Low-income Urban Neighborhoods Research Articles

Bridging the Affordability Gap: Towards a Financing Mechanism for Slum Upgrading at Scale in Nairobi – Analysing NGO Experiences With Local-Level Finance

The purpose of this paper is to contribute to an understanding of more inclusive financing options for decent low-income housing with a specific focus on experiences of housing improvements in Kenya’s low-income urban neighbourhoods. The paper summarises the findings of a study of three community led housing developments in Nairobi and Nakuru (Kenya). It has a specific focus on the affordability of loans given to residents and on the speed of consolidation within these neighbourhoods. The developments are all supported by the Muungano Alliance with the residents being members of Muungano wa Wanavijiji (a Kenyan federation of women-led savings schemes) and the monies being advanced by their loan fund, the Akiba Mashinani Trust (AMT). The study uses data on affordability assessments and loan repayments collected by AMT staff, and additional information that was collected to understand the scale and speed of future housing investment. Our findings show that repayments are lower than anticipated and that both affordability and weak loan management may be responsible. Based on what households have been able to repay, inclusive housing finance is likely to require both capital and interest rate subsidies, and must recognise the range of income levels and other heterogeneity within low-income urban communities. For example, considerable housing investment has been made in the form of additional rooms in the incremental development process; this shows that at least some households find the development affordable. A key motivation for additional investments is commercial opportunities including rental income.

Adolescent childbirth, miscarriage, and abortion: associations with changes in alcohol, marijuana, and cigarette use.

Adolescent girls who become pregnant demonstrate greater risk for substance use than same-aged peers. However, it remains unclear how risk relates to normative changes in adolescence. Few studies have examined adolescent substance use changes before, during, and after pregnancy and considered how pregnancy outcomes (childbirth, miscarriage, abortion) differentially influence substance use changes. The present study examined associations between different adolescent pregnancy outcomes and within-person changes in substance use from prepregnancy to postpregnancy. Participants included 2,450 girls (52% Black) oversampled from low-income urban neighborhoods in Pittsburgh, PA. Participants self-reported pregnancy outcomes and substance use frequency (alcohol, cigarette, marijuana) annually from ages 11-20. Fixed effects regressions focused on first births, first miscarriages, and first abortions occurring from ages 12-19 to test the associations between pregnancy outcomes and within-individual changes in substance use from prepregnancy to postpregnancy. By design, models controlled for all potential time-stable confounds,and models included age and subsequent pregnancies as time-varying covariates. Consistent with prior studies, girls who became pregnant (20%) reported greater early risk for substance use problems than never-pregnant adolescents, including earlier age of onset and more regular marijuana and cigarette use. Childbirth predicted a 26%-51% within-individual reduction in alcohol, marijuana, and cigarette use that remained significantly lower than prepregnancy levels after childbirth. Alcohol and marijuana use decreased (32%-47%) after miscarriage. Abortion was not associated with long-term changes in substance use; however, marijuana and cigarette use gradually increased (44%-46%) in the years leading up to the year of and after abortion, respectively, before returning to prepregnancy levels. Findings highlight important differences in adolescent substance use patterns based on pregnancy outcome. For pregnant adolescents with heightened pre-existing risk for substance use, pregnancy may be a window of opportunity for substance use screening and behavioral intervention.

Changes in Fast Food Outlet Availability Near Schools: Unequal Patterns by Income, Race/Ethnicity, and Urbanicity

