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Assessing the health benefits of urban air pollution reductions associated with climate change mitigation (2000-2020): Santiago, São Paulo, México City, and New York City.

To investigate the potential local health benefits of adopting greenhouse gas (GHG) mitigation policies, we develop scenarios of GHG mitigation for México City, México; Santiago, Chile; São Paulo, Brazil; and New York, New York, USA using air pollution health impact factors appropriate to each city. We estimate that the adoption of readily available technologies to lessen fossil fuel emissions over the next two decades in these four cities alone will reduce particulate matter and ozone and avoid approximately 64,000 (95% confidence interval [CI] 18,000-116,000) premature deaths (including infant deaths), 65,000 (95% CI 22,000-108,000) chronic bronchitis cases, and 46 million (95% CI 35-58 million) person-days of work loss or other restricted activity. These findings illustrate that GHG mitigation can provide considerable local air pollution-related public health benefits to countries that choose to abate GHG emissions by reducing fossil fuel combustion.

Adolescent↗

Political behavior: voting participation of inner-city elderly blacks compared to other populations in a medium-sized city.

Voting participation was examined across nine elections in Omaha, Nebraska. Voting frequencies of all eligible voters in the city, all elderly eligible voters, and a random sample of inner-city elderly black voters were compared. The analysis shows that frequency of voting among inner-city elderly black individuals was the same as among all elderly persons in seven of the nine elections and significantly higher than that found among eligible voters of all ages in all nine of the elections.

Aged↗

Mortality among the population of the city and voivodeship of Lodz contrasted with death rates in other voivodeships and large and medium-sized cities in Poland in 1993.

"The paper presents the problem of mortality in the Lodz area and the city of Lodz in 1993. The basis for this description is comparisons across voivodeships, and these between large and medium-sized cities in Poland. The comparisons were made allowing for the basic demographic features such as sex and age of the dead. Levels of mortality were identified for voivodeships and cities using fractional death rates for five year age groups, with the deaths among infants treated as a separate group."

Age Distribution↗

Noise level in different places of Dhaka Metropolitan City (DMC) and noise-induced hearing loss (NIHL) in Dhaka City dwellers.

A cross sectional, exploratory study was designed at "National Center for Hearing and Speech for Children" (NCHSC), Dhaka, Bangladesh, from May 2001 to June 2002, with a view to determine the average noise level in different places of Dhaka Metropolitan City (DMC), and also aiming at evaluating the extent of Noise-induced Hearing Loss (NIHL) in different groups of city dwellers and finally a base line information. A total of 32 places in DMC were selected randomly. The highest noise level recorded 104 dB at Sayedabad bus terminal and the lowest 68 dB in Banani and Baridhara residential area. In silent zone of DMC, average noise level was 79 dB, in residential zone 72 dB, in commercial zone 90 dB, and in mixed zone average noise level was recorded at 91 dB. Measured noise levels were more than acceptable and permissible levels in all places of DMC. A total of 312 persons aged between 15-45 years (mean age- 24.64 years) were enrolled for the study as per inclusion criteria. Gender-wise male were 211(67.62%) and female were 101(32.57%). Profession-wise Automobile drivers were 57(18.26 %), Garment workers 58(18.55 %), City dwellers 72(23.07%), Students 72(23.07%), Traffic polices 12(3.85%), Hawkers and Road side shopkeepers were 41(13.1%). Definite noise notch (>25dB) at 4KHz observed in 33(10.58%) audiogram of persons under study. Automobile drivers, Traffic polices, Road side hawkers and Shop keepers, Garment workers are mostly affected were 17.54%, 16.4%, 12.09% and 12.06% respectively. A total of 201 persons (64.42%) were not aware of their hearing impairment, 244(78%) of the person had poor level of knowledge regarding bad effects of noise on health and about protective means available. Amongst persons (33) found to have NIHL did not use any protective device.

Adult↗

[Analysis of the biological effect of city smog extract. II. Effect of a city smog extract on cell growth and DNA synthesis of hamster kidney cells in vitro (author's transl)].

