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Introduction: A neighbourhood's environmental characteristics can positively or negatively influence health and well-being. To date, no studies have examined this concept in the context of Saudi Arabian youth. Therefore, this study aimed to evaluate the association between a neighbourhood's environmental characteristics and health risk factors among Saudi Arabian youth. Methods: A total of 335 secondary-school students (175 males, 160 females), aged 15–19 years old, participated. Body mass index (BMI) and waist circumference measurements were taken, and physical activity (steps) was measured via pedometer. The perceived neighbourhood environment was assessed using the International Physical Activity Questionnaire Environment Module (IPAQ-E). Results: Significant differences were found between the youths from urban, rural farm, and rural desert locations in terms of BMI, waist circumference, daily steps, accessibility, infrastructure, social environment, household vehicles, safety, and access to facilities (p < 0.001). Rural desert youths were less active, and males (26.43 + 8.13) and females (24.68 + 5.03) had higher BMIs compared to the youths from other areas. Chi-square analysis revealed a significant difference (χ21 = 12.664, p < 0.001) between the genders as to social-environment perceptions. Males perceived their neighbourhood as a social environment more than was reported by females (68.39% and 50.28%, respectively). Pearson's correlation revealed negative significant relationships between steps and both safety of neighbourhood (r = −0.235, p < 0.001) and crime rate (r = −0.281, p < 0.001). Discussion: Geographical location, cultural attitudes, lack of facilities, and accessibility impact youth physical-activity engagement and weight status; this includes environmental variables such as residential density, neighbourhood safety, household motor vehicles, and social environment. Conclusions: This is the first study examining associations with neighbourhood environments in the youths of the Kingdom of Saudi Arabia. Significant associations and geographical differences were found. More research and policy interventions to address neighbourhoods' environmental characteristics and health risk factors relative to Saudi Arabian youth are warranted. [ABSTRACT FROM AUTHOR]

Background: Anxiety and depression often exacerbate multimorbidity conditions, leading to increased disability rates among affected individuals. Objective: The study aimed to assess the mental health status of individuals with multimorbidity belonging to the marginalized population of Karachi, Pakistan. Specifically, the prevalence of anxiety and depression was investigated. Methods: A multicenter cross-sectional study was conducted between July 2022 and June 2023 in 10 primary healthcare clinics located in 4 peri-urban areas of Karachi. A total of 9331 participants were included in the study. The Patient Health Questionnaire 4 (PHQ-4), Generalized Anxiety Disorder 7 (GAD-7), and Patient Health Questionnaire 9 (PHQ-9) were used to assess symptoms of anxiety and depression. The data collected were analyzed using the statistical analysis system (SAS) version 9.4. Results: Among the study participants, 2894 (31%) were men and 5534 (59.3%) were women. The prevalence of moderate to severe anxiety was 31% among men and 59.3% among women. The age group between 41 and 60 years exhibited the highest rates of moderate to severe anxiety, 19.3% as evaluated by GAD-7 and 34.6% by PHQ-9. The Pathan ethnic group had the highest prevalence of anxiety (11%) and depression (28.3%) in the neighborhoods. Unemployed participants showed moderate to severe anxiety in 21.3% of the cases and moderate to severe depression in 25.5% of the cases. Conclusion: The study revealed a significant cooccurrence of anxiety and depression among individuals with multimorbidity in the marginalized population of Karachi, Pakistan. Furthermore, the presence of anxiety symptoms in multimorbidity patients with depression indicates a more unfavorable health state. It is essential to explore the implementation of screening measures and therapeutic interventions for comorbid anxiety and depression in this population to improve clinical outcomes. [ABSTRACT FROM AUTHOR]

Background: In October 2023, the U.S. Environmental Protection Agency announced a final endangerment finding that leaded aviation gasoline (avgas) contributes to air pollution that is harmful to public health. This study evaluates the evidence for a link between living in proximity to airports and children's blood lead levels in Colorado. Methods: We analyzed the association between childhood blood lead levels (BLLs) and proximity to airport point locations in children tested for lead in Colorado over a 10-year study period (2011–2020) using a correlated random effects model with bootstrapped standard errors (N = 56,002 observations, 47,322 individuals). Along with distance from airport point locations, we identified the number of days sampled children lived downwind of their nearest airport during the 60 days prior to their test date. We also adjusted the model for age, sex, detection limit, test type, sample order, seasonality, time, proximity to lead-releasing facilities, estimated monthly aircraft traffic, and demographic characteristics of the surrounding neighborhood. Results: Our primary model estimates that living one mile (1.6 km) further from airport point locations decreases mean blood lead levels by 0.068 µg/dL. Additional analysis estimates that living one mile further from airport point locations decreases the odds of having a blood lead level ≥ 3.5 µg/dL by 13.2%. Conclusion: Our results suggest that lead emissions from aircraft using leaded avgas have a small but statistically significant effect on the BLLs of children living near airport point locations in Colorado. While the risk from proximity to airports is likely less than the risks associated with deteriorating lead paint and dust, our findings highlight the value of lead testing in children who may be at risk of exposure from all sources, including those who live near airports. [ABSTRACT FROM AUTHOR]

Background: Physical inactivity is a major public health concern, exacerbated in countries with a (sub)tropical climate. The built environment can facilitate physical activity; however, current evidence is mainly from North American and European countries with activity-friendly climate conditions. This study explored associations between built environment features and physical activity in global tropical or subtropical dry or desert climate regions. Methods: A systematic review of four major databases (Web of Science, Scopus, PubMed, and SportDISCUS) was performed. To be included, studies had to investigate associations between perceived or objective built environment characteristics and adult's physical activity and had to be conducted in a location with (sub)tropical climate. Each investigated association was reported as one case and results were synthesized based upon perceived and objectively assessed environment characteristics as well as Western and non-Western countries. Study quality was evaluated using a tool designed for assessing studies on built environment and physical activity. Results: Eighty-four articles from 50 studies in 13 countries with a total of 2546 built environment-physical activity associations were included. Design (connectivity, walking/cycling infrastructure), desirability (aesthetics, safety), and destination accessibility were the built environment characteristics most frequently associated with physical activity across the domains active transport, recreational physical activity, total walking and cycling, and moderate-to-vigorous physical activity, particularly if multiple attributes were present at the same time. Very few studies assessed built environment attributes specifically relevant to physical activity in (sub)tropical climates. Most studies were conducted in Western countries, with results being largely comparable with non-Western countries. Findings were largely generalizable across gender and age groups. Results from natural experiments indicated that relocating to an activity-friendly neighborhood impacted sub-groups differently. Conclusions: Built environment attributes, including destination accessibility, connectivity, walking and cycling infrastructure, safety, and aesthetics, are positively associated with physical activity in locations with (sub)tropical climate. However, few studies focus on built environment attributes specifically relevant in a hot climate, such as shade or indoor recreation options. Further, there is limited evidence from non-Western countries, where most of the urban population lives in (sub)tropical climates. Policy makers should focus on implementing activity-friendly environment attributes to create sustainable and climate-resilient cities. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to conduct a comprehensive spatio-temporal analysis of suicide-related emergency calls in the city of Valencia (Spain) over a six-year period. To this end we first examined age and gender patterns and, second, the influence of neighborhood characteristics on general and gender-specific spatio-temporal patterns of suicide-related emergency calls. Method: Geocoded data on suicide-related emergency calls between 2017 and 2022 (N = 10,030) were collected from the 112 emergency service in Valencia. Data were aggregated at the census block group level, used as a proxy for neighborhoods, and trimesters were considered as the temporal unit. Two set of analyses were performed: (1) demographic (age and gender) and temporal descriptive analyses and (2) general and gender-specific Bayesian spatio-temporal autoregressive models. Results: Descriptive analyses revealed a higher incidence of suicide-related emergency calls among females and an increase in calls among the 18-23 age group from 2020 onwards. The general spatio-temporal model showed higher levels of suicide-related emergency calls in neighborhoods characterized by lower education levels and population density, and higher residential mobility, aging population, and immigrant concentration. Relevant gender differences were also observed. A seasonal effect was noted, with a peak in calls during spring for females and summer for males. Conclusions: These findings highlight the need for comprehensive mental health targeted interventions and preventive strategies that account for gender-specific disparities, age-related vulnerabilities, and the specific characteristics of neighborhoods. [ABSTRACT FROM AUTHOR]