Previous research has observed income or racial/ethnic inequalities in fast food restaurant availability near schools. The purpose of this study was to investigate changes in fast food restaurant availability near schools between 2000 and 2010 by school neighborhood income, race/ethnicity, and urbanicity. Using data from 7,466 California public schools, negative binomial regression models estimated the relative ratios to evaluate the income gradient in fast food restaurant availability, examine differences in the income gradient in fast food restaurant availability between 2000 and 2010, and investigate if fast food restaurant availability changed in 2010 versus 2000, stratified by race/ethnicity and urbanicity. The analyses were conducted in 2018 and early 2019. In urban areas, there was a negative school neighborhood income gradient in fast food restaurant availability in both 2000 and 2010, and across all race/ethnic groups, except majority African American schools. The income gradient in fast food restaurant availability was steeper in 2010 relative to 2000 among Latino majority urban schools. Fast food restaurant availability increased in 2010 relative to 2000 among majority African American, majority Latino, and majority Asian schools in the least affluent neighborhoods. Among majority white schools in similar neighborhoods the availability of fast food restaurants did not change but declined in the most affluent school neighborhoods. In nonurban areas, the income patterns in fast food restaurant availability were less clear, and fast food restaurant availability increased among majority white and Latino schools within the middle neighborhood income tertile. These findings suggest the need for future interventions to target schools in low-income urban neighborhoods. Additionally, reducing child health disparities and improving health for all children requires monitoring changes in the food environment near schools.

Associations between open drain flooding and pediatric enteric infections in the MAL-ED cohort in a low-income, urban neighborhood in Vellore, India

BackgroundOpen drains are common methods of transporting solid waste and excreta in low-income urban neighborhoods. Open drains can overflow due to blockages with solid waste and during rainfall, posing exposure risks. The goal of this study was to evaluate whether pediatric enteric infection was associated with open drains and flooding in a dense, low-income, urban neighborhood.MethodsAs part of the MAL-ED study in Vellore, India, a cohort of 230 children provided stool specimens at 14–17 scheduled home visits and during diarrheal episodes in the first two years of life. All specimens were analyzed for enteric pathogens. Caregivers in 100 households reported on flooding of drains and households and monthly frequency of contact with open drains and flood water. Household GPS points were collected. Monthly rainfall totals for the Vellore district were collected from the Indian Meteorological Department. Clustering of reported drain and house flooding were identified by Kulldorff’s Bernoulli Spatial Scan. Differences in enteric infection were assessed for household responses and spatial clusters, with interactions between reported flooding and rainfall to approximate monthly drain flooding retrospectively, using multivariable, mixed-effects logistic regression models.ResultsCoverage of household toilets was low (33%), and most toilets (82%) discharged directly into open drains, suggesting poor neighborhood fecal sludge management. Odds of enteric infection increased significantly with total monthly rainfall for children who lived in households that reported that the nearby drain flooded (4% increase per cm of rain: OR: 1.04, 95% CI: 1.00–1.08) and for children in households in a downstream spatial cluster of reported drain flooding (5% increase per cm of rain: OR: 1.05, 95% CI: 1.01–1.09). There was no association between odds of enteric infection and frequency of reported contact with drain or floodwater.ConclusionsChildren in areas susceptible to open drain flooding had increased odds of enteric infection as rainfall increased. Results suggested that infection increased with rainfall due to neighborhood infrastructure (including poor fecal sludge management) and not frequency of contact. Thus, these exposures may not be mitigated by changes in personal behaviors alone. These results underscore the importance of improving the neighborhood environment to improve children’s health in low-income, urban settings.

Using Telehealth to address disparities in cognitive, language, and emotion regulation problems in young children: A case illustration using the INvesT model.

Over the past decade, there has been a rise in the prevalence of developmental disabilities. Early diagnosis and access to healthcare services are essential for children with developmental delays to optimize development. For families living in poverty, accessing specialized assessment/intervention services for children with developmental disabilities is often a formidable task. In this study, we provide preliminary evidence for the implementation of a developmental risk assessment screening questionnaire using a telehealth format to address the gap in access to services in a community clinic serving a low-income urban neighborhood. Ninety-seven caregivers of children between 12 months and 7 years of age participated in this study. Caregivers completed the risk assessment screening questionnaire using an iPad that was available to them at the clinic. Results showed that while only 11% of caregivers indicated they were initially concerned about their child's overall development, completion of the focused risk assessment resulted in a completely different picture. Fifty percent of caregivers reported that their child had three or more concerns in at least one area of development that would warrant further evaluation. Alerting both families and professionals to these concerns as early as possible may position the family and child to receive the much-needed services that have the potential to mitigate more serious developmental problems. This article discusses the promising role that Telehealth can play in providing screening services for all families, but especially low-income urban households.

