Chicago Neighborhoods Research Articles

Well-Being of Children and Families in COVID-19 Hotspots in Chicago.

Families in high-risk communities for COVID-19 transmission experienced a disproportionate burden during the pandemic. This study assessed these families' needs, changes in children's well-being, and perceptions related to the pandemic. Four online surveys were administered January 2021 to September 2021 to parents of students, enrolled in parochial, kindergarten-eighth grade schools in Chicago neighborhoods with higher COVID-19 incidence rates by ZIP code, compared to the city average, and higher resource need. The response rate was 69.1% (n = 186 of 269) in the baseline survey; and other surveys were at 1 (n = 151), 3 (n = 145), and 5 months (n = 154). Of the sample, 83% of parents identified as Hispanic/Latinx with a mean age of 38.3 years (SD: 8.5). Approximately a quarter of parents reported difficulty paying cable and internet bills (26%) and paying utilities (25%). Parents reported children as happy (94% and 95%, p = .59) and hopeful (96% and 95%, p = .74) at 1-month (February to May 2021) and 5-month surveys (June to September 2021). Parents also reported fewer children were irritable (29% vs 19%, p = .03), felt lonely (17% vs 10%, p = .03), and felt isolated (28% vs 9%, p < .001) between those survey waves. The majority (67%) of parents felt that their child had no difficulty wearing a mask in public. In this longitudinal study, Chicago parents rated children's well-being highly and reported a decrease in negative emotions over time. The areas of need identified may be particularly relevant for outreach and providing resources to Hispanic/Latino families in future emergencies or global health threats.

“We have to lie low … that sort of poisons me more and more”: A qualitative study of violent political rhetoric and health implications for Spanish and Chinese speaking immigrants

BackgroundIn recent years, the historical legacy of anti-immigrant sentiment in the US has resurfaced, fueled by a new wave of anti-immigrant political rhetoric. Violent political rhetoric, defined as either explicit or metaphorically targeted language to dehumanize targeted groups, can incite discriminatory treatment of immigrants at both interpersonal and institutional levels, shaping their health and healthcare experiences. This qualitative study explores and compares how Spanish- and Chinese-speaking immigrant populations in Chicago make sense of violent political rhetoric against their racial and ethnic identities, utilize coping strategies to maintain their sense of belonging, and experience downstream health consequences. MethodsIn 2019, 14 semi-structured focus groups were conducted among immigrants to the U.S. (n = 79). Participants were recruited from four community sites in either Hispanic/Latino or Chinese neighborhoods in Chicago. Focus groups were conducted by racially- and linguistically concordant interviewers in Spanish, Mandarin, or Cantonese. The research team developed a codebook iteratively and analyzed transcripts using grounded theory and the constant comparison method. ResultsParticipants included Chinese (61%) and Spanish-speaking immigrants (39%), with an average age of 61.4 years (sd = 13); the majority were female (62%), unemployed (68%), and attained less than a high school diploma (53%). Self-reported stress due to political rhetoric was more pronounced among Spanish-speaking participants (93%) than Chinese participants (39.6%). Immigrants responded to manifestations of violent political rhetoric in numerous ways including mobilizing the model minority myth with internalized racism, anticipatory stress, and “high effort” coping mechanisms (John Henryism), all with downstream health effects. ConclusionViolent political rhetoric is one of the mechanisms by which racism and xenophobia exacerbate a toll on the health of racialized immigrant groups. These processes have implications for both interpersonal and institutional experiences, as well as health and healthcare interactions. We propose a conceptual model that outlines these mechanisms and points to potential areas of intervention to ameliorate immigrant health inequities.

