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PubMed2004

Suburban sprawl and physical and mental health.

OBJECTIVE: To study the association between objective measures of suburban sprawl and chronic medical conditions and mental health disorders in the USA. METHODS: Cross-sectional analysis of survey data merged with objective measures of suburban sprawl. Outcomes are self-reported medical conditions, mental health disorders and health-related quality of life. RESULTS: Sprawl significantly predicts chronic medical conditions and health-related quality of life, but not mental health disorders. An increase in sprawl from one standard deviation less to one standard deviation more than average implies 96 more chronic medical problems per 1000 residents, which is approximately similar to an aging of the population of 4 years. CONCLUSIONS: A robust association between sprawl and physical (but not mental) health suggests that suburban design may be an important new avenue for health promotion and disease prevention.

Adult↗
PubMed2002

Estimated cost effectiveness of a police automated external defibrillator program in a suburban community: 7 years experience.

OBJECTIVE: To estimate the cost effectiveness of a 7-year police automatic external defibrillator (AED) program in four suburban communities. METHOD: 10-year retrospective study (7/89-7/99) of patients of four suburban communities during two study periods: (1) police first response and advanced life support (ALS) care (No-AED) and; (2) AED equipped police first response (P-AED) with subsequent ALS care. Using the perspective of the communities, we obtained costs of AED program from police agencies. We estimated cost/life saved and cost/year lives saved using decreased time to VF shock by EMS. We performed a sensitivity analysis for estimates of potential benefit using estimated improved survival as a result of decreased EMS response interval and obtained survival data. We used literature-based estimates of life expectancy after cardiac arrest survival to estimate cost/year life saved. We used student's t-test and chi(2) to estimate differences between groups. RESULTS: During the 10-year study period 208 patients met study criteria; (81 No-AED, 128 P-AED). The two groups were not different by patient age, ALS response interval, percent in VF, percent witnessed (WIT), or arrest location. Interval to first defibrillator equipped EMS vehicle arrival was less in the P-AED group (2.0 vs. 5.4 min, P<0.001) as was the interval from the emergency (911) call to first VF shock (6.6 vs. 8.4 min, P=0.02). Survival to DC was not statistically different with P-AED (11.9 vs. 9.9%, P=0.66) but this study was not powered to detect a difference. Estimated cost per life saved with P-AED varied from $23542 to $70342 and cost per year life saved ranged from $1582 to $16060. CONCLUSION: Police AED appears to be a cost-effective intervention in these suburban communities which have relatively rapid EMS response intervals.

Aged↗
PubMed2000

Dating violence: a comparison of rural, suburban, and urban teens.

This study analyzed rural, suburban, and urban differences in teen dating violence using the 1996 Teen Assessment Project data. Teens in rural school districts were more likely to be victims of dating violence than their suburban and urban counterparts; males reported being slapped, hit, or kicked more frequently than females. The findings of this study indicate that students in rural school districts are at greater risk for participating in dating violence than suburban and urban students, with rural female students at greatest risk.

Adolescent↗
PubMed1999

Contextual factors in substance use: a study of suburban and inner-city adolescents.

Objectives in this research were to examine contextual differences in correlates of substance use among high school students. The focus was on two broad categories of adjustment indices: personal psychopathology (internalizing and externalizing problems) and behaviors reflecting social competence (academic achievement, teacher-rated classroom behaviors, and peer acceptance or rejection). Associations between drug use and each of these constructs were examined in two sociodemographically disparate groups: teens from affluent, suburban families (n = 264), and low socioeconomic status adolescents from inner-city settings (n = 224). Results indicated that suburban youth reported significantly higher levels of substance use than inner-city youth. In addition, their substance use was more strongly linked with subjectively perceived maladjustment indices. Comparable negative associations involving grades and teacher-rated behaviors were found in both groups, and among suburban males only, substance use showed robust positive associations with acceptance by peers. Results are discussed in terms of developmental perspectives on adolescent deviance, contextual socializing forces, and implications for preventive interventions and treatment.

Achievement↗
PubMed1997

Prevalence of stages of change for physical activity in rural, suburban and inner-city communities.

