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PubMed2006

[Urban greenbelt eco-service value of Hangzhou City under effects of land use change: an evaluation with CITYgreen model].

Based on the Landset TM information of land use/cover change and greenbelt distribution in Hangzhou city in 1994 and 2004, and by using CITYgreen model, this paper estimated the eco-service value of urban greenbelt in the city under the effects of land use change and economic development. The results showed that in the 10 years from 1994 to 2004, the greenbelt area in the city decreased by 20. 4% , while its eco-service value increased by 168 million yuan. The annual increment of greenbelt eco-service value and GDP was 111.92% and 5. 32% , respectively. Suitable adjustment of land use pattern in the city harmonized the relationships between urban economic development and urban eco-function, and achieved higher eco-service efficiency of land utilization.

China↗
PubMedDate not supplied

Accretion, reform, and crisis: a theory of public health politics in New York City.

Standard interpretations of the history of public health in New York City in the twentieth century describe either the decline or the growth of the importance accorded to public health activities. To the contrary, public health has, paradoxically, both declined in salience and attracted increasing resources. This article describes the politics of public health in New York City since the 1920s. First it describes events in the history of public health in the context of events in the economy and in city, state, and national politics. Then it proposes three descriptive models for arraying the data about public health politics: accretion, reform, and crisis. Next it describes how the politics of AIDS in New York City in the 1980s was a consequence of the history that produced these three political styles. Finally, it argues that the three political styles are generalizable to the history of public health throughout the United States in the twentieth century.

Financing, Organized↗
PubMed1990

[AIDS-related mortality among Puerto Rican women in New York City, 1981-87].

The present study analyzes the impact of AIDS on the mortality experience of Puerto Rican women in New York City for the time period 1981-1987. This study shows that Puerto Rican women in New York City are at higher risk for AIDS than any other racial or ethnic group. Economic and sociocultural factors in the Puerto Rican community related to the use of intravenous drug use, as well as trends in migration and marriage, are associated to the high risk of AIDS in this group. This information is of particular interest for Puerto Rico and New York City given the migration patterns of Puerto Ricans traveling between Puerto Rico and New York City.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Cancer mortality, ethnicity, and socioeconomic status: two New York City groups.

Cancer mortality rates for 1979-81 among Puerto Ricans and non-Hispanic whites in New York City are analyzed for cancer in six sites. They include cancers of the lung, esophagus, breast, stomach, colon, ovary, and all cancers. New York City health areas were divided into four quartiles representing four levels of income. In general, Puerto Ricans in New York City have lower mortality rates from cancer than non-Hispanic white residents of the city. In comparing cancer mortality by quartile, Puerto Rican males show little variation. Puerto Rican females show their highest mortality rates from breast cancer in the wealthiest quartile, and non-Hispanic white women show highest mortality rates from breast cancer in the poorest quartile. Non-Hispanic white males show mortality rates from lung cancer in the poorest quartile that are distinctly higher than in the more affluent ones. For all groups, with the exception of Puerto Rican males, mortality rates from all cancers increased progressively with decreasing income. Factors influencing differential mortality rates by quartile appear to include tobacco use, alcohol consumption, occupational hazards, fertility, and differential use of health facilities.

Breast Neoplasms↗
PubMed1995

Deaths associated with a purported aphrodisiac--New York City, February 1993-May 1995.

During February 1993-May 1995, the New York City Poison Control Center (NYCPCC) was informed about onset of illness in five previously healthy men after they ingested a substance marketed as a topical aphrodisiac; four of the men died. These cases were investigated by the New York City Department of Health, the New York City Department of Environmental Protection, and the Food and Drug Administration (FDA). Four cases were referred to the NYCPCC and one case to the New York City medical examiner's office. The decedents died from cardiac dysrhythmias, and all five patients had measurable levels of digoxin* detected in their serum. Digoxin had not been prescribed for therapeutic purposes for any of these patients, and none had medical conditions associated with endogenous digoxin-like immunoreactive substances. The purported aphrodisiac contains bufadienolides, naturally occurring cardioactive steroids that have digoxin-like effects. This report describes three of the five case reports, summarizes the investigations of the five cases, and underscores the health risks associated with inappropriate use of preparations containing digoxin-like substances.

Adolescent↗
PubMed1994

Typhoid fever in New York City, 1980 through 1990.

