Poor Neighborhoods Research Articles

(Dis)connected by design? Using participatory citizen science to uncover environmental determinants of social connectedness for youth in under-resourced neighbourhoods.

Social isolation and loneliness are a growing public health concern. Inadequacies in neighbourhood social infrastructure can undermine social connectedness, particularly for youth, who are dependent on their local environments yet often marginalized from public spaces and city planning. Integrating citizen science with participatory action research, the Youth.hood study set out to explore how neighbourhood built environments help or hinder social connectedness from the understudied perspective of youth in under-resourced and racialized communities. Youth (n = 42) from three neighbourhoods in Vancouver, Canada were recruited to: (1) Assess environmental assets and barriers to connectedness in their neighbourhoods using a digital photovoice app; (2) Analyze and prioritize their collective data into themes; and (3) Design and advocate for environmental improvements through a participatory workshop and forum with residents, city planners, and elected officials. Data on participant characteristics and neighbourhood perceptions were collected via an online survey and analyzed descriptively. Participatory analysis was conducted with youth using methods from thematic analysis, photovoice, and design thinking. Youth captured 227 environmental features impacting their connectedness. The most frequently reported assets were parks and nature (n = 39, 17%), including formal and informal green spaces, and food outlets (n = 25, 11%). Top barriers included poor neighbourhood aesthetics (n = 14, 6%) and inadequate streets and sidewalks (n = 14, 6%). Thematic analysis with youth underscored four themes: (1) Connecting through mobility: The fun and functionality of getting around without a car; (2) The power of aesthetics: Mediating connections to people and place; (3) Retreating to connect: Seeking out social and restorative spaces for all; and (4) Under-resourced, not under-valued: Uncovering assets for sociocultural connection. Youth described their local environments as affording (or denying) opportunities for physical, emotional, and cultural connection at both an individual and community level. Our findings extend evidence on key environmental determinants of social connectedness for youth, while highlighting the potential of community design to support multiple dimensions of healthy social development. Additionally, this work demonstrates the resilience and agency of youth in under-resourced settings, and underscores the importance of honouring assets, co-production, and intergenerational planning when working to advance healthy, connected, and youthful cities.

Negligible impact of supermarkets on food security (so far) in low-income neighborhoods of Accra, Ghana

In recent years, African policymakers have embraced supermarket development as a form of food system modernization, but the impacts of the proximity of supermarkets on low-income households in a developing African city are largely unexplored. Using a sample of 680 households in seven of Accra’s poorer neighborhoods, we examine the dimensions and level of food security, household-level determinants, and what impact, if any, the arrival of supermarkets has had on local food security. Using two internationally accepted food-security metrics, (Food Consumption Score and Household Food Insecurity Access Scale), two economic measures (income equivalence and asset ownership), and satellite imagery of supermarket locations, we find that physical proximity to supermarkets is not significantly associated with household food security in low-income areas of Accra. The majority of poor households in Accra are currently food secure, but asset ownership is a much stronger predictor of food security than income. The relatively high degree of food security in Accra is likely related to credit-based relationships that households have with local food vendors. Further, given that supermarkets can compete with these so-called “informal” vendors for access to public space, these credit-based relationships will suffer with new supermarket development. Our study highlights the need for nuanced understanding regarding the role of consumer-retailer and retailer-retailer relationship in ensuring food access for low-income households in urban Africa.

Social determinants of health affect disease severity among preschool children with sickle cell disease

