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How people pay is critically important to consumers and businesses alike. Many consumers are choosing to pay for goods and services from an increasing number of options. Tech‐savvy urbanites buy coffee by tapping their phone on a reader. Parents returning from a night out use peer‐to‐peer payment apps, such as Venmo, to pay the sitter. The recent explosion of financial innovations promises faster, more efficient, and cheaper transactions. These increasing digital payment options coincide with decreased number and volume of cash transactions. However, vulnerable populations face more constrained payment choices and often rely exclusively on cash. Without experience, devices, or acceptable credit histories, vulnerable populations may have little access to digital transactions. The advantages of falling digital costs and other benefits thus accrue to the digitally connected. At the same time, those who must transact in coins and paper money are likely to find their relative costs increasing. This paper highlights payment trends and the potential impact on vulnerable populations in the United States as we move toward a cashless society. This paper should stimulate discussions of public policy initiatives to mitigate digital payment issues for vulnerable people. [ABSTRACT FROM AUTHOR]

A longstanding line of research in urban studies explores how cities can be understood through their appearance. However, what remains unclear is to what extent urban dwellers' everyday life can be explained by the visual clues of the urban environment. In this paper, we address this question by applying a computer vision model to 27 million street view images across 80 counties in the United States. Then, we use the spatial distribution of notable urban features identified through the street view images, such as street furniture, sidewalks, building façades, and vegetation, to predict the socioeconomic profiles of their immediate neighborhood. Our results show that these urban features alone can account for up to 83% of the variance in people's travel behavior, 62% in poverty status, 64% in crime, and 68% in health behaviors. The results outperform models based on points of interest (POI), population, and other demographic data alone. Moreover, incorporating urban features captured from street view images can improve the explanatory power of these other methods by 5% to 25%. We propose "urban visual intelligence" as a process to uncover hidden city profiles, infer, and synthesize urban information with computer vision and street view images. This study serves as a foundation for future urban research interested in this process and understanding the role of visual aspects of the city. [ABSTRACT FROM AUTHOR]

This paper examines whether people's mood and optimism affect economic activity. We consider two sets of exogenous proxies for optimism that are unrelated to the economic environment: (1) weather (average temperature and cloud cover) and (2) sports and political optimism. We show that economic recessions are weaker and expansions are stronger in the United States where local individuals are more optimistic. Further, local optimism has a stronger impact on state‐level business cycles of smaller states and regions with low levels of risk sharing. In contrast, the incremental effects of local optimism are weaker in states where people are younger, more educated and sophisticated, and socially more connected. States with larger concentration of minority and urban population also exhibit lower sensitivity to variations in mood and optimism. Alternative explanations based on the state's industrial composition, tax environment, migration, seasonal affective disorder (SAD), oil shocks, and direct economic impact of weather cannot explain these findings. [ABSTRACT FROM AUTHOR]

Background: The paper examines the role of community-based participatory research (CBPR) within the context of social justice literature and practice. Methods: Two CBPR case studies addressing health inequities related to Type 2 Diabetes and Cardiovascular disease were selected from a national cross-site study assessing effective academic-community research partnerships. One CBPR partnership works with African Americans in rural Pemiscot County, Missouri and the other CBPR partnership works with African American and Latinos in urban South Bronx, New York City. Data collection included semi-structured key informant interviews and focus groups. Analysis focused on partnerships' context/ history and their use of multiple justice-oriented strategies to achieve systemic and policy changes in order to address social determinants of health in their communities. Results: Community context and history shaped each partnership's strategies to address social determinants. Four social justice approaches (identity/recognition, procedural, distributive, and structural justice) used by both partnerships were identified. These social justice approaches were employed to address underlying causes of inequitable distribution of resources and power structures, while remaining within a scientific research framework. Conclusion: CBPR can bridge the role of science with civic engagement and political participation, empowering community members to become political agents who integrate evidence into their social justice organizing strategies. [ABSTRACT FROM AUTHOR]