Childhood Exposure to Firearm Violence in Chicago and Its Impact on Mental Health

ObjectiveTo describe how often Chicago children are exposed to firearm violence, the types of exposure, and the parent-reported impact of these exposures on child mental health symptoms. MethodsData were collected in May-July 2022 using the Voices of Child Health in Chicago Parent Panel Survey, administered to parents with children aged 2–17 years from all 77 Chicago neighborhoods. Firearm violence exposure was characterized as indirect (hearing gunshots or knowing someone who was shot) or direct (witnessing a shooting, being threatened with a firearm, being shot at but not injured, or being shot and injured). Parents indicated if children in their household had any of the following mental health symptoms associated with firearm violence exposure: fear, anxiety, sadness, isolation, difficulty concentrating, difficulty in school, or aggression. Chi-squared tests and multivariable logistic regression models were used for statistical analysis. ResultsResponses were received from 989 Chicago parents. More than one third (37%) of children were exposed to firearm violence with an indirect exposure prevalence of 32% and a direct exposure prevalence of 10%. Mental health symptoms associated with firearm violence exposure were reported for 20% of children. Mental health symptoms were reported for 7% of children without firearm violence exposure compared to 31% with indirect exposure (aOR 6.2, 95% CI: 3.7, 10.6) and 68% with direct exposure (aOR 36.1, 95% CI: 16.6, 78.6) ConclusionsChicago children with indirect and direct exposure to firearm violence had more parent-reported mental health symptoms than unexposed children. Trauma informed care approaches to mitigate the negative mental health effects of both direct and indirect firearm violence exposure are critical.

Social determinants of health profiles and survival among US cancer survivors: A cluster analysis.

402 Background: Healthcare payers and clinicians increasingly focus on social determinants of health (SDOH) to reduce disparities in care and improve patient outcomes in US. Prognostic value of single SDOH factors has been described, but not for clusters of multiple SDOHs. We characterize cancer survivors by their SDOH profiles and examine associations with survival. Methods: 11,237 cancer survivors were identified from the 2013-2018 National Health Interview Survey (NHIS) with linkage to NHIS Mortality Files. 9 SDOHs were included in 5 a priori identified domains: 1) healthcare access (medical financial hardship, delayed care due to transportation and/or other barriers); 2) economic instability (unemployment, food insecurity, housing insecurity); 3) social isolation (marital status); 4) education and literacy (&lt; high school education); and 5) neighborhood quality (low neighborhood social cohesion (nSC) based on 4 item scale developed by the Project on Human Development in Chicago Neighborhoods Community Survey). The most significant SDOH in each domain was identified with Cox regressions. We then clustered patients into 5 groups using the inter-person Gower distance of the 5 selected SDOHs and examined survival among each cluster adjusting for age, sex, race, region, and survey era. Results: 5 distinct clusters of cancer survivors were identified with top-ranking SDOHs in each domain: 1) Healthy Hopefuls: young, employed, and married with fewer socio-economic and health burdens; 2) Independent Phoenixes: single, employed rising above adversity, maintaining health and financial wellness; 3) Enduring Companions: older, unemployed, and married navigating health challenges while maintaining financial stability; 4) Solo Warriors: older, single, unemployed with health complications and financial hardships; and 5) Resilient Overcomers: unemployed minorities in low-quality neighborhoods, overcoming the obstacles of higher health and socio-economic challenges. Groups 3, 4, and 5 had worse survival than group 1 in adjusted analyses (Table). Conclusions: SDOH profiles were strongly associated with survival in US cancer survivors. Findings support the need to identify SDOH profiles in efforts to personalize mitigation strategies and enhance long-term wellness.[Table: see text]

The idea of “Own Space” through “Vignettes” in Sandra Cisneros’ The House on Mango Street

This paper delves into the theme of "Own Space" in Sandra Cisneros' novel, The House on Mango Street. It scrutinizes how the protagonist, Esperanza, navigates the complex concept of home and belonging in a Hispanic neighborhood in Chicago. Drawing from the theories of spatial belonging, patriarchal constraints, and feminist perspectives, the paper highlights Esperanza's quest to carve out her unique space within the constraints of her environment. The use of vignettes as a literary device is explored, demonstrating how they provide insights into Esperanza's evolving identity and the challenges she faces in defying gender roles and societal spatial practices. In addition, it underscores the importance of space production theory, highlighting the role of vignettes in immersing the reader in Esperanza's coming-of-age journey. Ultimately, it argues that Cisneros' narrative style and Esperanza's experiences reflect the broader context of the Chicana experience, making The House on Mango Street a significant contribution to the discussion of cultural identity, gender, and space.

