Health In Urban Communities Research Articles

Promoting healthy food access initiatives in urban areas of the USA: Strategies to address food insecurity and improve nutritional health

This concept paper proposes initiatives to promote healthy food access in urban areas of the USA, addressing food insecurity and improving nutritional health. By implementing strategies such as community gardens, farmers' markets, and incentives for grocery stores, this paper aims to create sustainable solutions to improve food access and health outcomes in urban communities. Access to healthy food is a critical determinant of health, yet many urban areas in the USA face challenges related to food insecurity and limited access to nutritious foods. This concept paper explores strategies to promote healthy food access initiatives in urban areas of the USA, with a focus on addressing food insecurity and improving nutritional health. The paper discusses the current state of food insecurity and its impact on health outcomes in urban areas, highlighting the need for targeted interventions to improve access to healthy foods. It then examines various strategies that have been successful in promoting healthy food access, including community gardens, farmers' markets, and mobile food markets. Key components of successful healthy food access initiatives, such as community engagement, policy advocacy, and partnerships with local organizations, are discussed. The paper also explores the role of technology, such as online grocery delivery services, in improving access to healthy foods in urban areas. Through a comprehensive analysis, this concept paper aims to provide insights into effective strategies for promoting healthy food access in urban areas of the USA. By implementing these strategies, policymakers, healthcare providers, and community organizations can work together to address food insecurity and improve nutritional health in urban communities. Keywords: Healthy Food, Insecurity, USA.

The Effect of Changes in Land Cover and Vegetation Density on Urban Heat Island in Semarang City

The urbanization process can be seen not only as influenced by increasing population growth but also the phenomenon of urbanization. The city of Semarang from 1999 to 2019 saw an increase of half a million people with a total population of around 1.81 million people. Along with population growth that occurs, land conversion to meet the needs of life often clashes with the presence of vegetated land. As a result, the area ofvegetated land slowly decreases. On the other hand, the massive build-up of this area makes it easier to reflect and absorb solar heat. As a result, the average surface temperature of the city gradually rises which causes the formation of hot spots that cause changes in climate and weather elements, thus triggering the formation of an Urban Heat Island (UHI). The increase in temperature in urban areas affects not only the comfort of cities but also the health of urban communities, which will impact various city line activities. This urban heat island study, related to changes in land use in Semarang, is urgently needed to make wiser spatial planning decisions. In line with the problems above, this study is aimed at analyzing the effect of changes in land cover and vegetation density on the area of Urban Heat Island (UHI) in Semarang City. The approach used is forecasting with multiple regression analysis methods. Sources of data used are secondary data and population data. The data used is time series data. Based on the statistical analysis results indicate that the variables of land cover and vegetation density have a significant influence on the distribution of surface temperature. The land cover component has a positive effect while the vegetation density component harms the surface temperature distribution area. The appearance of the trendline results in an increasing area of surface temperature distribution in 2030 with 3 scenarios, namely, pessimistic, moderate, and optimistic. The preparation of a planning scenario in which an optimistic scenario can be adopted by the government so that the area of high urban surface temperatures does not expand and have an impact on the level of community vulnerability to extreme weather.

Comprehensive Genome and Plasmidome Analysis of Antimicrobial Resistant Bacteria in Wastewater Treatment Plant Effluent of Tokyo.