AbstractIndividuals with sickle cell disease (SCD) face the burden of managing a lifelong chronic illness, increasing vulnerability to social determinants of health (SDoH). However, how SDoH contributes to health disparities is understudied. We hypothesized that preschool children with SCD living in poor neighborhoods with higher socio-economic distress would experience increased acute care utilization (ACU; described as emergency department visits plus hospitalizations) despite disease-modifying therapy. Participants' home addresses (aged 0-6 years) were mapped using census tract environmental data from the US Department of Agriculture Food Access Research Atlas. In multivariable analyses controlled for sickle genotype and disease-modifying therapies (hydroxyurea and chronic transfusion), SDoH indicators, that is, limited access to food, lack of vehicle, low income, and inadequate education, were associated with higher ACU. Living in households with children >1 mile from a supermarket was associated with more hospitalizations (odds ratio [OR], 1.44; 95% confidence interval [CI], 1.13-1.85) and ACU (OR, 1.37; 95% CI, 1.06-1.80) among children with SCD (aged <6 years). In households with at least 1 bachelor's degree, children with SCD experienced less ACU (OR, 0.67; 95% CI, 0.50-0.93) and hospitalizations (OR, 0.67; 95% CI, 0.49-0.92). Preschool children with SCD with limited access to food and transportation are at a higher risk of acute complications despite receiving free evidence-based therapy and social support. The family education level may have a protective effect. Although SDoH in crowded households and health care maintenance visits were not a focus of this study, future research should consider these factors. Understanding the SCD and SDoH association is crucial for directing resources to improve affected children's health.

Household Well-Being, Environment and Health in the Peripheries of the Metropolitan Area of Oaxaca City

Objective: The economy of poor urban households is analyzed using a well-being function that also considers incomes, sociodemographic characteristics (CS), housing and the environment. Theoretical structure: The dependent variable is household well-being (BF) and the explanatory variables are all incomes obtained from the market economy, as well as government transfers (TG). The CS represent resources that facilitate obtaining income; housing provides income indicators; and the environment are the physical conditions that determine the state of health. Methodology: A probabilistic survey was applied to a sample of households in four poor peripheral neighborhoods. The equations were constructed using ordinary least squares regression and the beta coefficients measure the contribution of the variables from the four categories above to the BF. The effects of these variables on health expenditure (GS) are also measured. Discoveries: The main incomes that contribute to the BF were determined and these make a contribution equivalent to that of the set of variables of the CS, housing and family businesses. Likewise, the environment and diseases increase GS. Practical and social implications: Research shows that poor peripheral urban households participate in the market economy and that an increase in average age contracts their level of BF. Originality/value: The tested model turned out to be versatile and accurate in analyzing the economies of poor urban households and has greater explanatory power than the agricultural household models and the applied general equilibrium model.

Inequalities in the risk and prevention of invasive meningococcal disease in the United States - A systematic literature review.

Vaccination remains the most effective strategy to prevent invasive meningococcal disease (IMD), with MenACWY, MenB and MenABCWY recommended for adolescents/young adults in the United States (US). However, vaccination coverage remains suboptimal, which could be related to population inequalities. To understand the impact of IMD risk, prevention and control inequalities, a global systematic literature review (Medline, Embase, 2012-2022) was conducted on individual, socioeconomic, and environmental inequalities associated with IMD risk, prevention and control in all ages. Studies on IMD risk (n = 15) and prevention (n = 14) inequalities were identified. IMD incidence proportions were higher in Medicaid versus commercially insured populations, and IMD mortality was higher in poorer neighborhoods. White adolescents, adolescents from lower income families, and with lower maternal education were more likely to receive MenB vaccination; while Black and Hispanic adolescents, and adolescents with higher family incomes, were more likely to receive MenACWY vaccination. Meningococcal vaccination was associated with being up-to-date with other vaccinations, having multiple healthcare/well child visits, having a pediatrician as healthcare provider (HCP), and attending private facilities; while being uninsured was associated with lower vaccination. States with a MenACWY vaccination mandate and higher pediatrician-to-children ratios had higher vaccination rates. Important inequalities were due to individual differences, socioeconomic, and environmental factors. IMD prevention is suboptimal, especially among adolescents/young adults. To improve health equity, health policy makers could ameliorate meningococcal vaccination coverage across the US, with simplified and stronger meningococcal vaccine recommendations from public health authorities, and initiatives to enhance parental/patient and HCP knowledge of IMD and vaccine recommendations.

Population-based estimates of major forms of housing insecurity among community-living older Americans.