Education, Experience, and Exchange: The Hull House Women, an International Network, and Chicago’s Immigrant Population

This paper explores the creation and purpose of Chicago’s Hull House. It provides an overview of volunteer work by women in the US and addresses the European influence on Jane Addams’s idea for Hull House and the various educational aspects and approaches used by the Hull House educators.&#x0D; Founded, funded, and administered by women, the Hull House settlement is shown as a prime example of the nascent spirit of American volunteerism that epitomized that era. Women were able to participate in the settlement because of the evolving perception of their role in society. It was possible to devote one’s life to charity and not to marriage and child-raising. The force of the Hull House residents was to combine their individual skills and strengths to work as a united group of very dynamic and talented women. Education, experience, and exchange were the three pillars of their very successful settlement home. In their efforts to reform and better the living conditions in the rundown Chicago neighborhood, the Hull House women became involved in politics and policymaking. Thereby, they began to have a voice which became louder and louder and could not be silenced.

Marginal structural models for estimating the longitudinal effects of community violence exposure on youths' internalizing and externalizing symptoms.

Longitudinal observational data pose a challenge for causal inference when the exposure of interest varies over time alongside time-dependent confounders, which often occurs in trauma research. We describe marginal structural models (MSMs) using inverse probability weighting as a useful solution under several assumptions that are well-suited to estimating causal effects in trauma research. We illustrate the application of MSMs by estimating the joint effects of community violence exposure across time on youths' internalizing and externalizing symptoms. Our sample included 4,327 youth (50% female, 50% male; 1.4% Asian American or Pacific Islander, 34.7% Black, 46.9% Hispanic, .8% Native American, 14.3%, White, 1.5%, Other race/ethnicity; Mage at baseline = 8.62, range = 3-15) from the Project on Human Development in Chicago Neighborhoods. Wave 3 internalizing symptoms increased linearly with increases in Wave 2 and Wave 3 community violence exposure, whereas effects on externalizing symptoms were quadratic for Wave 2 community violence exposure and linear for Wave 3. These results fail to provide support for the desensitization model of community violence exposure. MSMs are a useful tool for researchers who rely on longitudinal observational data to estimate causal effects of time-varying exposures, as is often the case in the study of psychological trauma. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Community engagement for early recognition and immediate action in stroke (CEERIAS): Pre and post COVID-19

Engagement science can help healthcare providers understand promising practices that address health disparities. The Community Engagement in Early Recognition and Immediate Action in Stroke (CEERIAS) study began in 2014 with the aim of improving health outcomes related to stroke and addressing racial inequities among at-risk South Side Chicago neighbourhoods by engaging community members called ‘Stroke Promoters’ in designing and implementing a stroke preparedness programme. Launched in 2020, Phase II (2CEERIAS) furthered this aim by developing a replicable virtual platform for the programme in response to challenges prompted by the COVID-19 pandemic. The CEERIAS community engagement programme results provided meaningful data to South Side Chicago communities; nearly 40,000 ‘Pact to Act FAST’ pledges were collected over 11 months, and although early hospital arrival and emergency medical services (EMS) usage for confirmed stroke did not increase overall, early arrivals for suspected stroke increased significantly for men, younger people and black community members along with EMS usage for suspected stroke. The 2CEERIAS virtual programme collected nearly 3,800 new pledges in a 90-day window during the onset of the COVID-19 pandemic. The engagement of trusted nonclinical laypeople during both phases of the CEERIAS study demonstrates that community engagement can positively influence clinical outcomes and increase reach and sustainability for such efforts. The use of engagement science can also generate a deep sense of co-creation among community members, and the ‘social contract’ approach can effect behavioural change. The virtual adaption reinforced important engagement science principles for interventions aimed at eliminating stroke disparities. To this day, eight years after research support ended for the CEERIAS programme, community members trained as ‘Stroke Promoters’ remain connected to the researchers and continue to educate family and neighbours about stroke preparedness.

