Suchergebnisse

We explore how a 1987 New York State court decision—Boreali v. Axelrod—affected public health rule-making nationally and, with considerable impact, locally in New York City (NYC). We discuss the history of the origin of the NYC Board of Health (BOH), and establish that legislatures can be challenging venues in which to enact public health–related laws. We describe how, as the NYC Department of Health and Mental Hygiene began to tackle modern public health problems (e.g., chronic diseases caused by food and tobacco), the regulatory power of its BOH was challenged. In an era when industry funds political causes and candidates, the weakening of the independence of rule-making boards of health, such as the NYC BOH, might result in illness and death.

AbstractWe assessed how many US deaths would have been averted each year, 1933–2021, if US age-specific mortality rates had equaled the average of 21 other wealthy nations. We refer to these excess US deaths as "missing Americans." The United States had lower mortality rates than peer countries in the 1930s–1950s and similar mortality in the 1960s and 1970s. Beginning in the 1980s, however, the United States began experiencing a steady increase in the number of missing Americans, reaching 622,534 in 2019 alone. Excess US deaths surged during the COVID-19 pandemic, reaching 1,009,467 in 2020 and 1,090,103 in 2021. Excess US mortality was particularly pronounced for persons under 65 years. In 2020 and 2021, half of all US deaths under 65 years and 90% of the increase in under-65 mortality from 2019 to 2021 would have been avoided if the United States had the mortality rates of its peers. In 2021, there were 26.4 million years of life lost due to excess US mortality relative to peer nations, and 49% of all missing Americans died before age 65. Black and Native Americans made up a disproportionate share of excess US deaths, although the majority of missing Americans were White.

Objectives. To assess if historical redlining, the US government's 1930s racially discriminatory grading of neighborhoods' mortgage credit-worthiness, implemented via the federally sponsored Home Owners' Loan Corporation (HOLC) color-coded maps, is associated with contemporary risk of preterm birth (< 37 weeks gestation). Methods. We analyzed 2013–2017 birth certificate data for all singleton births in New York City (n = 528 096) linked by maternal residence at time of birth to (1) HOLC grade and (2) current census tract social characteristics. Results. The proportion of preterm births ranged from 5.0% in grade A ("best"—green) to 7.3% in grade D ("hazardous"—red). The odds ratio for HOLC grade D versus A equaled 1.6 and remained significant (1.2; P < .05) in multilevel models adjusted for maternal sociodemographic characteristics and current census tract poverty, but was 1.07 (95% confidence interval = 0.92, 1.20) after adjustment for current census tract racialized economic segregation. Conclusions. Historical redlining may be a structural determinant of present-day risk of preterm birth. Public Health Implications. Policies for fair housing, economic development, and health equity should consider historical redlining's impacts on present-day residential segregation and health outcomes.

Background In the United States, Black Americans are suffering from significantly disproportionate incidence and mortality rates of COVID-19. The potential for racial-justice interventions, including reparations payments, to ameliorate these disparities has not been adequately explored. Methods We compared the COVID-19 time-varying R (t) curves of relatively disparate polities in terms of social equity (South Korea vs. Louisiana). Next, we considered a range of reproductive ratios to back-calculate the transmission rates β (i→j) for 4 cells of the simplified next-generation matrix (from which R (0) is calculated for structured models) for the outbreak in Louisiana. Lastly, we modeled the effect that monetary payments as reparations for Black American descendants of persons enslaved in the U.S. would have had on pre-intervention β (i→j) . Results Once their respective epidemics begin to propagate, Louisiana displays R (t) values with an absolute difference of 1.3 to 2.5 compared to South Korea. It also takes Louisiana more than twice as long to bring R (t) below 1. We estimate that increased equity in transmission consistent with the benefits of a successful reparations program (reflected in the ratio β (b→b) / β (w→w) ) could reduce R (0) by 31 to 68%. Discussion While there are compelling moral and historical arguments for racial injustice interventions such as reparations, our study describes potential health benefits in the form of reduced SARS-CoV-2 transmission risk. As we demonstrate, a restitutive program targeted towards Black individuals would not only decrease COVID-19 risk for recipients of the wealth redistribution; the mitigating effects would be distributed across racial groups, benefitting the population at large.