Home visits for uncontrolled asthma among low-income adults with patient portal access

Asthma disproportionately affects low-income and minority adults. In an era of electronic records and Internet-based digital devices, it is unknown whether portals for patient-provider communication can improve asthma outcomes. We sought to estimate the effect on asthma outcomes of an intervention using home visits (HVs) by community health workers (CHWs) plus training in patient portals compared with usual care and portal training only. Three hundred one predominantly African American and Hispanic/Latino adults with uncontrolled asthma were recruited from primary care and asthma specialty practices serving low-income urban neighborhoods, directed to Internet access, and given portal training. Half were randomized to HVs over 6months by CHWs to facilitate competency in portal use and promote care coordination. One hundred seventy (56%) patients used the portal independently. Rates of portal activity did not differ between randomized groups. Asthma control and asthma-related quality of life improved in both groups over 1year. Differences in improvements over time were greater for the HV group for all outcomes but reached conventional levels of statistical significance only for the yearly hospitalization rate (-0.53; 95% CI, -1.08 to -0.024). Poor neighborhoods and living conditions plus limited Internet access were barriers for patients to complete the protocol and for CHWs to make HVs. For low-income adults with uncontrolled asthma, portal access and CHWs produced small incremental benefits. HVs with emphasis on self-management education might be necessary to facilitate patient-clinician communication and to improve asthma outcomes.

Urban Internet myths and Realities: A Detroit case study

ABSTRACT This study challenges conventional expectations around Internet access and use in distressed urban neighbourhoods in the United States. Based on the findings of a survey of 525 Detroit, Michigan, residents, this study suggests that Detroit communities are more interested and more instrumental in their use of the Internet than suggested by characterizations of residents in low-income urban neighbourhoods being less engaged in the digital world. In countering these myths, our data provide a more realistic assessment of digital divides in Detroit, namely a divide between those with an Internet Service Provider (ISP) contract and those who are overly dependent on mobile, which has limited valuable uses of the Internet. Attitudes about the value of the Internet and concerns about costs have shaped ISP subscriptions and an overreliance on mobile phones. Those without home access and those more reliance on mobile phones engage in fewer online activities, such as health information seeking, fact finding, and shopping. This case study identifies key attitudes and barriers to access and use of ISPs in Detroit, which could be relevant to other distressed urban communities.

Comparing Diet Quality of Racial Minority Children from Low-Income Households During the Summer versus School Year: Results from the Project SWEAT Study (P04-102-19)