The number of older adults struggling to maintain adequate housing is growing. Prior studies have used various criteria to measure housing insecurity; however, no standardized definition exists to date. Using a multidimensional approach, our study sought to calculate population-based estimates of various forms of housing insecurity among community-living older Americans and determine how these estimates differ across key characteristics. This study utilized data from the 2011 round of the National Health and Aging Trends Study (NHATS), a prospective longitudinal study of Medicare beneficiaries aged 65 years or older. Three key forms of housing insecurity were operationalized: poor housing affordability (PHA), poor housing quality (PHQ), and poor neighborhood quality (PNQ). Population-based estimates of these forms of housing insecurity were calculated using analytic sampling weights and stratified by age, gender, race and ethnicity, frailty status, and dementia status. Totally 6466 participants were included in the analysis, representing 29,848,119 community-living older Americans. The mean (standard deviation) age was 77.3 (7.7) years; by weighted percentages, 56.0% identified as female, 81.3% as White, 8.2% Black, and 7.1% Hispanic. At least one form of housing insecurity was identified in 38.5% of older Americans. Individually, the prevalence of PHA was 14.8%, PHQ 24%, and PNQ 12.5%. The prevalence of at least one form of housing insecurity was higher among persons of color (62.9% Black and 66% Hispanic vs White; p < 0.001), those with frailty (40.9% pre-frail and 49.4% frail vs robust; p < 0.001), and those with cognitive impairment (48.1% possible and 51% probable dementia vs no dementia; p < 0.001). Nearly one in three community-living older Americans experience at least one form of housing insecurity. This was most common among vulnerable subgroups. Our multidimensional approach to defining various forms of housing insecurity can be used for future studies focused on improving social determinants of health among high-risk older adults.

Comparison of Aedes aegypti arbovirus transmission thresholds in two communities with differing water supply infrastructure

BackgroundTo assess whether the ‘economic boom’ in the tropical seaport city of Barranquilla improved tapped water supplies to socio-economically poor neighbourhoods resulting in: (1) their reduced use for domestic water-storage in large (> 1,000-litre) custom-made cement tanks which are their principal Aedes aegypti breeding sites and (2) their pupae/person index (PPI) values to below their established 0.5–1.5 PPI arbovirus transmission-threshold value, compared to matched neighbourhoods in the: (a) pre-economic boom (2004) period in Barranquilla and (b) economically-neglected seaport city of Buenaventura.MethodsThe simple, accurate and robust water surface sweep-net/calibration factor or total count methods were used to determine the total Ae. aegypti pupae numbers in greater or less than 20-litre water-holding container types located ‘inside’ or ‘outside’ these neighbourhood premises. The women residents also participated in questionnaire-based responses about their domestic water supplies, water-storage and maintenance and mosquito life stages and disease transmission knowledge, to subsequently plan appropriate resident education programmes. Microsoft Excel 8.0 with OpenEpi was used to determine the samples sizes and the statistical values.ResultsTapped water supplies to the three poor Barranquilla neighbourhoods were dramatically increased from 2004 to 2023 resulting in their residents significantly reducing their: (a) large cement water-storage tanks from 1 per 6.9 (2004) to 1 per 31.2 (2020) premises (z = 10.5: p = 0) and (b) PPI values to 0.16, 0.19 and 0.53 (mean: 0.29: 95% CI ± 0.4) in each study neighbourhood. In contrast, tapped water supplies remained inadequate in the Buenaventura neighborhoods, thereby resulting in their continued use of many large (> 1,000-litre) water-storage containers (Barranquilla: 1 per 31.2 and Buenaventura: 1 per 1.5 premises: z = − 9.26: p = 0), with unacceptably high 0.81, 0.88 and 0.99 PPI values in each study neighbourhood (mean 0.89: 95% CI ± 0.12).ConclusionsImproved tapped water supplies resulted in reduced numbers of large custom-made stoneware water-containers, as are employed by poor residents throughout the world, as well as their Ae. aegypti PPI transmission threshold values which, together with appropriate residents’ education programmes, are also urgently to reduce to prevent/reduce Ae. aegypti transmitted human diseases globally.