To characterize environmental antimicrobial resistance (AMR) in urban areas, extended-spectrum β-lactamase- (ESBL)/carbapenemase-producing bacteria (EPB/CPB, respectively) from urban wastewater treatment plant effluents in Tokyo were isolated on CHROMagar ESBL plate. Complete genome sequence analysis, including plasmids, indicated that 126 CTX-M-positive isolates (31%) were identified among the 404 obtained isolates. The CTX-M-9 group was predominant (n = 65, 52%), followed by the CTX-M-1 group (n = 44, 35%). Comparative genome analysis revealed that CTX-M-27-positive E. coli O16:H5-ST131-fimH41 exhibited a stable genome structure and clonal-global dissemination. Plasmidome network analysis revealed that 304 complete plasmid sequences among 85 isolates were grouped into 14 incompatibility (Inc) network communities (Co1 to Co14). Co10 consisted of primarily IncFIA/IncFIB plasmids harboring blaCTX-M in E. coli, whereas Co12 consisted primarily of IncFIA(HI1)/Inc FIB(K) plasmids harboring blaCTX-M, blaKPC, and blaGES in Klebsiella spp. Co11 was markedly located around Co10 and Co12. Co11 exhibited blaCTX-M, blaKPC, and blaNDM, and was mainly detected in E. coli and Klebsiella spp. from human and animal sources, suggesting a mutual role of Co11 in horizontal gene transfer between E. coli and Klebsiella spp. This comprehensive resistome analysis uncovers the mode of relational transfer among bacterial species, highlighting the potential source of AMR burden on public health in urban communities.

Food web restructuring across an urban estuarine gradient.

Food webs in urban estuaries support valuable ecosystem services that are subject to a wide range of stressors that can degrade the structure of trophic networks. Multiple trophic pathways stabilize food webs by providing complementary diet resources for consumers but the consequences of urbanization on estuarine food webs are relatively unknown. In estuarine creeks across an urban-to-suburban gradient, we demonstrate trophic decoupling of benthic and pelagic pathways, trophic niche contraction, and increasing human health risk arising with the same factors that are associated with ecological degradation. This suggests an urban estuarine paradox-human activities often create larger volumes of deep water habitat, yet human activities also render much of this area unproductive with measurable opportunity costs to food webs. Our findings emphasize the shared consequences of environmental degradation for the ecological integrity of urban estuaries and the health of urban communities that rely on estuaries for sustenance.

Examining the Relationship Between Sleep-Related Infant Deaths and Social Determinants of Health in Urban Communities.

The purpose of this article is to develop a case for considering the relationship between racial disparities in SRID and social determinants of health (SDOH) in impoverished communities. The later has been related to chronic stress impacting biological and psychological functioning. The authors advocate that undesirable SDOH be regarded when developing safe sleep strategies for at risk communities, since chronic stress can impact psychological and biologic functioning, possibly manifesting in inconsistent safe sleep practices by caregivers. An adapted environmental scan (AES), using SRID and SDOH data from impoverished communities, was used to illustrate the comparison of SRID and SDOH in contrasting Baltimore neighborhoods. The AES revealed a match between disparities in SRID and SDOH (e.g., educational achievement, unemployment, poverty, poor housing, and violence). The comparison between the SDOH and SRID increases together for named impoverished neighborhoods, as compared to those with low SRID rates in Baltimore. Rather than limit safe sleep interventions to crib and infant sleeper give-aways, for example, hazardous SDOH seen in impoverished communities should be addressed. We posit that these results will stimulate discussion for well-placed and financed programs, along with policies that focus on decreasing SRID by improving poor SDOH.

Community Based Pollution Prevention for Two Urban Cities—A Case Study

Pollution prevention is an approach for generating less waste using fewer toxic chemicals while conserving water and energy. Even though pollution prevention practices have been encouraged for over thirty years, many smaller businesses have not considered or adopted such techniques. This study examines the effect of a community-based approach designed to emphasize the benefits to the health and economic well-being of urban communities when source reduction practices are implemented by businesses in the community. Partnering with existing community groups in Newark and Jersey City, NJ, technical assistance was provided to small and medium-sized businesses under grant funding from Region 2 of the US Environmental Protection Agency. In this research, 32 small and medium-sized businesses were evaluated for source reduction opportunities and implementation plans were drawn up. After these businesses implemented operational changes, emission and cost savings were determined and reported back to respective small business owners as well as to the communities during community meetings designed to encourage additional participation. Based on 32 case studies, several measurable benefits were achieved, including the yearly saving of 932 pounds of hazardous waste, 3917 pounds of non-hazardous waste, 13.62 metric tons of carbon equivalent (MTCE) of greenhouse gases and $5335 USD. The initial findings suggest that community-based programs such as this can be beneficial but must be sustained over a period of time. One issue that was repeatedly observed, and is likely widely believed, is the concern of small business operators that cooperation with any group funded by a government program may lead to the assessment of fines or penalties for environmental violations. This concern limits the willingness of many smaller businesses to participate. The findings of this study suggest that a sustained community-based program may overcome that concern through demonstration of the benefit to the business and the community, and through credibility building achieved by regular community reporting and the absence of official intervention.

