Browsing by Subject "Neighborhood"
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Item Exposure to alcohol outlets, alcohol access, and alcohol consumption among adolescents(Elsevier, 2019-12-01) Morrison, Christopher N.; Byrnes, Hilary F.; Miller, Brenda A.; Wiehe, Sarah E.; Ponicki, William R.; Wiebe, Douglas J.; Pediatrics, School of MedicineBackground: Adolescents who live near more alcohol outlets tend to consume more alcohol, despite laws prohibiting alcohol purchases for people aged <21 years. We examined relationships between adolescents' exposure to alcohol outlets, the sources through which they access alcohol, and their alcohol consumption. Methods: Participants for this longitudinal study (n = 168) were aged 15-18 years and were from 10 cities in the San Francisco Bay Area. We collected survey data to measure participant characteristics, followed by 1 month of GPS tracking to measure exposure to alcohol outlets (separated into exposures near home and away from home for bars, restaurants, and off-premise outlets). A follow-up survey approximately 1 year later measured alcohol access (through outlets, family members, peers aged <21 years, peers aged ≥21 years) and alcohol consumption (e.g. count of drinking days in last 30). Generalized structural equation models related exposure to alcohol outlets, alcohol access, and alcohol consumption. Results: Exposure to bars and off-premise outlets near home was positively associated with accessing alcohol from peers aged <21, and in turn, accessing alcohol from peers aged <21 was positively associated with alcohol consumption. There was no direct association between exposure to alcohol outlets near home or away from home and alcohol consumption. Conclusions: Interventions that reduce adolescents' access through peers aged <21 may reduce adolescents' alcohol consumption.Item In the Crosshairs: How Systemic Racism Compelled Interstate Development Through Black Neighborhoods(2020-12) Townsend, Andrew L.; Scarpino, Phillip V.; Wokeck, Marianne S.; Mullins, Paul R.I present this thesis in two parts. The first is composed of a 35:41-minute documentary film entitled In the Crosshairs: how systemic racism compelled interstate development through Black neighborhoods. Accompanying it is this written essay that outlines my position and provides citations linking evidence to argument. Each component serves a different master. While the essay is intended for an academic reader, the film is intended for a general audience. Each component advances the argument. As a result of systemic racism, minority neighborhoods in Indianapolis have been devalued over time and, therefore, their residents have been left disproportionally vulnerable to displacement from federal interstate highway construction. They were vulnerable because their property was assessed as less valuable than surrounding land. Also, they lacked the political clout to resist “urban development”. Furthermore, their vulnerability was socially constructed. It never occurred to me that my place in society was arranged to my advantage. I didn’t feel advantaged in any way. Everybody I knew was like me or better than me, it seemed. As I matured, I learned that history is subjective and my world is only a small slice of history. I had never considered my whiteness an advantage. In truth, my situation has been shaped by a myriad of forces that were socially constructed. I discovered that the definition of “white” is fluid but, throughout history, has had an enormous impact on how people are treated. The following is a deep dive into what I discovered when I examined only one aspect of how race impacted the advantages I enjoyed simply because my parents were deemed sufficiently “white.”Item Neighborhood and Community Giving 2007(2007) Ottoni-Wilhelm, MarkItem Neighborhood and Community Giving 2009(2009) Ottoni-Wilhelm, MarkItem Neighborhood Differences in COVID-19 Testing, Incidence, and Mortality in the State of Indiana(2020-04-15) Timsina, Lava; Nicole, Ashley; Haggstrom, David A.; Jenkins, Peter; Connors, Jill; Bell, Teresa M.Background: COVID-19 is a highly contagious pandemic disease. This study aims to identify neighborhood-level sociodemographic, health behaviors, adherence to social distancing policies, and healthcare access factors associated with geographic variability of COVID-19 testing, case incidence, and mortality in the U.S. state of Indiana. Methods: The study population included all Indiana residents. Geographic distribution of COVID-19 testing, positive cases, and mortality were estimated for each county and plotted using choropleth maps. Generalized bivariate and multivariable negative binomial regression were used to estimate effects of county-level factors. Results: Higher rates of testing, case detection, and mortality were associated with a greater proportion of non-white residents. Counties with better scores in social distancing and greater proportion of older residents had lower incidence of laboratory testing. We found the highest socioeconomic tertile was associated with higher rates of cases, but no difference in testing or mortality. Improved social distancing lowered the incidence of COVID-19 testing and cases. Densely populated counties had higher testing and incidence of COVID-19 cases per capita, however, higher mortality rates were observed in rural/mixed counties. Conclusion: Differences in COVID-19 testing, case detection, and mortality in Indiana are associated with neighborhood-level characteristics. Local contexts should be considered in COVID-19 response planning.Item Neighborhood socioeconomic status and low-value breast cancer care(Wiley, 2022) Chen, J. C.; Li, Yaming; Fisher, James L.; Bhattacharyya, Oindrila; Tsung, Allan; Obeng‐Gyasi, Samilia; Economics, School of Liberal ArtsBackground: The objective of this study is to examine the association between neighborhood socioeconomic status (nSES) and receipt of low-value breast cancer procedures. Methods: Patients with breast cancer diagnosed between 2010 and 2016 were identified in the Surveillance, Epidemiology, and End Results (SEER) Program. Low value procedures included: (1) axillary lymph node dissection (ALND) for patients with limited nodal disease receiving breast conservation therapy (BCT); (2) contralateral prophylactic mastectomies (CPM); and (3) sentinel lymph node biopsies (SLNB) in patients ≥70 years old with clinically node negative early-stage hormone-positive breast cancer. The cohort was divided by nSES. Univariable and multivariable logistic regression analysis compared the groups. Results: The study included 412 959 patients. Compared to patients in high nSES areas, residing in neighborhoods with low nSES (odd ratio [OR] 2.20, 95% confidence interval [CI] 2.0-2.42) and middle nSES (OR 1.42, 95% CI 1.20-1.56) was associated with a higher probability of undergoing low value ALND. Conversely, patients in low SES neighborhoods were less likely to receive low value SLNB (OR 0.89, 95% CI 0.85-0.94) or CPM than (low nSES OR 0.75, 95% CI 0.73-0.77); middle nSES OR 0.91 (0.89-0.92) those in high SES neighborhoods. Conclusion: In the SEER Program, low nSES was associated with a lower probability of low value procedures except for ALND utilization.