Studies of neighborhood change rely on interpolated data to cope with inconsistent boundaries of geographic units over time. The standard approach introduces error by assuming, counterfactually, that all kinds of people are distributed in the same manner within tracts as the whole population. This study evaluates estimates of 2,000 neighborhood characteristics using 2010 boundaries in the Longitudinal Tract Data Base (LTDB) that uses the standard approach, and an alternative trait-based (TB) method that uses additional small area data to account for spatial heterogeneity. Both are compared to the true (but confidential) original census data. For variables that are available from full-count census data at the block level (including race, age, and some housing characteristics), the TB estimates are much better than the LTDB estimates. The same general approach is ineffective, however, when the small area data are subject to sampling variability and published with less spatial granularity. [ABSTRACT FROM AUTHOR]

Background: Existing research on the impacts of adversity on young children's psychological well‐being has largely focused on household‐level risk factors using observational methods in high‐income countries. This study leverages natural variation in the timing and location of community homicides to estimate their acute effects on the regulatory, behavioral, and developmental outcomes of Brazilian 3‐year‐olds. Methods: We compared the outcomes of children who were assessed soon after a recent neighborhood homicide to those of children from the same residential neighborhoods who had not recently experienced community violence. Our sample included 3,241 3‐year‐olds (Mage = 41.05 months; 53% female; 45% caregiver education less than middle school; 26% receiving a public assistance program) from seven neighborhoods in São Paulo, Brazil. Child outcome measures included parent reports of effortful control and behavior problems as well as direct assessments of children's developmental (cognitive, language, and motor) skills. Community homicides were measured using police records. Results: Recent exposure to community homicides was associated with lower effortful control, higher behavior problems, and lower overall developmental performance for children (d =.05–.20 standard deviations; p = ns – <.001). Effects were consistent across subgroups based on sociodemographic characteristics and environmental supports, but generally largest when community violence exposure was geographically proximal (within 600 m of home) and recent (within 2 weeks prior to assessment). Conclusions: Results highlight the pervasive effects that community violence can have on young children as well as the need to expand support to mitigate these effects and prevent inequities early in life. [ABSTRACT FROM AUTHOR]

Background: Neighbors are an important component of personal social network (PSN) and despite their peripheral role and being considered as familiar strangers, they typically provide instrumental support. For people who is discharged after long-term psychiatric hospitalizations, neighbors would offer other types of social support and play a different role fostering the process of becoming full member of a given community. Aims: To analyze the effects of neighboring on both, those who have had long-term psychiatric hospitalizations and their neighbors. Method: Data was collected between 2020 and 2021, including interviews with formal care staff of three housing support experiences in Argentina, and short testimonies from formerly discharged mental health service users living in the community and their neighbors. We analyzed the data using the Framework Method with a focus on the different aspects of social support and equity and reciprocity theories. Results: Results suggest that emotional support was a frequent function displayed by neighbors toward people with a history of long-term psychiatric hospitalizations, which differs from typical neighboring relationships. Conclusions: Despite reciprocity was observed, users and neighbors displayed an unbalanced helping relationship. [ABSTRACT FROM AUTHOR]

The capacity of families with autistic children to demonstrate resilience is a notable strength that has received little attention in the literature. A potential predictor of family resilience in households with autistic youth is neighborhood support. This study examined the relationship between neighborhood support and family resilience in households with autistic youth utilizing data from the National Survey of Children's Health. A structural equation model was constructed as neighborhood support and family resilience were latent variables. Findings demonstrated that neighborhood support significantly predicts family resilience. This study contributes to the literature as the first quantitative investigation of predictors of family resilience with this group. Strengths of autistic youth, their families, and their communities can be and should be leveraged to address challenges. [ABSTRACT FROM AUTHOR]

This cross-sectional observational study sought to examine the environmental correlates of physical activity and screen-time among youth with autism spectrum disorder (ASD). Parents of youth with ASD (n = 1,165) from seven countries/regions provided responses to an online survey form measuring environmental correlates (i.e., physical activity neighborhood environment, social network, social trust and cohesion, bedroom media, social home environment) and outcomes (i.e., physical activity, screen-time). Multiple linear regression analyses were conducted to determine environmental predictors of the outcomes. Physical activity neighborhood environment (B = 0.15, p = 0.047), social network (B = 0.16, p = 0.02), and social home environment (B = 1.07, p < 0.001) were significantly associated with physical activity, whereas social trust and cohesion and bedroom media were not. Further, social trust and cohesion (B = -0.14, p = 0.001), bedroom media (B = 0.10, p = 0.001), and social home environment (B = -0.16, p < 0.001) were significantly associated with screen-time while neighborhood environment and social network were not. The identified environmental attributes of physical activity and screen-time behaviors should be targeted for health promotion among youth with ASD. [ABSTRACT FROM AUTHOR]

Background: Maternal health outcomes in the United States raises concern due to elevated rates of pregnancy‐related deaths compared to other developed and underdeveloped countries. This scoping review explores relationships between social determinants of health (SDOH), postpartum visit attendance, and pregnancy‐related deaths. Methods: Utilizing the Arksey and O'Malley framework and PRISMA‐Scr guidelines, a systematic review was conducted to identify pertinent literature. Results: Eight studies were analyzed, providing insights into SDOH, postpartum visits, and pregnancy‐related deaths. The findings highlight healthcare access/quality, economic stability, education, and social/community context as influential in postpartum care utilization. Health insurance emerges a key factor for postpartum attendance. In addition, disparities in geographic access to maternity care services were linked to pregnancy‐related deaths. Social contextual factors, such as marital status and social support, exhibited varying associations with postpartum visit attendance. Conclusion: While the analyzed studies provided valuable insight, there remains a gap in the literature examining all three key elements: SDOH, postpartum visit attendance, and pregnancy‐related deaths. In conclusion, this scoping review highlights the vital role of addressing social determinants in improving maternal health outcomes. Further research is necessary to better inform interventions to reduce pregnancy‐related deaths. [ABSTRACT FROM AUTHOR]

Externalizing psychopathology has been found to have small to moderate associations with neighborhood and family sociodemographic characteristics. However, prior studies may have used suboptimal operationalizations of neighborhood sociodemographic characteristics and externalizing psychopathology, potentially misestimating relations between these constructs. To address these limitations, in the current study we test different measurement models of these constructs and assess the structural relations between them. Using a population-representative sample of 2,195 twins and siblings from the Georgia Twin Study and data from the National Neighborhood Data Archive and 2000 U.S. Census, we assessed the fit of competing measurement models for family sociodemographic, neighborhood sociodemographic, and neighborhood environment characteristics. In structural models, we regressed a general externalizing dimension on different operationalizations of these variables separately and then simultaneously in a final model. Latent variable operationalizations of family sociodemographic, neighborhood sociodemographic, and neighborhood environment characteristics explained no more variance in broad externalizing psychopathology than other operationalizations. In an omnibus model, family sociodemographic characteristics showed a small association with externalizing psychopathology, while neighborhood sociodemographic and environmental characteristics did not. Family sociodemographic characteristics showed small associations with neighborhood sociodemographic and environmental characteristics, and neighborhood sociodemographic characteristics were moderately associated with neighborhood environment. These findings suggest that family sociodemographic characteristics are more associated with the development of broad externalizing psychopathology in youth than neighborhood sociodemographic characteristics and neighborhood environment. General Scientific Summary: The current study finds that some ways of measuring family sociodemographic characteristics and neighborhood environment are better than others at explaining externalizing psychopathology in children and adolescents. It also finds the strongest support for direct associations between family sociodemographic characteristics and externalizing psychopathology. [ABSTRACT FROM AUTHOR]

