less appealing in the two cities than compensated SSP, it was found that when the median per capita income of a city reaches RMB2000 per month, a high participation rate for uncompensated waste recovery is more likely to occur. Education and income levels are the chief factors affecting littering behavior and the potential for waste avoidance. Contrary to general belief, the local Chinese community is active in microwaste management. The concern, however, is over the inability of the grassroots bureaucracy to deal with rising expectations for waste collection services and neighborhood cleanliness.

Adolescent↗
PubMed2006

Evaluating the environmental performance of urban parks in Mediterranean cities: an example from the Barcelona metropolitan region.

In a context of increasing urban sprawl and water scarcity common to other Mediterranean cities, this article focuses on the urban parks in the Region of Barcelona (Catalonia, Spain) to examine how these parks are distributed in this region and to assess whether their design and management follow criteria adapted to Mediterranean environmental conditions, especially in what concerns water use. In order to evaluate the environmental performance of these parks, we selected four factors possibly influencing the adoption of park management practices at the local scale: urban density, population size of the municipality, municipal income per capita, and political orientation of the city council. After determining the location and area of urban parks in the region, we correlated these four explanatory factors with several management tasks extracted from two different samples of parks (one of 315 parks and another of 125 parks) and a survey of 86 city councils. Results show that, in general, urban parks were more frequent in large, dense, and left/green municipalities but that environmentally sound practices were more common in small and low-density municipalities. We conclude that changes in certain practices (especially the substitution of high water demanding species) could improve significantly the environmental performance of public spaces in large urban areas with Mediterranean climates. Our observations may be pertinent for other cities interested in the provision of environmental public goods such as parks that necessitate water for irrigation.

Cities↗