Multidisciplinary understanding of modifiable physical disability risk factors for health professionals: A scoping review protocol.

INTRODUCTION: Physical disability represents a major burden to health and lifespan, particularly as the proportion of older adults within the United States is expected to grow. Prevention efforts for physical disability targets methods and strategies to decrease modifiable risk factors. Potential challenges for health professionals may exist in synthesizing and interpreting this broad spectrum of literature due to the discipline-specific nuance of language used, practice type or specialty, and lack of interdisciplinary resources. This scoping review will map and synthesize the literature across healthcare disciplines to identify modifiable risk factors and the evidence related to their ability to predict physical disability. We will also draw attention to the possibility of modifiable risk factors for physical disability being operationalized as pre-disability in order to strengthen primary and secondary prevention efforts. METHODS: A planned search strategy using physical disability terminology will be searched in English across MEDLINE, CINAHL, Health Source, PEDro, and REHABDATA by two reviewers in line with our review objectives and inclusion criteria. Eligibility for inclusion include peer-reviewed primary research published in the English language and have established a relationship between a person-level measurable characteristic that is modifiable by changes in lifestyle behaviors and any of the commonly accepted terms used to categorize or describe physical disability. EXPECTED RESULTS: Presentation of results will be using the PRISMA flowchart, with additional mapping and synthesis of evidence for modifiable risk factors for physical disability to clarify divergent terms used in classifying and measuring these factors and their potential for prediction of physical disability. EXPECTED CONCLUSION: It is anticipated that this scoping review will identify and highlight a variety of modifiable risk factors for physical disability that may aid primary and secondary prevention efforts for health professionals.

Concepts, Characterizations, and Cautions: A Public Health Guide and Glossary for Planning Food Environment Measurement.

Background: There is no singular approach to measuring the food environment suitable for all studies. Understanding terminology, methodology, and common issues is crucial to choosing the best approach. Objective: This review is designed to support a shared understanding so diverse multi-institutional teams engaged in food environment measurement can justify their measurement choices and have informed discussions about reasons for measurement strategies to vary across projects. Methods: This guide defines key terms and provides annotated resources identified as a useful starting point for exploring the food environment literature. The writing team was an academic-practice collaboration, reflecting on the experience of a multi-institutional team focused on retail environments across the US relevant to cardiovascular disease. Results: Terms and annotated resources are divided into three sections: food environment constructs, classification and measures, and errors and strategies to reduce error. Two examples of methods and challenges encountered while measuring the food environment in the context of a US health department are provided. Researchers and practice professionals are directed to the Food Environment Electronic Database Directory (https://www.foodenvironmentdirectory.com/) for comparing available data resources for food environment measurement, focused on the US; this resource incorporates updates informed by user input and literature reviews. Discussion: Measuring the food environment is complex and risks oversimplification. This guide serves as a starting point but only partially captures some aspects of neighborhood food environment measurement. Conclusions: No single food environment measure or data source meets all research and practice objectives. This shared starting point can facilitate theoretically grounded food environment measurement.

Validation of a neighborhood-level COVID Local Risk Index in 47 large U.S. cities.

OBJECTIVES: To present the COVID Local Risk Index (CLRI), a measure of city- and neighborhood-level risk for SARS COV-2 infection and poor outcomes, and validate it using sub-city SARS COV-2 outcome data from 47 large U.S. cities. METHODS: Cross-sectional validation analysis of CLRI against SARS COV-2 incidence, percent positivity, hospitalization, and mortality. CLRI scores were validated against ZCTA-level SARS COV-2 outcome data gathered in 2020-2021 from public databases or through data use agreements using a negative binomial model. RESULTS: CLRI was associated with each SARS COV-2 outcome in pooled analysis. In city-level models, CLRI was positively associated with positivity in 11/14 cities for which data were available, hospitalization in 6/6 cities, mortality in 13/14 cities, and incidence in 33/47 cities. CONCLUSIONS: CLRI is a valid tool for assessing sub-city risk of SARS COV-2 infection and illness severity. Stronger associations with positivity, hospitalization and mortality may reflect differential testing access, greater weight on components associated with poor outcomes than transmission, omitted variable bias, or other reasons. City stakeholders can use the CLRI, publicly available on the City Health Dashboard (www.cityhealthdashboard.com), to guide SARS COV-2 resource allocation.

Urban Scaling of Health Outcomes: a Scoping Review.