BACKGROUND: Although typhoid fever incidence decreased in the 1960s and 1970s in New York City and elsewhere, it did not disappear. In this article, trends associated with various modes of transmission of Salmonella typhi in New York City patients are described. METHODS: Typhoid fever surveillance reports from 1980 to 1990 were reviewed for clinical, demographic, and epidemiologic characteristics. Cases of typhoid fever were classified as travel related or domestically acquired. RESULTS: In all, 479 typhoid cases were identified, of which 67% were travel related. The age groups most frequently affected were children and adolescents. Cases more than doubled in the decade, and the ratio of travel-related cases to domestically acquired cases increased steadily from 63% to 80%. Travelers to Southeast Asia were at three times higher risk than those visiting South America and eight times higher than those visiting the Caribbean. The case-fatality proportion was 1.5%. CONCLUSION: The trends of S typhi infection in New York City followed the trends observed in the United States since 1978, which demonstrates the importance of international travel. Although food and water precautions may be effective for short-term travelers, selective use of oral antityphoid vaccines for New York City travelers to high-risk endemic countries should be encouraged.

Adolescent↗
PubMed1993

Bringing comprehensive health education to the New York City Public Schools: a private-public success story.

The New York Academy of Medicine has pioneered a far-sighted effort which successfully introduced two model health education curricula into the New York City Public Schools at both the elementary and middle school levels. The curriculums for kindergarten through sixth grades, Growing Healthy, are currently being used in 525 of New York's 625 elementary schools, and the curriculum for seventh and eighth grades, Being Healthy, is in place in 60 of 200 junior high schools. These curricula offer a comprehensive approach to health education that promotes emotional well-being as well as physical health by improving health behaviors, attitudes, and academic performance of students through hands-on and interactive activities which develop decision-making skills and the ability to make healthful choices. The program has met with ongoing success and expanding influence, as the result of several important factors. First, the New York Academy of Medicine took a leadership role in supporting a venture outside its own walls and became an active advocate for comprehensive health education in the public schools. The Academy's standing as a prestigious yet independent medical association brought influence to the organizing efforts and contributed the credibility needed to get the program off the ground. Second, the Division of Student Support Services of the New York City Public Schools gave strong acceptance and cooperation leading to ongoing financial support and institutionalization of the program. Added to that is the enthusiasm of teachers, administrators, and other in-school personnel who have made the lessons of Growing Healthy and Being Healthy meaningful by reaching hundreds of thousands of students across New York City. Another important factor is the oversight and longevity which has been provided by the unusual gathering of doctors, educators, public health specialists, funders, and city administrators who created an effective private-public coalition 15 years ago and have remained committed to working together. Last through its ongoing efforts, the Academy's Office of School Health Programs has stayed at the forefront of developments in health education. By continuing to evaluate their activities and by constantly integrating new materials into the existing curricular framework, they have demonstrated that a comprehensive health education program can be both meaningful to children and responsive to community needs by reflecting current public health issues and concerns.

Child↗
PubMed1993

Association of tuberculosis infection with increased time in or admission to the New York City jail system.

OBJECTIVE: To establish the association between time spent in jail or number of jail admissions and development of tuberculosis in a cohort of inmates incarcerated without evidence of tuberculosis infection on entry. DESIGN: Nested case-control design within a prospective cohort. A cohort of 2636 tuberculin skin test-negative inmates incarcerated in 1985 was matched against the Tuberculosis Registry of New York City. Each case of tuberculosis reported prior to May 15, 1992, was assigned to three randomly selected controls from the cohort. We determined time spent in jail by reviewing the computer records of the New York City Inmate Information System. Conditional logistic regression modeling was performed to establish the association of jail time with the development of tuberculosis. SETTING: New York City Jail. RESULTS: Sixty inmates developed tuberculosis by May 15, 1992. Eighty-five percent of these had pulmonary tuberculosis. Univariate analysis identified the number of jail admissions (P = .02), age greater than or equal to 30 years (P = .001), and assignment to a methadone detoxification unit (P = .001) as significant in predicting tuberculosis. Multivariate modeling identified these same variables and jail time as significant. One year of jail time increased the odds of tuberculosis to 2.2 (95% confidence interval, 1.1 to 4.4). CONCLUSION: The demonstrated association between jail time or jail admissions and development of tuberculosis suggests that the New York City jail system may be an important amplification point in the ongoing tuberculosis epidemic, deserving significant public health attention.

Adult↗
PubMed1996

Markers for primary care: missed opportunities to immunize and screen for lead and tuberculosis by private physicians serving large numbers of inner-city Medicaid-eligible children.