PURPOSE This mixed methods study sought to describe the extent to which family physicians in urban communities serve socially vulnerable patients and to better understand their practices, their challenges, and the structural supports that could facilitate their patient care. METHODS We conducted a quantitative analysis of questionnaire data from 100% of US physicians recertifying for family medicine from 2017 to 2020. We conducted qualitative analysis of in-depth interviews with 22 physician owners of urban, small, independent practices who reported that the majority of their patients were socially vulnerable. RESULTS In 2020, in urban areas across the United States, 19.3% of family physicians served in independent practices with 1 to 5 clinicians, down from 22.6% in 2017. Nearly one-half of these physicians reported that >10% of their patients were socially vulnerable. Interviews with 22 physicians who reported that the majority of their patients were socially vulnerable revealed 5 themes: (1) substantial time spent addressing access issues and social determinants of health, (2) minimal support from health care entities, such as independent practice associations and health plans, and insufficient connection to community-based organizations, (3) myriad financial challenges, (4) serious concerns about the future, and (5) deep personal commitment to serving socially vulnerable patients in independent practice. CONCLUSIONS Small independent practices serving vulnerable patients in urban communities are surviving because deeply committed physicians are making personal sacrifices. Health equity–focused policies could decrease the burden on these physicians and bolster independent practices so that socially vulnerable patients continue to have options when seeking primary care. [ABSTRACT FROM AUTHOR]

The spatial distribution of income shapes the structure and organisation of cities and its understanding has broad societal implications. Despite an abundant literature, many issues remain unclear. In particular, all definitions of segregation are implicitely tied to a single indicator, usually rely on an ambiguous definition of income classes, without any consensus on how to define neighbourhoods and to deal with the polycentric organization of large cities. In this paper, we address all these questions within a unique conceptual framework. We avoid the challenge of providing a direct definition of segregation and instead start from a definition of what segregation is not. This naturally leads to the measure of representation that is able to identify locations where categories are over- or underrepresented. From there, we provide a new measure of exposure that discriminates between situations where categories co-locate or repel one another. We then use this feature to provide an unambiguous, parameter-free method to find meaningful breaks in the income distribution, thus defining classes. Applied to the 2014 American Community Survey, we find 3 emerging classes—low, middle and higher income—out of the original 16 income categories. The higher-income households are proportionally more present in larger cities, while lower-income households are not, invalidating the idea of an increased social polarisation. Finally, using the density—and not the distance to a center which is meaningless in polycentric cities—we find that the richer class is overrepresented in high density zones, especially for larger cities. This suggests that density is a relevant factor for understanding the income structure of cities and might explain some of the differences observed between US and European cities. [ABSTRACT FROM AUTHOR]

• Previous studies on contamination spread by flooding undercount sites. • 3.3 million people are at risk of contamination from flooding in US urban areas. • Due to changes in urbanization and climate change these figures are likely to increase. • These risks pose complex challenges for environmental managers and urban planners. Climate change is imposing substantial consequences across physical and social infrastructures. The extent of social disruption and risk to human health are, however, potentially much broader than these general consequences, taken individually, would suggest. To address this gap, we assess the distribution of contaminated sites in the United States (US) and then estimate the impact that flood hazards in urban areas will have on these contaminated sites. Using these measures, we draw inferences about the risk of contamination from climate-impacted extreme weather events, climate adaptation at the local level, social risk and how it is distributed, and a broader understanding of the potential global consequences of climate change. In this paper we address three critical points: 1) the role classification of contaminated sites on our understanding of risk due to climate change; 2) the relationship between contaminated sites and flood risk; and 3) the potential for climate adaption strategies to mediate this risk. We estimate that of the roughly one-third of the US population living in urban areas, up to 3,338,518 people, are living in high-risk flood zones near contaminated sites. Our results suggest severe potential implications for estimates of the negative consequences from climate change and contamination and provide critical insights into the relationship between climate change and the built environment for urban planners and environmental policy makers and managers alike. [ABSTRACT FROM AUTHOR]

