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We study the problem of synthesizing lockdown policies—schedules of maximum capacities for different types of activity sites—to minimize the number of deceased individuals due to a pandemic within a given metropolitan statistical area (MSA) while controlling the severity of the imposed lockdown. To synthesize and evaluate lockdown policies, we develop a multiscale susceptible, infected, recovered, and deceased model that partitions a given MSA into geographic subregions, and that incorporates data on the behaviors of the populations of these subregions. This modeling approach allows for the analysis of heterogeneous lockdown policies that vary across the different types of activity sites within each subregion of the MSA. We formulate the synthesis of optimal lockdown policies as a nonconvex optimization problem and we develop an iterative algorithm that addresses this nonconvexity through sequential convex programming. We empirically demonstrate the effectiveness of the developed approach by applying it to six of the largest MSAs in the United States. The developed heterogeneous lockdown policies not only reduce the number of deceased individuals by up to 45 percent over a 100 day period in comparison with three baseline lockdown policies that are less heterogeneous, but they also impose lockdowns that are less severe. [ABSTRACT FROM AUTHOR]

The coronavirus disease 2019 pandemic triggered nationwide school closures in March 2020, putting millions of children in the United States who were reliant on subsidized school meals at risk of experiencing hunger. In response, the US Department of Agriculture mobilized the Summer Food Service Program and Seamless Summer Option program to provide emergency free school meals. There is a need to investigate the effectiveness of these programs in covering underresourced communities during the pandemic. This study assessed associations between meal distribution and census tract demographics (ie, poverty level, race/ethnicity, and deprivation level based on social deprivation index score). An observational study using longitudinal meal distribution data collected over an 18-month period following school closures (March 2020 to August 2021). Monthly meal distribution data were collected for community sites serving 142 census tracts within 4 urban New Jersey cities predominantly populated by people with low incomes and from racial and ethnic minority groups. Main outcome measures were the number of meals served monthly by Summer Food Service Program and Seamless Summer Option meal sites. A 2-part multivariable regression approach was used to analyze the data. In the first step, logistic regression models showed that high-deprivation tracts were more likely to serve meals during the observed period (odds ratio 3.43, 95% CI 1.001 to 11.77; P = 0.0499). In the second step, among tracts that served any meals during the observed period, mixed effects negative binomial regression models showed that high-poverty and high-deprivation tracts served comparatively more meals (incidence rate ratio [IRR] 2.83, 95% CI 2.29 to 3.51; P < 0.001 and IRR 1.94, 95% CI 1.65 to 2.28; P < 0.001, respectively). Findings show that meal distribution during the pandemic was higher within census tracts with higher poverty and deprivation levels, indicating that underresourced communities with higher need had more free meals available during this unprecedented public health emergency. [ABSTRACT FROM AUTHOR]

This research presents a study of visits to farmers' markets, a rapidly growing urban phenomenon in the U.S., from a geographic perspective. Although the social and economic impacts of farmers' markets have received considerable attention recently, examining farmers' market access in space-time is still lacking in the existing analytical frameworks. This study challenges conventional food access measures that have been primarily focused on the spatial separation between markets and consumers' homes and proposes a more realistic space-time based strategy. A survey was conducted on twelve markets in Tucson, Arizona. Analysis results show that majority of market patrons went to a market that was different from the one nearest to their homes, and the market choice, including the geographic location and the associated market operating time, was highly affected by patrons' other daily activities. The particular types of activities combined with farmers' market trips were found to vary temporally and fluctuate based on patron's employment characteristics. Our study suggests that conventional food access measures should be used in caution to assess farmers' market access as these measures can lead to an overestimate of the travel consumers are willing or even able to incur. [ABSTRACT FROM AUTHOR]

Type 2 Diabetes (T2D) has reached epidemic levels among the pediatric population. Furthermore, disparities in T2D among youth are distributed in a manner that reflects the social inequality between population sub-groups. Here, we investigated the neighborhood determinants of T2D risk among a sample of Latino adolescents with obesity residing in Phoenix, Arizona (n = 133). In doing so we linked together four separate contextual data sources: the American Community Survey, the United States Department of Agriculture Food Access Research Atlas, the Arizona Healthy Community Map, and the National Neighborhood Data Archive to systematically analyze how and which neighborhood characteristics were associated with T2D risk factors as measured by fasting and 2-h glucose following a 75 g oral glucose tolerance test. Using linear regression models with and without individual/household covariates, we investigated how twenty-two housing and transportation sociodemographic and built and food environment characteristics were independently and jointly associated with T2D risk. The main finding from these analyses was the strong association between the density of fast food restaurants and 2-h glucose values (b = 2.42, p < 0.01). This association was independent of individual, household, and other neighborhood characteristics. Our results contribute to an increasingly robust literature demonstrating the deleterious influence of the neighborhood food environment, especially fast food, for T2D risk among Latino youth.

Background: Clandestine laboratory operators commonly extract ephedrine and pseudoephedrine-precursor chemicals used to synthesize methamphetamine-from over-the-counter cold/allergy/sinus products. To prevent this activity, two states, Oregon in 07/2006 and Mississippi in 07/2010, implemented regulations classifying ephedrine and pseudoephedrine as Schedule III substances, making products containing them available by prescription only. Using simple pre-regulation versus post-regulation comparisons, reports claim that the regulations have substantially reduced clandestine laboratory seizures (an indicator of laboratory prevalence) in both states, motivating efforts to implement similar regulation nationally. This study uses ARIMA-intervention time-series analysis to more rigorously evaluate the regulations' impacts on laboratory seizures., Methods: Monthly counts of methamphetamine clandestine laboratory seizures were extracted from the Clandestine Laboratory Seizure System (2000-early 2011) for Oregon, Mississippi and selected nearby states (for quasi-control)., Findings: Seizures in Oregon and nearby western states largely bottomed out months before Oregon's regulation, and changed little thereafter. No significant impact for Oregon's regulation was found. Mississippi and nearby states generally had elevated seizures before Mississippi's regulation. Mississippi experienced a regulation-associated drop of 28.9 seizures (50.2%) in the series level (p<0.01), while nearby states exhibited no comparable decline., Conclusions: Oregon's regulation encountered a floor effect, making any sizable impact infeasible. Mississippi, however, realized a substantial impact, suggesting that laboratories, if sufficiently extant, can be meaningfully impacted by prescription precursor regulation. It follows that national prescription precursor regulation would have little impact in western states with low indicated laboratory prevalence, but may be of significant use in regions facing higher indicated prevalence., (Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.)