OBJECTIVE: This study examines coverage levels for immunization, missed opportunities to immunize, and extent of lead and tuberculosis screening in inner-city storefront physician offices and then relates child, visit, and physician characteristics to missed opportunities. METHODOLOGY: With the use of a nested sampling strategy, 232 charts were selected for review in 31 physicians' offices. Charts selected were for children 0 to 35 months of age who had three or more visits in more than 3 months. Physicians were selected from those in specific low-income New York inner-city neighborhoods who submitted large volumes of Medicaid billing claims. Variables examined were missed opportunities to immunize, immunization coverage levels, lead, and tuberculosis screening. The outcome measure was missed opportunities to immunize. RESULTS: Only 26% of the children were up to date for their age for diphtheria, tetanus, pertussis (DTP), oral polio vaccine (OPV), and measles, mumps, rubella (MMR) compared with a city-wide coverage level of 49%. Children who were not up to date for immunization coverage were more likely not to be up to date for lead (RR = 1.24, CI 0.96 to 1.60) or tuberculosis (RR = 1.54, CI 1.14 to 2.08) screening. Physicians miss opportunities to immunize in 84% of the eligible visits. Opportunities to immunize are missed more frequently at sick care or follow-up visits (95% and 91% missed opportunities) than at well care visits (41% missed opportunities). CONCLUSIONS: The quality of pediatric primary care given by these inner-city storefront physicians is suboptimal. Sick and follow-up visits predominate; well care visits are infrequent. If care is to be improved, Medicaid reimbursement policies, which make delivery of well care unprofitable, will need to be changed. In addition, monitoring the quality of care will need to be more aggressive. In the near future children who receive Medicaid in New York will be in managed care. If reimbursement and monitoring policies that provide incentives for delivering pediatric primary care are to be in place, it will be the managed care plans that implement this.

Child, Preschool↗
PubMed1997

The influence of birthplace on mortality among Hispanic residents of New York City.

To determine the mortality experience of Hispanic residents of New York City and the influence of birthplace on their mortality rates, NYC Department of Health mortality records for 1988 to 1992 were linked for analysis with 1990 United States census data for New York City. Age-specific death rates for all Hispanics were compared by birthplace with those of non-Hispanic whites. Age-adjusted death rates were also compared. Overall, Hispanics had death rates lower than non-Hispanic blacks, and death rates similar to those of non-Hispanic whites. Hispanics had higher rates of death from HIV-infection, diabetes, stroke/hypertensive disease, cirrhosis and homicide, and fewer deaths from cancer and coronary heart disease than did non-Hispanic whites. Moreover, there were substantial differences in mortality between Hispanic subgroups categorized by birthplace. Migrants from Puerto Rico had the highest, and those from Central and South America the lowest mortality rates. United States-born Hispanics, although younger, had age-adjusted mortality rates higher than New York City non-Hispanic whites. In summary, the mortality of Hispanics generally approximated that of non-Hispanic whites, and was lower than that of non-Hispanic blacks. However, stratification of Hispanics by birthplace revealed substantial variation within the Hispanic population of New York City.

Adolescent↗
PubMedDate not supplied

[Carcinogens in the urban environment of Italian cities: benzene and benzo(a)pyrenes].

In Italian urban areas air pollution from benzene and benzo(a)pyrene-B(a)P--is mostly caused by traffic. The concentration limits in the atmosphere fixed by Italian legislation up to December 31, 1998 expressed as annual means are 15 micrograms/m3 and 2.5 ng/m3 for benzene and B(a)P respectively and, starting from January 1, 1999, 10 micrograms/m3 and 1 ng/m3. In the city of Florence the concentrations detected and expressed as annual means of benzene and B(a)P in an area with heavy traffic (32.1 micrograms/m3 and 3.5 ng/m3), in a densely populated area (9.2 micrograms/m3 and 1.86 ng/m3), and in a city park (6.0 micrograms/m3 and 0.25 ng/m3), suggest a marked progressive reduction in the atmospheric levels of these chemicals with the distance from the main roads. The environmental data obtained from densely populated areas of a number of Italian cities (Firenze, Milano, Roma, Bologna, Bolzano, Pavia, Modena), the only ones that allow evaluation of the health risk, show benzene concentrations ranging from 6.0 to 11.3 micrograms/m3 and B(a)P levels, measured in heavy traffic areas, from 1.0 to 3.5 ng/m3 respectively (annual mean in 1996). The data obtained in the city of Florence show that the population is exposed weekly to average concentrations of 14.3 micrograms/m3 for benzene and 2.0 ng/m3 for B(a)P. These results suggest that, regarding benzene and B(a)P pollution, the situation in Florence is far from being critical but not such as to ensure that long-term exposure is without adverse effects.

