Erratum: Neighborhood conditions and birth outcomes: understanding the role of perceived and extrinsic measures of neighborhood quality: Erratum.
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PROVIDER: S-EPMC9916117 | biostudies-literature | 2023 Feb
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Erratum: Neighborhood conditions and birth outcomes: understanding the role of perceived and extrinsic measures of neighborhood quality: Erratum.
Environmental epidemiology (Philadelphia, Pa.) 20230113 1
[This corrects the article DOI: 10.1097/EE9.0000000000000224.]. ...[more]
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Project description:Living in a disadvantaged neighborhood has been associated with adverse birth outcomes. Most prior studies have conceptualized neighborhoods using census boundaries and few have examined the role of neighborhood perceptions, which may better capture the neighborhood environment. In the present study, we examined associations between extrinsic and perceived neighborhood quality measures and adverse birth outcomes.MethodsParticipants resided in the San Francisco Bay Area of California and were enrolled in Chemicals in Our Bodies, a prospective birth cohort (N = 817). The Index of Concentration at the Extremes (ICE) for income, Area Deprivation Index (ADI), and the Urban Displacement Project's measure of gentrification were included as census block group-level extrinsic neighborhood quality measures. Poor perceived neighborhood quality was assessed using an interview questionnaire. Linear regression models were utilized to examine associations between extrinsic and perceived neighborhood quality measures, and gestational age and birthweight for gestational age z-scores. Covariates in adjusted models were chosen via a directed acyclic graph (DAG) and included maternal age, education, and marital status.ResultsIn adjusted models, having poor perceived neighborhood quality was associated with higher birthweight z-scores, relative to those who did not perceive their neighborhood as poor quality (β = 0.21, 95% confidence intervals = 0.01, 0.42). Relative to the least disadvantaged tertile, the upper tertile of the ADI was associated with a modest reduction in gestational age (β = -0.35, 95% confidence intervals = -0.67, -0.02).ConclusionsIn the Chemicals in Our Bodies study population, extrinsic and perceived neighborhood quality measures were inconsistently associated with adverse birth outcomes.
| S-EPMC9555921 | biostudies-literature
Project description:Background: Despite improvements, air pollution still remains a major public health issue. Numerous epidemiological studies have demonstrated the adverse health effects of air pollution exposure based on modeled measures, but only a few have considered the health impact of perceived air quality. Improving our knowledge of individual perceptions is crucial to defining targeted actions and promoting appropriate intervention measures. Our objective is to investigate the relationship between subjective and objective measures of air pollution and to focus on how individual characteristics combined with the neighborhood socioeconomic deprivation index, measured at a fine spatial scale, may or may not alter this relationship. Materials and Methods: The subjective measures of air quality reported by a sample of Lyon residents were collected via an individual questionnaire. The objective measures of air pollution were modeled by the local air quality monitoring network of the Rhône-Alpes region at census block level. We used a socioeconomic deprivation index to capture the different socioeconomic dimensions at census block level. The statistical analysis was structured in two steps: (1) identification of individual determinants of the subjective measures of air quality using multiple correspondence analysis followed by hierarchical clustering; (2) identification of individual and contextual characteristics that may alter the relationship between the objective and subjective measures of air pollution. Results: Among the youngest and the middle aged population (ages 30 to 59), consistent results between level of satisfaction, perceived air quality and objective measures of air pollution were found whatever the individual characteristics of the population. It is less clear among the oldest population: globally no significant difference between the NO₂ concentrations and the level of satisfaction was observed. Conclusions: We found a significant relationship between the subjective and objective measures of air pollution in many population sub-groups with different combinations of individual characteristics. The relationship is less clear among the oldest population, which confirms previous findings. Our finding highlights that age combined with low level of education and unemployment, or women or health problems as well as the neighborhood deprivation index influence the level of air quality satisfaction.