This study documented the differing prevalence rates for stages of change for physical activity across rural, suburban and inner city communities using survey methods and controlling for education, gender and disease status. Respondents (n = 4768) were participants in the baseline survey for the evaluation of the Québec Heart Health Demonstration Project, a health promotion program implemented in various communities throughout the province of Québec. A total of 2639 female and 2087 male parents answered a questionnaire they received from their grade 4 to grade 6 children. The questionnaire dealt with demographic information, health-related behaviors, and intentions for these behaviors. The response rates were 90%, 77% and 70% in the rural, suburban and inner city communities respectively. Results showed that prevalence rates differed significantly between communities with rural communities having the highest rates of readiness for physical activity in comparison to suburban and inner city communities. These findings suggest that above and beyond individual difference variables, structural components such as type of community are related to people's readiness for physical activity involvement.

Adult↗
PubMed1981

Urban-suburban differences in the predictors of morale among the aged.

Research on the habitability of the city for older people and research on the predictors of well-being have led to the search for patterns of adaptation which distinguish the urban elderly adults from their non-urban counterparts. This study compares neighborhood perceptions and use and social network involvement in an urban and suburban sample of older people. Differences in patterns of adaptation characteristic of urban and suburban elderly adults were sought by comparing the ability of neighborhood and social network factors to predict morale in each sample. Results revealed differences in urban and suburban elderly adults' perceptions and use of neighborhood facilities. Urban older people reported more frequent interactions with friends, greater dissatisfaction with friendships and greater organizational participation. Informal social relationships were related to elderly urbanites' morale but had practically no bearing on suburbanites' morale. Differences in cultural heterogeneity and environmental demand seem to provide the best explanation for the findings.

Aged↗
PubMed2001

Impact of ambulance diversion policies in urban, suburban, and rural areas of Central Maryland.

UNLABELLED: As a method to control patient flow to overburdened hospitals, effective emergency medical services (EMS) systems provide policies for ambulance diversion. The Maryland state EMS system supports two types of alert for general hospital use: red alert, aimed at limiting the delivery of patients who may require intensive care unit (ICU) admission, and yellow alert, aimed at preventing further overload of already overtaxed emergency departments (EDs). OBJECTIVE: To examine the effect of those alert policies in different geographical environments, urban, suburban, and rural. METHODS: Alert data for 23 hospitals in Central Maryland and ambulance arrival data for approximately 138,000 ambulance calls during calendar year 1996 were combined and analyzed. The impacts of diversion practices in the geographic areas were compared. RESULTS: Red alert reduced volume in all patient acuity levels in all geographic areas by a statistically significant 0.4 patient/hr. Yellow alert diverted low-acuity patients at the rate of 0.13 patient/hr (p<0.001) in urban areas and at the rate of 0.16 patient/hr (p<0.001) in suburban areas, but had minimal impact in the flow of patients in the rural environment. CONCLUSIONS: The ED diversion policy has some limited effect in preventing further patient volume in urban and suburban areas, but has virtually no impact in rural areas. However, an ICU diversion policy diverts patients of all acuities uniformly and inordinately diverts patients not likely to require ICU admissions while having only minimal impact on patients who do require ICU resources. The impact of red alert is uniform in all geographic areas. The impact and efficacy of ambulance diversion policies should be evaluated to ensure they are having the intended effect. While perhaps initially effective, the impact of alert policies may change over time.

Ambulances↗
PubMed1997

Higher asthma occurrence in an urban than a suburban area: role of house dust mite skin allergy.

Understanding of geographical differences in asthma prevalence may be helpful in explaining recent increases in the occurrence of asthma. We wondered whether differences in allergic sensitization or other factors could explain differences in reported occurrence of asthma between an urban centre and a neighbouring suburban area. From the European Community Respiratory Health Survey (ECRHS) questionnaire, responses on asthma symptoms and risk factors and results of 11 skin allergy tests were available from 656 young adults living in urban or south suburban Antwerp, Belgium. Answers to five asthma questions were selected as dependent variables, and eight personal or environmental risk factors, as well as house dust mite (HDM) allergy, as independent variables. The effect of each independent variable on the association of asthma variables with area was assessed. Prior asthma diagnosis, present asthma symptoms, the selected risk factors and HDM allergy were all more frequently recorded in urban Antwerp. Difference in HDM allergy accounted for most of the difference in prior (mostly childhood) asthma diagnosis, since correction for it decreased the odds ratio from 2.10 to 1.65. On the contrary, the regional differences in recent asthma symptoms were not explained by HDM allergy differences nor by any other factor under study. This urban-suburban comparison indicated that house dust mite allergy is a major determinant of prior (childhood) asthma, whereas factors contributing to higher urban prevalence of present asthma symptoms could not be identified. Furthermore, our results indicate that it may be inappropriate to combine data from neighbouring areas, when their similarity has not been verified.