Desistance as an Intergenerational Process

Nearly 35 years ago, Sampson and Laub popularized the concept of desistance from crime and isolated core factors that promote and inhibit this process. In this article, we introduce the concept of intergenerational desistance and provide guidance on measuring and explaining this process, encouraging researchers to think of the life-course of crime in terms of both individuals and generations. We first review research on the intergenerational transmission of family criminality and criminal justice contact, relying also on research outside of criminology to highlight how using broader conceptions of the family, including social parents, entire generations, and three (or more) generations could enliven this area. Bridging these literatures allows us to then introduce the concept of intergenerational desistance and elaborate on the concept of intergenerational escalation and demonstrate how they can be measured using data from the Project on Human Development in Chicago Neighborhoods (PHDCN). We close by developing a research agenda for considering intergenerational desistance and escalation in ways that enhance our understanding of how the life-course of crime, criminal justice contact, and other troubles in life (e.g., with alcohol, drugs, and mental health) progress through families.

Differential health outcomes of the COVID‐19 pandemic among minority populations: An analysis based on Chicago's neighborhoods

AbstractBackgroundThe study examines the effects of the COVID‐19 pandemic on different ethnic and racial groups. It aims to investigate the existence or nonexistence of significant variations in COVID‐19 health outcomes among two ethnic and racial minorities that resided in Chicago neighborhoods during the onslaught of the pandemic. Researchers have traditionally studied health disparities by comparing the health of minorities representing “underserved” populations and those with adequate healthcare. This study focuses on the heterogeneity of health outcomes between different minority populations, mainly Black and Hispanic, traditionally considered underserved populations.MethodsThis cross‐sectional study uses secondary data from a public reporting site. The unit of analysis is neighborhood units based on US postal zip codes that are cross‐referenced with the US Census Bureau's zip code tabulation area codes. We used Chicago neighborhood data and applied geographic analyses to describe the patterns of similarities and differences in the outcomes of the COVID‐19 pandemic among neighborhoods with different ethnic and racial minorities residing in them. Using the one‐way analysis of variance technique, we also tested research hypotheses about the COVID‐19 outcome differences and/or similarities among the neighborhoods.ResultsOur findings show that although Hispanic neighborhoods disproportionately carried a higher burden of infection by the disease, the mortality due to the illness or the case fatality rate was not much higher than in the other neighborhoods. In contrast, African American neighborhoods did experience significantly higher case fatality rates—although their infection rate was not statistically significantly higher than the average infection rates of the other Chicago neighborhoods.ConclusionsMinority status creates distinct adverse effects on different minority groups. The patterns of distinct outcomes need to be well understood through further studied and considered by policymakers when health policies are designed to address the impact of health disparities.

Heart 2 Heart: Pilot Study of a Church-Based Community Health Worker Intervention for African Americans with Hypertension.

African Americans (AAs) have higher prevalence of uncontrolled hypertension than Whites, which leads to reduced life expectancy. Barriers to achieving blood pressure control in AAs include mistrust of healthcare and poor adherence to medication and dietary recommendations. We conducted a pilot study of a church-based community health worker (CHW) intervention to reduce blood pressure among AAs by providing support and strategies to improve diet and medication adherence. To increase trust and cultural concordance, we hired and trained church members to serve as CHWs. AA adults (n = 79) with poorly controlled blood pressure were recruited from churches in a low-income, segregated neighborhood of Chicago. Participants had an average of 7.5 visits with CHWs over 6months. Mean change in systolic blood pressure across participants was - 5mm/Hg (p = 0.029). Change was greater among participants (n = 45) with higher baseline blood pressure (- 9.2, p = 0.009). Medication adherence increased at follow-up, largely due to improved timeliness of medication refills, but adherence to the DASH diet decreased slightly. Intervention fidelity was poor. Recordings of CHW visits revealed that CHWs did not adhere closely to the intervention protocol, especially with regard to assisting participants with action plans for behavior change. Participants gave the intervention high ratings for acceptability and appropriateness, and slightly lower ratings for feasibility of achieving intervention behavioral targets. Participants valued having the intervention delivered at their church and preferred a church-based intervention to an intervention conducted in a clinical setting. A church-based CHW intervention may be effective at reducing blood pressure in AAs.

Historical redlining and park use during the COVID-19 pandemic: Evidence from big mobility data.