Background: Psoriasis is a major global health burden affecting ~ 60 million people worldwide. Existing studies on psoriasis focused on individual-level health behaviors (e.g. diet, alcohol consumption, smoking, exercise) and characteristics as drivers of psoriasis risk. However, it is increasingly recognized that health behavior arises in the context of larger social, cultural, economic and environmental determinants of health. We aimed to identify the top risk factors that significantly impact the incidence of psoriasis at the neighborhood level using populational data from the province of Quebec (Canada) and advanced tree-based machine learning (ML) techniques. Methods: Adult psoriasis patients were identified using International Classification of Disease (ICD)-9/10 codes from Quebec (Canada) populational databases for years 1997–2015. Data on environmental and socioeconomic factors 1 year prior to psoriasis onset were obtained from the Canadian Urban Environment Health Consortium (CANUE) and Statistics Canada (StatCan) and were input as predictors into the gradient boosting ML. Model performance was evaluated using the area under the curve (AUC). Parsimonious models and partial dependence plots were determined to assess directionality of the relationship. Results: The incidence of psoriasis varied geographically from 1.6 to 325.6/100,000 person-years in Quebec. The parsimonious model (top 9 predictors) had an AUC of 0.77 to predict high psoriasis incidence. Amongst top predictors, ultraviolet (UV) radiation, maximum daily temperature, proportion of females, soil moisture, urbanization, and distance to expressways had a negative association with psoriasis incidence. Nighttime light brightness had a positive association, whereas social and material deprivation indices suggested a higher psoriasis incidence in the middle socioeconomic class neighborhoods. Conclusion: This is the first study to highlight highly variable psoriasis incidence rates on a jurisdictional level and suggests that living environment, notably climate, vegetation, urbanization and neighborhood socioeconomic characteristics may have an association with psoriasis incidence. [ABSTRACT FROM AUTHOR]

Simple Summary: This cross-sectional study analyzed how multilevel social factors affect patient-reported outcomes in children under 18 who survived cancer. Study participants include 293 pairs of these survivors who received survivorship care at a U.S.-based comprehensive cancer center between 2017 and 2018 and their primary caregivers. Findings indicate that higher caregiver anxiety is linked to worse depression, stress, fatigue, sleep problems, and lower positive affect in survivors of pediatric cancer. The study also found that family conflicts are associated with sleep issues in childhood cancer survivors. Furthermore, survivors living in socioeconomically deprived areas experience poorer sleep quality, and those residing in environments with high physical deprivation experience more psychological stress and fatigue, alongside reduced positivity and mobility. These results highlight the significant impact of parental, familial, and neighborhood factors on a range of patient-reported outcomes among young cancer survivors, suggesting these social factors as crucial targets for intervention. In this study, the social determinants of patient-reported outcomes (PROs) in young survivors of childhood cancer aged <18 years are researched. This cross-sectional study investigated social determinants associated with poor PROs among young childhood cancer survivors. We included 293 dyads of survivors receiving treatment at St. Jude Children's Research Hospital who were <18 years of age during follow-up from 2017 to 2018 and their primary caregivers. Social determinants included family factors (caregiver-reported PROs, family dynamics) and county-level deprivation (socioeconomic status, physical environment via the County Health Rankings & Roadmaps). PROMIS measures assessed survivors' and caregivers' PROs. General linear regression tested associations of social determinants with survivors' PROs. We found that caregivers' higher anxiety was significantly associated with survivors' poorer depression, stress, fatigue, sleep issues, and reduced positive affect (p < 0.05); caregivers' sleep disturbances were significantly associated with lower mobility in survivors (p < 0.05). Family conflicts were associated with survivors' sleep problems (p < 0.05). Residing in socioeconomically deprived areas was significantly associated with survivors' poorer sleep quality (p < 0.05), while higher physical environment deprivation was associated with survivors' higher psychological stress and fatigue and lower positive affect and mobility (p < 0.05). Parental, family, and neighborhood factors are critical influences on young survivors' quality of life and well-being and represent new intervention targets. [ABSTRACT FROM AUTHOR]

Purpose: Women and children continue to miss preventive visits. Which neighborhood factors predict inadequate prenatal care (PNC) and well-child visit (WCV) attendance remain unclear. Description: In a retrospective case–control study at Virginia Commonwealth University Health System, mothers with less than 50% adherence or initiation after 5 months gestation were eligible as cases and those with ≥ 80% adherence and initiation before 5 months were eligible as controls. Children in the lowest quintile of adherence were eligible as cases and those with ≥ 80% of adherence were eligible as controls. Cases and controls were randomly selected at a 1:2 ratio and matched on birth month. Covariates were derived from the 2018 American Community Survey. A hotspot was defined as a zip code tabulation area (ZCTA) with a proportion of controls less than 0.66. ZCTAs with fewer than 5 individuals were excluded. Weighted quantile regression was used to determine which covariates were most associated with inadequate attendance. Assessment: We identified 38 and 35 ZCTAs for the PNC and WCV analyses, respectively. Five of 11 hotspots for WCV were also hotspots for PNC. Education and income predicted 51% and 34% of the variation in missed PNCs, respectively; language, education and transportation difficulties explained 33%, 29%, and 17% of the variation in missed WCVs, respectively. Higher proportions of Black residents lived in hotspots of inadequate PCV and WCV attendance. Conclusion: Neighborhood-level factors performed well in predicting inadequate PCV and WCV attendance. The disproportionate impact impact of inadequate PCV and WCV in neighborhoods where higher proportions of Black people lived highlights the potential influence of systemic racism and segregation on healthcare utilization. Significance: What is already known on this subject? Many pregnant women and children continue to miss preventive visits. It is not known what geographic factors contribute to missed visits. What this study adds? Neighborhood-level factors performed well in predicting inadequate prenatal care and well-child attendance. There were disproportionate missed preventive visits in neighborhoods where higher proportions of Black people lived, highlighting the role of systemic racism and segregation on healthcare utilization. [ABSTRACT FROM AUTHOR]

The study of the antecedents of child maltreatment has advanced through ecological research, but there has been a limited focus on the role of community social capital. This study investigates the effects of community social capital on child maltreatment and how these associations differ by regional type, using data on child maltreatment rates in 226 localities in South Korea from 2014 to 2019. Surprisingly, our results show that social trust, networks, and engagement in community affairs are positively associated with child maltreatment rates. Additionally, the mechanisms of social capital effects on child maltreatment vary by place, being more pronounced in small‐ and medium‐sized cities and rural areas. Our findings suggest that a more nuanced understanding of social capital mechanisms across dimensions and locations is required to effectively address child maltreatment. This study contributes to both theory and practice by highlighting the importance of community social capital in preventing child maltreatment and demonstrating the contextual nature of these associations. [ABSTRACT FROM AUTHOR]

Technological environments change social interactions within local communities, potentially leading to the erosion of the sense of local community. In this study, we examined the social, psychological, environmental, and technological factors that predict a sense of local community. Employing a longitudinal approach, we analysed predictors of a sense of local community among Finnish adults aged 18–80 years (N = 1,226) at three time points (spring 2021, spring 2022, and spring 2023). Our results, based on hybrid multilevel regression models, showed that greater neighbourhood engagement and perceived residential environment pleasantness positively predicted a sense of local community over time. Neighbourhood engagement, perceived residential environment pleasantness, use of neighbourhood technology, and positive attitude towards neighbourhood technologies showed positive effects and perceived loneliness and perceived level of urbanization negative between‐person effects, on a sense of local community. The results shed light on the determinants of a sense of local community and carry implications for broader community engagement efforts. Enhancing perceived residential environment pleasantness and promoting more active engagement within neighbourhoods could help increase a sense of local community. Future initiatives may also focus on utilizing neighbourhood technology as a tool to help strengthen a sense of local community. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement. [ABSTRACT FROM AUTHOR]

To investigate associations between perceived childhood neighborhood safety and sleep over the life course. Among a cohort of 1693 Black/African American women aged 23–35 years at enrollment (2010–2012), participants recalled neighborhood safety (safe vs. unsafe) when they were 5, 10, and 15 years old. Participants' mothers/caregivers and participants reported sleep-related health behaviors at age 5. We used ordinal logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for sleep-related health behaviors (i.e., rarely/never or sometimes vs. mostly/always going to bed by 8:00 p.m., bed in a quiet room, bed in a dimly lit or unlit room), separately. Adulthood sleep duration and insomnia symptoms were reported at enrollment and over three follow-up periods. We applied generalized estimating equations to log binomial regression models to estimate relative risks (RR) for adulthood sleep characteristics. Four percent of participants reported an unsafe neighborhood at age 5 years, only, and 12% reported an unsafe neighborhood at all ages. Participants in perceived unsafe vs. safe neighborhoods at age 5 had higher odds of poor sleep-related health behaviors (e.g., rarely/never or sometimes going to bed in a quiet room: OR = 1.73 [1.27–2.35]). Participants in perceived unsafe vs. safe neighborhoods throughout childhood had higher risk of short sleep (RR = 1.10 [1.02–1.18]) and insomnia symptoms (RR = 1.07 [1.00–1.15]) during adulthood after adjustment for life course socioeconomic characteristics and adulthood health behaviors and characteristics. Perceived unsafe childhood neighborhood was associated with poorer sleep over the life course and may serve as an early intervention target. • We assessed perceived childhood neighborhood safety and life course sleep. • Perceived unsafe childhood neighborhood was associated with poor sleep in childhood. • Perceived unsafe childhood neighborhood was associated with poor sleep in adulthood. • Living in unsafe neighborhoods during childhood may impact life course sleep health. [ABSTRACT FROM AUTHOR]