Urban scaling is a framework that describes how city-level characteristics scale with variations in city size. This scoping review mapped the existing evidence on the urban scaling of health outcomes to identify gaps and inform future research. Using a structured search strategy, we identified and reviewed a total of 102 studies, a majority set in high-income countries using diverse city definitions. We found several historical studies that examined the dynamic relationships between city size and mortality occurring during the nineteenth and early twentieth centuries. In more recent years, we documented heterogeneity in the relation between city size and health. Measles and influenza are influenced by city size in conjunction with other factors like geographic proximity, while STIs, HIV, and dengue tend to occur more frequently in larger cities. NCDs showed a heterogeneous pattern that depends on the specific outcome and context. Homicides and other crimes are more common in larger cities, suicides are more common in smaller cities, and traffic-related injuries show a less clear pattern that differs by context and type of injury. Future research should aim to understand the consequences of urban growth on health outcomes in low- and middle-income countries, capitalize on longitudinal designs, systematically adjust for covariates, and examine the implications of using different city definitions.

Heterogeneity in Spatial Inequities in COVID-19 Vaccination Across 16 Large US Cities.

Differences in vaccination coverage can perpetuate coronavirus disease 2019 (COVID-19) disparities. We explored the association between neighborhood-level social vulnerability and COVID-19 vaccination coverage in 16 large US cities from the beginning of the vaccination campaign in December 2020 through September 2021. We calculated the proportion of fully vaccinated adults in 866 zip code tabulation areas (ZCTAs) of 16 large US cities: Long Beach, Los Angeles, Oakland, San Diego, San Francisco, and San Jose, all in California; Chicago, Illinois; Indianapolis, Indiana; Minneapolis, Minnesota; New York, New York; Philadelphia, Pennsylvania; and Austin, Dallas, Fort Worth, Houston, and San Antonio, all in Texas. We computed absolute and relative total and Social Vulnerability Index-related inequities by city. COVID-19 vaccination coverage was 0.75 times (95% confidence interval: 0.69, 0.81) or 16 percentage points (95% confidence interval: 12.1, 20.3) lower in neighborhoods with the highest social vulnerability as compared with those with the lowest. These inequities were heterogeneous, with cities in the West generally displaying narrower inequities in both the absolute and relative scales. The Social Vulnerability Index domains of socioeconomic status and of household composition and disability showed the strongest associations with vaccination coverage. Inequities in COVID-19 vaccinations hamper efforts to achieve health equity, as they mirror and could lead to even wider inequities in other COVID-19 outcomes.

Tracking COVID-19 Inequities Across Jurisdictions Represented in the Big Cities Health Coalition (BCHC): The COVID-19 Health Inequities in BCHC Cities Dashboard.

Objectives. To describe the creation of an interactive dashboard to advance the understanding of the COVID-19 pandemic from an equity and urban health perspective across 30 large US cities that are members of the Big Cities Health Coalition (BCHC). Methods. We leveraged the Drexel‒BCHC partnership to define the objectives and audience for the dashboard and developed an equity framework to conceptualize COVID-19 inequities across social groups, neighborhoods, and cities. We compiled data on COVID-19 trends and inequities by race/ethnicity, neighborhood, and city, along with neighborhood- and city-level demographic and socioeconomic characteristics, and built an interactive dashboard and Web platform to allow interactive comparisons of these inequities across cities. Results. We launched the dashboard on January 21, 2021, and conducted several dissemination activities. As of September 2021, the dashboard included data on COVID-19 trends for the 30 cities, on inequities by race/ethnicity in 21 cities, and on inequities by neighborhood in 15 cities. Conclusions. This dashboard allows public health practitioners to contextualize racial/ethnic and spatial inequities in COVID-19 across large US cities, providing valuable insights for policymakers. (Am J Public Health. 2022;112(6):904-912. https://doi.org/10.2105/AJPH.2021.306708).

Urban scaling of health outcomes: a protocol for a scoping review.

INTRODUCTION: With most of the world's population living in urban areas, it is important to understand the health effects of city living. Precise descriptions of the relations of city size and growth with population health metrics have not been systematically described. Describing these relationships can provide clues regarding the factors driving differences in health across cities. OBJECTIVE: The goal of this scoping review is to map the existing evidence regarding the scaling properties of health outcomes, with a special emphasis on city size and growth. METHOD AND ANALYSIS: We will conduct this scoping review based on a structured search of a combination of keywords for the exposures that aim to capture the population growth and size of cities along with degree of urbanisation, for health-related outcomes regardless of their type (incidence or prevalence of diseases and injuries and mortality). We will search the MEDLINE and Latin American & Caribbean Health Sciences Literature databases from inception for studies in English, Spanish or Portuguese and perform manual searches of references and citations in the included studies. The search will be conducted from April 2019 to September 2019. We will report results using the PRISMA-ScR guidelines. This review aims to inform future research on the role of increasing levels of urbanisation on health outcomes, provide clues into what city level factors may drive patterns of urban health and lead to the design and implementation of policies that promote sustainable growth and improved health. ETHICS AND DISSEMINATION: This review will not collect any primary data and will rely on published articles. The findings of this review will be published in a peer-reviewed scientific journal.