High air temperatures are a public health threat, causing 1300 deaths annually in the United States (US) along with heat-related morbidity and increased electricity consumption for air-conditioning (AC). Increasing tree canopy cover has been proposed as one way to reduce urban air temperatures. Here, we assemble tree cover and developed land-cover information for 97 US cities, housing 59 million people, and use regression relationships to analyze how much current urban tree cover reduces summer (JJA) air temperatures and associated heat-related mortality, morbidity, and electricity consumption. We find that 78% of urban dwellers are in neighborhoods with less than 20% tree cover. Some 15.0 million people (25% of total) experience a reduction of 0.5–1.0°C from tree cover, with another 7.9 million (13% of total) experiencing a reduction of greater than 1.0°C. Current relationships between temperature and health outcomes imply that urban tree cover helps avoid 245–346 deaths annually. Heat–mortality relationships in the 1980s, when a smaller fraction of US households had AC, imply a greater role in the past for urban tree cover in avoiding heat-related mortality. As AC availability has increased, the value of tree cover for avoiding heat-related mortality has decreased, while the value of tree cover for reducing electricity consumption likely has increased. Currently, for the 97 cities studied, the total annual economic value of avoided mortality, morbidity, and electricity consumption is an estimated $1.3–2.9 billion, or $21–49 annually per capita. Applying our results to the entire US urban population, we estimate urban tree cover annually supplies heat-reduction services worth $5.3–12.1 billion. [ABSTRACT FROM AUTHOR]

The three decades from 1940 through 1970 mark a turning point in the spatial scale of Black–White residential segregation in the United States compared with earlier years. We decompose metropolitan segregation into three components: segregation within the city, within the suburbs, and between the city and its suburbs. We then show that extreme levels of segregation were well established in most cities by 1940, and they changed only modestly by 1970. In this period, changes in segregation were greater at the metropolitan scale, driven by racially selective population growth in the suburbs. We also examine major sources of rising segregation, including region, metropolitan total, and Black population sizes, and indicators of redlining in the central cities based on risk maps prepared by the Home Owners Loan Corporation (HOLC) in the late 1930s. In addition to overall regional differences, segregation between the city and suburbs and within suburbia increased more in metropolitan areas with larger Black populations, but this relationship was found only in the North. In contrast to some recent theorizing, there is no association between preparation of an HOLC risk map or the share of city neighborhoods that were redlined and subsequent change in any component of segregation. [ABSTRACT FROM AUTHOR]

Diversification of police forces is widely promoted as a reform for reducing racial disparities in police-civilian interactions and increasing police legitimacy. Despite these potential benefits, nearly every municipal police department in the United States remains predominately White and male. Here, we investigate whether the scale and persistence of minority underrepresentation in policing might partly be explained by a lack of support for diversification among voters and current police officers. Across two studies (N = 2, 661) sampling the US adult population and residents from a city with one of the least representative police forces in the country, individuals significantly overestimate officer diversity at both the local and national levels. We find that correcting these biased beliefs with accurate information reduces trust in police and increases support for hiring new officers from underrepresented groups. In the municipal sample, these corrections also cause an increase in residents' willingness to vote for reforms to diversify their majority White police department. Additional paired decision-making experiments (N = 1, 663) conducted on these residents and current police officers demonstrate that both prefer hiring new officers from currently underrepresented groups, independent of civil service exam performance and other hiring criteria. Overall, these results suggest that attitudes among voters and police officers are unlikely to pose a major barrier to diversity reforms. [ABSTRACT FROM AUTHOR]