At the peak of the COVID-19 pandemic it became clear that Black people were experiencing more severe symptoms and had higher rates of mortality from COVID-19 than White people. However, data on racial differences in death and hospitalization rates in Alaska were less clear. To address this, the Alaska Black Caucus initiated the first Black Alaskans health needs assessment to understand the health status, needs, and resources of the Black community of Alaska. This article reports on the design, implementation, and descriptive results from the survey portion of the first community health needs assessment of Black Alaskans. The findings indicate that a majority of Black Alaskans report being moderately healthy, having access to health insurance, owning their homes, and having a favorable view of their neighborhood. However, too many are unable to work due to poor physical or mental health challenges and are diagnosed with one or more chronic health diseases. In addition, Black Alaskans experience high rates of substance abuse, have untreated mental health conditions, consume tobacco products at a high rate, and are not screening for some cancers. The article will conclude by presenting additional strategies for improving healthcare access and responsiveness for Black Alaskans. [ABSTRACT FROM AUTHOR]

Evidence suggests neighborhood contexts play a vital role in shaping the availability and diversity of youth sport and participation rates, especially for African American or Black girls. Currently, no index captures interscholastic sport opportunities (eg, sport diversity) within and across school districts and specifically applied to African American or Black girls. To visualize the inequalities present in interscholastic sport opportunities for girls across school districts using a novel index in a selected study area of St Louis City and County, Missouri, and discuss the implications for African American or Black girls. Cross-sectional study. Database secondary analysis. Data for 47 public high schools in the 23 St Louis City and County school districts. We gathered data from the 2014–2018 American Community Survey and Missouri State High School Activities Association. We assessed sport diversity for girls by constructing a sport diversity index (SDI) that uses an entropy index as its foundation. Census-tract data were used to examine the association with neighborhood demographics and contributors to school district income and sport diversity. Descriptive spatial statistics were calculated to evaluate distributions in St Louis City and County, with the bivariate local indicator of spatial autocorrelation used to determine any correlations between variables of interest. The St Louis City school district, which has areas with high rates of renter-occupied housing and poverty and high percentages of non-Hispanic African American or Black students, had the lowest SDI for girls, contrasted with the school districts in St Louis County, which showed an inverse pattern on average. The SDI for girls was correlated with the percentages of renter-occupied housing and poverty. The SDI for girls was also correlated with race: an increasing presence of the non-Hispanic African American or Black population was associated with decreased sport diversity for girls. The SDI for girls demonstrated a spatial association with neighborhood-level determinants of sport-opportunity availability for non-Hispanic African American or Black girls in St Louis. The role of social and political determinants of health in shaping community context and resultant health in athletic training research, policy, and practice should be considered. [ABSTRACT FROM AUTHOR]

This paper presents research into communication pathways between young people and political decision‐makers. The aim of the study was to give young people a platform to challenge how they are perceived in urban public space. Using innovative creative mapping methods, a group of teenagers shared insights into their everyday experiences of their urban neighbourhood with elected political representatives. This paper argues that the perception of young people within the political establishment inhibits engagement and change, but that the participation process is an important step towards reframing perceptions and affecting change. [ABSTRACT FROM AUTHOR]

Purpose: Socioeconomically disadvantaged areas are more resource poor, impacting adherence to swallowing care recommendations. Neighborhood-level disadvantage metrics, such as the Area Deprivation Index (ADI), allow for examination of social determinants of health (SDOH) in a precise region. We examined ADI in a cohort of persons living with dementia (PLWD) to determine representation of those residing in areas of socioeconomic disadvantage (high ADI), distribution of swallowing care provided, and frequency of SDOH-related counseling or resource linking prior to discharge. Method: A retrospective chart abstraction was performed for all inpatients with a diagnosis of dementia (N = 204) seen by the Swallow Service at a large academic hospital in 2014. State ADI Deciles 1 (least) to 10 (most socioeconomic disadvantage) and decile groups (1–3, 4–7, and 8–10) were compared with the surrounding county. Frequency of videofluoroscopic swallowing evaluations (VFSEs) based on ADI deciles was recorded. To determine whether SDOH-related counseling or resource linking occurred for those in high ADI (8–10) neighborhoods, speech-language pathology notes, and discharge summaries were reviewed. Descriptive statistics, independent samples t tests, and one-way analysis of variance were calculated. Results: ADI was significantly higher in this cohort (M = 3.84, SD = 2.58) than in the surrounding county (M = 2.79, SD = 1.88, p = .000). There was no significant difference in utilization of swallowing services across decile groups (p = .88). Although the majority (85%) in high ADI areas was recommended diet modifications or alternative nutrition likely requiring extra resources, there was no documentation indicating that additional SDOH resource linking or counseling was provided. Conclusions: These findings raise important questions about the role and responsibility of speech-language pathologists in tailoring swallowing services to challenges posed by the lived environment, particularly in socioeconomically disadvantaged areas. This underscores the need for further research to understand and address gaps in postdischarge support for PLWD in high-ADI regions and advocate for more equitable provision of swallowing care. [ABSTRACT FROM AUTHOR]

Little is known about resilience responses to COVID-19 stressors from emerging adults in minority world contexts. In this cross-sectional study, we explored the association between self-reported COVID-19 stressors and capacity for resilience in 351 emerging adults (Meanage = 24.45, SD = 2.57; 68% female) who self-identified as Black African. We were interested in whether age, gender and neighbourhood quality influenced this association. The main findings were that higher pandemic stress was associated with a greater capacity for resilience. Older participants showed higher levels of resilience, while there was no gender difference in this regard. Those who perceived their neighbourhoods as being of a good quality also showed greater capacity for resilience, despite all participants residing in disadvantaged communities. The theoretical and practical implications of these results are considered. [ABSTRACT FROM AUTHOR]

Prior theoretical and empirical research has highlighted links between positive parenting and the socioeconomic characteristics of the family's neighborhood, but has yet to illuminate the etiologic origins of this association. One possibility is that the various predictors of parenting outlined by Belsky (1984; e.g., characteristics of the child, characteristics of the parent, and contextual influences) may matter more in some neighborhood contexts than in others. To examine this possibility, we conducted etiologic moderation analyses in a sample of 1,030 families of twins (average age 8 years; 51% male, 49% female; racial composition: 82% White, 10% Black, 1% Asian, 1% Indigenous, and 6% multiracial) from the Twin Study of Behavioral and Emotional Development in Children in the Michigan State University Twin Registry. Neighborhood and parenting were assessed using multiple informants and assessment strategies (neighborhood and family informants, administrative data, and videotaped parent–child interactions). Results pointed to strong evidence of etiologic moderation, such that child effects on positive mothering were prominent in neighborhoods with little opportunity and near zero in neighborhoods with ample opportunity. Such findings not only reframe the magnitude of child effects on the parenting they receive as context-dependent, but also indicate that mothers in impoverished neighborhoods may be more responsive to their children's characteristics than mothers in neighborhoods with ample opportunity. Public Significance Statement: Our findings confirm the long-running notion that children are active participants in the parenting they receive. However, we find that child effects on positive parenting are also context-dependent, such that child effects on positive parenting are especially pronounced in underresourced neighborhood contexts. [ABSTRACT FROM AUTHOR]

