Disparities in Bicycle Commuting: Could Bike Lane Investment Widen the Gap?

2021 ◽  
pp. 0739456X2199390
Author(s):  
Lindsay M. Braun
Keyword(s):  
Regression Models ◽  
Block Group ◽  
Group Level ◽  
Interaction Terms ◽  
Bicycle Commuting ◽  
Heterogeneous Effects ◽  
Sociodemographic Disparities ◽  
Block Groups

This article examines how bicycle commuting is associated with bike lane access and sociodemographic advantage at the block group level in twenty-two U.S. cities. Using regression models with interaction terms, I find that associations between bike lanes and bicycle commuting are stronger among more advantaged block groups, due primarily to limited bicycle commuting in disadvantaged block groups even when bike lanes are present. This indicates the importance of considering heterogeneous effects in planning research and suggests that bike lane investment, in isolation, could widen sociodemographic disparities in cycling and its benefits if non-infrastructure barriers to cycling are not also addressed.

Abstract P368: Neighborhoods and Subclinical Cardiovascular Disease

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Todd R Sponholtz ◽  
Ramachandran S Vasan
Keyword(s):  
Cardiovascular Disease ◽  
Risk Score ◽  
Block Group ◽  
Group Level ◽  
Census Block ◽  
Cvd Risk ◽  
Block Level ◽  
Block Groups ◽  
Level Group ◽  
Variance Explained

Background: Research on the health impact of the built environment has focused on health behaviors such as diet and exercise, and conditions such as obesity and diabetes. Few studies have examined its influence on downstream outcomes such as cardiovascular disease. We investigated the proportional variance in the 10-year and 30-year Framingham risk score (FRS) attributable to neighborhoods in the Framingham Heart Study. Methods: Offspring- and Generation 3 cohort members’ homes at the time of exam 7 (Offspring, 1998-2001) or exam 1 (Generation 3, 2002-2005) were geocoded to 2000 Census block groups. We evaluated Framingham Offspring and Generation 3 cohort participants inhabiting private residences in block groups within Massachusetts containing the residences of 5 or more participants. Analyses of the 10-year FRS were further restricted to participants aged 30-74 at the time of the relevant exam and those of the 30-year FRS to participants 20-59 years old. Cardiovascular risk was determined on the bases of sex, age, systolic blood pressure, anti-hypertensive medication, smoking, diabetes, total cholesterol, and HDL. The outcomes were the standardized residuals of log-transformed FRS regressed on age and sex. We analyzed the percentage of variance of FRS explained at the block-group level and 95% confidence intervals using multilevel linear regression. An empty model was first used to estimate the total variance and the following factors were then added singly to evaluate their influence on the group-level FRS variance explained by education, body mass index, waist circumference, physical activity score, and depression (CES-D score ≥16). Analyses were repeated stratified by sex. Results: The analysis of 10-year FRS included a total of 2,882 participants in 188 census block groups. The block-group-level variance explained for this outcome was 1.77% (95% CI=0.69, 4.44). Upon the addition of BMI to the model, the variance explained dropped to 1.11% (95% CI=0.28%, 4.30%). None of the other covariates had a substantial impact. Among 1,363 women in 117 block groups, the block level group explained a total of 2.03% of the FRS variance at the block level group (95% CI=0.61, 6.56), which dropped to 0.64% (95% CI=0.03, 13.82) when BMI was added to the model. Results were somewhat stronger in analysis of the 30-year FRS. The group-level FRS variance explained by census blocks was 3.56% (95% CI=1.75, 7.12) among 2096 participants in 156 neighborhoods. Similar to the 10-year CVD risk score, the variance explained among women (959 in 97 block groups) was higher (6.06%, 95% CI=2.75, 12.83), but null among males. Conclusions: In this relatively homogenous suburban white population, census block groups explained a small percentage of the variance in CVD risk. The explained variance was higher among women (19% non-working vs. 5% of males), and largely explained by the clustering of obesity.

scholarly journals Self-Rated Health Status Based on the Type of Health Insurance: A Socioeconomic Perspective