Despite the health benefits of urban green space, disparities in its access and use have long existed. Emerging evidence suggests an adverse impact of redlining, a discriminatory practice decades ago, on multiple health outcomes. However, whether and to what degree redlining contributes to these disparities remains unknown particularly during a pandemic. With newly available mobility data tracking the locations of large numbers of mobile devices, this study links historical redlining with changes in green space use during the COVID-19 pandemic. This study examines how changes in park visits during the lockdown period (3/23/2020-8/2/2020) are associated with redlining across census tracts in three large U.S. cities. HOLC neighborhood redlining grade data were merged with SafeGraph mobility data at census tract level for New York City, Chicago, and Philadelphia. Ordinary Least Square regressions were conducted to assess the association between dominant redlining grade and relative change in park visits in census tracts by comparing the lockdown period to the reference period. Spatial error and lag models were also used to account for potential spatial autocorrelation. Park visits during the lockdown period in 2020 decreased by at least one-third in the three cities. The influence of redlining varied across neighborhoods and cities. In New York City, neighborhoods with more redlined areas experienced the largest drop, sharper decreases concentrated in neighborhoods previously graded as "best" or "still desirable" in Philadelphia, but the effect was barely present in Chicago. In addition, changes in park visits are positively correlated between neighborhoods in New York City and Chicago, but it's not observed in Philadelphia. Using emerging big mobility data, our study revealed large drops in park visits, a better measure than commonly-used access measures in capturing green space exposure, during the lockdown period. We found that historical redlining has a lasting impact on current green space use. More decreases in park visits were observed in the redlined areas in New York City, but patterns vary by neighborhood and city due to local-specific neighborhood dynamics. And changes in park visits were spatially, positively correlated across places.

Inequalities in Exposure to Firearm Violence by Race, Sex, and Birth Cohort From Childhood to Age 40 Years, 1995-2021

The past quarter-century has seen both sharp declines and increases in firearm violence in the United States. Yet, little is known about the age of first exposure to firearm violence and how it may differ by race, sex, and cohort. To examine race, sex, and cohort differences in exposure to firearm violence in a representative longitudinal study of children who grew up in periods with varying rates of firearm violence in the United States and to examine spatial proximity to firearm violence in adulthood. This population-based representative cohort study included multiple cohorts of children followed-up from 1995 through 2021 in the Project on Human Development in Chicago Neighborhoods (PHDCN). Participants included Black, Hispanic, and White respondents from 4 age cohorts of Chicago, Illinois, residents, with modal birth years of 1981, 1984, 1987, and 1996. Data analyses were conducted from May 2022 to March 2023. Firearm violence exposure, including age when first shot, age when first saw someone shot, and past-year frequency of fatal and nonfatal shootings within 250 m of residence. There were 2418 participants in wave 1 (in the mid-1990s), and they were evenly split by sex, with 1209 males (50.00%) and 1209 females (50.00%). There were 890 Black respondents, 1146 Hispanic respondents, and 382 White respondents. Male respondents were much more likely than female respondents to have been shot (adjusted hazard ratio [aHR], 4.23; 95% CI, 2.28-7.84), but only moderately more likely to have seen someone shot (aHR, 1.48; 95% CI, 1.27-1.72). Compared with White individuals, Black individuals experienced higher rates of all 3 forms of exposure (been shot: aHR, 3.05; 95% CI, 1.22-7.60; seen someone shot: aHR, 4.69; 95% CI, 3.41-6.46; nearby shootings: adjusted incidence rate ratio [aIRR], 12.40; 95% CI, 6.88-22.35), and Hispanic respondents experienced higher rates of 2 forms of violence exposure (seen someone shot: aHR, 2.59; 95% CI, 1.85-3.62; nearby shootings: aIRR, 3.77; 95% CI, 2.08-6.84). Respondents born in the mid-1990s who grew up amidst large declines in homicide but reached adulthood during city and national spikes in firearm violence in 2016 were less likely to have seen someone shot than those born in the early 1980s who grew up during the peak of homicide in the early 1990s (aHR, 0.49; 95% CI, 0.35-0.69). However, the likelihood of having been shot did not significantly differ between these cohorts (aHR, 0.81; 95% CI, 0.40-1.63). In this longitudinal multicohort study of exposure to firearm violence, there were stark differences by race and sex, yet the extent of exposure to violence was not simply the product of these characteristics. These findings on cohort differences suggest changing societal conditions were key factors associated with whether and at what life stage individuals from all race and sex groups were exposed to firearm violence.