ObjectivesCompare the diet quality of racial minority school-age children from low-income households during the summer versus school year. MethodsTwo elementary schools in low-income urban neighborhoods of Columbus, OH were recruited. Families with children at these schools were invited to participate. Caregivers completed a demographic survey at baseline (t0). Child diet was assessed using three 24-hr dietary recalls (2 weekdays and 1 weekend day) at 3 time points: 1) baseline/beginning of summer (t0); 2) middle of summer (t1); and 3) beginning of subsequent school year (t2). Demographic data were summarized. Healthy Eating Index (HEI) 2015 was calculated: total [100] and component [Adequacy: total fruit (5), whole fruit (5), total vegetable (5), greens and beans (5), whole grains (10), dairy (10), total protein (5), seafood and plant protein (5), fatty acids (10); Moderation: refined grains (10), sodium (10), added sugars (10), saturated fats (10)]. Paired t-tests were conducted to determine differences in diet quality between time points (t0: t1, t1: t2, t0: t2). Results62 children (39 families) enrolled. Mean age was 7.08 ±0.34 yr, 80.67% were African American, and 69.35% low-income. Participant retention from t0: t1 and t0: t2 was 95.16% and 75.81%. Mean total HEI was 47.37 ± 1.57 (t0), 47.51 ± 1.22 (t1), and 51.13 ± 1.46 (t2) with significant differences between summer and school year time points (t0: t2, P = 0.02; t1: t2, P = 0.01). Significant differences in adequacy and moderation HEI component scores between the two summer time points and school year time point were observed such that child diet quality was better during the school year. Adequacy: whole fruit (t1: t2 P = 0.02), total vegetable (t0: t2 P < 0.01; t1: t2 P < 0.01), greens beans (t0: t1 P < 0.01; t1: t2 P < 0.01), and seafood and plant protein (t0: t2 P = 0.06; t1: t2 P = 0.08). Moderation: sodium (t0: t2 P = 0.07) and added sugar (t0: t2 P = 0.06; t1: t2 P = 0.02). The HEI component score for whole grains was significantly better during the summer compared to the school year (t0: t2 P < 0.01; t1: t2 P < 0.01). ConclusionsExcept for whole grains, child diet quality is better during the school year versus summer. Findings from this study provide the first insight into potential determinants of unhealthy weight gain observed among economically disadvantaged, school-age children during the summer months. Funding SourcesUSDA North Central Nutrition Education for Excellence.

Neighborhood context and transitions in marijuana use among urban young adults

Background: In emerging adulthood when many youth are maturing out of marijuana use, Blacks continue to have high rates of use and disorder. Theory suggests that factors tied to neighborhood disadvantage may partially explain this phenomenon but research is limited. Objectives: This study examines the influence of neighborhood physical and social disorder on transitions in marijuana use during emerging adulthood in a low-income urban sample. Methods: 379 primarily Black young adults residing in low-income neighborhoods in Baltimore City were followed-up annually from ages 18 to 21. Neighborhood environment was evaluated using a valid and reliable field-rater assessment of the residential block. Longitudinal latent class and latent transition analyses were performed. Results: Fit indices supported three-classes of marijuana use: no use, infrequent use and frequent use. Between ages 18 and 21, young adults tended to transition toward lower levels of use. However, neighborhood physical disorder was associated with transitioning to increased marijuana use (no use to frequent use; AOR = 2.712; p = .023) while positive neighborhood social activity was associated with a decreased risk (AOR = 0.002; p = .013). Neighborhood social activity was also associated with decreases in use (frequent to infrequent use; AOR = 2.342; p = .020). Conclusions/Importance: These findings demonstrate that physical disorder within the context of a low-income urban neighborhood adversely impacts marijuana use. However, even in the presence of physical disorder, interventions that foster collective efficacy among residents through positive social activity may prevent initiation and progression of marijuana use.

“Flint Can’t Get in the Hearing”: The Language of Urban Pathology in Coverage of an American Public Health Crisis

This study examines the presence and influence of urban pathology language in coverage of the Flint, Michigan, water crisis. The use of urban pathology language to describe low-income urban neighborhoods may lead news consumers to “understand those communities entirely in terms of their problems.” This study of coverage in The New York Times and the Wall Street Journal describes urban pathology frames that suggest a lack of agency among residents. The use of those frames, the study argues, may distract from broader questions of environmental justice.

In Defense of Food Curriculum: A Mixed Methods Outcome Evaluation in Afterschool.