2021 ◽  
Vol 58 ◽  
pp. 004695802110281
Author(s):  
Minsung Sohn ◽  
Minsoo Jung ◽  
Mankyu Choi
Keyword(s):  
Socioeconomic Status ◽  
Health Insurance ◽  
Health Status ◽  
Regression Models ◽  
Private Health Insurance ◽  
Public And Private ◽  
Logistic Regression Models ◽  
Self Rated Health ◽  
Interaction Terms ◽  
Healthcare Coverage

To investigate the effects of public and private health insurance on self-rated health (SRH) status within the National Health Insurance (NHI) system based on socioeconomic status in South Korea. The data were obtained from 10 867 respondents of the Korea Health Panel (2008-2011). We used hierarchical panel logistic regression models to assess the SRH status. We also added the interaction terms of socioeconomic status and type of health insurance as moderators. Medical aid (MA) recipients were 2.10 times more likely to have a low SRH status than those who were covered only by the NHI, even though the healthcare utilization was higher. When the interaction terms were included, those not covered by the NHI and had completed elementary school or less were 16.59 times more likely to have a low SRH status than those covered by the NHI and had earned a college degree or higher. Expanding healthcare coverage to reduce the burden of non-payment and unmet use to improve the health status of MA beneficiaries should be considered. Particularly, the vulnerability of less-educated groups should be focused on.

Interpretation of linear regression models that include transformations or interaction terms

1992 ◽  
Vol 2 (5) ◽  
pp. 735-744 ◽  
Author(s):  
W. Dana Flanders ◽  
Rebecca DerSimonian ◽  
David S. Freedman
Keyword(s):  
Linear Regression ◽  
Regression Models ◽  
Linear Regression Models ◽  
Interaction Terms

Flavored Tobacco Sales Prohibition (2009) and Noncigarette Tobacco Products in Retail Stores (2017), New York City

2020 ◽  
Vol 110 (5) ◽  
pp. 725-730
Author(s):  
Shannon M. Farley ◽  
Julia Sisti ◽  
John Jasek ◽  
Kevin R. J. Schroth
Keyword(s):  
New York ◽  
New York City ◽  
York City ◽  
Tobacco Product ◽  
Block Group ◽  
Group Level ◽  
Tobacco Products ◽  
Product Availability ◽  
Tobacco Sales ◽  
Flavored Tobacco

Objectives. To assess explicit- (products clearly labeled flavored) and emergent concept- (products implying flavoring but not clearly labeled) flavored tobacco product availability following New York City’s flavor restriction. Methods. We examined explicit- and concept-flavored tobacco product availability, with 2017 New York City Retailer Advertising of Tobacco Survey data (n = 1557 retailers). We assessed associations between block group–level demographic characteristics and product availability by using logistic regression. Results. Most retailers sold explicit-flavored (70.9%) or concept-flavored (69.3%) products. The proportion of non-Hispanic Black neighborhood residents predicted explicit- and concept-flavored product availability, as did having a high school within a retailer’s block group for concept-flavored products. Conclusions. Explicit- and concept-flavored other tobacco products persisted throughout New York City, despite 2009 legislation restricting sales. Public Health Implications. Making local sales restrictions or federal production bans inclusive of all explicit and concept flavors would reduce retailer and industry evasion opportunities and protect the health of youths and others.

scholarly journals Depressive symptoms among children attending community based support in South Africa – pathways for disrupting risk factors

2020 ◽  
Vol 25 (4) ◽  
pp. 984-1001
Author(s):  
Lorraine Sherr ◽  
Alexa R Yakubovich ◽  
Sarah Skeen ◽  
Mark Tomlinson ◽  
Lucie D Cluver ◽  
...  
Keyword(s):  
South Africa ◽  
Depressive Symptoms ◽  
Community Violence ◽  
Southern Africa ◽  
Regression Models ◽  
Psychosocial Support ◽  
Community Based ◽  
Moderation Effects ◽  
Interaction Terms ◽  
Family Level