| S-EPMC5750977 | biostudies-literature
Project description:We examined whether dialysis facility characteristics, neighborhood demographics, and region are associated with Centers for Medicare and Medicaid Services (CMS) dialysis facility quality measures in order to determine the most important targets for intervention.We linked US census data to the CMS Dialysis Compare File which contains information for facility outcomes for all CMS-certified dialysis facilities in 2007 (n=5616). We then used linear and logistic regression to characterize the association between dialysis facility quality--worse than expected patient survival, and the proportion of individuals in a facility achieving dialysis adequacy (urea reduction rate >65) or target hemoglobin (10<Hgb<12 g/dL)--and dialysis facility characteristics, neighborhood demographics, and region.Only an increasing proportion of African Americans in the neighborhood is consistently associated with worse dialysis facility outcomes, even after controlling for neighborhood poverty. Facilities with the highest proportion of African Americans in the neighborhood had worse patient survival [odds ratio (OR) 4.6; 95% confidence interval (CI), 2.8-7.6], were less likely to have adequate dialysis (? -1.4; 95% CI, -2.3 to -0.6), and achieve targeted hemoglobin (? -3.1; 95% CI, -4.7 to -1.6) compared to those with the lowest proportion. No other predictor-facility, neighborhood, or region--was consistently associated with dialysis facility quality.The proportion of African Americans in the dialysis facility neighborhood is strongly and consistently associated with lower facility quality. Quality improvement efforts are particularly needed for dialysis facilities in minority communities.
| S-EPMC3651911 | biostudies-literature
Project description:ImportanceInfants born with unhealthy birth weight are at greater risk for long-term health complications, but little is known about how neighborhood characteristics (eg, walkability, food environment) may affect birth weight outcomes.ObjectiveTo assess whether neighborhood-level characteristics (poverty rate, food environment, and walkability) are associated with risk of unhealthy birth weight outcomes and to evaluate whether gestational weight gain mediated these associations.Design, setting, and participantsThe population-based cross-sectional study included births in the 2015 vital statistics records from the New York City Department of Health and Mental Hygiene. Only singleton births and observations with complete birth weight and covariate data were included. Analyses were performed from November 2021 to March 2022.ExposuresResidential neighborhood-level characteristics, including poverty, food environment (healthy and unhealthy food retail establishments), and walkability (measured by both walkable destinations and a neighborhood walkability index combining walkability measures like street intersection and transit stop density). Neighborhood-level variables categorized into quartiles.Main outcomes and measuresThe main outcomes were birth certificate birth weight measures including small for gestational age (SGA), large for gestational age (LGA), and sex-specific birth weight for gestational age z-score. Generalized linear mixed-effects models and hierarchical linear models estimated risk ratios for associations between density of neighborhood-level characteristics within a 1-km buffer of residential census block centroid and birth weight outcomes.ResultsThe study included 106 194 births in New York City. The mean (SD) age of pregnant individuals in the sample was 29.9 (6.1) years. Prevalence of SGA and LGA were 12.9% and 8.4%, respectively. Residence in the highest density quartile of healthy food retail establishments compared with the lowest quartile was associated with lower adjusted risk of SGA (with adjustment for individual covariates including gestational weight gain z-score: risk ratio [RR], 0.89; 95% CI 0.83-0.97). Higher neighborhood density of unhealthy food retail establishments was associated with higher adjusted risk of delivering an infant classified as SGA (fourth vs first quartile: RR, 1.12; 95% CI, 1.01-1.24). The RR for the association between density of unhealthy food retail establishments and risk of LGA was higher after adjustment for all covariates in each quartile compared with quartile 1 (second: RR, 1.12 [95% CI, 1.04-1.20]; third: RR, 1.18 [95% CI, 1.08-1.29]; fourth: RR, 1.16; [95% CI, 1.04-1.29]). There were no associations between neighborhood walkability and birth weight outcomes (SGA for fourth vs first quartile: RR, 1.01 [95% CI, 0.94-1.08]; LGA for fourth vs first quartile: RR, 1.06 [95% CI, 0.98-1.14]).Conclusions and relevanceIn this population-based cross-sectional study, healthfulness of neighborhood food environments was associated with risk of SGA and LGA. The findings support use of urban design and planning guidelines to improve food environments to support healthy pregnancies and birth weight.