Addressing how ecosystem services (ES) are distributed among groups of people is critical for making conservation and environmental policy-making more equitable. Here, we evaluate the distribution and equity of changes in ES benefits across demographic and socioeconomic groups in the United States (US) between 2020 and 2100. Specifically, we use land cover and population projections to model potential shifts in the supply, demand, and benefits of the following ES: provision of clean air, protection against a vector-borne disease (West Nile virus), and crop pollination. Across the US, changes in ES benefits are unevenly distributed among socioeconomic and demographic groups and among rural and urban communities, but are relatively uniform across geographic regions. In general, non-white, lower-income, and urban populations disproportionately bear the burden of declines in ES benefits. This is largely driven by the conversion of forests and wetlands to cropland and urban land cover in counties where these populations are expected to grow. In these locations, targeted land use policy interventions are required to avoid exacerbating inequalities already present in the US. Social inequalities may be reflected in how ecosystem services are distributed among groups of people. Here the authors estimate the distribution of three ecosystem services across demographic and socioeconomic groups in the US between 2020 and 2100, finding that non-white and lower-income groups disproportionately bear the loss of ecosystem service benefits. [ABSTRACT FROM AUTHOR]

Background A minority of patients with opioid use disorder are treated for hepatitis C virus infection (HCV). While colocated HCV and opioid agonist therapy (OAT) along with harm reduction can facilitate prevention and cascade to cure, there are few real-world examples of such embedded care models in the United States in the direct-acting antiviral (DAA) era. Methods We conducted a retrospective chart review to determine sustained virologic response (SVR) and reinfection rates during the first 5-year period of DAA availability among individuals tested and treated on-site at Rhode Island's only nonprofit methadone maintenance program. Results Of 275 who initiated DAAs, the mean age (range) was 43 (22–71) years, 34.5% were female, 57.5% had genotype 1a, 23.3% had cirrhosis, and 92% were Medicaid recipients. SVR was 85.0% (232/273), while modified intent-to-treat SVR was 93.2% (232/249); 17 patients did not achieve SVR, 2 awaited SVR 12 weeks post-end-of-treatment, and 24 were lost to follow-up. Thirty reinfections were identified over 375.5 person-years of follow-up (rate, 7.99/100 person-years). The median time to first reinfection (interquartile range) was 128 (85.25–202.5) days. Before July 1, 2018, 72 patients accessed DAAs over 3.7 years; after Medicaid DAA restrictions were lifted, 109 patients accessed DAAs over 1.3 years. The Prior Authorization (PA) process requires many steps, differing across 11 RI insurers, taking 45–120 minutes per patient. Conclusions DAA treatment was effective among a marginalized population in an urban colocated OAT/HCV program. Removing DAA restrictions facilitates treatment initiation. The PA process remains a modifiable barrier to expanding capacity in the United States. [ABSTRACT FROM AUTHOR]

The purpose of this study was to better understand residential segregation and child/youth health by examining the relationship between a measure of Black-White residential segregation, the index of dissimilarity, and a suite of child and youth health measures in 235 U.S. metropolitan statistical areas (MSAs). MSAs are urban areas with a population of 50,000 or more and adjacent communities that share a high degree of economic and social integration. MSAs are defined by the Office of Management and Budget. Health-related measures included child mortality (CDC WONDER), teen births (NCHS natality data), children in poverty (SAIPE program), and disconnected youth (Measure of America). Simple linear regression and two-level hierarchical linear regression models, controlling for income, total population, % Black, and census region, examined the association between segregation and Black health, White health, and Black-White disparities in health. As segregation increased, Black children and youth had worse health across all four measures, regardless of MSA total and Black population size. White children and youth in small MSAs with large Black populations had worse levels of disconnected youth and teen births with increasing segregation, but no associations were found for White children and youth in other MSAs. Segregation worsened Black-White health disparities across all four measures, regardless of MSA total and Black population size. Segregation adversely affects the health of Black children in all MSAs and White children in smaller MSAs with large Black populations, and these effects are seen in measures that span all of childhood. Residential segregation may be an important target to consider in efforts to improve neighborhood conditions that influence the health of families and children. [ABSTRACT FROM AUTHOR]