Background. Highly processed foods are inexpensive and abundant in our food supply, nutritionally poor, and disproportionately marketed to minority youth. This study is part of a curriculum development project to develop, implement, and evaluate the In Defense of Food (IDOF) curriculum designed to increase intake of whole/minimally processed foods and decrease intake of highly processed foods in youth. Aims. This pilot outcome evaluation was undertaken to assess initial effectiveness and to provide an in-depth understanding of changes in behavioral outcomes and psychosocial mediators. Methods. We used an explanatory mixed method approach, including a single-arm pretest-posttest of intervention effect, followed by a food rules assessment and in-depth interviews to describe participant responses to the intervention in more detail. The study was conducted in three afterschool classrooms in urban low-income neighborhoods with 32 multiethnic middle-school youth, receiving 10 weekly 2-hour sessions. Results. Two weeks postintervention, there was a large positive significant increase in whole/minimally processed food intake (p < .01; d = 0.59) and a small decrease in consumption of highly-processed foods (p = ns; d = 0.06), compared with baseline. Significant increases in psychosocial mediators: Self-efficacy and positive outcomes expectations were seen; others were not significant but changed in the desired direction. Qualitative assessments suggest that the intervention promoted skill building, but environmental barriers made these difficult to use. Discussion. The IDOF curriculum may be most effective for promoting consumption of fruits and vegetables, rather than decreasing intake of highly processed foods. In addition, in this young age-group, short actionable food rules may support self-regulation and behavior change. Conclusion. Among adolescent students in low-income urban neighborhoods, the IDOF afterschool curriculum may help promote self-efficacy and positive outcome expectancies and increase fruit and vegetable intake. Focusing on food processing and using "Food Rules" may be promising to elicit behavior change in youth; however, greater supports are needed to overcome social and environmental barriers.

“Order as well as Decency”: The Development of Order Maintenance Policing in Black Atlanta

In 1971, Ebony magazine named Atlanta the country’s “new Black Mecca,” citing its black political and economic leadership as well as the success of black businesses in the city. At this same time, however, Atlanta, like cities around the country, experienced rising crime rates and economic decline in its urban core. This article examines how Atlanta’s black political leaders, supported by both white and black business owners, responded to the crime crisis by privileging the preservation of order and the protection of capital in their public safety policies. It suggests that this commitment to orderliness, often overlooked in examinations of black political culture, undergirded black political leaders’ advocacy of punitive crime control procedures in the postcivil rights era. Analyzing how black political officials and property owners advocated for intensified foot patrol policing and public decency legislation, this article argues that the city’s black political class were early theorizers and codifiers of order maintenance, or “broken windows,” or still “quality-of-life” policing. Consequently, black business owners and municipal officials sanctioned the expansion of police power in low-income urban neighborhoods in the postcivil rights era.

Adaptation of DASH diet (Dietary Approach to Stop Hypertension) for postpartum nutritional care at primary healthcare.

Postpartum weight retention has been found to predict obesity. However, in Brazil, there's no national strategy for nutritional care of postpartum woman. This study aimed to adapt DASH diet (Dietary Approaches to Stop Hypertension) for nutritional counseling of postpartum woman, at primary healthcare. Methodological study, carried out in 2016, at low-income urban neighborhood in the city of Rio de Janeiro. It was developed in four steps: translation, food and food groups adaptation, identification of geographic and economic access to food and viability evaluation. The food groups of original diet were structured to Brazilian dietary pattern. After viability analysis, it was observed that the geographical access of food should be accounted to enable greater adherence. A qualitative and illustrated meal plan was elaborated for nutritional counseling. The adapted DASH diet for nutritional care of postpartum woman seems to be according to the Brazilian dietary pattern, maintaining nutritional characteristics that provide the health benefits previously demonstrated. Currently, it's being used in interventional study in two primary healthcare unities at the city of Rio de Janeiro.

Amygdala reactivity as a marker of differential susceptibility to socioeconomic resources during early adulthood.