Opposing Misperceptions of Wealth: Liberals Overestimate Their Neighborhoods’ Wealth in Wealthier Neighborhoods While Conservatives Overestimate Their Neighborhoods’ Wealth in Poor Neighborhoods

Although perceptions of wealth are shaped by people’s social environment and ideological beliefs, few studies integrate these two perspectives. We address this oversight by examining the association between participants’ actual and estimated average neighborhood household income and whether political orientation moderates this relationship. Using a large, nationwide random sample of New Zealand adults (N = 14,853), our results reveal that both liberals and conservatives overestimated the wealth of their own neighborhoods—but these differences only emerged in the poorest and wealthiest neighborhoods. Specifically, in poor neighborhoods, conservatives were less accurate than liberals at estimating the average income of their neighborhood. In rich neighborhoods, liberals were less accurate than conservatives at this same task. The implications of these results for understanding (mis)perceptions of wealth on both sides of the political spectrum are discussed.

Interactions among neighborhood conditions, sleep quality, and episodic memory across the adult lifespan

ABSTRACT Objectives On average, adults racialized as non-Hispanic Black and Hispanic sleep more poorly than adults racialized as non-Hispanic White (hereafter, Black, Hispanic, White), but associations between factors that may moderate sleep-memory associations in these groups, such as neighborhood conditions, are unclear. Poorer neighborhood conditions (e.g. lower neighborhood cohesion) may be negatively associated with sleep quality and multiplicatively influence sleep-memory associations. We hypothesized lower ratings of neighborhood conditions would be associated with poorer sleep quality and moderate the association between sleep quality and episodic memory, especially in Black and Hispanic adults, who are disproportionately situated in poor neighborhood conditions. Design Seven-hundred-thirty-six adults across the adult lifespan (27-89 years) were recruited from the northern Manhattan community as a part of the Offspring Study of Racial and Ethnic Disparities in Alzheimer’s disease. Sleep quality was assessed using a modified version of the Pittsburgh Sleep Quality Index, and episodic memory was evaluated with the Buschke Selective Reminding Test. With multiple regression models, we measured associations between perceived neighborhood conditions and sleep quality and the interaction between sleep quality and neighborhood conditions on episodic memory stratified by racial/ethnic and gender identity groups. Results Overall, poorer neighborhood conditions were associated with poorer sleep quality. In Black and Hispanic women, the sleep-memory association was moderated by neighborhood conditions. With more favorable neighborhood conditions, Black women showed an association between higher sleep quality and higher memory performance, and Hispanic women showed a protective effect of neighborhood (higher memory even when sleep quality was poor). Conclusion Poorer neighborhood experiences may contribute to poorer sleep quality across groups. In Black and Hispanic women, the association between sleep quality and episodic memory performance was dependent upon neighborhood conditions. These findings may inform tailored, structural level sleep interventions, aimed to improve neighborhood experiences and thereby sleep quality and episodic memory.

Immigrants, slums, and housing policy: The spatial dispersal of the Ethiopian population in Israel

Nearly 40 years after the first wave of Ethiopian immigration to Israel, the country’s Ethiopian population still suffers from significant socioeconomic disadvantage: Many of its members live in highly homogeneous poor neighborhoods, which expose them to a variety of negative externalities. This study is the first to examine empirically the impact of Israel’s policy of absorption and spatial distribution on the formation of homogeneous ghettos of Ethiopians, and the contribution of the government’s major housing assistance programs for Ethiopians to solving or exacerbating this problem. The study, structured into four main stages, embraces a mixed-methods research approach drawing on diverse theoretical and methodological frameworks. In the first stage, we use descriptive statistics to introduce the current characteristics of the Ethiopian population in Israel and compare them with those of other marginalized social groups. In the second stage, we analyze the government’s various housingassistance programs for the Ethiopian population, focusing on three flagship programs. The third stage analyzes the spatial outcomes of the primary housing-assistance program, which remains active to date. Lastly, through in-depth interviews with policymakers and Ethiopian leaders, we delve into the underlying considerations that lay behind the policy decisions made. The research findings indicate that Ethiopians experience social and economic disadvantages, yet their spatial situation seems to be better than that of other disadvantaged groups, because a significant part of this population apparently enjoys the advantages of living in the center of the country. The findings further show that while the various government housing-assistance programs have elevated homeownership rates among Ethiopians, they have not prevent the formation and proliferation of spatial concentrations of poverty. Nor have they ever provided both the means and the knowledge needed to enable Ethiopians households to enhance their quality of life by moving out of these neighborhoods. To truly address the problem of homogeneous concentrations of poverty, a holistic but tailor-made housing policy is essential. This policy should not simply mirroring the national housing policy, which focuses almost exclusively on homeownership, but rather incorporate diverse policy measures for different populations. A good and just housing policy must take into account the existing spatial dynamic and the core–periphery relations and ensure an environment that provides quality employment and education opportunities alongside social networks that the residents can leverage to increase their social, economic, and cultural capital. Otherwise, the government housing-assistance programs will continue to be mere lip service and too little, too late.