Bridging Silos: Collaborating for Environmental Health and Justice in Urban Communities - Katrina Smith Korfmacher

Bridging Silos: Collaborating for Environmental Health and Justice in Urban Communities - Katrina Smith Korfmacher

Mitigating Environmental Sustainability Challenges and Enhancing Health in Urban Communities: The Multi-functionality of Green Infrastructure

Green Infrastructure (GI) facilities have the capacity to enhance health and mitigate Environmental Sustainability Challenges (ESC). However, the extent of the mitigation and health benefits is unclear in developing countries. This study examined the impact of GI on ESC and Perceived Health (PH) of urban residents in Lagos Metropolis, Nigeria. Multi-stage sampling technique was used to select 1858 residents of Lagos Metropolis who completed semi-structured questionnaires. Descriptive statistics and chi-square test were used to explore data distributions and assess the association of the availability of GI with resident’s PH and ESC. Odds ratio with 95% confidence interval (OR;95%CI) were estimated for good health and ESC mitigation. Participants were mostly men (58.9%) and younger than 50 years old (86.3%). Good health (20.5%) and high mitigation of ESC (collection and disposal of waste-52.7% and official development assistance-63.9%) were reported where GI is mostly available. Participants were more likely to report good health (OR:1.40; 95%CI:1.02-1.92) and high mitigation of ESC [water quality (OR:1.42; 95%CI:1.12-1.81) passenger transport mode (OR:1.41; 95%CI:1.06-1.89)] where GI are mostly available. Availability of Green infrastructure is supporting health and mitigating environmental sustainability challenges in the study area. Green infrastructure should be provided in urban areas where environmental sustainability is under threat.

The Role of Urban Morphology Design on Enhancing Physical Activity and Public Health.

Along with environmental pollution, urban planning has been connected to public health. The research indicates that the quality of built environments plays an important role in reducing mental disorders and overall health. The structure and shape of the city are considered as one of the factors influencing happiness and health in urban communities and the type of the daily activities of citizens. The aim of this study was to promote physical activity in the main structure of the city via urban design in a way that the main form and morphology of the city can encourage citizens to move around and have physical activity within the city. Functional, physical, cultural-social, and perceptual-visual features are regarded as the most important and effective criteria in increasing physical activities in urban spaces, based on literature review. The environmental quality of urban spaces and their role in the physical activities of citizens in urban spaces were assessed by using the questionnaire tool and analytical network process (ANP) of structural equation modeling. Further, the space syntax method was utilized to evaluate the role of the spatial integration of urban spaces on improving physical activities. Based on the results, consideration of functional diversity, spatial flexibility and integration, security, and the aesthetic and visual quality of urban spaces plays an important role in improving the physical health of citizens in urban spaces. Further, more physical activities, including motivation for walking and the sense of public health and happiness, were observed in the streets having higher linkage and space syntax indexes with their surrounding texture.