Children in Southern Africa are exposed to high rates of structural and family adversities. This study tests whether services from Community Based Organisations (CBOs) in South Africa can promote children’s resilience against depression exposed to such adversities. Two linked longitudinal studies were conducted, comprising n = 1848 children aged 9 to 13 years. One group received CBO services, whilst the other (quasi-control) did not. Analyses used interaction terms in regression models to test for potential moderation effects of CBO attendance, and marginal effects models to interpret significant interactions. Two interaction effects were shown, demonstrating moderation effects of CBO attendance on common structural disadvantages. First, children exposed to community violence showed increased depression (contrast = 0.62 [95%CI 0.43, 0.82], p < .001), but this association was removed by CBO access (contrast = 0.07 [95%CI −0.28, 0.43], p = .682). Second, children living in informal housing showed increased depression (contrast = 0.63 [95%CI 0.42, 0.85], p < .001), however, this association was removed by CBO access (contrast = 0.01 [95%CI −0.55, 0.56], p = .977). CBO attendance is associated with fewer depressive symptoms, and can buffer against important structural adversities of poor housing and violence that are common in high HIV-prevalence areas. However, CBO attendance was not able to remove the increased psychosocial distress associated with some family-level vulnerabilities such as orphanhood and abuse. These findings highlight the centrality of CBO-provided psychosocial support for children in Southern Africa, and suggest areas for bolstering provision.

scholarly journals Early Gestational Exposure to High-Molecular-Weight Phthalates and Its Association with 48-Month-Old Children’s Motor and Cognitive Scores

2020 ◽  
Vol 17 (21) ◽  
pp. 8150
Author(s):  
Libni A. Torres-Olascoaga ◽  
Deborah Watkins ◽  
Lourdes Schnaas ◽  
John D. Meeker ◽  
Maritsa Solano-Gonzalez ◽  
...  
Keyword(s):  
Molecular Weight ◽  
High Molecular Weight ◽  
Regression Models ◽  
First Trimester ◽  
Environmental Toxicants ◽  
Second Trimester ◽  
Linear Regression Models ◽  
Interaction Terms ◽  
Gestational Exposure ◽  
Early Life Exposure

In utero phthalate exposure has been associated with neurodevelopmental disorders, nevertheless, trimester-specific susceptibility remains understudied. Our aim was to identify susceptible windows to the effects of gestational High-Molecular-Weight Phthalates (HMWP) exposure on 48 months’ neurodevelopment. We measured six HMWP metabolites (MEHP, MEHHP, MEOHP, MECPP, MBzP and MCPP) in urine samples collected during each trimester from women in the Early Life Exposure in Mexico to Environmental Toxicants (ELEMENT) cohort (n = 218). We assessed children’s motor (MS), cognitive (GCI) and memory (MeS) abilities using McCarthy Scales of Children’s Abilities (MSCA). We used linear regression models to examine associations between trimester-specific phthalate metabolites and MSCA scores, adjusted for sex, gestational age, breastfeeding, and maternal IQ. Although phthalate concentrations were similar across trimesters, first and second trimester phthalates were inversely associated with MS and GCI, with first trimester associations with MS being the strongest and statistically significant. Stronger associations were seen with MS and GCI among boys compared to girls, however interaction terms were not statistically significant. Our results suggest that early gestation is a sensitive window of exposure to HMWP for neurodevelopment, particularly in boys. Regulations on phthalate content in food as well as pregnancy consumption guidelines are necessary to protect future generations.

scholarly journals Impacts of the Primary School Free Breakfast Initiative on socio-economic inequalities in breakfast consumption among 9–11-year-old schoolchildren in Wales

2013 ◽  
Vol 17 (6) ◽  
pp. 1280-1289 ◽  
Author(s):  
Graham F Moore ◽  
Simon Murphy ◽  
Katherine Chaplin ◽  
Ronan A Lyons ◽  
Mark Atkinson ◽  
...  
Keyword(s):  
Primary School ◽  
Primary Schools ◽  
Regression Models ◽  
Controlled Trial ◽  
School Level ◽  
Breakfast Skipping ◽  
Interaction Terms ◽  
Dietary Behaviours ◽  
Interaction Term ◽  
Economic Inequalities