Dynamic neighborhood isolation and resilience during the pandemic in America's 50 largest cities

Planners have been in the war against neighborhood isolation for a long time. But studies have largely focused on the isolation within a neighborhood, ignoring its disconnectedness with the city and other neighborhoods based on human mobility. Analyses of human mobility data in America's largest 50 cities indicate that poor neighborhoods—regardless of its racial characteristics—are far less connected with mainstream neighborhoods (nonpoor and white neighborhoods) than nonpoor neighborhoods, and the gap is even wider during the pandemic. We also explored the resilience of neighborhoods in recovering the connection with the city and mainstream neighborhoods, and its built environment determinants. Our findings offer new insights for equitable neighborhood planning and policymaking in the context of the COVID-19 pandemic.

TRANSFORMING MEDELLÍN: ARCHITECTURE AND URBAN DESIGN AS AGENTS OF SOCIAL CHANGE

This article examines the transformative impact of Sergio Fajardo’s mayoral administration (2003–2007) in Medellín, Colombia, focusing on architecture and urban design projects that have promoted equity. Central to this urban renaissance was the Proyecto Urbano Integral (PUI) Nororiental, which revitalized informal settlements in the city’s northeastern zone. The initiative leveraged financing from Empresas Públicas de Medellín (EPM), a city-owned utility company, ensuring sustainable investment in public works without reliance on international loans. This financial model enabled the redistribution of funds to Medellín’s poorest neighborhoods, fostering transparency and combating corruption. Key to this urban strategy was the involvement of the Empresa de Desarrollo Urbano (EDU) which implemented the PUI with an intersectional planning approach combining public transit, education, culture, recreation, health, and safety initiatives. The PUI emphasized community participation through “Imaginary Workshops” promoting ownership and engagement among residents. The PUI Nororiental, enhanced by the Metrocable transit system and associated public spaces, has successfully integrated isolated neighborhoods while reducing violence and fostering social cohesion. Despite critiques of high costs, this article argues that quality public spaces and civic buildings promote community pride and destigmatization. Medellín’s “social urbanism” serves as a model for addressing inequity in Latin America and the broader Global South, demonstrating how architecture and urban design can drive social change.

Playing the ‘pibe chorro’ game: masculine skills and legitimate peripheral participation in street culture

ABSTRACT In this article, I analyse the street learning that a group of boys in a poor neighbourhood in Argentina produce when they play at being ‘pibes chorros’. Through the observation of interviews, photos and audio recordings made in the neighbourhood since 2010, I show how these games are occasions for boys to learn to pretend they know how to steal and to recreate a masculine image of toughness in order to cope with both street life and local working life. In this way, street culture, which in other studies is often seen as a constraint on available educational opportunities, in this article is a central place for learning by legitimate peripheral participation to occur (Lave and Wenger [1991]. Situated Learning: Legitimate Peripheral Participation. Cambridge: Cambridge University Press). The masculine acquisitions and skills of street play allow these boys greater preparation and participation social for life in highly formal spaces such as oil, the police and the local state.