Childhood adversity can have detrimental impacts on life course mental and physical health. Timing, nature, severity, and chronicity of adversity are thought to explain much of the variability in health and developmental outcomes among exposed individuals. The current study seeks to characterize heterogeneity in adverse experiences over time at the individual, family, and neighborhood domains in a cohort of predominantly Black children (85% Black and 15% White, 46.2% girls, 67.2% free/reduced lunch in first grade), and to examine associations with mental health from sixth grade to age 26. Participants were part of a randomized universal preventive interventions trial in first grade with prospective follow-up through early adulthood. Separate models characterized heterogeneity in adversity in elementary, middle, and high schools. Changes in adversity over time and relationships with mental health (anxiety, depression, suicidal behaviors) were investigated using a random-intercept latent transition analysis (RI-LTA). We identified three-class solutions in early childhood, middle school, and high school. Generally, both a higher and a lower poly-adversity class were observed at each time point, with varying nature of adversity characterized by the third class. RI-LTA indicated prevalent within-individual changes in adverse exposure over time and differential associations with mental health and suicidal behaviors. Results suggest that treating adverse exposures as a static construct may limit the ability to characterize salient variation over time. Identifying complexity in adverse experiences and their relation to health and well-being is key for developing and implementing effective prevention and early intervention efforts to mitigate negative effects through the life course. Public Significance Statement: Children are exposed to changing forms of adversity across development with differential impacts on mental health. Focusing on repeated, adaptive, coordinated, and multilevel preventive mental health efforts will be crucial to support the well-being of children and adolescents throughout the life course. [ABSTRACT FROM AUTHOR]

Fear of victimization (FOV) is a powerful determinant of behavior and prompts behavioral responses such as avoidance, associated with a decline in health-promoting activities and quality of life. Avoidance behaviors, which include constraining activities to perceived safe areas and avoiding areas regarded as unsafe, are of particular interest due to their high prevalence as a coping response to FOV and their link to adverse physical and mental health. Most research on FOV-related avoidance treats it as a single construct and have yet to elucidate the potential heterogeneity within this set of behaviors. We argue that such approach could mask potential heterogeneity among people who respond to FOV through avoidance and how they adapt to manage perceived risk. Our analysis extends the foundational knowledge regarding FOV-related avoidance using a person-centered approach. We attempted to capture distinct profiles across avoidance behaviors and how they are shaped by physical and social vulnerabilities. Data from the 2021 Mexico's National Survey of Victimization and Perception of Security Survey (n = 83,696) was analyzed using Latent Class Analysis focusing on 15 avoidance behaviors (e.g., stopped using public transportation). We conducted multinomial logistic regression to test whether age, gender, education, and neighborhood deprivation significantly predicted class membership. Findings revealed three classes: avoidant (most behavioral adjustments across the board), cautious (only adapted some behaviors), and protective (least behavioral adjustments, but more concerned about minors in their households). The results supported the hypothesized associations between age, gender, education, and neighborhood deprivation with group membership, but the significance differed by group. This research underscores the role of environmental context in shaping individual perceptions of safety and avoidance behavior. Finally, contrary to the approach of treating avoidance behavior as a single category, these findings present a more complex picture as distinct and meaningful patterns emerged across the three groups. [ABSTRACT FROM AUTHOR]

Objectives Sensory health declines with age but remains critical to the navigation and enjoyment of everyday life. Neighborhoods are key sites of environmental exposure, social engagement, and access to resources that can shape sensory health, yet the residential neighborhood is understudied as a determinant of sensory function. Methods We use data from Rounds 1 and 2 of the National Social Life, Health, and Aging Project to examine how subjective and objective measures of older adults' residential areas are associated with sensory health in a series of cross-sectional and multilevel regression models. Results In cross-sectional models, higher levels of perceived neighborhood social ties are associated with significantly better self-rated vision. Older adults who reside in more densely populated tracts are more likely to have significantly worse olfactory identification, whereas residing in tracts with higher levels of concentrated disadvantage is associated with significantly lower levels of self-rated vision. In multilevel models, residing in more densely populated tracts is associated with significantly worse olfactory identification, whereas tract-level concentrated disadvantage is associated with significantly worse hearing and vision. Discussion We propose that neighborhood characteristics could influence certain environmental exposures, the amount of time that older adults spend out of the home, patterns of social engagement, and access to preventative care that collectively affect sensory health. Residential neighborhoods may be important sites of potential intervention to slow age-related sensory declines and other related conditions. [ABSTRACT FROM AUTHOR]

The differential contributions that interpersonal relationships at family, peer, and school levels provide to overall life satisfaction are studied. These are examined in conjunction with the safety and infrastructure conditions in the neighborhoods and schools of 10- to 12-year-old Chilean children. The sample consists of 1065 youths from 10 to 12 years of age, who were selected through a representative and random strategy. This sample is part of a larger study (International Survey of Children's Well-Being, ISCWeB), sponsored by the International Society of Child Indicators (ISCI). The structural equation model analysis (SEM) was utilized to examine the contribution of the variable of satisfaction with interpersonal relationships and satisfaction with the environment to children's subjective well-being. The results show that the latent dimension of satisfaction with interpersonal relationships held a significant and positive relationship with children's life satisfaction. The latent dimension of satisfaction with the environment functions equally as an independent variable, as it also sustains a significant and positive relationship with the life satisfaction of the students. Both latent variables individually serve as unique and differentiated factors. This study aims to provide evidence of the differentiating effect on overall satisfaction at distinct contextual levels. In particular, it provides information on the effects of environmental dimensions such as the experience and sense of safety in the school and neighborhood, as well as, the conditions of urban spaces. Highlights: The satisfaction that adolescents have with their interpersonal relationships has a significant impact on their satisfaction with life. The satisfaction that adolescents have with their environment has a significant impact on their satisfaction with life. Satisfaction with interpersonal relationships and satisfaction with the environment together explained 56% of the participants' overall satisfaction with life. [ABSTRACT FROM AUTHOR]

Background and Objectives A growing number of older adults in the United States need subsidized housing, but only 36% of eligible households receive assistance. The purpose of this study is to examine if older renters living in subsidized housing are less likely to experience health decline and mortality over 2 years compared to low-income older renters who are likely eligible, but do not receive assistance. Research Design and Methods Baseline data include 671 subsidized and unsubsidized low-income older renters from the 2015 National Health and Aging Trends Study. Outcomes of interest include self-rated health decline, developing a new activity limitation, or 2-year mortality between 2015 and 2017. Weighted stepwise logistic regression models test (a) if subsidized older renters were less likely to experience health decline or 2-year mortality compared to unsubsidized older renters, and (b) if housing quality and neighborhood factors mediate the association between subsidized housing and health decline/mortality. Results Subsidized older renters were less likely to develop a new activity limitation compared to unsubsidized older renters, but there was not a statistically significant difference in experiencing self-rated health decline or 2-year mortality by subsidized housing status. Housing quality and neighborhood factors did not significantly mediate this association. Discussion and Implications The results provide some support that improving access to subsidized housing for low-income older renters may have additional health benefits, even in the short term. To inform program improvements and maximize potential health benefits, more research is needed to understand the specific health-promoting features of subsidized housing. [ABSTRACT FROM AUTHOR]

Background and Hypothesis Serious mental illness (SMI) may compromise diabetes self-management. This study assessed the association between SMI and glycemic control, and explored sociodemographic predictors and geographic clustering of this outcome among patients with and without SMI. Study Design We used electronic health record data for adult primary care patients with diabetes from 2 San Francisco health care delivery systems. The primary outcome was poor glycemic control (hemoglobin A1c >9.0%), which was modeled on SMI diagnosis status and sociodemographics. Geospatial analyses examined hotspots of poor glycemic control and neighborhood characteristics. Study Results The study included 11 694 participants with diabetes, 21% with comorbid SMI, of whom 22% had a schizophrenia spectrum or bipolar disorder. Median age was 62 years; 52% were female and 79% were Asian, Black, or Hispanic. In adjusted models, having schizophrenia spectrum disorder or bipolar disorder was associated with greater risk for poor glycemic control (vs participants without SMI, adjusted relative risk [aRR] = 1.24; 95% confidence interval, 1.02, 1.49), but having broadly defined SMI was not. People with and without SMI had similar sociodemographic correlates of poor glycemic control including younger versus older age, Hispanic versus non-Hispanic White race/ethnicity, and English versus Chinese language preference. Hotspots for poor glycemic control were found in neighborhoods with more lower-income, Hispanic, and Black residents. Conclusions Poor diabetes control was significantly related to having a schizophrenia spectrum or bipolar disorder, and to sociodemographic factors and neighborhood. Community-based mental health clinics in hotspots could be targets for implementation of diabetes management services. [ABSTRACT FROM AUTHOR]