Adult↗
PubMedDate not supplied

Differences in drug use among rural and suburban high school students in Ohio.

This exploratory study examines differences in the prevalence of drug use by gender among twelfth grade students (n = 464) in selected rural and suburban high schools in west-central Ohio. The lifetime use of alcohol and other drugs is common among all groups. Proportionally fewer boys in rural schools than boys in suburban schools reported the use of marijuana, inhalants, and LSD, or recent episodes of drunkenness. No statistically significant differences emerged between girls in rural and suburban schools. Afterschool employment practices may help explain the observed differences.

Adolescent↗
PubMed2000

A comparison of suburban and urban daytime telephone triage calls.

OBJECTIVE: To compare daytime nurse telephone triage calls received by a suburban practice with those received by a hospital-based, inner-city pediatric practice. METHODS: A research assistant, listening simultaneously with triage personnel, prospectively coded all calls received by the nurse triage telephone offices in 2 pediatric practices. Calls were coded the first full, nonholiday week of 3 consecutive summer and 3 consecutive winter months, alternating morning and afternoon sessions. One practice was suburban and had almost all commercially insured patients; the other was hospital-based, in an inner-city, and consisted mostly of patients with Medicaid coverage or no health insurance. RESULTS: A total of 901 calls were triaged in the suburban practice (SP) and 768 in the urban practice (UP). The chief complaints of calls regarding medical problems were similar at both sites. Difficulties with language were noted less often in SP compared with UP (1% vs 17%). The reason for the calls differed by site: medical problem relating to illness or injury (SP 55% vs UP 40%); social issue (SP 1% vs UP 9%); documentation request (SP 2% vs UP 7%); request for laboratory work (SP.3% vs UP 4%); and well child advice (SP 9% vs UP 5%). The disposition of calls also differed by site: telephone advice was offered significantly more in SP than in UP (32% vs 20%); fewer calls required the need for the medical record in SP than in UP (2% vs 12%). CONCLUSIONS: Calls received by a daytime nurse telephone triage office in an affluent SP and a UP are similar in regard to medical problems. Training programs can feasibly prepare physicians and nurses for both kinds of practice settings. The urban site received more calls affected by language and social issues. This could have administrative implications for staffing ratios, language skills of staff and knowledge of available support services.

Child↗
PubMed2005

Difference in serum calcidiol and parathyroid hormone levels between elderly urban vs suburban women.

The present study initially included 106 volunteers, elderly women living in urban or suburban Khon Kaen, Thailand. One case was excluded because of extremely high levels of alkaline phosphatase. The means (+/- SD) of the serum calcidiol and the PTH concentrations in the urban vs suburban groups were 31.45(+/- 1.15) ng/mL vs 36.15(+/- 2.4) pg/mL and 41.53(+/- 3.94) ng/mL vs 17.43(+/- 2.88)pg/mL, respectively. The urban group had a higher percentage and a higher risk of hypovitaminosis D and osteoporosis of the femoral neck than the suburban group, an odds ratio of more than 4 times higher.

Age Factors↗
PubMed1991

Pediatric lead screening in a suburban family practice setting.

BACKGROUND: The adverse effects of lead on behavioral and intellectual development have been recognized for many years. During the past 10 years several studies have shown that lead is toxic to children at levels previously thought to be harmless. Black children living in urban neighborhoods have been identified as being at greatest risk. METHODS: To determine whether children seen in a suburban family practice center were being exposed to lead, voluntary screening of 1-year-old patients was performed. RESULTS: Over a 7-month period venous specimens for blood lead level were obtained from 40 children. Seventeen (43%) of the children had levels of 0.0 to 0.2 mumol/L (0 to 4 micrograms/dL). Fifteen (38%) had levels of 0.24 to 0.43 mumol/L (5 to 9 micrograms/dL). Eight (20%) children had levels of 0.48 mumol/L (10 micrograms/dL) or greater. The highest value obtained was 0.82 mumol/L (17 micrograms/dL). Seventy-five percent of the children with significantly elevated lead levels resided in suburban communities. CONCLUSIONS: Children seen in a suburban family practice setting are at risk for lead exposure, and screening should be considered by primary care physicians who practice in nonurban settings.

Family Practice↗
PubMed1989

Urban-suburban differences in the incidence of low birthweight in a metropolitan black population.