Place Matters: Small Business Financial Health in Urban Communities

While many researchers have observed overall heterogeneity in the small business sector, existing data sources provide limited information about community-level differences in small business financial outcomes. In this report, we use de-identified transaction data from business deposit accounts to identify small business financial outcomes in ZIP codes across 25 U.S. metropolitan areas. While the majority of small businesses were profitable, many had limited cash liquidity. Moreover, community-level differences in small business profitability and cash liquidity were persistent from 2013 to 2017. We also found that small business cash liquidity and profitability were correlated with other community-level indicators. Small businesses held more cash and were more profitable in communities with higher home values, higher shares of college-graduates, and smaller shares of non-White residents. Finally, we found that larger high-tech and other professional services firms were less prevalent in communities where small businesses had limited profitability or cash liquidity. These community-level differences suggest that place-based small business economic development programs may contribute to broad-based economic growth, that policies that address household financial wealth and education might also benefit small businesses, that programs could be targeted to the needs of small businesses most prevalent in majority Black and Hispanic communities, and that both high-tech and lower-tech firms can serve as anchor institutions in supporting community economic development.

Measuring the Impact of Environment on the Health of Large Cities.

The relative significance of indicators and determinants of health is important for local public health workers and planners. Of similar importance is a method for combining and evaluating such markers. We used a recently developed index, the Urban Health Index (UHI), to examine the impact of environmental variables on the overall health of cities. We used the UHI to rank 57 of the world’s largest cities (based on population size) in low- and middle-income countries. We examined nine variables in various combinations that were available from the Demographic and Health Surveys conducted in these countries. When arranged in ascending order, the distribution of UHIs follows the previously described pattern of gradual linear increase, with departures at each tail. The rank order of cities did not change materially with the omission of variables about women’s health knowledge or childhood vaccinations. Omission of environmental variables (a central water supply piped into homes, improved sanitation, and indoor solid fuel use) altered the rank order considerably. The data suggest that environmental indicators, measures of key household level risk to health, may play a vital role in the overall health of urban communities.

Bikeshare Use in Urban Communities: Individual and Neighborhood Factors.

Bicycling is an affordable way to increase access to employment, schooling, and services and an effective measure against obesity. Bikeshare programs can make bicycling accessible to diverse populations, but little evidence exists on their adoption in low-resource neighborhoods. Our study examined factors associated with bikeshare use in a metropolitan area in the southern United States. We performed a retrospective cross-sectional analysis of a database of clients (N=815) who rented a bicycle from Zyp Bikeshare in Birmingham, Alabama between October 2015 and November 2016. Individual-level variables included bike use frequency, average speed, total miles traveled, total minutes ridden, bike type (traditional vs electricity-assisted pedelec), membership type, sex, and age. Area-level data aggregated to Census tracts, proxies for neighborhoods, were obtained from the 2010 US Census after geocoding clients' billing addresses. Using exploratory factor analysis, a neighborhood socioeconomic disadvantage index (SDI) was constructed. Bikeshare station presence in a tract was included as a covariate. Multivariate linear regression models, adjusted for clustering on Census tracts, were estimated to determine predictors of bikeshare use. In a multivariate regression model of individual and neighborhood characteristics adjusted for clustering, each decile increase in the SDI was associated with a 9% increase in bikeshare use (P<.001). Bikeshare use was also positively associated with speed (.1, P<.001), total miles (.008, P<.001), and pedelec use (1.02, P<.01). Higher neighborhood socioeconomic disadvantage is associated with higher bikeshare use. Bikeshare is a viable transportation option in low-resource neighborhoods and may be an effective tool to improve the connectivity, livability, and health of urban communities.

Walker occupancy has an impact on changing airborne bacterial communities in an underground pedestrian space, as small-dust particles increased with raising both temperature and humidity.

