Browsing by Author "Galea, Sandro"

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    Disasters and the Health of Urban Populations
    (2005) Galea, Sandro
    The average number of reported disasters worldwide, based on International Federation of the Red Cross criteria, increased from an average of 428 per year between 1994 and 1998 to 707 per year between 1999 and 2003.1 Although definitions of disasters vary, most definitions concur that disasters may be attributed to natural, technological, or human causes. During the past decade, several high profile disasters have sharpened the media and scientific focus on disasters. In terms of natural disasters, the horrific Southeast Asian tsunami at the end of 2004, claiming more than 200,000 lives worldwide, highlighted both the devastation that natural disasters can wreak and their unpredictability. Our increasing reliance on technology comes hand in hand with a greater risk of the possible consequences of this reliance. The dam collapse at Buffalo Creek and the threatened nuclear power plant failure at Three Mile Island were two of the sentinel events of the past decades that increased our awareness of the threat of technological disasters. With respect to human-made disasters, two unprecedented terrorist attacks, the bombing of the Murrah Federal Building in Oklahoma City in 1995 and the attacks on the World Trade Center in New York City in 2001, brought home the notion that human-made mass traumatic events are a source of concern in the United States. Two-and-a-half years after the September 11, 2001 terrorist attacks, on March 11, 2004, the Madrid train bombings were the largest single terrorist attack in Europe. In addition, other mass traumatic events continue to threaten the health of populations worldwide. There are approximately 16 wars being fought today.2 In 2004, there were 17,084,100 refugees around the world,3 ensuring that the consequences of these wars would continue for years to come.
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    Distribution of Education and Population Health: An Ecological Analysis of New York City Neighborhoods
    (2005) Galea, Sandro; Ahern, Jennifer
    Objectives: We assessed the relationship between distribution of education and health indicators in a large urban area to determine if distribution of education may be a determinant of population health. Methods: We studied the association between distribution of education, measured with the education Gini coefficient, and rates of 8 health indicators in 59 neighborhoods in New York City. Results: In separate adjusted ecological models, neighborhoods with more poorly distributed education had better population health indicators that might plausibly be associated with short-term changes in the social environment (e.g., homicide and infant mortality rate); there was no association between education distribution and health indicators more likely to be associated with long-term accumulation of social and behavioral stressors (e.g., cardiovascular disease and chronic lung disease mortality rates). These findings were robust to measures of income and to adjustment for several potential confounders (e.g., gender and race/ethnicity). Conclusions: The presence in a neighborhood of highly educated people may be salutary for all residents, independent of the potentially deleterious consequences of income maldistribution.
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    Do Neighborhood Economic Characteristics, Racial Composition, and Residential Stability Predict Perceptions of Stress Associated with the Physical and Social Environment? Findings from a Multilevel Analysis in Detroit
    (2008) Schulz, Amy J.; Zenk, Shannon N.; Israel, Barbara A.; Mentz, Graciela; Stokes, Carmen; Galea, Sandro
    Abstract available at publisher's web site.
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    Variability and Vulnerability at the Ecological Level: Implications for Understanding the Social Determinants of Health
    (2002) Karpati, Adam; Galea, Sandro; Awerbuch, Tamara; Levins, Richard
    Objectives. We examined variability in disease rates to gain understanding of the complex interactions between contextual socioeconomic factors and health. Methods. We compared mortality rates between New York and California counties in the lowest and highest quartiles of socioeconomic status (SES), assessed rate variability between counties for various outcomes, and examined correlations between outcomes’ sensitivity to SES and their variability. Results. Outcomes with mortality rates that differed most by county SES were among those whose variability across counties was high (e.g., AIDS, homicide, cirrhosis). Lower- SES counties manifested greater variability among outcome measures. Conclusions. Differences in health outcome variability reflect differences in SES impact on health. Health variability at the ecological level might reflect the impact of stressors on vulnerable populations.