To study the urban-suburban differences in low birthweight among black Americans, 54,870 single births occurring to black mothers in the hospitals of Washington, DC, from 1980 to 1984 were analyzed. The observed data showed a 25% higher incidence of low birthweight (under 2501 gm) among infants born to urban mothers compared with those born to suburban mothers. Bivariate analysis showed that a greater proportion of urban mothers, compared with the proportion of suburban mothers, was teenage (23.6% vs 10.3%) and unmarried (67.6% vs 32.9%), had less than a high school education (31.7% vs 9.1%), and received inadequate prenatal care (34.3% vs 20.3%). The logit model fit to these data showed that by controlling for the above risk factors, the residential differences in the incidence of low birth rate were almost eliminated. Exploration of the medical risks associated with adverse pregnancy outcomes showed that the urban mothers had substantially higher rates for premature rupture of membrane, concurrent hypertension, pre-existing diabetes, hyperemesis, anemia, and narcotic addiction. The findings of the article underline the usefulness of studying intra-black differences rather than relying solely on race comparative research.

Black or African American↗
PubMed1990

Concurrent validity of the Test of Nonverbal Intelligence with referred suburban and Canadian native children.

The relationship between the Test of Nonverbal Intelligence (TONI) and the WISC-R was investigated for cultural differences. The samples consisted of 30 suburban and 22 Native children who were referred for learning difficulties. The results indicated the suburban group was higher than the Native group on Verbal IQ, but not Performance IQ, Full Scale IQ, or the TONI Quotient. The correlation coefficient between the TONI Quotient and PIQ was as expected in the Native group, but unexpectedly low in the suburban group. Implications of these findings for the testing of both referred majority and Native group members are discussed.

Child↗
PubMed1998

Suburban Areas in Developing Countries and Their Relationship to Groundwater Pollution: A Case Study of Mar del Plata, Argentina

/ Human activities carried out in suburban areas in many developing countries are directly related to groundwater pollution. The main objective of this paper is to analyze the relationship between land use and groundwater pollution in the suburban area of Mar del Plata (Argentina). We identified three elements that are endangering the quality of groundwater: horticultural activity, urban solid waste disposal sites, and sewage disposal on land. Fifty wells in an area of 175 km2 were sampled in order to verify the impact of these problems on groundwater. All samples were analyzed for major ions, and about 30 of them for fecal coliforms and heavy metals. Nineteen samples were selected for pesticide analyses. The average nitrate content was 80 mg/liter, eight times the regional background value. Fecal coliforms were detected in 60% of the analyzed samples. Zinc content and a high Cl-/HCO3- ratio were observed in the surroundings of the solid waste disposal area. Moreover, lindane and heptachlor pesticides were detected in ten samples.KEY WORDS: Suburban areas; Groundwater pollution; Groundwater management; Argentina

Journal Article↗
PubMed2004

Borrelia burgdorferi infection prevalences in questing Ixodes ricinus ticks (Acari: Ixodidae) in urban and suburban Bonn, western Germany.

From March to October 2003, a total of 2,518 host-seeking Ixodes ricinus ticks (1,944 nymphs, 264 females, 310 males) were collected by blanket dragging at 45 sites all over the city area of Bonn, western Germany, to be checked for Borrelia burgdorferi infection. The collection sites included 20 private gardens, nine public recreational parks, the boundaries of 14 sylvatic suburban areas and two footpaths between suburban farmed fields. Generally, numbers of specimens collected along sylvatic suburban areas and at urban sites with dense tree populations were significantly higher than at the other collection sites. Out of 1,394 specimens (865 nymphs, 241 females, 288 males) that were randomly chosen for Borrelia analysis by a simple PCR, 250 (17.9 %) were found to be infected with B. burgdorferi sensu lato. While the infection prevalences varied significantly between females (26.6%), males (12.5%) and nymphs (17.3%), there were no striking differences between sylvatic and unwooded sites. A total of 92.8% of the ticks Borrelia-positive by the simple PCR were also positive in a diagnostic nested PCR. Using genospecies-specific oligonucleotide probes, single Borrelia genospecies infections (91.4%) could be assigned to B. afzelii (39.5%), B. garinii (27.9%), B. burgdorferi sensu stricto (15.6%) and B. valaisiana (8.6%) by DNA hybridization. Various combinations of double infections were observed in 4.3% of the infected ticks. Another 4.3% of the Borrelia infections were untypeable. The B. burgdorferi genospecies distribution in the city area was shown to be variable from site to site and, even more, it was distinct from rural collection sites near Bonn. This is ascribed to a different spectrum of reservoir hosts. Taking into account the infection prevalences of host-seeking ticks in the forested surroundings of Bonn, our study demonstrates that the risk of acquiring Lyme disease after a tick bite in urban/suburban areas is comparably as high as in woodlands outside of the city.