Although human occupancy is a source of airborne bacteria, the role of walkers on bacterial communities in built environments is poorly understood. Therefore, we visualized the impact of walker occupancy combined with other factors (temperature, humidity, atmospheric pressure, dust particles) on airborne bacterial features in the Sapporo underground pedestrian space in Sapporo, Japan. Air samples (n = 18; 4,800L/each sample) were collected at 8:00 h to 20:00 h on 3 days (regular sampling) and at early morning / late night (5:50 h to 7:50 h / 22:15 h to 24:45 h) on a day (baseline sampling), and the number of CFUs (colony forming units) OTUs (operational taxonomic units) and other factors were determined. The results revealed that temperature, humidity, and atmospheric pressure changed with weather. The number of walkers increased greatly in the morning and evening on each regular sampling day, although total walker numbers did not differ significantly among regular sampling days. A slight increase in small dust particles (0.3–0.5μm) was observed on the days with higher temperature regardless of regular or baseline sampling. At the period on regular sampling, CFU levels varied irregularly among days, and the OTUs of 22-phylum types were observed, with the majority being from Firmicutes or Proteobacteria (γ-), including Staphylococcus sp. derived from human individuals. The data obtained from regular samplings reveled that although no direct interaction of walker occupancy and airborne CFU and OTU features was observed upon Pearson's correlation analysis, cluster analysis indicated an obvious lineage consisting of walker occupancy, CFU numbers, OTU types, small dust particles, and seasonal factors (including temperature and humidity). Meanwhile, at the period on baseline sampling both walker and CFU numbers were similarly minimal. Taken together, the results revealed a positive correlation of walker occupancy with airborne bacteria that increased with increases in temperature and humidity in the presence of airborne small particles. Moreover, the results indicated that small dust particles at high temperature and humidity may be a crucial factor responsible for stabilizing the bacteria released from walkers in built environments. The findings presented herein advance our knowledge and understanding of the relationship between humans and bacterial communities in built environments, and will help improve public health in urban communities.

How Co-Developed Are Community and Academic Partnerships?

The world-renowned resources of Johns Hopkins Hospital (JHH) in Baltimore, Maryland, stand in marked contrast with the surrounding impoverished neighborhoods. Community-based organizations (CBOs) are critical frontline responders to residents' needs. Baltimore CONNECT, an academic-community partnership, co-developed an intervention to strengthen connections between CBOs and between CBOs and the health care system. To understand how members of an academic- community partnership define the act of "co-development" and share perceptions of barriers, facilitators, and ways to measure it. We conducted semistructured interviews with 15 community partners, academic partners, and external stakeholders. Partners conceptualized co-development as a fluid and evolving process that is the outcome of shared decision making. This exploration revealed nuances within partnership dynamics, including motivations for participation, underlying incentives, partnership equality, balance of power, and trust and relation building. We present insights that can be used by academic researchers and community leaders looking to co-develop interventions to improve health in urban communities domestically and internationally.JHH in Baltimore, Maryland, is one of the most highly regarded hospitals in the United States. However, its institutional resources stand in marked contrast with those available to the impoverished neighborhoods that surround it. Many have called for JHH to play a greater role in the surrounding community, where it serves as a leading source of health care.

Associations between urban metrics and mortality rates in England.

BackgroundSeventy-five percent of the population in Europe live in urban areas and analysing the effects of urban form on the health of the urban population is of great public health interest. Not much is known, however, on the effects of urban form on the health of city dwellers. This study uses a novel approach to investigate whether associations exist between different measures of urban form and mortality risks in cities in England.MethodsWe conducted an ecological, cross-sectional study for urban areas in England with more than 100,000 residents (n = 50) and included all registered premature deaths (<65 years) between 1st January 2002 and 31st December 2009. To describe and categorise urban form we quantified the distribution and density of population, land cover and transport networks and measures of geographical characteristics. We used Poisson regression models to examine associations between the measures of urban form and age-standardised risks of deaths from all causes, cardiovascular disease, and traffic accidents after adjustment for socioeconomic status and smoking. Analysis was stratified by gender to explore differential associations between females and males.ResultsThere were a total of 200,200 premature deaths during the study period (Females: 37 %; Males: 63 %). Transport network patterns were associated with overall and cardiovascular mortality rates in cities. We saw 12 % higher mortality risk after adjustment in cities with high junction density compared to cities with low density [Females: RR 1.12 (95 % CI 1.10 – 1.15); Males: RR 1.12 (95 % CI 1.10–1.14)]; the risk was slightly higher for cardiovascular mortality [Females: RR 1.16 (95 % CI 1.10 – 1.22); Males: RR 1.12 (95 % CI 1.09 – 1.16)]. Associations between mortality and population patterns were of similar magnitude [Females: RR 1.10 (95 % CI 1.09 – 1.13); Males: RR 1.09 (95 % CI 1.07–1.10)]; associations between mortality and land cover patterns were inconclusive.ConclusionsWe found an association between transport patterns and risk of premature mortality. Associations between urban form and mortality observed in this study suggest that characteristics of city structure might have negative effects on the overall health of urban communities. Future urban planning and regeneration strategies can benefit from such knowledge to promote a healthy living environment for an increasing urban population.Electronic supplementary materialThe online version of this article (doi:10.1186/s12940-016-0106-3) contains supplementary material, which is available to authorized users.

