Minority Health and Health Equity Archive
Permanent URI for this collectionhttp://hdl.handle.net/1903/21769
Welcome to the Minority Health and Health Equity Archive (MHHEA), an electronic archive for digital resource materials in the fields of minority health and health disparities research and policy. It is offered as a no-charge resource to the public, academic scholars and health science researchers interested in the elimination of racial and ethnic health disparities.
Browse
4 results
Search Results
Item Is neighborhood racial/ethnic composition associated with depressive symptoms? The multi-ethnic study of atherosclerosis(2010) Mair, Christina; Diez Roux, Ana V.; Osypuk, Theresa L.; Rapp, Stephen R.; Seeman, Teresa; Watson, Karol E.Item Neighborhood Stressors and Race/Ethnic Differences in Hypertension Prevalence (The Multi-Ethnic Study of Atherosclerosis)(2011) Mujahid, Mahasin S.; Diez Roux, Ana V.; Cooper, Richard C.; Shea, Steven; Williams, David R.Abstract available at publisher's web site.Item Neighborhood Characteristics and Availability of Healthy Foods in Baltimore(2008) Franco, Manuel; Diez Roux, Ana V.; Glass, Thomas A.; Caballero, Benjamín; Brancati, Frederick L.BACKGROUND: Differential access to healthy foods may contribute to racial and economic health disparities. The availability of healthy foods has rarely been directly measured in a systematic fashion. This study examines the associations among the availability of healthy foods and racial and income neighborhood composition. METHODS: A cross-sectional study was conducted in 2006 to determine differences in the availability of healthy foods across 159 contiguous neighborhoods (census tracts) in Baltimore City and Baltimore County and in the 226 food stores within them. A healthy food availability index (HFAI) was determined for each store, using a validated instrument ranging from 0 points to 27 points. Neighborhood healthy food availability was summarized by the mean HFAI for the stores within the neighborhood. Descriptive analyses and multilevel models were used to examine associations of store type and neighborhood characteristics with healthy food availability. RESULTS: Forty-three percent of predominantly black neighborhoods and 46% of lower-income neighborhoods were in the lowest tertile of healthy food availability versus 4% and 13%, respectively, in predominantly white and higher-income neighborhoods (p<0.001). Mean differences in HFAI comparing predominantly black neighborhoods to white ones, and lower-income neighborhoods to higher-income neighborhoods, were -7.6 and -8.1, respectively. Supermarkets in predominantly black and lower-income neighborhoods had lower HFAI scores than supermarkets in predominantly white and higher-income neighborhoods (mean differences -3.7 and -4.9, respectively). Regression analyses showed that both store type and neighborhood characteristics were independently associated with the HFAI score. CONCLUSIONS: Predominantly black and lower-income neighborhoods have a lower availability of healthy foods than white and higher-income neighborhoods due to the differential placement of types of stores as well as differential offerings of healthy foods within similar stores. These differences may contribute to racial and economic health disparities.Item A New Tool for Epidemiology: The Usefulness of Dynamic Agent Models in Understanding Place Effects on Health(2008) Auchincloss, Amy H.; Diez Roux, Ana V.A major focus of recent work on the spatial patterning of health has been the study of how features of residential environments or neighborhoods may affect health. Place effects on health emerge from complex interdependent processes in which individuals interact with each other and their environment and in which both individuals and environments adapt and change over time. Traditional epidemiologic study designs and statistical regression approaches are unable to examine these dynamic processes. These limitations have constrained the types of questions asked, the answers received, and the hypotheses and theoretical explanations that are developed. Agent-based models and other systems-dynamics models may help to address some of these challenges. Agent-based models are computer representations of systems consisting of heterogeneous microentities that can interact and change/adapt over time in response to other agents and features of the environment. Using these models, one can observe how macroscale dynamics emerge from microscale interactions and adaptations. A number of challenges and limitations exist for agent-based modeling. Nevertheless, use of these dynamic models may complement traditional epidemiologic analyses and yield additional insights into the processes involved and the interventions that may be most useful.