Animals↗
PubMed2026

Association of Enterocytozoon bieneusi Infection with chronic/persistent diarrhea and ITS genotypic diversity: a hospital-based case-control study in Suburban Shanghai, China.

Enterocytozoon bieneusi is a globally distributed zoonotic enteric pathogen that remains largely overlooked in routine diarrheal disease surveillance. Although previous studies in Shanghai, China, have reported elevated prevalence in diarrheal populations, case-control data from suburban areas at the peri&#x2011;urban interface and the strength of the association between E. bieneusi infection and chronic diarrhea in non-immunocompromised individuals remain poorly characterized. We performed a hospital-based case-control study in suburban Shanghai, enrolling 286 diarrheal outpatients without documented immunodeficiency and 138 asymptomatic controls frequency-matched for age and sex. Fecal specimens were collected and subjected to genomic DNA extraction. E. bieneusi was detected via nested PCR amplification of the ribosomal internal transcribed spacer (ITS) region. Factors associated with infection were identified using multivariate logistic regression. Genotypic diversity and zoonotic potential were assessed by Sanger sequencing and phylogenetic analysis. The overall prevalence of E. bieneusi was 12.2% (35/286) in diarrheal patients, significantly higher than the 2.2% (3/138) observed in asymptomatic controls (P < 0.001). E. bieneusi positivity was independently associated with chronic/persistent diarrhea (adjusted odds ratio = 2.63, 95% confidence interval: 1.25-5.54, P = 0.011). Fourteen distinct ITS genotypes were identified, comprising five known genotypes (D, EbpD, SHW7, Henan-III, and CHG5) and nine novel genotypes (designated SHH2 to SHH10). Thirteen genotypes clustered within Group 1, and one genotype (CHG5) fell within Group 2, two phylogenetic groups that contain genotypes with documented zoonotic potential in global surveillance. E. bieneusi was detected at a relatively high prevalence among diarrheal patients in suburban Shanghai, and its detection was associated with chronic/persistent diarrhea. The predominance of zoonotic genotypes and the identification of nine novel Group 1 genotypes indicate phylogenetic similarity to known zoonotic lineages and warrant further investigation of local zoonotic transmission; no animal or environmental samples were analyzed in this study. These findings suggest that E. bieneusi testing may be considered as part of the differential diagnosis for patients with unexplained chronic/persistent diarrhea and highlight the need for One Health surveillance in the surveyed area.

Diarrhea↗
PubMed2005

Atmospheric deposition of polychlorinated dibenzo-p-dioxins (PCDDs) and dibenzofurans (PCDFs) in urban and suburban areas of Korea.

Bulk atmospheric samples (wet and dry) were collected monthly throughout a year at urban and suburban areas of Korea to assess the deposition flux and seasonal variations of polychlorinated dibenzo-p-dioxins (PCDDs) and dibenzofurans (PCDFs). The PCDDs/DFs deposition fluxes ranged from 1.0 to 3.7 ng TEQ/m2/year in the urban area and from 0.5 to 4.6 ng TEQ/m2/year in the suburban area. The deposition fluxes of PCDDs/DFs in this study were comparable to or lower than those previously reported at different locations. The atmospheric deposition fluxes of particles and PCDDs/DFs in winter tended to be higher than those in summer. However, monthly variations between particle and PCDDs/DFs deposition fluxes were small, and the correlation coefficients between the deposition fluxes of air particles and each homologue group of PCDDs/DFs varied according to the degree of chlorination of the homologue group. The deposition velocity of PCDDs/DFs in the urban area was estimated at 0.04 cm/s, which is a lower value than those found in other studies. The two most likely factors affecting the monthly variation of deposition fluxes are the ambient temperature and the amount of precipitation. In particular, the ambient temperature had an influence on the lower chlorinated homologues of PCDDs/DFs while precipitation had an influence on the higher chlorinated PCDDs/DFs. The PCDDs/DFs profiles in atmospheric deposition bulk samples showed a similar pattern at the urban and suburban sites. The possibility of the loading of PCDDs/DFs by Asian dust events could be partly confirmed by investigation of homologue profiles.

Air Pollutants↗