AbstractObjectivesUniversal interventions may widen or narrow inequalities if disproportionately effective among higher or lower socio-economic groups. The present paper examines impacts of the Primary School Free Breakfast Initiative in Wales on inequalities in children's dietary behaviours and cognitive functioning.DesignCluster-randomised controlled trial. Responses were linked to free school meal (FSM) entitlement via the Secure Anonymised Information Linkage databank. Impacts on inequalities were evaluated using weighted school-level regression models with interaction terms for intervention × whole-school percentage FSM entitlement and intervention × aggregated individual FSM entitlement. Individual-level regression models included interaction terms for intervention × individual FSM entitlement.SettingFifty-five intervention and fifty-six wait-list control primary schools.SubjectsApproximately 4500 children completed measures of dietary behaviours and cognitive tests at baseline and 12-month follow-up.ResultsSchool-level models indicated that children in intervention schools ate a greater number of healthy items for breakfast than children in control schools (b = 0·25; 95 % CI 0·07, 0·44), with larger increases observed in more deprived schools (interaction term b = 1·76; 95 % CI 0·36, 3·16). An interaction between intervention and household-level deprivation was not significant. Despite no main effects on breakfast skipping, a significant interaction was observed, indicating declines in breakfast skipping in more deprived schools (interaction term b = −0·07; 95 % CI −0·15, −0·00) and households (OR = 0·67; 95 % CI 0·46, 0·98). No significant influence on inequality was observed for the remaining outcomes.ConclusionsUniversal breakfast provision may reduce socio-economic inequalities in consumption of healthy breakfast items and breakfast skipping. There was no evidence of intervention-generated inequalities in any outcomes.

Living in a block group with a higher eviction rate is associated with increased odds of preterm delivery

2021 ◽  
pp. jech-2020-215377
Author(s):  
Alexa A Freedman ◽  
Britney P Smart ◽  
Lauren S Keenan-Devlin ◽  
Ann Borders ◽  
Linda M Ernst ◽  
...  
Keyword(s):  
Pregnancy Outcomes ◽  
Linear Trend ◽  
Adverse Pregnancy Outcomes ◽  
Adverse Outcomes ◽  
Future Research ◽  
Housing Instability ◽  
Block Group ◽  
Adverse Pregnancy ◽  
Block Groups ◽  
Filing Rate

BackgroundHousing instability is associated with adverse pregnancy outcomes. Recent studies indicate that eviction, which may affect a larger segment of the population than other forms of housing instability, is also associated with adverse pregnancy outcomes. However, these studies evaluate eviction across large areas, such as counties, so it remains unclear whether these patterns extend to individual-level pregnancy outcomes.MethodsWe used data on a cohort of all singleton live births at a single Chicago hospital between March 2008 and March 2018 to investigate the associations between block-group eviction rates and individual adverse pregnancy outcomes. Eviction data were obtained from the Eviction Lab at Princeton University. Generalised estimating equations were used to estimate associations and account for correlations among individuals living in the same block groups.ResultsIndividuals living in block groups in the highest quartile for eviction filing rate were 1.17 times as likely to deliver preterm (95% CI: 1.08 to 1.27) and 1.13 times as likely to deliver a small for gestational age infant (95% CI: 1.03 to 1.25) as compared with individuals living in block groups in the lowest quartile. Further, tests for linear trend indicated that for each quartile increase in eviction filing rate, there was a corresponding increase in odds of adverse outcomes (p<0.05). Results were strongest in magnitude for those with low neighbourhood and individual socioeconomic status, who are most likely to be renters and affected by local eviction policies.ConclusionOur results suggest that individuals living in block groups with higher eviction rates are more likely to deliver preterm. Future research should explore associations of individual experience with eviction on adverse pregnancy outcomes and examine whether policies to improve tenant protections also impact pregnancy outcomes.

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