| S-EPMC10261997 | biostudies-literature
Project description:Public reporting on quality aims to help patients select better hospitals. However, individual quality measures are suboptimal in identifying superior and inferior hospitals based on outcome performance.To combine structure, process, and outcome measures into an empirically derived composite quality measure for heart failure (HF), acute myocardial infarction (AMI), and pneumonia (PNA). To assess how well the composite measure predicts future high and low performers, and explains variance in future hospital mortality.Using national Medicare data, we created a cohort of older patients treated at an acute care hospital for HF (n=1,203,595), AMI (n=625,595), or PNA (n=1,234,299). We ranked hospitals on the basis of their July 2005 to June 2008 performance on the composite. We then estimated the odds of future (July to December 2009) 30-day, risk-adjusted mortality at the worst versus best quintile of hospitals. We repeated this analysis using 2005-2008 performance on existing quality indicators, including mortality.The composite (vs. Hospital Compare) explained 68% (vs. 39%) of variation in future AMI mortality rates. In 2009, if an AMI patient had chosen a hospital in the worst versus best quintile of performance using 2005-2008 composite (vs. Hospital Compare) rankings, he or she would have had 1.61 (vs. 1.39) times the odds of dying in 30 days (P-value for difference <0.001). Results were similar for HF and PNA.Composite measures of quality for HF, AMI, and PNA performed better than existing measures at explaining variation in future mortality and predicting future high and low performers.
| S-EPMC4181330 | biostudies-literature
Project description:Access to healthy food is a necessity for all people. However, there is still a lack of reviews on the assessment of respondent-based measures of neighborhood food environments (perceived food environments). The aim of this systematic review was to evaluate the measurement tools for perceived food environments by five dimensions of food access and to obtain the overview of their associations with dietary habits among people aged 18 years and older in middle- and high-income countries. Observational studies using perceived food environment measures were identified through a systematic review based on two databases for original studies published from 2010 to 2020. A total of 19 final studies were extracted from totally 2926 studies. Pertaining to the five dimensions of food access, 12 studies dealt with accessibility, 13 with availability, 6 with affordability, 10 with acceptability, 2 with accommodation, and 8 with a combination of two or more dimensions. Perceived healthy food environments were positively associated with healthy dietary habits in 17 studies, but 8 of them indicated statistically insignificant associations. In conclusion, this review found accessibility and availability to be major dimensions of perceived food environments. The relationship between healthy food environments and healthy diets is presumably positive and weak.
| S-EPMC9099956 | biostudies-literature
Project description:Background: Adverse birth outcomes are related to unfavorable fetal growth conditions. A latent variable, named Favorable Fetal Growth Condition (FFGC), has been defined by Bollen et al., in 2013; he showed that this FFGC latent variable mediates the effects of maternal characteristics on several birth outcomes. Objectives: The objectives of the present study were to replicate Bollen's approach in a population of newborns in Paris and to investigate the potential differential effect of the FFGC latent variable according to the neighborhood socioeconomic level. Methods: Newborn health data were available from the first birth certificate registered by the Maternal and Child Care department of the City of Paris. All newborns (2008-2011) were geocoded at the mother residential census block. Each census block was assigned a socioeconomic deprivation level. Several mothers' characteristics were collected from the birth certificates: age, parity, education and occupational status and the occupational status of the father. Three birth outcomes were considered: birth weight (BW), birth length (BL) and gestational age (GA). Results: Using a series of structural equation models, we confirm that the undirected model (that includes the FFGC latent variable) provided a better fit for the data compared with the model where parental characteristics directly affected BW, BL, and/or GA. However, the strength, the direction and statistical significance of the associations between the exogenous variables and the FFGC were different according to the neighborhood deprivation level. Conclusion: Future research should be designed to assess the how robust the FFGC latent variable is across populations and should take into account neighborhood characteristics to identify the most vulnerable group and create better design prevention policies.