A city smog extract from an urban area inhibits the cell growth of hamster kidney cells in vitro. Parallel to an inhibition of cell multiplication a diminished rate of total DNA synthesis appeared. The number of cells in DNA synthesis is depressed in presence of city smog extract. These phenomena revealed a dose-response relationship. The biological effect of city smog extract is discussed.

Animals↗

[Response of the official Varazdin city physician, Dr. Bernard Vilim Müller, to the city magistrates concerning the delivery of a child by a Varazdin physician, Dr. Josip Mlinarić].

A Croatian translation of a Latin document dated February 15, 1836 found in the Historic Archives of the city of Varazdin is presented. The document concerns two Varazdin physicians from the first half of the nineteenth century. One of them, the official city physician, replies to the questions of the Municipal Board about the act committed by the other physician during delivery of a child. Rough curricula vitae of both physicians are also given. The physician's reply is a very strong criticism and condemnation not only of the other physician's act, but also of this work, lack of professional attitude, and dubious personal qualities. A negative judgement is also passed on the city surgeon of the time. The author offers possible ground for such criticism, and states his opinion about incorrect relationship between colleagues as physicians and men, that is matter not only of the past.

Correspondence as Topic↗

Impact of a coordinated tuberculosis Team in an inner-city hospital in New York City.

OBJECTIVE: To evaluate the impact of a coordinated approach for the isolation, diagnosis, and treatment of patients with tuberculosis. DESIGN: Retrospective cohort study. SETTING: Bronx-Lebanon Hospital Center, an inner-city hospital in the South Bronx, New York City. PATIENTS: Patients with smear-positive, culture-confirmed pulmonary tuberculosis. INTERVENTIONS: Institution of a coordinated tuberculosis team. RESULTS: Admissions of 46 patients before and 39 patients after the formation of a tuberculosis team were reviewed. Before institution of the tuberculosis team, 35% of patients were isolated within 24 hours of presentation, 41% never were isolated, and the mean number of days patients were not isolated was 19. After implementation of the tuberculosis team, 59% of patients were isolated within 24 hours, only 5% were never isolated, and the mean number of days patients were not isolated was 3.5. These differences were statistically significant. There also was a corresponding decrease in length of hospitalization. In addition, there were noticeable improvements in patient and staff morale and attitudes. CONCLUSIONS: The tuberculosis team likely has decreased the risk of nosocomial tuberculosis transmission by increasing the proportion of infectious tuberculosis patients admitted into AFB isolation and by reducing (by 780) the number of days out of isolation while smear positive. There also were concomitant financial savings.

Adolescent↗

Rates of and factors associated with self-reported prior HIV testing among adult medical patients in an inner city emergency department in the Bronx, New York City.

We studied the rates of and factors associated with self-reported prior human immunodeficiency virus (HIV) testing in adult patients visiting an emergency department (ED) in the Bronx, New York City. A total of 1,744 consecutive noncritical adult medical emergency patients responded to a standardized interview administered by ED physicians. The interview included questions pertaining to demographic characteristics, prior HIV testing, and HIV risk behaviors. On multivariate analysis, female gender, younger age, history of weight loss, injecting drug use (IDU), syphilis, and genital herpes were all associated with increased reported prior testing rates. Race (i.e., black race) was an independent predictor of increased rates among male subjects; comparatively low rates were reported by patients with a first language other than English, patients lacking medical insurance, and highly sexually active, nonblack men. Increased HIV testing rates were reported by subjects with recognized HIV risk behaviors in a New York City ED population; however, substantial proportions of subjects at risk had not been tested. Programs of HIV testing and counseling need to include older, uninsured, and non-English-speaking segments of the population who engage in high-risk behaviors.

Adolescent↗

Residential environmental evaluation of local cities considering regional characteristic and personal residential preference-a case study of Saga City, Japan.

Questionnaire surveys and subjective evaluations on residential environment were performed in order to grasp the main factors of residential environment of small local cities. The suitable evaluation index system was established, and the regional residential environment characteristics and personal residential preference types were analyzed, so that their influence on residential environment evaluation could be grasped. The results can be applied to the residential environment planning, construction and monitoring of local cities.

Cities↗

Psychosocial characteristics of inner-city children with asthma: a description of the NCICAS psychosocial protocol. National Cooperative Inner-City Asthma Study.