AbstractIntroductionWhile it is widely acknowledged that family relationships can influence health outcomes, their impact on the uptake of individual health interventions is unclear. In this study, we quantified how the efficacy of a randomized health intervention is shaped by its pattern of distribution in the family network.MethodsThe "Home‐Based Intervention to Test and Start" (HITS) was a 2×2 factorial community‐randomized controlled trial in Umkhanyakude, KwaZulu‐Natal, South Africa, embedded in the Africa Health Research Institute's population‐based demographic and HIV surveillance platform (ClinicalTrials.gov # NCT03757104).The study investigated the impact of two interventions: a financial micro‐incentive and a male‐targeted HIV‐specific decision support programme. The surveillance area was divided into 45 community clusters. Individuals aged ≥15 years in 16 randomly selected communities were offered a micro‐incentive (R50 [$3] food voucher) for rapid HIV testing (intervention arm). Those living in the remaining 29 communities were offered testing only (control arm). Study data were collected between February and November 2018.Using routinely collected data on parents, conjugal partners, and co‐residents, a socio‐centric family network was constructed among HITS‐eligible individuals. Nodes in this network represent individuals and ties represent family relationships. We estimated the effect of offering the incentive to people with and without family members who also received the offer on the uptake of HIV testing. We fitted a linear probability model with robust standard errors, accounting for clustering at the community level.ResultsOverall, 15,675 people participated in the HITS trial. Among those with no family members who received the offer, the incentive's efficacy was a 6.5 percentage point increase (95% CI: 5.3−7.7). The efficacy was higher among those with at least one family member who received the offer (21.1 percentage point increase (95% CI: 19.9−22.3). The difference in efficacy was statistically significant (21.1–6.5 = 14.6%; 95% CI: 9.3−19.9).ConclusionsMicro‐incentives appear to have synergistic effects when distributed within family networks. These effects support family network‐based approaches for the design of health interventions.

In this sweeping international perspective on reparations, Time for Reparations makes the case that past state injustice—be it slavery or colonization, forced sterilization or widespread atrocities—has enduring consequences that generate ongoing harm, which needs to be addressed as a matter of justice and equity.Time for Reparations provides a wealth of detailed and diverse examples of state injustice, from enslavement of African Americans in the United States and Roma in Romania, to colonial exploitation and brutality in Guatemala, Algeria, Indonesia, Jamaica, and Guadeloupe. From many vantage points, contributing authors discuss different reparative strategies and the impact they would have on the lives of survivor or descent communities.One of the strengths of this book is its interdisciplinary perspective—contributors are historians, anthropologists, human rights lawyers, sociologists, and political scientists. Many of the authors are both scholars and advocates, actively involved in one capacity or another in the struggles for reparations they describe. The book therefore has a broad and inclusive scope, aided by an accessible and cogent writing style. It appeals to scholars, students, advocates and others concerned about addressing some of the most profound and enduring injustices of our time

As COVID-19 made inroads in the United States in spring 2020, a common refrain rose above the din: "We're all in this together." However, the full picture was far more complicated—and far less equitable. Black and Latinx populations suffered illnesses, outbreaks, and deaths at much higher rates than the general populace. Those working in low-paid jobs and those living in confined housing or communities already disproportionately beset by health problems were particularly vulnerable. The contributors to The Pandemic Divide explain how these and other racial disparities came to the forefront in 2020. They explore COVID-19's impact on multiple arenas of daily life—including wealth, health, housing, employment, and education—while highlighting what steps could have been taken to mitigate the full force of the pandemic. Most crucially, the contributors offer concrete public policy solutions that would allow the nation to respond effectively to future crises and improve the long-term well-being of all Americans.Contributors. Fenaba Addo, Steve Amendum, Leslie Babinski, Sandra Barnes, Mary T. Bassett, Keisha Bentley-Edwards, Kisha Daniels, William A. Darity Jr., Melania DiPietro, Jane Dokko, Fiona Greig, Adam Hollowell, Lucas Hubbard, Damon Jones, Steve Knotek, Arvind Krishnamurthy, Henry Clay McKoy Jr., N. Joyce Payne, Erica Phillips, Eugene Richardson, Paul Robbins, Jung Sakong, Marta Sánchez, Melissa Scott, Kristen Stephens, Joe Trotter, Chris Wheat, Gwendolyn L. Wright

As COVID-19 made inroads in the United States in spring 2020, a common refrain rose above the din: "We're all in this together." However, the full picture was far more complicated-and far less equitable. Black and Latinx populations suffered illnesses, outbreaks, and deaths at much higher rates than the general populace. Those working in low-paid jobs and those living in confined housing or communities already disproportionately beset by health problems were particularly vulnerable. The contributors to The Pandemic Divide explain how these and other racial disparities came to the forefront in 2020. They explore COVID-19's impact on multiple arenas of daily life-including wealth, health, housing, employment, and education-while highlighting what steps could have been taken to mitigate the full force of the pandemic. Most crucially, the contributors offer concrete public policy solutions that would allow the nation to respond effectively to future crises and improve the long-term well-being of all Americans.Contributors. Fenaba Addo, Steve Amendum, Leslie Babinski, Sandra Barnes, Mary T. Bassett, Keisha Bentley-Edwards, Kisha Daniels, William A. Darity Jr., Melania DiPietro, Jane Dokko, Fiona Greig, Adam Hollowell, Lucas Hubbard, Damon Jones, Steve Knotek, Arvind Krishnamurthy, Henry Clay McKoy Jr., N. Joyce Payne, Erica Phillips, Eugene Richardson, Paul Robbins, Jung Sakong, Marta Sánchez, Melissa Scott, Kristen Stephens, Joe Trotter, Chris Wheat, Gwendolyn L. Wright