| S-EPMC6861961 | biostudies-literature
Project description:Women residing in neighborhoods of low socioeconomic status are more likely to experience adverse reproductive outcomes; however, few studies explore which specific neighborhood features are associated with poor maternal health behaviors and pregnancy outcomes. Based upon our conceptual model, directly observed street-level data from four North Carolina US counties were used to create five neighborhood indices: physical incivilities (neighborhood degradation), social spaces (public space for socializing), walkability (walkable neighborhoods), borders (property boundaries), and arterial features (traffic safety). Singleton birth records (2001-2005) were obtained from the North Carolina State Center for Vital Statistics and maternal health behavior information (smoking, inadequate or excessive weight gain) and pregnancy outcomes (pregnancy-induced hypertension/pre-eclampsia, low birthweight, preterm birth) were abstracted. Race-stratified random effect models were used to estimate associations between neighborhood indices and women's reproductive behaviors and outcomes. In adjusted models, higher amounts of physical incivilities were positively associated with maternal smoking and inadequate weight gain, while walkability was associated with lower odds of these maternal health behaviors. Social spaces were also associated with inadequate weight gain during pregnancy. Among pregnancy outcomes, high levels of physical incivilities were consistently associated with all adverse pregnancy outcomes, and high levels of walkability were inversely associated with pregnancy-induced hypertension and preterm birth for Non-Hispanic white women only. None of the indices were associated with adverse birth outcomes for Non-Hispanic black women. In conclusion, certain neighborhood conditions were associated with maternal health behaviors and pregnancy outcomes.
| S-EPMC4951203 | biostudies-literature
Project description:ObjectiveTo describe patients' perceived value and use of quality measures in evaluating and choosing community pharmacies.DesignFocus group methodology was combined with a survey tool. During the focus groups, participants assessed the value of the Pharmacy Quality Alliance's quality measures in evaluating and choosing a pharmacy. Also, participants completed questionnaires rating their perceived value of quality measures in evaluating a pharmacy (1 being low value and 5 being high) or choosing a pharmacy (yes/no). Thematic analysis and descriptive statistics were used to analyse the focus groups and surveys, respectively.SettingSemistructured focus groups were conducted in a private meeting space of an urban and a rural area of a Mid-western State in the USA.ParticipantsThirty-four adults who filled prescription medications in community pharmacies for a chronic illness were recruited in community pharmacies, senior centres and public libraries.ResultsWhile comments indicated that all measures were important, medication safety measures (eg, drug-drug interactions) were valued more highly than others. Rating of quality measure utility in evaluating a pharmacy ranged from a mean of 4.88 ('drug-drug interactions') to a mean of 4.0 ('absence of controller therapy for patients with asthma'). Patients were hesitant to use quality information in choosing a pharmacy (depending on the participant's location) but might consider if moving to a new area or having had a negative pharmacy experience. Use of select quality measures to choose a pharmacy ranged from 97.1% of participants using 'drug-drug interactions' (medication safety measure) to 55.9% using 'absence of controller therapy for patients with asthma'.ConclusionsThe study participants valued quality measures in evaluating and selecting a community pharmacy, with medication safety measures valued highest. The participants reported that the quality measures would not typically cause a switch in pharmacy but might influence their selection in certain situations.
| S-EPMC4305069 | biostudies-literature
Project description:Environmental correlates, barriers, and facilitators of physical activity, healthy eating, and socializing are understudied in older immigrants to developed countries. This study developed/adapted and validated measures of perceived barriers and neighborhood environmental characteristics related to these health-enhancing behaviors appropriate for older Chinese immigrants to Australia and similar Western countries. Older Chinese immigrants living in Melbourne (Australia) were recruited from neighborhoods varying in walkability and percentage of Chinese residents. Versions of the Neighborhood Environment for Healthy Aging-Chinese Immigrants to Australia (NEHA-CIA) questionnaire (20 subscales) and the Perceived Barriers to Health-Enhancing Behaviors questionnaire (four subscales) were developed from extant validated scales and information collected in formative qualitative research. Thirty-one participants took part in cognitive interviews aimed to pilot-test and refine the questionnaires. The modified questionnaires were administered to 52 participants twice, two weeks apart. Test-retest reliability (intraclass correlation coefficients), internal consistency (Cronbach's α), and construct validity (associations with theoretically-relevant constructs) were examined. Most items and subscales of both questionnaires had good test-retest reliability and internal consistency, while the NEHA-CIA also showed good construct validity. Future studies need to further examine the construct validity of the questionnaire of perceived barriers and determine the factorial validity of both measures on large representative samples.
| S-EPMC8123107 | biostudies-literature