Introduction: Higher Area Deprivation Index (ADI) scores, indicating higher social deprivation, have been associated with more frequent emergency department (ED) utilization. Access to clinical and social services can help prevent inappropriate ED use. A community-based medical school administering a primary and preventive care program focused on the social determinants of health (SDOH) tracks annual ED utilization by its households. This retrospective study determined household ADI scores and evaluated for associations with ED use. Methods: The ADI uses 17 publicly available variables to assign composite scores of social deprivation at the block group level. The Green Family Foundation Neighborhood Health Education Learning Program at Florida International University provides outreach, clinical, and educational services to > 850 disadvantaged households. We conducted Poisson regression to evaluate the association between households' ADI scores and self-reported ED utilization over 2 calendar years. Results: For both the 2018 and 2019 cohorts, independent Poisson regression results indicate that ED visit count is significantly and inversely associated with ADI raw scores and deciles (p < 0.001). Discussion: Based on findings from earlier studies, we had hypothesized a positive, yet reduced association between annual ED utilization and ADI level but surprisingly, we found an inverse association. The combination of providing primary care and connecting with social and behavioral health services as needed appeared to reverse the expected higher ED use at higher ADI scores. Conclusion: Tracking of ED utilization in association with composite, area-based indices such as the ADI may prove useful for other clinical and community health endeavors focused on SDOH. [ABSTRACT FROM AUTHOR]

Weekly and consistent physical activity can help minimize the risk of preventable disease and improve mental health and cognitive function among adults. Despite these benefits, adults with visual impairments tend to not meet physical activity recommendations. The purpose of this preliminary study was to examine how neighbourhood walk score (walkability) is associated with weekly walking minutes in adults with visual impairments. Participants were recruited from two visual impairment–related listservs in the United States. A total of 88 participants (aged 22–85 years; 78% female) were included. Participants completed an online survey including demographic, walking duration, and zip code questions. Linear regression analyses were performed to determine whether there were significant associations between walkability and weekly walking minutes. Walkability scores were not significantly related to walking minutes per week (p =.84), but age was negatively associated with walking minutes per week (β = −.16), holding other factors constant. Neighbourhood walkability was not significantly associated with walking minutes per week among adults with visual impairments in this study. As these adults age, the amount of walking decreased. Future research in this line of inquiry should expand to include other variables that may influence the relationship between walkability and walking minutes per week and examine the barriers to physical activity among individuals with visual impairments. [ABSTRACT FROM AUTHOR]

Background: In recent years, there has been a rise in international (care) movements that prioritise community-centred initiatives such as age-friendly communities, compassionate communities or integrated community care. Although these movements have different focal points, they share common features: seeking to address systemic failures in (care) services, value the participation of end-users, focus on unmet (care) needs, through a local, neighbourhood-oriented approach. In the Flemish and Brussels regions notably the concept of Caring Neighbourhoods is experiencing rapid growth. Objectives: The objective of the present study is to examine the development and implementation of 35 Caring Neighbourhood initiatives in Flanders and Brussels (Belgium) to explore the added value of such projects, as well as the crucial elements for creating Caring Neighbourhoods. Design: Thirty-five caring neighbourhood projects were examined by means of five focus group interviews with project coordinators (n = 34) and five focus group interviews with neighbourhood residents (n = 27), using participant-generated photo elicitation. Methods: The focus group sessions were recorded, transcribed and data were labelled using an inductive analytical framework, following the steps of reflexive thematic analysis. Results: The analysis of the 35 Caring Neighbourhoods showed that fostering connections was key in building Caring Neighbourhoods: connections among residents, connections between residents and care and support services and among care services themselves. The three primary ways to connect people were through activities, places and people. Also, the role of the Caring Neighbourhood coordinator is highlighted as key, which should focus on weaving existing resources, facilitating and coaching instead of organising. Altogether, the projects brought meaning and value to participants' lives, enhancing overall life satisfaction and well-being, with an emphasis on physical and psychosocial care and support. Conclusion: Through critically reflecting on our results and other research, we call on researchers to pay increased attention in research on community-centred care initiatives to death, dying and grief, equity and social justice and the need for both warm and cold solidarity. [ABSTRACT FROM AUTHOR]

Objective: Synthesize longitudinal research evaluating neighborhood environments and cognition to identify methodological approaches, findings, and gaps. Methods: Included studies evaluated associations between neighborhood and cognition longitudinally among adults >45 years (or mean age of 65 years) living in developed nations. We extracted data on sample characteristics, exposures, outcomes, methods, overall findings, and assessment of disparities. Results: Forty studies met our inclusion criteria. Most (65%) measured exposure only once and a majority focused on green space and/or blue space (water), neighborhood socioeconomic status, and recreation/physical activity facilities. Similarly, over half studied incident impairment, cognitive function or decline (70%), with one examining MRI (2.5%) or Alzheimer's disease (7.5%). While most studies used repeated measures analysis to evaluate changes in the brain health outcome (51%), many studies did not account for any type of correlation within neighborhoods (35%). Less than half evaluated effect modification by race/ethnicity, socioeconomic status, and/or sex/gender. Evidence was mixed and dependent on exposure or outcome assessed. Conclusion: Although longitudinal research evaluating neighborhood and cognitive decline has expanded, gaps remain in types of exposures, outcomes, analytic approaches, and sample diversity. [ABSTRACT FROM AUTHOR]

Exposure to community and individual level stressors during adolescence has been reported to be associated with increased substance use. However, it remains unclear what the relative contribution of different community- and individual-level factors play when alcohol and marijuana use become more prevalent during late adolescence. The present study uses a large longitudinal sample of adolescents (Wave 1: N = 2017; 55% Female; 54.5% White, 22.3% Black, 8% Hispanic, 15% other) to evaluate the association and potential interactions between community- and individual-level factors and substance use from adolescence to young adulthood (Wave 1 to Wave 3 Age Mean [SD]: 16.7 [1.1], 18.3 [1.2], 19.3 [1.2]). Across three waves of data, multilevel modeling (MLM) is used to evaluate the association between community affluence and disadvantage, individual household socioeconomic status (SES, measured as parental level of education and self-reported public assistance) and self-reported childhood maltreatment with self-reported 12-month alcohol and 12-month marijuana use occasions. Sample-selection weights and attrition-adjusted weights are accounted for in the models to evaluate the robustness of the estimated effects. Across the MLMs, there is a significant positive association between community affluence and parental education with self-reported alcohol use but not self-reported marijuana use. In post hoc analyses, higher neighborhood affluence in older adolescents is associated with higher alcohol use and lower use in younger adolescents; the opposite association is found for neighborhood disadvantage. Consistent with past literature, there is a significant positive association between self-reported childhood maltreatment and self-reported 12-month alcohol and 12-month marijuana use. Results are largely consistent across weighted and unweighted analyses, however, in weighted analyses there is a significant negative association between community disadvantage and self-reported 12-month alcohol use. This study demonstrates a nuanced relationship between community- and individual-level factors and substance use during the transitional window of adolescence which should be considered when contextualizing and interpreting normative substance use during adolescence. [ABSTRACT FROM AUTHOR]

Past research has failed to find consistent relationships between criminal victimization and fear of crime. Except for neighborhood disorder and crime rate, few studies have examined whether other neighborhood conditions matter the victimization—fear relationship. Using survey data in Guangzhou neighborhoods, the present analysis employs multinomial logistic regression models to examine whether neighborhood characteristics moderate the relationship between violent victimization and fear of violence, and between burglary victimization and fear of burglary, separately. Some aspects of the neighborhood environment do differentially influence victims' and non-victims' fear levels. Besides verifying the interaction effect of neighborhood disorder and victimization, the present study finds that neighborhood policing alleviates the harmful effect of violent victimization on fear, while collective efficacy fosters the harmful effect of burglary victimization on fear. This paper underscores the significance of the social context of urban China in explaining the interplay of neighborhood characteristics and victimization on fear of crime. [ABSTRACT FROM AUTHOR]

A cubic fuzzy graph is a type of fuzzy graph that simultaneously supports two different fuzzy memberships. The study of connectivity in cubic fuzzy graph is an interesting and challenging topic. This research generalized the neighborhood connectivity index in a cubic fuzzy graph with the aim of investigating the connection status of nodes with respect to adjacent vertices. In this survey, the neighborhood connectivity index was introduced in the form of two numerical and distance values. Some characteristics of the neighborhood connectivity index were investigated in cubic fuzzy cycles, saturated cubic fuzzy cycle, complete cubic fuzzy graph and complementary cubic fuzzy graph. The method of constructing a cubic fuzzy graph with arbitrary neighborhood connectivity index was the other point in this research. The results showed that the neighborhood connectivity index depends on the potential of nodes and the number of neighboring nodes. This research was conducted on the Central Bank's data regarding inter-bank relations and its results were compared in terms of neighborhood connectivity index. [ABSTRACT FROM AUTHOR]