Heat waves are an important type of extreme climate event and directly result in more than 130 deaths per year across the United States. Heat waves have been described by several attributes and combinations which constitute various event typologies. Attributes of heat waves from 10 cities are analyzed over the period 1950–2016 to understand how these attributes determine variability in local heat waves and how climate change affects heat waves across the United States. This study uses eight definitions to differentiate heat waves and tests for temporal trends in key properties of heat waves over the period 1950–2016. At least five harmful attributes of heat waves have increased simultaneously for Dallas, Miami, New York, Phoenix, and Portland.Miami showed the greatest change in heat wave season length, frequency, and timing over the study period. Surprisingly, the greatest mean heat wave intensities above daily thresholds were for Bismarck, ND (+8.2 °C) and Syracuse, NY (+6.5 °C). Similar results across Baltimore, MD, Colorado Springs, CO, Dallas, TX, Des Moines, IA, Miami, FL, New York, NY, Phoenix, AZ, and Portland, OR, are presented to clarify the many quantitative differences in heat wave attributes and variance in quantification approaches across climates. This work explores the nexus of quantitative description and social construction of heat waves through the lens of the various regional metrics to describe heat waves. Ultimately, this assessment will guide the development of various strategies to help communities understand and prepare for heat resilience based on local heat wave components. Plain Language Summary: Heat waves are a series of consecutive days and nights with very high temperatures. They impact human health and increase water and energy demands, particularly in the urban areas. Heat waves have different lengths, occur in various seasons, and have different ranges between daytime and nighttime temperatures. These variations create numerous types of heat waves. Although heat waves happen more frequently in hot regions, residents of cities in northern climates also experience various types of heat waves. Analysis of differences in heat wave occurrences from 1950 to 2016 in 10 cities with various climates across the United States shows how different types of heat waves are changing across the United States. We found that many descriptive characteristics are increasing in value through time. For example, heat wave duration has increased in Miami, FL. The findings of this study are intended to guide policy makers, urban managers, and first responders to better prepare for future changes in regional heat waves and mitigate negative impacts of heat waves on human health and the environment. Key Points: This study uses many different definitions for heat wave to make broad comparisonsRegional differences in heat wave components complicate uniform public health and urban management strategiesFrequency and intensity of extreme climate‐related urban heat wave events are increasing for the various climates of the United States [ABSTRACT FROM AUTHOR]

Objective: To quantify disparities in accessibility and availability of pediatric primary care by modeling interventions across multiple states that compare publicly insured versus privately insured children, and urban versus rural communities.Data Sources: Secondary data sources include 2013 National Plan and Provider Enumeration System, 2009 MAX Medicaid claims, 2012 American Community Survey.Study Design: The study models accessibility and availability of care for all children in seven states.Methods: Optimization modeling with access constraints is used to estimate access. Statistical hypothesis testing is used to quantify systematic disparities.Principal Findings: California has the best accessibility for privately insured children and Minnesota for publicly insured children. Mississippi has the lowest availability for both populations. Overall, the disparities in availability for pediatric primary care are not as significant as in accessibility. Both rural and urban communities are in need of improvement in accessibility to primary care for publicly insured children, although at varying levels across states.Conclusions: Disparities in availability are not as significant as disparities in accessibility. Opportunities to improve access to pediatric primary care vary by state. Generating specific recommendations for small areas is critical to enabling health policy decision makers to improvement access. [ABSTRACT FROM AUTHOR]