Air Pollutants↗
PubMed2001

Maternal depressive symptoms and emergency department use among inner-city children with asthma.

CONTEXT: Inner-city minority children with asthma use emergency departments (ED) frequently. OBJECTIVE: To examine whether maternal depressive symptoms are associated with ED use. DESIGN, SETTING, AND PATIENTS: Baseline and 6-month surveys were administered to mothers of children with asthma in inner-city Baltimore, Md, and Washington, DC. MAIN OUTCOME MEASURES: Use of the ED at 6-month follow-up was examined. Independent variables included asthma morbidity, age, depressive symptoms, and other psychosocial data. RESULTS: Among mothers, nearly half reported significant levels of depressive symptoms. There were no demographic or asthma-related differences between the children of mothers with high and low depressive symptoms. However, in bivariate analyses, mothers with high depressive symptoms were 40% (prevalence ratio [PR], 1.4; 95% confidence interval [CI], 1.0-3.6; P =.04) more likely to report taking their child to the ED. Mothers aged 30 to 35 years were more than twice as likely (PR, 2.2; 95% CI, 1.9-9.3; P =.001) to report ED use, as were children with high morbidity (PR, 1.9; 95% CI, 1.4-7.1; P =.006). Child age and family income were not predictive of ED use. After controlling for asthma symptoms and mother's age, mothers with depressive symptoms were still 30% more likely to report ED use. CONCLUSIONS: Depression is common among inner-city mothers of children with asthma. Beyond asthma morbidity, maternal age and depressive symptoms are strong predictors of reports of ED visits. Identifying and addressing poor psychological adjustment in mothers may reduce unnecessary ED visits and optimize asthma management among inner-city children.

Adult↗
PubMed1992

Gun-related violence in and around inner-city schools.

OBJECTIVE: To assess the degree to which inner-city high school students are victimized by threat of or actual firearm attack. DESIGN: Cross-sectional survey. SETTING: Ten inner-city high schools in five cities in four states. PARTICIPANTS: A total of 1653 male and female inner-city high school students responding anonymously. SELECTION PROCEDURES: Volunteer, convenience sample. INTERVENTIONS: None. MEASUREMENTS AND RESULTS: Twenty-three percent of respondents were classified as victims. Major variables predicting victimization levels were gender, number of siblings, exposure to violence outside of school, and personal violence-related attributes. Only one in 10 victimizations appeared to be random (ie, not predicted by these variables). CONCLUSIONS: Violence in school is brought into, rather than generated by, the school. Victimized students have characteristics that put them at higher risk of victimization than other students. Given the large number of victimizations and the large number of respondents with risk characteristics, intervention at the individual level seems ineffective. Instead, alteration of community social structure and culture appears to be the appropriate, although difficult, avenue of change for gun-related victimization levels.

Adolescent↗
PubMed1995

Social support of inner-city fathers and mothers.

OBJECTIVE: To examine mutual support of inner-city parents and how it relates to the father's expected role as a parent. DESIGN: Cross-sectional study. SETTING: An urban teaching hospital in inner-city Baltimore, Md. PATIENTS OR OTHER PARTICIPANTS: Inner-city-dwelling parents whose neonates were born at an urban teaching hospital between March and May 1992. INTERVENTION: Data were collected through structured independent interviews with each parent during the neonate's hospitalization. MAIN OUTCOME MEASURES: General social support was assessed by Sarason's Social Support Questionnaire. Paternal involvement was defined as the father's expected accessibility, engagement in child-rearing tasks, and decision-making responsibility during infancy. RESULTS: Most mothers and fathers cited the other parent as a source of general support. Most believed that the other parent would help and would not hinder them in their role as parent. For mothers, the father's expected accessibility, engagement, and decision-making responsibility was positively correlated with his general support. For the fathers, expected accessibility was positively related to general support from the mother. As parents' mutual support increased, so did concordance in their expectations of the father's role. CONCLUSIONS: Many inner-city parents do rely on each other. Pediatricians can promote shared parenting by recognizing and building on this mutual support.

Cross-Sectional Studies↗
PubMed1987

Effects of the mass screening of neuroblastoma in Sapporo City.