Patients with bipolar disorder have higher rates of type 2 diabetes (T2D) compared to the general population. Neighbourhood deprivation is associated with T2D and bipolar disorder. The aim of this study was to explore the potential effect of neighbourhood deprivation on incident T2D in patients with bipolar disorder. This nationwide open cohort study (1997–2018) included adults in Sweden ≥20 years with bipolar disorder (90,780 patients) to examine the subsequent risk of T2D. The association between neighbourhood deprivation and T2D was explored using Cox regression analysis, with hazard ratios (HRs) and 95% confidence intervals (95% CIs). All models were conducted in both men and women and adjusted for individual‐level sociodemographic factors and comorbidities. Neighbourhood deprivation was significantly associated with T2D in patients with bipolar disorder. The HRs were 1.61 (95% CI 1.40–1.86) for men and 1.83 (1.60–2.10) for women living in high deprivation neighbourhoods compared to those from low deprivation neighbourhoods. After adjustment, these results remained significant: 1.35 (1.17–1.56) in men and 1.39 (1.20–1.60) in women living in high deprivation neighbourhoods. The suggested graded association of higher incident T2D among patients with bipolar disorder, observed when levels of neighbourhood deprivation increased, raises important clinical and public health concerns. The results may help develop a contextual approach to prevention of T2D in patients with bipolar disorder that includes the neighbourhood environment. [ABSTRACT FROM AUTHOR]

Background and objectives: Population-wide racial inequities in child health outcomes are well documented. Less is known about causal pathways linking inequities and social, economic, and environmental exposures. Here, we sought to estimate the total inequities in population-level hospitalization rates and determine how much is mediated by place-based exposures and community characteristics. Methods: We employed a population-wide, neighborhood-level study that included youth <18 years hospitalized between July 1, 2016 and June 30, 2022. We defined a causal directed acyclic graph a priori to estimate the mediating pathways by which marginalized population composition causes census tract-level hospitalization rates. We used negative binomial regression models to estimate hospitalization rate inequities and how much of these inequities were mediated indirectly through place-based social, economic, and environmental exposures. Results: We analyzed 50 719 hospitalizations experienced by 28 390 patients. We calculated census tract-level hospitalization rates per 1000 children, which ranged from 10.9 to 143.0 (median 45.1; interquartile range 34.5 to 60.1) across included tracts. For every 10% increase in the marginalized population, the tract-level hospitalization rate increased by 6.2% (95% confidence interval: 4.5 to 8.0). After adjustment for tract-level community material deprivation, crime risk, English usage, housing tenure, family composition, hospital access, greenspace, traffic-related air pollution, and housing conditions, no inequity remained (0.2%, 95% confidence interval: -2.2 to 2.7). Results differed when considering subsets of asthma, type 1 diabetes, sickle cell anemia, and psychiatric disorders. Conclusions: Our findings provide additional evidence supporting structural racism as a significant root cause of inequities in child health outcomes, including outcomes at the population level. [ABSTRACT FROM AUTHOR]

The present study examined changes in ethnic and racial identity (ERI) over one year among 353 Black and Latino early adolescents in relation to ethnic-racial socialization (ERS) and neighborhood economic and demographic characteristics. Parent and child reports of ERS were collected, and child ERI was assessed via self-report. Neighborhood measures included economic disadvantage and ethnic diversity. Results indicated parent report of preparation for bias was associated with greater increases in exploration but not among boys living in non-impoverished neighborhoods. In contrast, child report of preparation for bias was associated with decreases in belonging independent of child gender or neighborhood context. These findings highlight the complexities of neighborhood economic disadvantage and ERI development. Implications for future research examining gender differences and children's interpretation of ERS messages are discussed. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to investigate whether the distance to a riverside park and the neighborhood built environment are related to individuals' leisure walking time by examining the case of the Geumho riverside park in Daegu, South Korea. Background: Walking, being an inexpensive means of transportation with numerous health benefits, is influenced by the conditions of neighborhood built environments. Methods: A survey was conducted from October 12 to November 8, 2022, including 184 adults aged 18 years or older. The dependent variable was the total weekly minutes of leisure walking, and the independent variables included the neighborhood built environment measured objectively using geographic information systems as well as demographic/individual characteristics and health attitude data. Analysis of variance was conducted to determine whether leisure walking time differed depending on the distance to the riverside park, and regression analysis was conducted to examine the association between leisure walking time and the neighborhood built environment. Results: Individuals living within a quarter-mile of the park walked an average of 155 min per week for leisure, which was significantly more than those living further than 1 mile (mean = 85.14 min/week). Moreover, greater access to the park, higher crosswalk density, and a lower road density were associated with more leisure walking time for residents. Conclusions: The findings of this study indicate that good access to riverside parks and pedestrian-centered neighborhood environments may be related to leisure walking among residents. These findings hold significance for urban planning and the formulation of public health policies. [ABSTRACT FROM AUTHOR]

Among one of the more significant societal impacts of the COVID‐19 pandemic, restrictions on people's movement accelerated, and in some cases outright caused, restaurant closures. By considering people's potential for both driving and walking to restaurants, this study aims to examine how restaurant closures are associated with neighborhood characteristics during the pandemic. To do so, we investigated changes in spatial accessibility to restaurants, identified hot spots of communities with large accessibility reductions, and explored relationships between the reductions and neighborhood characteristics in Leon County, Florida. Analysis showed that the area experiencing the largest reductions in spatial access to restaurants varied by transportation modes and the overall geographic patterns in accessibility reductions significantly differed. Communities with significant reductions in car‐based accessibility were areas with a small percentage of the older and non‐White populations and a longer distance to the central area. On the other hand, only being a shorter distance to the central area was more related to hot spots of changes in walking accessibility. Findings show geographic patterns of restaurant closures, which interacted with people's modes of transportation. As such, the closures most substantially affected people in more suburban areas who might rely on driving during the pandemic. [ABSTRACT FROM AUTHOR]

Background: Interracial romantic relationships and unions are a marker of social distance between racial and ethnic groups, but the role of geographic context at schools and neighborhoods during adolescence in shaping interracial romantic relationship formation in the transition to adulthood has been underexplored, which is important for understanding how intergroup contact in the school and neighborhood contexts during adolescence may have subsequent consequences for interracial union formation later in emerging and young adulthood. Methods: Using data from Waves I, III, and IV of the National Longitudinal Study of Adolescent to Adult Health, this study examines the roles of exposure to racial and ethnic diversity in schools and geographic regions in adolescence in shaping the likelihood of being in an interracial romantic relationship in emerging and young adulthood. Results: Adolescents who lived in a Census tract that had fewer of their own racial and ethnic groups were significantly more likely to be in interracial romantic relationships in emerging and in young adulthood. Adolescents who attended more racially and ethnically diverse high schools were also more likely to be in interracial romantic relationships in emerging adulthood. In young adulthood, Hispanic adolescents who went to primarily White high schools were more likely to be in interracial romantic relationships in emerging adulthood and young adulthood. Conclusions: Exposure to racially and ethnically diverse neighborhoods and schools is associated with an increased likelihood of interracial union formation in emerging and young adulthood. [ABSTRACT FROM AUTHOR]

Socioeconomic status (SES) at different points in a child's lifetime may have different effects on health outcomes. This study aimed to examine longitudinal associations between SES and psychosocial problems in preschool children (n = 2509, Mage = 24.2 ± 1.3 months). The psychosocial problems of children were assessed using the Brief Infant–Toddler Social and Emotional Assessment at age 2 years and age 3 years and categorized as having yes/no psychosocial problems. Four groups of pattern of presence/absence of psychosocial problems between age 2 and 3 years were classified: (1) 'no problems', (2) 'problems at age two', (3) 'problems at age three', and (4) 'continuing problems'. Five indicators of SES (i.e., maternal education level, single-parent family, unemployment, financial problems, and neighborhood SES) were evaluated. Results showed around one-fifth (2Y = 20.0%, 3Y = 16.0%) of children had psychosocial problems. Multinomial logistic regression models revealed low and middle maternal education levels were associated with 'problems at age two'; low maternal education level and financial problems were associated with 'problems at age three'; low and middle maternal education level, single-parent family, and unemployment were associated with 'continuing problems'. No associations were observed between neighborhood SES and any pattern. Results suggest children in a lower SES, indicated by maternal education, single-parent family, and financial stress, had higher odds of developing and continuously having psychosocial problems in early childhood. These findings call for optimally timing interventions to reduce the impact of disadvantaged SES in early childhood on psychosocial health. [ABSTRACT FROM AUTHOR]