Background: An array of risk factors has been associated with cardiovascular diseases, and developing nations are becoming disproportionately affected by such diseases. Cardiovascular diseases have been reported to be highly prevalent in the Mexican population, but local mortality data is poor. The Mexican side of the US-Mexico border has a culture that is closely related to a developed nation and therefore may share the same risk factors of cardiovascular diseases. We wanted to explore if there was higher cardiovascular mortality in the border region of Mexico compared to the rest of the nation.Methods: We conducted a population based cross-sectional time series analysis to estimate the effects of education, insurance and municipal size in Mexican border (n = 38) and non-border municipalities (n = 2360) and its association with cardiovascular age-adjusted mortality rates between the years 1998-2012. We used a mixed effect linear model with random effect estimation and repeated measurements to compare the main outcome variable (mortality rate), the covariates (education, insurance and population size) and the geographic delimiter (border/non-border).Results: Mortality due to cardiovascular disease was consistently higher in the municipalities along the US-Mexico border, showing a difference of 78 · 5 (95% CI 58 · 7-98 · 3, p < 0 · 001) more cardiovascular deaths after adjusting for covariates. Larger municipal size and higher education levels showed a reduction in cardiovascular mortality of 12 · 6 (95% CI 11 · 4-13 · 8, p < 0 · 001) deaths and 8 · 6 (95% CI 5 · 5-11 · 8, p < 0 · 001) deaths respectively. Insurance coverage showed an increase in cardiovascular mortality of 3 · 6 (95% CI 3 · 1-4 · 0, p < 0 · 001) deaths per decile point increase. There was an increase in cardiovascular mortality of 0 · 3 (95% CI -0 · 001-0 · 6, p = 0 · 050) deaths per year increase in the non-border but a yearly reduction of 2 · 9 (95% CI 0 · 75-5.0, p = 0 · 008) deaths in the border over the time period of 1998-2012.Conclusion: We observed that the Mexican side of the US-Mexico border region is disproportionately affected by cardiovascular disease mortality as compared to the non-border region of Mexico. This was not explained by education, population density, or insurance coverage. Proximity to the US culture and related diet and habits can be explanations of the increasing mortality trend. [ABSTRACT FROM AUTHOR]

Background: Patients with frequent hospital readmissions, or high-utilizer patients (HUPs), are a major driver of rising healthcare costs in the United States. This group has a significant burden of medical illness, but less is known about whether or how social determinants of health may drive their increased healthcare use and poor health outcomes. Our study aimed to define the population of HUPs at a large, safety-net hospital system, to understand how these patients differ from patients who are not HUPs, and to analyze how their demographic, medical, and social factors contribute to their healthcare use and mortality rates.Methods: For this case-control study, data were collected via retrospective chart review. We included 247 patients admitted three or more times in a single calendar year between 2011 and 2013 and 247 controls with one or two admissions in a single calendar year matched for age, sex, and year of high-utilization. We used multivariable logistic regression models to understand which demographic, clinical, and social factors were associated with HUP status, and if HUP status was independently associated with mortality.Results: The factors that contributed significant odds of being a HUP included having Medicaid (OR 3.34, 95% CI 1.50, 7.44) or Medicare (OR 3.39, 95% CI 1.50, 7.67), having a history of recreational drug use (OR 2.44, 95% 1.36, 4.38), and being homeless (OR 3.73, 95% CI 1.69, 8.23) The mortality rate among HUPs was 22.6% compared to 8.9% among controls (p < 0.0001).Conclusions: These data show that social factors are related to high-utilization in this population. Future efforts to understand and improve the health of this population need to incorporate non-clinical patient factors. [ABSTRACT FROM AUTHOR]

Objective: This aim of this study was to examine whether the construct of physical appearance perception differed among the three largest racial/ethnic groups in the United States using an adolescent sample.Methods: Black (46%), Latino (31%), and White (23%) adolescents in Grade 10 from the Healthy Passages study ( N  = 4,005) completed the Harter's Self-Perception Profile for Adolescents-Physical Appearance Scale (SPPA-PA) as a measure of physical appearance perception.Results: Overall, Black adolescents had a more positive self-perception of their physical appearance than Latino and White adolescents. However, further analysis using measurement invariance testing revealed that the construct of physical appearance perception, as measured by SPPA-PA, was not comparable across the three racial/ethnic groups in both males and females.Conclusions: These results suggest that observed differences may not reflect true differences in perceptions of physical appearance. Measures that are equivalent across racial/ethnic groups should be developed to ensure more precise measurement and understanding. [ABSTRACT FROM AUTHOR]