Community perceptions towards the establishment of an urban forest plantation: a case of Dzivaresekwa, Zimbabwe

The health of urban forest communities not only depend on the government and nongovernmental organizations, but also strongly rely on local community stewardship. A study was carried out to assess community perceptions on the establishment of an urban forest plantation among urban residents in Dzivaresekwa, an urban area in Harare. Randomized systematic sampling was used to select 150 households and one resident per household was interviewed using a pretested questionnaire with both closed and open-ended questions. The objectives of the study were to determine how age and gender and employment status variables, were related to the urban residents’ perceptions towards establishment of a forest plantation in an urban area. Most females (58.3%) viewed the plantation as a threat while most men (51.7%) viewed the plantation as a recreational area. The highest proportion (61.9%) of the middle age group (21-40 years) perceived the plantation as a source of employment. There was a statistically significant relationship (p = 0.040) between gender and the general perception of establishing a forest plantation in the urban area. However, there was no statistically significant relationship (p = 0.203) between age groups and the perception of establishing a forest plantation in the urban area. It is concluded that the community had diverse perceptions on urban community forestry. DOI: http://dx.doi.org/10.3329/ijarit.v4i1.20973 Int. J. Agril. Res. Innov. &amp; Tech. 4 (1): 16-23, June, 2014

Importance of Thinking Locally for Mental Health: Data from Cross-Sectional Surveys Representing South East London and England

BackgroundReliance on national figures may be underestimating the extent of mental ill health in urban communities. This study demonstrates the necessity for local information on common mental disorder (CMD) and substance use by comparing data from the South East London Community Health (SELCoH) study with those from a national study, the 2007 English Adult Psychiatric Morbidity Study (APMS).Methodology/Principal FindingsData were used from two cross-sectional surveys, 1698 men and women residing in south London and 7403 men and women in England. The main outcome, CMD, was indicated by a score of 12 or above on the Revised Clinical Interview Schedule. Secondary outcomes included hazardous alcohol use and illicit drug use. SELCoH sample prevalence estimates of CMD were nearly twice that of the APMS England sample estimates. There was a four-fold greater proportion of depressive episode in the SELCoH sample than the APMS sample. The prevalence of hazardous alcohol use was higher in the national sample. Illicit drug use in the past year was higher in the SELCoH sample, with cannabis and cocaine the illicit drugs reported most frequently in both samples. In comparisons of the SELCoH sample with the APMS England sample and the APMS sample from the Greater London area in combined datasets, these differences remained after adjusting for socio-demographic and socioeconomic indicators for all outcomes.Conclusions/SignificanceLocal information for estimating the prevalence of CMD and substance use is essential for surveillance and service planning. There were similarities in the demographic and socioeconomic factors related to CMD and substance use across samples.

