Objective: To characterize the spatio-temporal association between features of the built environment and subclinical liver disease.
Design: We used data from a large community-based population, the Multi-Ethnic Study of Atherosclerosis (2000-2002, N = 5542) with linked historical residential data that characterized past exposure to alcohol outlets (bars and liquor stores), healthy foods stores, and physical activity facilities (1990-2001). We examined whether and how past residential relate to hepatic steatosis (proxied by liver attenuation measured using computed tomography, with lower attenuation indicating higher hepatic steatosis).
Background: Forty percent of new cancer cases in the United States are attributed to modifiable risks, which can be influenced by the built environment. Recent cancer prevention guidelines include recommendations for making communities conducive to healthy living. Focused on the city of Philadelphia, the present study aims to 1) evaluate neighborhood-level adherence to cancer prevention guidelines by developing two novel indices and 2) identify factors driving low compliance in neighborhoods with high cancer mortality.
View Article and Find Full Text PDFNovel treatments in multiple myeloma (MM) could influence the incidence of skeletal-related events (SREs). We aimed to examine the incidence of SRE and the preventive use of osteoclast inhibitors (OIs) in a cohort of MM patients in the era of modern treatment. In this real-world retrospective study, we included 199 patients with a diagnosis of MM between January 1, 2010, and December 31, 2019, with follow-up at St.
View Article and Find Full Text PDFBackground: Outdoor aeroallergens, such as pollens and molds, are known triggers of asthma exacerbation; however, few studies have examined children's aeroallergen response based on sensitization.
Objective: Our aim was to compare the relative impact of aeroallergen levels on asthma exacerbation between pediatric patients with asthma who tested positive or negative for sensitization to particular allergens.
Methods: A case-crossover design study was conducted to examine associations between outdoor aeroallergen levels and asthma exacerbation events among children living in Philadelphia, Pennsylvania, who were treated within a large pediatric care network.
Respiratory virus infections are related to over 80% of childhood asthma exacerbations. They enhance pro-inflammatory mediator release, especially for sensitized individuals exposed to pollens/molds. Using a time-series study design, we investigated possible effect modification by respiratory virus infections of the associations between aeroallergens/PM and asthma exacerbation rates.
View Article and Find Full Text PDFObjective: It is unknown whether weight change or physical fitness is associated with chronic kidney disease (CKD) risk among nondiabetic adults with obesity.
Methods: This was a prospective, longitudinal cohort study of adults with obesity without baseline CKD or diabetes enrolled in the Multi-Ethnic Study of Atherosclerosis (MESA). Linear mixed-effects and multistate models were adjusted for demographics, time-varying covariates including blood pressure, and comorbidities these were used to examine associations of weight change and slow walking pace (<2 miles/h) with (i) rate of annual estimated glomerular filtration rate (eGFR) decline and (ii) incident CKD, defined as eGFR < 60 mL/min/1.
Fine particulate matter (PM) and aeroallergens (i.e., pollen, molds) are known triggers of asthma exacerbation.
View Article and Find Full Text PDFNeighborhood walkability-features of the built environment that promote pedestrian activity-has been associated with greater physical activity and lower body mass index (BMI; calculated as weight (kg)/height (m)2) among neighborhood residents. However, much of the literature has been cross-sectional and only a few cohort studies have assessed neighborhood features throughout follow-up. Using data from the Reasons for Geographic and Racial Differences in Stroke Study (2003-2016) and a neighborhood walkability index (NWI) measured annually during follow-up, we assessed whether the cumulative experience of neighborhood walkability (NWI-years) predicted BMI and waist circumference after approximately 10 years of follow-up, controlling for these anthropometric measures at enrollment.
View Article and Find Full Text PDFStudies of life expectancy (LE) in small areas of cities are relatively common in high-income countries but rare in Latin American countries. Small-area estimation methods can help to describe and quantify inequities in LE between neighborhoods and their predictors. Our objective was to analyze the distribution and spatial patterning of LE across small areas of Ciudad Autónoma de Buenos Aires (CABA), Argentina, and its association with socioeconomic characteristics.
View Article and Find Full Text PDFWe investigated the association of urban landscape profiles with health and environmental outcomes, and whether those profiles are linked to environmental and health co-benefits. In this ecological study, we used data from 208 cities in 8 Latin American countries of the (SALURBAL) project. Four urban landscape profiles were defined with metrics for the fragmentation, isolation, and shape of patches (contiguous area of urban development).
View Article and Find Full Text PDFObjectives: To evaluate variability in life expectancy at birth in small areas, describe the spatial pattern of life expectancy, and examine associations between small-area socioeconomic characteristics and life expectancy in a mid-sized city of a middle-income country.
