Biomedical subjects

Sasha Rudenstine

Publications and source records attributed to Sasha Rudenstine.

7 recordsLinked to original sources

PubMed2006

Education inequality and use of cigarettes, alcohol, and marijuana.

Education inequality at the neighborhood-level may influence population health and health behavior. We assessed the relations between education inequality and substance use in 59 New York City (NYC) neighborhoods. We used Gini coefficients of education to describe neighborhood education inequality and data from a random-digit-dial phone survey of adult residents of NYC to assess use of substances. Among 1355 respondents (female=56.2%; white=35.7%; mean age=40.4), 23.9% (95% confidence interval [CI]=20.3-27.5) reported smoking, 39.4% (95% CI=35.3-43.4) drinking, and 5.4% (95% CI=3.6-7.3) using marijuana in the previous 30 days. In multilevel models controlling for neighborhood education, neighborhood income inequality, and individual covariates, living in a neighborhood with high education inequality was associated with a greater prevalence of drinking (p=0.02) and of smoking marijuana (p=0.004) but among current drinkers it was associated (p=0.03) with having fewer drinks. The odds of alcohol use (OR=1.70) and marijuana use (OR=3.49) were greater in neighborhoods in the 75th percentile of education Gini compared to neighborhoods in the 25th percentile of education Gini. Statisical interactions suggest that there may be a stronger relation between education inequality and marijuana use in neighborhoods with low mean education than in neighborhoods with higher mean levels of education. These findings, taken together, suggest a complex relation between education inequality and substance use; likelihood of the use of alcohol and marijuana was higher in areas with higher education inequality suggesting potential roles for substance use norms and availability, whereas quantity used among drinkers was higher in areas with low education inequality, suggesting potential roles for both disadvantage and norms.

Adolescent↗

PubMed2006

PTSD and depression after the Madrid March 11 train bombings.

The March 11, 2004, train bombings in Madrid, Spain, caused the largest loss of life from a single terrorist attack in modern European history. We used a cross-sectional random digit dial survey of Madrid residents to assess the prevalence of posttraumatic stress disorder (PTSD) and major depression in the general population of Madrid 1 to 3 months after the March 11 train bombings. Of respondents 2.3% reported symptoms consistent with PTSD related to the March 11 bombings and 8.0% of respondents reported symptoms consistent with major depression. The prevalence of PTSD was substantially lower, but the prevalence of depression was comparable to estimates reported after the September 11 attacks in Manhattan. The findings suggest that across cities, the magnitude of a terrorist attack may be the primary determinant of the prevalence of PTSD in the general population, but other factors may be responsible for determining the population prevalence of depression.

Adolescent↗

PubMed2005

Participant reactions to survey research in the general population after terrorist attacks.

There remains concern that survey research after a disaster can precipitate or exacerbate distress among study participants. The authors surveyed 5,774 persons in three random-digit-dial telephone surveys of the general population of New York City conducted 1-2 months, 4-5 months, and 6-9 months after the terrorist attack on September 11, 2001. Overall, 746 (12.9%) people who finished the surveys said that the survey questions were upsetting but only 57 (1.0% overall) were still upset at the end of the interview, and 19 (0.3%) wanted assistance from a counselor. Ten persons who did not finish the survey also received counselor assistance. Persons with mental health symptoms were more likely to find the survey questions emotionally upsetting as were participants who lacked salutary resources, including health insurance and a regular health care provider. Although relatively few of those interviewed found the survey assessment disturbing, the presence of a small number of respondents who wanted mental health assistance suggests the need for a mental health backup system for research conducted soon after exposure to large-scale traumatic events.

Demography↗

PubMed2005

Drug use, misuse, and the urban environment.

Urbanization is probably the single most important demographic shift world-wide throughout the past and the new century and represents a sentinel change from how most of the world's population has lived for the past several thousand years. As urban living becomes the predominant social context for the majority of the world's population, the very ubiquity of urban living promises to shape health directly and to indirectly affect what we typically consider risk factors or determinants of population health. Although a growing body of research is exploring how characteristics of the urban environment may be associated with health (e.g. depression) and risk behaviours (e.g. exercise patterns), relatively little research has systematically assessed how the urban environment may affect drug use and misuse. In this paper we will propose a conceptual framework for considering how different characteristics of the urban environment (e.g. collective efficacy, the built environment) may be associated with drug use and misuse, summarize the existing empiric literature that substantiates elements of this framework, and identify potential directions for future research.

Health Services Accessibility↗

PubMed2005

Challenges in understanding disparities in drug use and its consequences.

Racial/ethnic disparities in health have long been documented in a broad range of medical conditions in the United States. For example, Blacks have higher HIV incidence and AIDS-related mortality than do Whites. This article summarizes racial/ethnic differences in drug use and its consequences in the United States and proposes three key challenges to the study of disparities in drug use and its consequences. These are (a) patterns of drug use and misuse are complex, with different patterns of use of different drugs in different racial/ethnic groups; (b) racial/ethnic differences in use of drugs are not always associated with comparable differences in the consequences of drug use; and (c) the consequences of drug use are associated with drug use itself and other social/economic circumstances. Each of these challenges is discussed, and suggestions offered for future research that may help overcome them.

HIV Infections↗

PubMed2005

Urban built environment and depression: a multilevel analysis.

STUDY OBJECTIVE: To assess the relations between characteristics of the neighbourhood internal and external built environment and past six month and lifetime depression. DESIGN AND SETTING: Depression and sociodemographic information were assessed in a cross sectional survey of residents of New York City (NYC). All respondents were geocoded to neighbourhood of residence. Data on the quality of the built environment in 59 NYC neighbourhoods were collected from the United Status census, the New York City housing and vacancy survey, and the fiscal 2002 New York City mayor's management report. MAIN RESULTS: Among 1355 respondents, residence in neighbourhoods characterised by a poor quality built environment was associated with greater individual likelihood of past six month and lifetime depression in multilevel models adjusting for individual age, race/ethnicity, sex, and income and for neighbourhood level income. In adjusted models, persons living in neighbourhoods characterised by poorer features of the built environment were 29%-58% more likely to report past six month depression and 36%-64% more likely to report lifetime depression than respondents living in neighbourhoods characterised by better features of the built environment. CONCLUSIONS: Living in neighbourhoods characterised by a poor quality built environment is associated with a greater likelihood of depression. Future prospective work designed to assess potential mechanisms underlying these associations may guide public health and urban planning efforts aimed at improving population mental health.

Adolescent↗

PubMed2003

Awareness and perceptions of a communitywide mental health program in New York city after September 11.

The Project Liberty program was established after the terrorist attacks of September 11, 2001, to offer free mental health services to New York City residents. The authors used data from a random-digit-dial telephone survey to assess public awareness of and willingness to make use of Project Liberty's services. They found that 24 percent of the New York City residents surveyed (480 of 2001 respondents) had heard of Project Liberty four months after September 11. Persons with lower socioeconomic status and those who had psychological symptoms consistent with posttraumatic stress disorder were more likely to say that they would contact Project Liberty. The results of the study suggest that although awareness of this public mental health services was low, Project Liberty was well received among the people who may be most likely to need its services.

Adolescent↗