“I Get to See Another Day”: Examining Where Black and Latinx Youth From Economically Disenfranchised Chicago Neighborhoods Find Happiness

The goal of this research is to document and contextualize sources of happiness for Black and Latinx youth living in economically disenfranchised, Chicago neighborhoods. We examined youth’s open-ended responses to the question “What makes you happiest in life?” The sample consists of 409 Black (73%) and Latinx (27%) youth (54% female; on average 15 years old, SD = 0.80). Using an inductive process, we developed relevant codes and applied them to the data. Whereas previous research has found that youth are happiest when they take a break from their routine lives (i.e., leisure), we find that youth include aspects of their daily lives in their concepts of happiness, including financial security and wellbeing, social support, spirituality, and goodwill and service. Youth’s in-depth reflections on what makes them happy are contextualized with quantitative data describing their experiences with structural oppression including poverty, financial hardship, neighborhood poverty, and exposure to violence. We find that youth find happiness despite, often by resisting, the structural constraints in their lives. These findings highlight that for Black and Latinx youth happiness may not solely be an emotional state, but also a strategy for coping with structural oppression.

Abstract #1402660: Association of Social Vulnerability Index Themes and Pre-Diabetes in Chicago Neighborhoods

Pre-diabetes, defined as a glycosylated hemoglobin between 5.7% and 6.4%, is a common condition that is amenable to intervention to ameliorate progression to diabetes. The distribution of pre-diabetes at the census tract level in diverse urban communities and the neighborhood factors that may influence community pre-diabetes rates are not well understood. The social vulnerability index (SVI) was created by the Centers for Disease Control and Prevention to study how communities may be affected following natural disasters. SVI scores range from 0 to 1 with higher SVI scores representing increased social vulnerability. SVI is composed of four neighborhood level themes — socioeconomic status, household composition and disability, minority status and language, and housing type and transportation. The objective of this proof-of-concept project was to determine the distribution of pre-diabetes in patients from census tracts served by a single academic health center and to understand how census tract SVI scores amongst the four SVI themes may be associated with pre-diabetes. For data available in 2018, pre-diabetes rates varied from 0.5% to 16.7% for 1,203 out of the 1,313 census tracts for which there were at least 25 adult patients seen at Rush University Medical Center. A linear regression model was used to assess the change in SVI theme score with the rate of pre-diabetes. Each 0.1 unit increase in SVI theme score for the socioeconomic status, household composition and disability, and minority status and language themes were associated with a 0.37% (SE = 0.027; p-value < 0.0001), 0.36% (SE = 0.027; p-value < 0.0001), and 0.14% (SE = 0.029; p-value = 0.0045) increase in the rate of pre-diabetes, respectively. However, the housing and transportation theme had a non-significant 0.08% decreased rate of pre-diabetes per 0.1-unit change (SE = 0.029, p-value = 0.07). While there was significant heterogeneity of SVI theme scores and pre-diabetes rates in census tracts served by a single, urban health center, this proof-of-concept work shows a potential relationship between SVI themes and pre-diabetes rates at the census-tract level. If confirmed in future studies, SVI could be a tool for future targeted neighborhood-specific interventions to reduce the health impact of pre-diabetes, such as providing more resources to address disparities in socioeconomic status, household composition and disability, and minority status and language domains.