Models of differential susceptibility hypothesize that neural function may be a marker of differential susceptibility to context, but no studies have tested this hypothesis. Using a sample of 310 young men from low-income urban neighborhoods, this study investigated amygdala reactivity to facial expressions as a moderator of the relations between socioeconomic resources and later antisocial behavior (AB) and income. For individuals with high amygdala reactivity, greater socioeconomic resources at age 20 predicted less AB and greater income at age 22. For young men with low amygdala reactivity, however, socioeconomic resources at age 20 did not predict later outcomes. Amygdala reactivity to fearful facial expressions, key to the etiology of AB, moderated links between resources and AB. In contrast, amygdala reactivity more generally to multiple facial expressions moderated the effects of resources on later income attainment. Both interactions met rigorous quantitative criteria for patterns of differential susceptibility rather than diathesis stress or vantage sensitivity. Moreover, these associations remained significant after inclusion of socioeconomic resources during earlier developmental periods. These results suggest that greater amygdala reactivity to facial expressions is a marker of greater susceptibility to context, for better or for worse, during the transition to adulthood. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

#digital hood: Engagement with Risk Content on Social Media among Black and Hispanic Youth.

The digital neighborhood is the amalgamation of the spaces online where youth connect with others. Just as Black and Hispanic youth live in neighborhoods that influence their health, they are also influenced by online digital neighborhoods. Youth are exposed to social media content featuring substance use, sexual risk, and violence, yet little is known about the extent to which youth engage with such content. Using a modified venue sampling strategy, we administered CASI surveys to 145 Black and Hispanic youth aged 13-24 living in low-income urban neighborhoods. Across social media platforms, respondents reported high levels of exposure to sexual, alcohol, drug, and violence-related content (65-84%). Users reported lower levels of engagement with risk-related content (on an engagement continuum), ranging from passive exposure to dissemination. While negative risks may be amplified in the digital neighborhood, youth appear to strategically limit their engagement with that content. However, because risk behavior messaging is common in these digital neighborhoods, these spaces provide opportunities for health promotion interventions.

"Whatever I Have to Do That's Right:" Culture and the Precariousness of Personhood in a Poor Urban Neighborhood.

This article presents a person-centered case study of one woman's struggles to realize a meaningful sense of personhood in a low-income urban neighborhood in Milwaukee, Wisconsin. An analysis of longitudinal ethnographic data for this case reveals how everyday aspirations toward a morally resonant lived-sense of personhood were informed by a core assemblage of three cultural models: "providing" and "being there" as a parent and doing so within a framework of "defensive individualism". This assemblage of cultural models was particularly compelling because of a combination of the embodied residue of childhood experiences and moments of "moral breakdown" in adult life. The experiences of moral breakdown were particularly meaningful because recurrent episodes of material hardship that constantly threatened to upend past efforts to realize a meaningful sense of personhood in everyday life and, in turn, generated a constant effort to reclaim and repair the symbolic markers of an achieved personhood that had been lost. These observations point to a precariousness of personhood that seemed to further motivate an investment in a self-definition in terms of this combination of cultural models.

Who you are and where you live can determine how long you live: What nurses need to know about cardiovascular disease among low‐income urban‐dwelling minority communities

Who you are and where you live can determine how long you live: What nurses need to know about cardiovascular disease among low‐income urban‐dwelling minority communities

Community change and resident needs: Designing a Participatory Action Research study in Metropolitan Boston

The health implications of urban development, particularly in rapidly changing, low-income urban neighborhoods, are poorly understood. We describe the Healthy Neighborhoods Study (HNS), a Participatory Action Research study examining the relationship between neighborhood change and population health in nine Massachusetts neighborhoods. Baseline data from the HNS survey show that social factors, specifically income insecurity, food insecurity, social support, experiencing discrimination, expecting to move, connectedness to the neighborhood, and local housing construction that participants believed would improve their lives, identified by a network of 45 Resident Researchers exhibited robust associations with self-rated and mental health. Resident-derived insights into relationships between neighborhoods and health may provide a powerful mechanism for residents to drive change in their communities.