Community gardens are more popular than ever, yet we know little about how leadership structure and neighborhood characteristics relate to programming. Hence, this paper analyzes how the racial/ethnic backgrounds of the community garden leaders are related to the activities the garden undertakes. What types of initiatives do gardens undertake to reduce food insecurity? The paper analyzes how the location of the garden impacts what it does. The article presents novel findings on the impact of leadership and neighborhood characteristics on community garden operations and outcomes. Hence, the essay examines how the race/ethnicity of garden managers and their sex and neighborhood characteristics, such as poverty rate, household income, and racial composition, are related to garden initiatives. Finally, the paper examines how community gardens responded to increased demands for food and services during the Coronavirus Disease 2019 pandemic. We studied 53 community gardens in Michigan from the summer 2020 through the winter 2021. Whites manage 66% (35) of the gardens, while People of Color manage 34% (18). Roughly half of the gardens are managed by males and the remainder by females. The gardens, which lack paid staff, rely heavily on volunteers. Almost 53% of the gardens are in low-income census tracts (with median income of $40,000 or less). During the pandemic, 31% of the gardens reduced their staff, 51.4% had fewer volunteers than in pre-pandemic times, and 51.9% had increased amounts of people seeking food. [ABSTRACT FROM AUTHOR]

We plotted trends in social work telehealth use among Veterans in a U.S. national social work staffing program and examined the relationship between geographic factors (rurality and neighborhood disadvantage) and telehealth use (audio and video) using linear probability models. Social work telehealth use increased among Veterans during the COVID-19 pandemic. There were no geographic differences in telephone telehealth use. Video telehealth use was less common among Veterans in isolated rural areas and among Veterans in highly disadvantaged areas. Outreach efforts can address barriers that Veterans who live in rural and disadvantaged areas may experience in using video telehealth. [ABSTRACT FROM AUTHOR]

Introduction: Shared sanitation facilities are used by over 500 million people around the world. Most research evidence indicates that shared sanitation conveys higher risk than household sanitation for many adverse health outcomes. However, studies often fail to account for variation between different types of shared facilities. As informal housing development outpaces sanitation infrastructure, it is imperative to understand which components of shared facilities may mitigate the health risks of shared sanitation use. Methods: This cross-sectional study determines whether sanitation improvement or compound hygiene were associated with stunting or diarrhoeal prevalence in children under five living in Maputo, Mozambique who rely on shared sanitation facilities. The study uses logistic and linear multivariable regression analysis to search for associations and control for potential confounding factors. Results: 346 children (43.9%) in the study population were stunted. Each unit increase in sanitation score was associated with an approximate decrease of 22% in the odds of stunting (OR: 0.78, CI: 0.66, 0.92), and an increase in height of 0.23 height-for-age z-scores (CI: 0.10, 0.36). There was no evidence that the compound hygiene score was associated with height as measured by stunting (OR: 1.05, CI: 0.87, 1.26) or z-score (-0.06, CI: -0.21, 0.09). Neither sanitation nor compound hygiene score were associated with diarrhoea in the population. Conclusions: Use of an improved shared latrine is associated with decreased odds of stunting. There is no evidence of an association between latrine improvement and diarrhoea. Further investigation is necessary to isolate attributes of shared sanitation facilities that may reduce health risks. Significance: As urban growth increases and expansion of informal housing outpaces sanitation infrastructure, it is imperative to understand which components of a shared facility may mitigate the health risks associated with shared sanitation use. Thereby, an evidence base can be built so that recommendations can be adopted by the WHO. [ABSTRACT FROM AUTHOR]

Elucidating the influence of microsystem and exosystem factors on development is an important goal of developmental psychopathology. This study examined the effects of maltreatment and neighborhood risk on child-caregiver attachment. Maltreatment records, neighborhood risk indices, and Strange Situation data were collected from a diverse sample of 170 four-year-old children and their caregivers. Relative contributions of maltreatment, neighborhood risk, and their interaction on attachment insecurity and disorganization were explored via latent moderation. Maltreated children demonstrated higher rates of insecure attachment, but not attachment disorganization, independent of neighborhood risk. Controlling for maltreatment, preliminary results suggested no effects of neighborhood risk on attachment. Findings support prior research that has identified maltreatment as a salient risk to the formation of secure attachment relationships. However, results add heterogeneity to the limited research investigating effects of neighborhood on attachment. Overall, this study highlights the importance of examining multilevel ecological risk in relation to attachment relationship development. [ABSTRACT FROM AUTHOR]

Evidence suggests that lower socioeconomic status (SES) and negative social determinants of health (SDOH) contribute to health care disparities. Due to their accessibility in the high school setting, secondary school athletic trainers (SSATs) may encounter patients who are historically underserved in health care, such as patients with low SES. However, a significant gap in knowledge exists regarding how SDOH and SES may influence SSATs' clinical management decisions. To describe SSATs' perceptions of how patient SDOH and SES influence clinical management decisions and to identify barriers to athletic health care. Cross-sectional study. Online survey. National Athletic Trainers' Association SSATs (6.7% response rate). Secondary school athletic trainers were asked about their perceptions of patient SDOH and SES (content validity index = 0.83 for relevancy). The levels of relevance and agreement were answered on a 4-point Likert scale. Data were summarized using means and SDs, frequencies and proportions (%), and median scores. A total of 380 SSATs participated (mean years of experience = 14.9 ± 11.7 years). When providing care, most (71.3%) SSATs believed their patients' health or health care access to be the most relevant of the 5 SDOH, whereas the other 4 SDOH were less than 60% relevant. Most SSATs agreed or strongly agreed that patient SES affected both referral (67.4%) and the reliance on conservative treatment before referral (71.2%). Secondary school athletic trainers identified patient or guardian compliance (70.2%) and type of health insurance (61.5%) as barriers to providing care to patients with low SES. Secondary school athletic trainers perceived health or health care access as the most relevant social determinant when providing care to patients with low SES. When SSATs further considered the SES of patients, they identified all SDOH as barriers that they were ill equipped to navigate as they delivered care and engaged in patient referral. [ABSTRACT FROM AUTHOR]

Neurocognitive testing is a critical tool in the management of sport-related concussions. Adversity during childhood and adolescence affects cognitive tasks, behavioral outcomes, and academic performance. Adversity may be important in baseline concussion test validity as well; however, the influence of these experiences is not well understood. To examine the relationship between individual-level experiences of adversity and baseline test validity of Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT). We hypothesized that experiences of poverty, maltreatment, or extreme neighborhood deprivation would be associated with lower odds of baseline test validity. Case-control study. Cuyahoga County, Ohio. A total of 6495 student-athletes born from 1995 through 2005 who completed a baseline ImPACT test between 10 and 18 years old and were identified in the Child-Household Integrated Longitudinal Data system, a comprehensive data system with demographic and social service usage outcomes for children in Cuyahoga County, Ohio. Baseline concussion test validity was determined using the ImPACT built-in validity measure. Experiences of adversity during the sensitive developmental periods of early childhood and adolescence were key independent variables. Our findings suggested that social mobility may play an important role in baseline validity. Youth with upward social mobility (ie, poverty or neighborhood deprivation in early childhood only) were not different from youth without such experiences (odds ratio [OR] = 0.91, P =.74). Youth with persistent adversity across childhood or downward social mobility (ie, poverty or high neighborhood deprivation in adolescence only) had 50% to 72% lower odds of achieving a valid baseline test (persistent poverty, OR = 0.59, P =.05; adolescent poverty only, OR = 0.50, P =.004; adolescent neighborhood deprivation only, OR = 0.28, P <.001). Maltreatment had no significant effect on test validity. These findings indicated that certain patterns of adversity may predispose youth to invalid baseline testing scores, potentially increasing their risk of inappropriate injury management and poor outcomes. [ABSTRACT FROM AUTHOR]