Neighborhood social cohesion and obesity in the United States

Low neighborhood social cohesion (nSC) has been associated with obesity. Still, few studies have assessed the nSC-obesity relationship among a large, nationally representative, and racially/ethnically diverse sample of the United States population. To address this literature gap, we examined cross-sectional associations among 154,480 adult participants of the National Health Interview Survey (NHIS) from 2013 to 2018. We also determined if associations varied by race/ethnicity, sex/gender, age, annual household income, and food security status. Based on a 4-item scale from the Project on Human Development in Chicago Neighborhoods Community Survey, we categorized nSC as low, medium, and high. Based on body mass index (BMI) recommendations, we categorized obesity as ≥30 kg/m2. We used Poisson regression with robust variance to directly estimate prevalence ratios (PRs) and 95 % confidence intervals (CIs) while adjusting for sociodemographic characteristics, such as annual household income, educational attainment, and marital status, along with other confounders. Study participants' mean age ± standard error was 47.1 ± 0.1 years; most (69.2 %) self-identified as Non-Hispanic (NH)-White; and 51.0 % were women. NH-Black and Hispanic/Latinx adults comprised more of the population in neighborhoods with low nSC (14.0 % NH-Black, 19.1 % Hispanic/Latinx, and 61.8 % NH-White) versus high nSC (7.7 % NH-Black, 10.4 % Hispanic/Latinx and 77.0 % NH-White). Low vs. high nSC was associated with a 15 % higher prevalence of obesity (PR = 1.15 [95 % CI: 1.12–1.18]), and the magnitude of the association was more substantial among NH-White adults (PR = 1.21 [95 % CI: 1.17–1.25]) compared to associations among Hispanic/Latinx (PR = 1.04 [95 % CI: 0.97–1.11]) and NH-Black (PR = 1.01 [95 % CI: 0.95–1.07]) adults. Low vs. high nSC was associated with a 20 % higher prevalence of obesity in women (PR = 1.20 [95 % CI: 1.16–1.24]) compared to a 10 % higher prevalence in men (PR = 1.10 [95 % CI: 1.06–1.14]). Low vs. high nSC was associated with a 19 % higher prevalence of obesity among adults ≥50 years old (PR = 1.19 [95 % CI: 1.15–1.23]) compared to a 7 % higher prevalence of obesity among adults <50 years old (PR = 1.07 [95 % CI: 1.03–1.11]). Efforts to address nSC may improve health and address health disparities.

Community-Academic Initiative to Measure and Improve Underrepresented Group Participation in Parkinson’s Disease Research (P10-11.002)

<h3>Objective:</h3> To better understand the reason for lack of racial and ethnic diversity in Parkinson’s Disease (PD) clinical trials by measuring community members’ baseline knowledge of PD, trust of researchers, and willingness to participate in research. <h3>Background:</h3> PD clinical trial participants are disproportionately non-Hispanic Caucasian, creating limited generalizability of research findings. It is unclear why there is incommensurate rates of underrepresented group (URG) research participation; lower health literacy and lack of trust have been suggested as contributors. Community engagement through education on PD and associated studies has the potential to improve awareness and understanding of research, and in turn increase participation rates. <h3>Design/Methods:</h3> Four educational workshops with a total of 92 participants were held at community centers in URG-predominant Chicago neighborhoods. Pre- and post-workshop surveys qualitatively assessed participants’ knowledge of PD symptoms and signs, trust in medical researchers, and willingness to participate in clinical trials. <h3>Results:</h3> The majority of participants identified as either African American (35.9%) or Asian (37%). Survey results indicated that on the whole, community members were trustful of clinical researchers and had positive feelings towards research and researchers’ intentions. Participants were most open to participate in studies that could be done within their homes or offered financial compensation, and were least open to participate in studies that involved obtaining biological samples. Very few respondents had ever been asked to participate in a PD clinical trial before (8.1%). Respondents had a basic baseline understanding of PD, and tremor was the symptom most commonly identified as an early sign of PD (32.6%). <h3>Conclusions:</h3> Surveying predominantly AA and Asian community members of URG-rich Chicago communities revealed moderate to high levels of trust of researchers in these groups, and a willingness to participate in patient-centered clinical trials that mitigate barriers and include facilitators. <b>Disclosure:</b> An immediate family member of Ms. Marre has received personal compensation for serving as an employee of EMD Serono, Inc.. An immediate family member of Ms. Marre has received personal compensation for serving as an employee of MFS Investment Management. Ms. Marre has received research support from Office of Undergraduate Research which is administered by Northwestern University’s Office of the Provost. Emily Zivin has nothing to disclose. Karen Williams has nothing to disclose. Mr. Shramuk has received personal compensation for serving as an employee of Northwestern University. Ms. Lancki has nothing to disclose. Dr. Adrissi has nothing to disclose. Dr. Larson has received personal compensation in the range of $0-$499 for serving as a Consultant for Acadia Pharmaceuticals.