One hundred sixty-seven cases of neuroblastoma in the Registry of Childhood Malignancies in Hokkaido Prefecture from 1969 to 1984 were studied, using the age at diagnosis, the clinical stage at diagnosis, and the survival rate to assess the influence of the mass screening of neuroblastoma performed in Sapporo City since 1981. In Sapporo City, the capital of Hokkaido Prefecture, the condition of the three parameters improved significantly after the institution of mass screening (e.g., the 48-month survival rate improved--from 21.3% to 87.5%). In Hokkaido Prefecture (Sapporo City excluded), however, where the mass screening had not yet been performed, no significant change was observed in any of the three parameters (48-month survival rate changed only from 21.1% to 28.1%). Consequently, the improvement in Sapporo City was thought to be attributable to the effects of the mass screening.

Age Factors↗
PubMed1993

Use of city directories as a source of occupational data in a case-control study.

The association between occupational factors and male breast cancer was investigated in a population-based case-control study conducted in Western New York state. Since 9% of cases and controls were missing occupational information in the tumor registry (usual occupation) and screening clinic (type of work done) files, supplemental occupational data were collected from commercial city directories. Occupational data were located for 69% of participants via the city directory thereby reducing the missing occupational data to 3%. For individuals with occupational listings in both the original source document and the city directories, similar titles were found for 94% of cases. Factors to be considered in assessing the feasibility of directory usage include purpose of study, degree of directory coverage within the geographic area, gender of participants, and availability of personnel and resources. City directories are a valuable supplemental source of occupational data for hypothesis generating case-control studies or registry-based studies of men conducted in urban areas.

Breast Neoplasms↗
PubMed2003

Primates as pets in Mexico City: an assessment of the species involved, source of origin, and general aspects of treatment.

The large human populations in cities are an important source of demand for wildlife pets, including primates, and not much is known about the primate species involved in terms of their general origin, the length of time they are kept as pets, and some of the maintenance problems encountered with their use as pets. We report the results of a survey conducted in Mexico City among primate pet owners, which was aimed at providing some of the above information. We used an ethnographic approach, and pet owners were treated as informants to gain their trust so that we could enter their homes and learn about the life of their primate pets. We surveyed 179 owners of primate pets, which included 12 primate species. Of these, three were native species (Ateles geoffroyi, Alouatta pigra, and A. palliata). The rest were other neotropical primate species not native to Mexico, and some paleotropical species. Spider monkeys and two species of howler monkeys native to Mexico accounted for 67% and 15%, respectively, of the primate cases investigated. The most expensive primate pets were those imported from abroad, while the least expensive were the Mexican species. About 45% of the native primate pets were obtained by their owners in a large market in Mexico City, and the rest were obtained in southern Mexico. Although they can provide companionship for children and adults, primate pets are subject to a number of hazards, some of which put their lives at risk. The demand by city dwellers for primate pets, along with habitat destruction and fragmentation, exerts a significant pressure on wild populations in southern Mexico.

Accidents↗
PubMed1994

Correlation between meteorological conditions and mutagenicity of airborne particulate samples in a tropical monsoon climate area from Kaohsiung City, Taiwan.

Kaohsiung is a city of 1.5 million located in the southern part of Taiwan. It has a serious air pollution problem mainly attributable to much industrial and commercial activity. In order to estimate the effects of traffic, season, and meteorological conditions on the mutagenicity of Kaohsiung City's urban ambient particulate matter, 624 airborne particulate samples were collected on a weekly basis from 12 locations for an entire year. The mutagenic potential of acetone extracts of air samples was evaluated by the Salmonella/microsomal test with S. typhimurium TA98 in the presence and absence of S9 mixtures. The air samples from November 1990 showed the highest direct and indirect mutagenicity among the 12 months, whereas those from June and July 1991 had the lowest direct and indirect mutagenic activity, respectively. The mutagenicity showed a good correlation with amounts of the acetone extractable matter of airborne particulates. The meteorological conditions, monthly mean precipitation, and wind speed also showed a good correspondence with mutagenicity. Wind direction and temperature had a moderate relationship. The major mutagenic fractions of air samples that had the highest mutagenic activity in a month were purified using Sephadex LH-20 column chromatography, and the contents of PAHs, 1-NP, and DNPs were analyzed by HPLC. The characteristic concentration ratios of PAHs indicated that, for the main pollution sources of airborne particulates from Kaohsiung city, the mobile sources were more important than the stationary ones. The total amounts of 1-NP and DNPs in airborne particulates seemed to correspond to their mutagenicity. Although the total amounts of 1-NP and DNPs in the air samples correlated with their mutagenicity, the major mutagenic chemicals in the airborne particulate samples from Kaohsiung City need further investigation.

Air Pollutants↗