Previous research has demonstrated a significant reciprocal relationship between psychosocial factors and asthma morbidity in children. The National Cooperative Inner-City Asthma Study investigated both asthma-specific and non-specific psychosocial variables, including asthma knowledge beliefs and management behavior, caregiver and child adjustment, life stress, and social support. This article presents these psychosocial characteristics in 1,528 4-9-year-old asthmatic urban children and their caretakers. Caretakers demonstrated considerable asthma knowledge, averaging 84% correct responses on the Asthma Information Quiz. However, respondents provided less than one helpful response for each hypothetical problem situation involving asthma care, and most respondents had more than one undesirable response, indicating a potentially dangerous or maladaptive action. Both adults and children reported multiple caretakers responsible for asthma management (adult report: average 3.4, including the child); in addition, children rated their responsibility for self-care significantly higher than did adults. Scores on the Child Behavior Checklist indicated increased problems compared to normative samples (57.3 vs. 50, respectively), and 35% of children met the criteria for problems of clinical severity. On the Brief Symptom Inventory, adults reported elevated levels of psychological distress (56.02 vs norm of 50); 50% of caretakers had symptoms of clinical severity. Caretakers also experienced an average of 8.13 undesirable life events in the 12 months preceding the baseline interview. These findings suggest that limited asthma problem-solving skills, multiple asthma managers, child and adult adjustment problems, and high levels of life stress are significant concerns for this group and may place the inner-city children in this study population at increased risk for problems related to adherence to asthma management regimens and for asthma morbidity.

Adult↗

Correlation between T.S.P., F.S.P. and visibility in a high altitude city (Mexico City).

the metropolitan area of Mexico City is located in a high altitude basin (2 240 m above sea level) at a latitude of 19 degrees 26'13" North. It has a population of 15 million inhabitants, and the motor vehicles cruising in the city amount to 1.5 million and around 21% of the total industrial activity of the country is sited in the metropolitan area. All this activity has created an acute air pollution problem in the area which, as a direct result, has resulted in decreased visibility and possible health effects.

Air Pollution↗

A randomized clinical trial to reduce asthma morbidity among inner-city children: results of the National Cooperative Inner-City Asthma Study.

OBJECTIVE: To evaluate a family-focused asthma intervention designed for inner-city children 5 to 11 years old with moderate to severe asthma. STUDY DESIGN: Randomized, multisite, controlled trial to minimize symptom days (wheeze, loss of sleep, reduction in play activity) measured by a 2-week recall assessed at 2-month intervals over a 2-year follow-up period. The intervention was tailored to each family's individual asthma risk profile assessed at baseline. RESULTS: Averaged over the first 12 months, participants in the intervention group (n = 515) reported 3.51 symptom days in the 2 weeks before each follow-up interview compared with 4.06 symptom days for the control group (n = 518), a difference of 0.55 (95% CI, 0.18 to 0.92, P =.004). The reduction among children with severe asthma was approximately 3 times greater (1.54 d/2 wk). More children in the control group (18.9%) were hospitalized during the intervention compared with children in the intervention group (14. 8%), a decrease of 4.19% (CI, -8.75 to 0.36, P =.071). These improvements were maintained in the intervention group during the second year of follow-up, during which they did not have access to the asthma counselor. CONCLUSIONS: We demonstrated that an individually tailored, multifaceted intervention carried out by Masters-level social workers trained in asthma management can reduce asthma symptoms among children in the inner city.

Asthma↗

Results of the National Cooperative Inner-City Asthma Study (NCICAS) environmental intervention to reduce cockroach allergen exposure in inner-city homes.