Outcomes of a mobile medical unit for low-threshold buprenorphine access targeting opioid overdose hot spots in Chicago

IntroductionOpioid overdoses in Chicago are unevenly distributed, affecting medically underserved neighborhoods most acutely. Innovations in reaching patients perceived to be hard-to-reach (e.g., unstably housed, marginalized), especially in these underserved neighborhoods, are urgently needed to combat the overdose crisis. This study characterizes the pilot year of a mobile medical unit partnership between a large urban academic center and a community-based harm reduction organization in Chicago. MethodsThis is a retrospective cohort study of all patients who were seen on a mobile medical unit focused on providing low-threshold buprenorphine and primary care in areas with high opioid overdose rates on Chicago's West Side. Treatment episodes were accrued between July 1, 2021, and June 30, 2022 in the first year of operation. The main outcomes were number of patients seen, demographic characteristics of patients, and reason(s) for visit over time. ResultsThe study saw 587 unique patients on the mobile medical unit between July 1, 2021, and June 30, 2022. Approximately 64.6 % were African American, and more than half lacked active insurance or could not confirm insurance status at the time of visit. The most common reason for initial visit was COVID-19 vaccination (42.4 %), and the most common reason for follow-up visit was buprenorphine treatment (51.0 %). Eleven patients initially presented for other health concerns and later returned to initiate buprenorphine. ConclusionsThe mobile medical unit successfully reached nearly 600 patients in traditionally medically underserved Chicago neighborhoods with the highest overdose rates. The mobile unit's integrated approach met a variety of health needs, including buprenorphine initiation, with a unique opportunity for postoverdose initiation. Several patients initiated buprenorphine after presenting for different health concerns, showing the potential of an integrated approach to build on past mobile outreach programs and reach people with opioid use disorder who are not yet ready to initiate treatment.

Analysis on the Persisting Effects of Redlining on Green Infrastructure in Chicago Neighborhoods

This report looks at “redlining” maps produced by the Home Owners’ Loan Corporation (HOLC) to analyze the current green infrastructure levels in various neighborhoods of Chicago. Redlining maps, produced in the first half of the 20th century, essentially graded neighborhoods on their riskiness for mortgage lenders. These maps often followed strict racial lines marking neighborhoods with a majority of black and other minority occupants in red to indicate they were the riskiest, hence the term redlining.1 Gathering geospatial data from these HOLC maps and overlaying them with maps showcasing green infrastructure indicators provides a visual representation of the relationship between structural disinvestment in neighborhoods and their current green infrastructure levels. Additionally, some neighborhoods break the pattern, showcasing which areas have changed the most with investment, indicating changes that can be associated with things like gentrification. In the end, k-means clustering best showcases the patterns that have emerged when looking at two variables with such a large gap in time between when the data was collected: redlining information from the 1940’s, and green infrastructure indicators from to 2010’s.&#x0D; This research was taken a step further to begin descriptive analytical assessments of the ways in which redlining information relates to a variety of other datasets on the built environment. In this way, trends were starting to emerge that could suggest redlining as a predictor for other variables, however, the neighborhood scale at which the data was categorized does not produce strong enough indications. Nonetheless, continuing this line of study at a smaller scale, perhaps at the census tract level, could lead to more conclusive findings with a stronger correlation between redlining information and other datasets on the built environment that highlight the need for, and lack thereof, green infrastructure in disenfranchised areas.

Teasing and alcohol drinking among African American adolescents in Chicago's Southside: Implications for nursing practice

Guided by the routine activity theory, the current study proposes and tests pathways by which an absence of a capable guardian can contribute to interactions with motivated offenders and suitable targets, increasing the likelihood of teasing others and using alcohol. The study participants consisted of 612 African American adolescents in four low-income neighborhoods in Chicago's Southside. Measures include alcohol use, absence of a capable guardian, the presence of a motivated offender, target suitability, and teasing. Covariates include age, biological sex, and government assistance. Analyses included descriptive statistics, correlation analysis, and structural equation modeling. The absence of a capable guardian variable positively correlated with the presence of a motivated offender. The presence of a motivated offender variable was positively associated with target suitability, which was positively related to teasing and alcohol use. The presence of a motivated offender and target suitability variables were positively associated with teasing and alcohol use. Findings highlight the importance of capable guardians and potentially have implications for nursing practice.