Background and Objectives: Great variety exists in the roles that family medicine residency faculty fill in the lives of their residents. A family medicine-specific model has never been created to describe and promote effective training relationships. This research aims to create a consensus model for faculty development, ethics education, and policy creation.Methods: Using a modified grounded theory methods, researchers conducted phone interviews with 22 key informants from US family medicine residencies. Data were analyzed to delineate faculty roles, common role conflicts, and ethical principles for avoiding and managing role conflicts. Key informants were asked to apply their experience and preferences to adapt an existing model to fit with family medicine residency settings.Results: The primary result of this research is the creation of a family medicine-specific model that describes faculty roles and provides insight into how to manage role conflicts with residents. Primary faculty roles include Role Model, Advisor, Teacher, Supervisor, and Evaluator. Secondary faculty roles include Friendly Colleague, Wellness Supporter, and Helping Hand. The secondary roles exist on a continuum from disengaged to enmeshed. When not balanced, the secondary roles can detract from the primary roles. Differences were found between role expectations of physician versus behavioral science faculty and larger/university/urban residencies versus smaller/community/rural residencies.Conclusions: Diversity of opinion exists related to the types of roles that are appropriate for family medicine faculty to maintain with residents. This new model is a first attempt to build consensus in the field and has application to faculty development, ethics education, and policy creation. [ABSTRACT FROM AUTHOR]

Background: This study examined trends in body mass index (BMI), waist circumference (WC), and childhood overweight and obesity prevalence between 1998-2001 and 2010-2012 according to household income and urbanity among nationally representative Korean children and adolescents aged 10-19.Methods: The repeated cross-sectional data from Korean National Health and Nutrition Examination Surveys in 1998-2001 and 2010-2012 were used. Gender specific trends in age-adjusted means of WC and BMI by household equivalized income and urbanity were compared between years. The age-standardized prevalence of childhood overweight and obesity was calculated using three international criteria (International Obesity Task Force, World Health Organization, US Centers for Disease Control and Prevention) and a Korean national reference standard.Results: Among boys, overall BMI and overweight prevalence increased between 1998-2001 and 2010-2012, while overall WC decreased. Clear gender differences were found in the relationship of childhood obesity metrics with household income and urbanity and the time trends of those relationships. Positive relationships between these parameters were found for boys while negative relationships appeared for girls. In addition, compared with the childhood obesity prevalence among boys in rural areas, the prevalence among boys in urban areas were slightly lower in 1998-2001 but became greater in 2010-2012.Conclusions: This study revealed gender difference in the association of childhood obesity with household income and urbanity and its time trends. The long-term gender-specific monitoring of socioeconomic and urban-rural differences in childhood obesity measures is warranted in South Korea. [ABSTRACT FROM AUTHOR]

This article explores intersections between place, race/ethnicity, and gender amongst American Twitter users and makes an argument that studying the intensity of tweets provides insights into how and why particular groups tweet. Given recent events in American political life such as the shooting in Ferguson, Missouri and the reactions by young, urban African Americans on Twitter, understanding the role of race, place, gender, and age is important. We observed the time between tweets of urban American Twitter users and explored whether the medium may be providing traditionally marginalized groups, such as young Black men, with potential avenues for mobilizing communication and access to resources. [ABSTRACT FROM AUTHOR]