BACKGROUND: Cockroach allergen is important in asthma. Practical methods to reduce exposure are needed. OBJECTIVE: We sought to evaluate the effectiveness of house cleaning and professional extermination on lowering cockroach antigen levels in inner-city dwellings. METHODS: As part of the National Cooperative Inner-City Asthma Study intervention, 265 of 331 families with asthmatic children who had positive skin test responses to cockroach allergen consented to a professional home extermination with 2 applications of a cockroach insecticide (Abamectin, Avert) combined with directed education on cockroach allergen removal. On a random subset of 48 homes undergoing cockroach extermination in the intervention group, Bla g 1 was measured in settled dust from the kitchen, bedroom, and TV/living room. The first sample was collected 1 week before extermination, with additional samples after the exterminations at approximately 2, 6, and 12 months after the first sample. Self-reported problems with cockroaches were collected at baseline and after 12 months of follow-up in both the intervention and control group. RESULTS: The geometric mean kitchen level of Bla g 1 decreased at 2 months (33.6 U/g) relative to preextermination levels (68.7 U/g, P <.05). The percent of kitchens with over 8 U/g of Bla g 1 followed a similar pattern, but only the decrease from preextermination to 6-month levels was significant (86.8% vs 64.3%, P <.05). By the 12-month visit, the allergen burden had returned to or exceeded baseline levels. Except for an increase in the bedroom at 2 months (8.9 U/g vs 11.1 U/g, P <.05), no other significant change was seen. Only about 50% of the families followed the cleaning instructions; no greater effect was found in these homes. Self-reported problems with cockroaches showed no difference between the intervention and control group after 1 year of follow-up. CONCLUSIONS: Despite a significant, but short-lived, decrease the cockroach allergen burden remained well above levels previously found to be clinically significant.

Allergens↗

Managing risk in the city: the role of welfare professionals in managing risks arising from vulnerable individuals in cities.

Modern cities depend on individualism and the process of contracting. Contracts between individuals contribute to stability and order in cities. However, this is challenged by risks and uncertainties especially those relating to vulnerable individuals who are unable or unwilling to enter into contractual relations. This paper focuses on the role of caring professions and the impact of new strategies for managing risks related to vulnerable adults and children, especially the shift from managing risk in institutions to managing risk in the community. This paper is based on research funded through the ESRC Risk and Human Behaviour Programme.

Adult↗

Promoting healthy aging in cities: the Healthy Cities project in Europe.

Health promotion is a growing field, spreading into various settings. This paper focuses on the city as a setting for health promotion and on the "Healthy Cities project" (HCP) of the Regional Office for Europe of the World Health Organization in particular. In the context of the HCP, various activities to promote the health of older citizens have been carried out in recent years. These are illustrated in this paper through case studies.

Journal Article↗

Community-based care for the mentally disordered in Kawasaki City: experiences from Kawasaki City Psychiatric Rehabilitation Center.

The basic aims of Kawasaki City Psychiatric Rehabilitation Center are: (i) taking some measures for the hospitalized patients unable to leave because of residential problems; (ii) providing a daily program for the discharged from psychiatric hospital; (iii) developing vocational rehabilitation for the mentally disordered; and (iv) developing a support network for the mentally disordered in the community. To fulfill these aims and to meet the various needs of our users, we have provided a very comprehensive program composed of a ward, outpatient section, day care groups, vocational service and half-way house. According to the program, various services such as medical treatment in a narrow sense, basic training of social skills and human relations, vocational training system that meets the various needs and work abilities of the users, and after care services that enable them to support themselves living in the community are available. These services give them great comfort to live in the community; however, they might serve to increase their dependency on the center. Our future task is to cooperate with various social resources such as workshops, group homes and places to stay and rest during the day, which are being developed in Kawasaki City. By supporting those facilities, we expect to refer our members to them and we put more weight on the indirect service than the direct one, which would hopefully enable us to cover and care for more people in need.

Community Mental Health Services↗

Prevalence and severity of coronary atherosclerosis in males living in Mexico City: the Mexico City project.

The current prevalence of coronary atherosclerosis was investigated in 174 necropsic studies performed on males who died violently between 1984 and 1986 in Mexico City. In young adults, coronary atherosclerosis was found in 35% of the cases, 5% of whom had significant obstruction in one coronary vessel. In subjects aged 50-69 years, coronary atherosclerosis occurred in 69% of the cases and obstructive disease in 24%. Current figures suggest an increase in the severity of coronary atherosclerosis in this population which may be linked with nutritional changes. This makes further investigations, as well as the design of a program for ischemic heart disease prevention in Mexico City imperative.

Adult↗