Abstract C48: Colorectal cancer among African-Americans: Examining the relationship between dietary habits, physical activity, and colorectal cancer screening to reduce cancer risk and health disparities

Abstract Colorectal cancer (CRC) is the second leading cancer killer in the United States affecting both men and women. It is found that African-American men and women have the highest rates of CRC as well as suffer the highest rates of mortality from CRC than any other racial or ethnic group. Research shows that unhealthy dietary habits such as a diet low in fruits and vegetables, a low-fiber and high-fat diet all contribute to an increased risk of CRC. Low levels of physical activity and being overweight or obese also contribute to an increased risk of developing CRC, and the African-American community has the highest rates of obesity (48.1%) compared to other racial and ethnic groups. CRC can be prevented through lifestyle behaviors, such as diet, physical activity, smoking, weight, and appropriate CRC screening. A majority of the literature does not specifically focus on examining how these lifestyle behaviors influence CRC screening within the African-American community. In the past few years, diabetes has emerged as a potential link with CRC. Obesity is a risk factor for comorbidities such as diabetes and hypertension and CRC. The aim of this study is to examine the relationship between dietary habits, physical activity, comorbidities, and CRC screening in the African-American community. Methods: This study is a secondary data analysis of a longitudinal study, assessing a family health history intervention on the prevention of cancer and chronic diseases. A total of 164 participants were recruited from barbershops/salons, located in low-income urban neighborhoods in the Washington, D.C. metropolitan area. Baseline survey measures include participants' demographics, CRC screening status, family history of cancer, body mass index (BMI), diagnosed chronic diseases, dietary habits, levels of physical activity, and stress, among others. Diet was assessed at baseline with use of PrimeScreen inventory, a short dietary assessment questionnaire, the results of which compare well with extended food frequency questionnaires and biomarkers. PrimeScreen assessed self-reported intake of various foods, specifically fruits, vegetables, whole grains, fish, and red meat as well as other foods with saturated and trans fats. The survey also included the number of meals prepared away from the home and meals from fast-food establishments. Body mass index was calculated with participant self-reported height and weight. According to the Centers for Disease Control, an overweight BMI is 25-29.99 and obese BMI is ≥30. Physical activity was measured through self-reported activity level, opportunities to engage in activity, and the number of days the participant was physically active in the past 7 days. Results: Preliminary analysis shows participants were primarily African-American (89%), female (54%), and aged ≥50 (53%). According to BMI, 52% were obese and 30% were overweight. Only 18% of participants were familiar with “MyPlate.” Participants unaware of “MyPlate” reported greater unhealthy dietary habits (p=.007). In regards to comorbidities, participants were diagnosed with high blood pressure (44.5%) and diabetes (15.2%). Only 29.9% of participants had an up-to-date CRC screening at baseline. Multivariate analysis will be presented to identify predictors of CRC screening, comorbidities, BMI, physical activity, and dietary habits. Conclusion: A better understanding of the role that diet, physical activity, and comorbidities play among African-Americans is integral to promote healthy dietary habits to reduce obesity and cancer risk. This information can be used to inform public health interventions that specifically target dietary habits and physical activity to reduce cancer risk and ultimately reduce cancer health disparities. Citation Format: Noora S. Kanfash, Mary A. Garza, Luciana Assini-Meytin. Colorectal cancer among African-Americans: Examining the relationship between dietary habits, physical activity, and colorectal cancer screening to reduce cancer risk and health disparities [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr C48.

The Neighborhood Impacts of Local Infrastructure Investment: Evidence from Urban Mexico

This paper reports on the results of a large infrastructure investment experiment in which $68 million in spending was randomly allocated across a set of low-income urban neighborhoods in Mexico. We show that the program resulted in substantial improvements in access to infrastructure and increases in private investment in housing. While a pre-committed index of social capital did not improve, we find an apparent decrease in the incidence of personal assault and teen misbehavior in neighborhoods where investments were made. The program increased the aggregate real estate value in program neighborhoods by two dollars for every dollar invested. (JEL H76, O18, R23, R31, R53, Z13)