Sexual Health, Marital Sex, and Sexual Risk in Urban Poor Communities in India

Marital sex has been an unaddressed component of sexual risk. This article explores marital sex and its link to men's extramarital sexual behavior in 3 economically marginal communities in Mumbai, India. Using in-depth interviews with women, men, and couples, qualitative results are presented on first night experiences, ability of women to refuse their husbands' demands for sex, sexual communication, and sexual pleasure associated with marital sex. Using regression analysis of survey data for 260 couples, the quantitative results indicate that greater sexual satisfaction for both men and women is significantly related to men's lesser involvement in extramarital sex. These results provide a basis for a couples' intervention effort that can yield greater marital and sexual communication and reduction in sexual risk.

Temporal and spatial variation of heat-related illness using 911 medical dispatch data

Background The adverse effect of hot weather on health in urban communities is of increasing public health concern, particularly given trends in climate change. Objectives To demonstrate the potential public health applications of monitoring 911 medical dispatch data for heat-related illness (HRI), using historical data for the summer periods (June 1–August 31) during 2002–2005 in Toronto, Ontario, Canada. Methods The temporal distribution of the medical dispatch calls was described in relation to a current early warning system and emergency department data from the National Ambulatory Care Reporting System (NACRS). Geospatial methods were used to map the percentage of heat-related calls in each Toronto neighborhood over the study period. Results The temporal pattern of 911 calls for HRI was similar, and sometimes peaked earlier, than current heat health warning systems (HHWS). The pattern of calls was similar to NACRS HRI visits, with the exception of 2005 where 911 calls peaked earlier. Areas of the city with a relatively higher burden of HRI included low income inner-city neighborhoods, areas with high rates of street-involved individuals, and areas along the waterfront which include summer outdoor recreational activities. Conclusions Identifying the temporal trends and geospatial patterns of these important environmental health events has the potential to direct targeted public health interventions to mitigate associated morbidity and mortality.

S33.C Adolescents' health and sleep problems in Thai urban and rural communities

There is a global trend of increase in sleep problems, among adolescents with rapid changes in lifestyles, academic and social demand. Modernization, media and information technologies with less parental control, allow children and adolescents to spend more time particularly during late hours, disrupting their normal sleep waking cycles. In addition, socio-economic and political problems increase conflicts and violence in families and communities have added more stresses to life. In this community based study, using 2 steps stratified random sampling method to identify 1670 households representatives of the population in five provinces located in different geographical areas in Thailand, 315 adolescents age 12−18 years old, mean age 14.70±1.97 years, were interviewed during home visit. Thai version of Subjective Health Complaints Questionnaire, Strength and Difficulties Questionnaire (SDQ) and Health Related Quality of Life (HRQoL) Questionnaire were used for self assessment. Sleep problems were reported in 35.7%; with significantly higher prevalence in females (41.8%) than males (26.6%); late adolescence 16 years (41.2%) than younger age groups (34.3%); and in urban (41.3%) than rural settings (29%). Among those with sleep problems, self assessment of strength and difficulties showed significantly higher difficulties mean score 14.18±6.31 versus 11.6±4.51 (p = 0.0001), with higher emotional problems scores. Significant association was found in Subjective Health Complaints between sleep problem and tiredness, depression, and anxiety. Excellent and very good health status was found in higher percentage among those without sleep problem (46.46%) than poor sleepers (29.09%). The HRQoL revealed that in the last 30 days, the numbers of days affected by physical illness, mental problems and inability to function normally increased according to the severity of sleep problems. Adolescents with sleep problems reported more days affected by physical and mental problems within the last 30 days. Severe sleep problems associated with longer period of absence from schools or work at highly significant level (6.8±10.7 versus 1.04±3.1 days; p = 0.00001). In conclusion, Thai adolescents were faced with sleep problems which related negatively to both their physical and mental health. Parents, health care providers, educators, children and adolescents themselves need to be aware about sleep problems and the consequences on health and performance, implement high school sleep education programs and cooperate in adjusting daily routine for adequate sleep. Contributed support: Research grants from Royal Thai Government through Mahidol University.