Design: Cross-sectional, using data from death registries (2015-2018) and socioeconomic characteristics data from the 2010 national population census.
Participants/setting: 40 898 death records in 99 small areas of the city of Córdoba, Argentina.
Objective: To describe national disparities in retail food environments by neighbourhood composition (race/ethnicity and socio-economic status) across time and space.
Design: We examined built food environments (retail outlets) between 1990 and 2014 for census tracts in the contiguous USA ( 71 547). We measured retail food environment as counts of all food stores, all unhealthy food sources (including fast food, convenience stores, bakeries and ice cream) and healthy food stores (including supermarkets, fruit and vegetable markets) from National Establishment Time Series business data.
Latin America is the world's most urbanized region and its heterogeneous urban development may impact chronic diseases. Here, we evaluated the association of built environment characteristics at the sub-city -intersection density, greenness, and population density- and city-level -fragmentation and isolation- with body mass index (BMI), obesity, and type 2 diabetes (T2D). Data from 93,280 (BMI and obesity) and 122,211 individuals (T2D) was analysed across 10 countries.
View Article and Find Full Text PDFIntroduction: The burden of Alzheimer's disease (AD) and AD-related dementias (ADRD) is increasing nationally and globally, with disproportionate impacts on lower-income, lower education and systematically marginalised older adults. Presence of inequalities in neighbourhood factors (eg, social context, physical and built environments) may affect risk of cognitive decline and be key for intervening on AD/ADRD disparities at the population level. However, existing studies are limited by a dearth of longitudinal, detailed neighbourhood measures linked to rich, prospective cohort data.
View Article and Find Full Text PDFWhile income gradients and gender inequalities in excess weight have been noted elsewhere, data from Latin American cities is lacking. We analyzed gender-specific associations between city-level women's empowerment and income inequality with individual-level overweight/obesity, assessing how these associations vary by individual education or living conditions within cities in Latin America. Data came from national surveys and censuses, and was compiled by the SALURBAL project (Urban Health in Latin America).
View Article and Find Full Text PDFThe prevalence of multiple myeloma (MM) is increasing in Nordic countries and the rest of the western world. Patients aged ≥75 years at diagnosis constitute an increasing proportion of all MM patients, but are underrepresented in randomized clinical trials. There is an urgent need for studies of the characteristics, treatment and outcome in this cohort.
View Article and Find Full Text PDFThere is limited empirical evidence on how travel time affects dietary patterns, and even less in Latin American cities (LACs). Using data from 181 LACs, we investigated whether longer travel times at the city level are associated with lower consumption of vegetables and higher consumption of sugar-sweetened beverages and if this association differs by city size. Travel time was measured as the average city-level travel time during peak hours and city-level travel delay time was measured as the average increase in travel time due to congestion on the street network during peak hours.
View Article and Find Full Text PDFThere is growing evidence that longer travel time by private car poses physical and mental risks. Individual-level obesity and diabetes, two of the main public health challenges in low- and middle-income contexts, could be associated to city-level travel times by car. We used individual obesity and diabetes data from national health surveys from individuals in 178 Latin American cities, compiled and harmonized by the SALURBAL project.
View Article and Find Full Text PDFAmong patients of an urban primary care network in Philadelphia with a universal hepatitis C virus (HCV) screening policy for patients born during 1945-1965, we examined whether being unscreened and HCV positivity were associated with attributes of the census tracts where patients resided, which we considered as proxies for social health determinants. For patients with at least one clinic visit between 2014 and mid-2017, we linked demographic and HCV screening information from electronic health records with metrics that described the census tracts where patients resided. We used generalized estimating equations to estimate adjusted relative risk ratios (aRRs) for being unscreened and HCV positive.
View Article and Find Full Text PDFBackground: Mental health is an important contributor to the global burden of disease, and depression is the most prevalent mental disorder in Latin America and the Caribbean (LAC). Informal jobs, often characterized by precarious working conditions, low wages, and limited employment benefits, are also highly prevalent in LAC and may be associated with poorer mental health. Our study tests the association between informal employment and major depressive symptoms in LAC cities.
View Article and Find Full Text PDFLow socioeconomic status (SES) and living in a disadvantaged neighborhood are associated with poor cardiovascular health. Multiple lines of evidence have linked DNA methylation to both cardiovascular risk factors and social disadvantage indicators. However, limited research has investigated the role of DNA methylation in mediating the associations of individual- and neighborhood-level disadvantage with multiple cardiovascular risk factors in large, multi-ethnic, population-based cohorts.
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