Background: Cadmium (Cd), lead (Pb), mercury (Hg), and arsenic (As) exposure is ubiquitous and has been associated with higher risk of growth restriction and cardiometabolic and neurodevelopmental disorders. However, cost-efficient strategies to identify at-risk populations and potential sources of exposure to inform mitigation efforts are limited. The objective of this study was to describe the spatial distribution and identify factors associated with Cd, Pb, Hg, and As concentrations in peripheral blood of pregnant women.Methods: Heavy metals were measured in whole peripheral blood of 310 pregnant women obtained at gestational age ~12 weeks. Prenatal residential addresses were geocoded and geospatial analysis (Getis-Ord Gi* statistics) was used to determine if elevated blood concentrations were geographically clustered. Logistic regression models were used to identify factors associated with elevated blood metal levels and cluster membership.Results: Geospatial clusters for Cd and Pb were identified with high confidence (p-value for Gi* statistic <0.01). The Cd and Pb clusters comprised 10.5 and 9.2 % of Durham County residents, respectively. Medians and interquartile ranges of blood concentrations (μg/dL) for all participants were Cd 0.02 (0.01-0.04), Hg 0.03 (0.01-0.07), Pb 0.34 (0.16-0.83), and As 0.04 (0.04-0.05). In the Cd cluster, medians and interquartile ranges of blood concentrations (μg/dL) were Cd 0.06 (0.02-0.16), Hg 0.02 (0.00-0.05), Pb 0.54 (0.23-1.23), and As 0.05 (0.04-0.05). In the Pb cluster, medians and interquartile ranges of blood concentrations (μg/dL) were Cd 0.03 (0.02-0.15), Hg 0.01 (0.01-0.05), Pb 0.39 (0.24-0.74), and As 0.04 (0.04-0.05). Co-exposure with Pb and Cd was also clustered, the p-values for the Gi* statistic for Pb and Cd was <0.01. Cluster membership was associated with lower education levels and higher pre-pregnancy BMI.Conclusions: Our data support that elevated blood concentrations of Cd and Pb are spatially clustered in this urban environment compared to the surrounding areas. Spatial analysis of metals concentrations in peripheral blood or urine obtained routinely during prenatal care can be useful in surveillance of heavy metal exposure. [ABSTRACT FROM AUTHOR]

Long-term exposure to outdoor particulate matter with an aerodynamic diameter less than or equal to 2.5 µm (PM2.5) has been associated with cardiovascular morbidity and mortality. The chemical composition of PM2.5 that may be most responsible for producing these associations has not been identified. We assessed cross-sectional associations between long-term concentrations of PM2.5 and 4 of its chemical components (sulfur, silicon, elemental carbon, and organic carbon (OC)) and subclinical atherosclerosis, measured as carotid intima-media thickness (CIMT) and coronary artery calcium, between 2000 and 2002 among 5,488 Multi-Ethnic Study of Atherosclerosis participants residing in 6 US metropolitan areas. Long-term concentrations of PM2.5 components at participants' homes were predicted using both city-specific spatiotemporal models and a national spatial model. The estimated differences in CIMT associated with interquartile-range increases in sulfur, silicon, and OC predictions from the spatiotemporal model were 0.022 mm (95% confidence interval (CI): 0.014, 0.031), 0.006 mm (95% CI: 0.000, 0.012), and 0.026 mm (95% CI: 0.019, 0.034), respectively. Findings were generally similar using the national spatial model predictions but were often sensitive to adjustment for city. We did not find strong evidence of associations with coronary artery calcium. Long-term concentrations of sulfur and OC, and possibly silicon, were associated with CIMT using 2 distinct exposure prediction modeling approaches. [ABSTRACT FROM PUBLISHER]

Turtles are particularly susceptible to the negative impacts of urbanization due to low mobility and a life history strategy emphasizing long generation times and high adult survival. In addition to declines directly through habitat loss, urbanization has been hypothesized to limit populations of aquatic turtles through changes in population structure, as adult females are disproportionally killed on and near roads, leading to male-biased populations, which can lead to population declines or local extirpations. The purpose of this study was to better understand how urbanization impacts the sex ratios of painted turtles (Chrysemys picta) in an urban ecosystem, as empirical results linking male-biased turtle populations to roads and urbanization are mixed. Using eight years of trapping data from a long-term monitoring program in a suburb of Chicago, IL, USA, we report one of the most male-biased populations ( x ¯ = 75% male) of turtles in the USA, consistent with prevailing road mortality hypotheses. However, we found no evidence that male-biased populations were related to road density or the amount of protected area around a sampling location and found that impervious surface (a metric of urbanization) was weakly related to less male-biased populations. Our results highlight the importance of replicating ecological studies across space and time and the difficulty in assessing population structure in aquatic turtles. We suggest that active conservation measures may be warranted for the continued persistence of urban turtle populations. [ABSTRACT FROM AUTHOR]