Urban growth and stratification: The role of locational externalities

Urban areas that have undergone rapid and recent growth processes can shed light on the forces driving urban stratification and gentrification. This article analyzes how the process of urban growth itself, driven by migration, affects the stratification of the city. The availability of detailed data makes it possible to observe how high-income settlement patterns are driven by attraction (homophily) and repulsion (heterophobia). We consider neighborhood composition (i.e., the number of high-income residents in the vicinity of a given location) as a potential factor that can explain agents' higher willingness to pay in some locations. We propose a model of urban spatial equilibrium with locational externalities, related to preexisting neighborhood characteristics, that can help explain why new rich neighborhoods are located close to existing rich neighborhoods and far from poor neighborhoods. In this model a monopolistic owner will allocate available locations to those agents willing to pay the most, taking advantage of agents' willingness to pay more when locations are surrounded by high-income individuals. The location externality influences the dynamics of urban configuration through attraction-repulsion effects, as new rich neighborhoods are located near other rich neighborhoods and far from poor neighborhoods, thus reinforcing socio-spatial-stratification. This mechanism sheds light on why gentrification occurs only in some areas, while others with a priori better localization do not experiment changes.

Collusion and Violence in Underground Drug Markets

Abstract Poor urban neighborhoods throughout the Americas are marked by high rates of interpersonal violence, much of which is associated with the underground drug trade. Scholars have examined the social dynamics that produce and shape violence among neighborhood residents and the state agents who police them. But less is known about the clandestine collaborations between residents and agents of the state and how those collaborations might contribute to violence. This study draws on ethnographic fieldwork and an original legal archive to analyze the links between police collusion with drug market groups and interpersonal violence. We find that 1) police provide their collaborators with powerful weapons and ammunition; 2) state agents become involved and help escalate violent territorial disputes between underground market groups; and 3) violence erupts between state agents colluding with civilian dealers and those attempting to disrupt the drug trade. These findings shed new light on the social and organizational factors shaping patterns of violence in poor neighborhoods, illuminating the ways that state agents contribute to that violence. In doing so, the findings advance our understanding of policing, drug markets, and the role of the state in shaping the everyday lives of the urban poor.

Concealed exchanges: relational work in racially segregated housing markets

Abstract How do real-estate investors make decisions about where to purchase properties? In recent years, an increasing share of the market has gone to investors, making it critical that we understand the behaviors of these important actors. This study examines investment as a relational process. Through 74 interviews with real estate investors, as well as additional interviews with homeowners and renters in low- to middle-income neighborhoods in Baltimore, I find that strategic interactions and intimate relational work among professional and amateur investors are key to understanding how properties are sold. Professional investors cultivate bonds with new investors by identifying common goals and obstacles. They also use concealment strategies to sell homes, including: legal concealment, concealment through bundling, and concealment through brokers. Legal concealment involves using legal vehicles to transfer properties between owners. Concealment through bundling occurs when properties are bundled together to be sold in bulk. Finally, concealment through brokers entails finding brokers who can connect sellers to investors from other markets. These strategies obscure not only the nature of the relationship between buyers and sellers but also the quality of products being sold. The series of exchanges resemble how products are sold within direct-selling organizations and other predatory industries, which rely on a pyramid-like structure of sponsors and distributors. Furthermore, concealment strategies are more likely to happen in weaker markets and poorer neighborhoods where investor behavior is less constrained—this suggests that concealment has potential to increase urban inequality.

Discrimination Experienced by Biracial Children in Angeles City, Philippines

There is a lack of study on the nature and scope of discrimination experienced by biracial children in the Philippines. Aiming to contribute to filling the gap, this article draws from a doctoral thesis that used an indigenous Filipino research approach to investigate Filipino biracial children’s view of their dignity. Biracial children from poor neighborhoods in Angeles City participated in the study. Their caregivers and some community members were also interviewed. The research found that colonial beliefs and practices led to formation of biases which triggered the discrimination experienced by the biracial child participants and negatively affected their dignity. The biases were manifested during incidences of bullying and name-calling, cultural/racial stereotyping, social stigma, not being consulted, and corporal punishment. Recommended measures to address discrimination include access to education and promotion of pakikipagkapwa (treating others as fellow human being).

Gang Rule(s): Towards a Political Economy of Youth Gang Dynamics in Nicaragua

This article explores the longitudinal dynamics of youth gang transformation in urban Nicaragua. On the basis of an overview of successive gang iterations that have emerged over the past 30 years in barrio Luis Fanor Hernández, a poor neighborhood in Managua, the capital city of Nicaragua, the article identifies key elements for the articulation of a political economy of both change and stability. In particular, drawing on Bourdieusian theory, it conceives of a gang as a “social field” rather than as a discrete organizational form. It traces how different processes of individual and collective capital accumulation underpinning the social order promulgated by distinct gang iterations emerge and interact with each other, and the consequences that this has for their evolution over time. In doing so, the article offers a better understanding of the logic of what might be termed “gang rule(s)”.

Depressive Symptoms and Urbanization - A Cross-Sectional Network Analysis

IntroductionWith increasing urbanization, more people are exposed to mental health risk factors stemming from the urban social or physical environment. However, research on urbanization and depression is not clear.ObjectivesThis study aimed to explore environmental and social factors with depression symptoms in view of a network theory of mental health disorders.MethodsThe study was conducted among a representative sample of 3,296 habitants of Metropolis GZM (63% of women)– the most urbanized region in Poland. The measurements used were PHQ-9, UCLA, Neighbourhood Cohesion (Neighbourhood Belonging and Social Cohesion), REAT 2.0 (Quality of architecture in neighborhood area), distance and frequency use of green public areas, Self-Rated Health, Physical Activity, size of place of residence per person.ResultsThe prevalence of depression risk in villages (N=713), towns under 20,000 (N=219), towns (under 99,000; N=823), and cities (under 300,000; N=1541) was 44.2%, 44.7%, 39.2%, and 34.9% respectively.The depression nodes with the highest centrality degree and expected influence were PHQ9 (suicidal thoughts), PHQ2 (feeling depressed), and neighborhood belonging. Living in a more urbanized area (UA) had a smaller centrality degree in the network. Edges between PHQ9 and environmental factors were mediated by loneliness (UCLA). Poor architectural conditions (REAT) were linked positively with neighborhood belonging and adversely with social cohesion. Living in UA was negatively related to PHQ9, PHQ5 (eating control), and PHQ2, social cohesion, and green area distance, while positively to PHQ7 (problems with being focused), poor physical health, REAT, and neighborhood belonging (Figure 1).ConclusionsLiving in a city is negatively related to the most central depression symptoms. Even though social cohesion is negatively linked to UA, neighborhood belonging is higher in more urbanized areas.The balance between detrimental environmental factors and those that protect mental health requires a better understanding of the interaction between urban living and depression.Disclosure of InterestNone Declared

Crowded and warmer: Unequal dengue risk at high spatial resolution across a megacity of India

The role of climate factors on transmission of mosquito-borne infections within urban landscapes must be considered in the context of the pronounced spatial heterogeneity of such environments. Socio-demographic and environmental variation challenge control efforts for emergent arboviruses transmitted via the urban mosquito Aedes aegypti. We address at high resolution, the spatial heterogeneity of dengue transmission risk in the megacity of Delhi, India, as a function of both temperature and the carrying-capacity of the human environment for the mosquito. Based on previous results predicting maximum mosquitoes per human for different socio-economic typologies, and on remote sensing temperature data, we produce a map of the reproductive number of dengue at a resolution of 250m by 250m. We focus on dengue risk hotspots during inter-epidemic periods, places where chains of transmission can persist for longer. We assess the resulting high-resolution risk map of dengue with reported cases for three consecutive boreal winters. We find that both temperature and vector carrying-capacity per human co-vary in space because of their respective dependence on population density. The synergistic action of these two factors results in larger variation of dengue’s reproductive number than when considered separately, with poor and dense locations experiencing the warmest conditions and becoming the most likely reservoirs off-season. The location of observed winter cases is accurately predicted for different risk threshold criteria. Results underscore the inequity of risk across a complex urban landscape, whereby individuals in dense poor neighborhoods face the compounded effect of higher temperatures and mosquito carrying capacity. Targeting chains of transmission in inter-epidemic periods at these locations should be a priority of control efforts. A better mapping is needed of the interplay between climate factors that are dominant determinants of the seasonality of vector-borne infections and the socio-economic conditions behind unequal exposure.