Poor Urban Neighborhoods Research Articles

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.

Uncovering the determinants of health in deprived urban neighborhoods in Accra, Ghana: a qualitative and participatory reconnaissance study.

Delivering primary care services within the context of rapid urbanization and a changing disease burden is a major challenge in sub-Saharan Africa. Rural models of primary care, including the "Community-based Health Planning and Services" (CHPS) programme in Ghana, have shown improved health outcomes. However, adapting these to the urban context has proved problematic. Differences in the determinants of health found in these settings may help to explain the challenges of delivering CHPS in poor urban neighborhoods in Accra. To inform the redesign of CHPS for the urban context, we aimed to understand the determinants driving health and engagement with health services in three informal settlements in Accra. This study formed a reconnaissance phase for a subsequent participatory action research study. We used qualitative and participatory methods to explore the influence of wider and proximal determinants on health and the use and perceptions of CHPS. Three transect walks with community leaders across the study settings informed interview guides and the recruitment of suitable participants for key informant and focus group interviews. Using a Framework Approach, we analysed transcripts and reports from these activities and developed themes and sub-themes in participants' experiences accessing healthcare. Our findings highlight the importance of wider and proximal determinants of health including physical environment, gender and other social stratifiers including age, ethnicity, religion and disability, on health, health seeking behavior and personal behaviors such as substance misuse, tobacco use and alcohol. Utilization of CHPS was low and seen primarily as a service for maternal and child health. Private providers, ranging from informal drug stores to private clinics, were used most commonly. Community leaders and groups were active, but engagement was limited by opportunity costs for members. Traditional service delivery packages need to be adapted to include non-communicable diseases driven by risk behaviors such as tobacco, unhealthy diet, alcohol and substance abuse. Assets such as volunteerism and nurses embedded within communities are challenging to attain in complex urban settings, yet other assets exist including occupational associations and a range of informal and private providers that could support delivery of preventive and promotive health care with equitable reach.

Local non-violent strategies amid Guatemala’s post-accord violence: understanding the potential and limitations in poor urban neighbourhoods

ABSTRACT The impact residents of violence-affected communities can have on addressing insecurity is underexplored, particularly amid criminal violence. In non-conflict contexts, can non-violent actions by committed individuals transform their violent environments given criminal groups’ social control and capacity to exert violence? Investigating two urban neighbourhoods in post-accord Guatemala, the article evidences how residents engage in violence disruption, breaking generalised self-protection strategies – silence, avoidance and displacement – to proactively address local violence. In doing so, residents can attain tangible security improvements and foster cohesion, social capital and informal leadership – facilitating further collective action. The article draws on 47 interviews, triangulated with police data and documentary evidence. The article contributes novel empirical evidence on the underexplored phenomenon of non-violent engagement with criminal groups. Conceptually, the article advances the emerging concept of violence disruption as a distinct form of agency and a useful framework to neither overlook nor overstate the impact of grassroots strategies.

Transport policy: Empowering local community for poverty alleviation in a deprived neighborhood in Colombia

Social exclusion is directly related, amongst others, to a lack of educational opportunities, transport accessibility or poor transport policies. Socialcapital can deliver a solution to reduce inequity by providing community transport (CT) to an underprivileged neighborhood. The aim of this paper is to provide a case study on how community participation has proven to be an efficient way of procuring the basic needs of a poor community, such as those involved in providing daily mobility despite the apparent lack of a clear public transport policy. Results indicate that community participation and engagement in a common need can not only provide badly needed means of transportation but also be the impetus to tackle greater transport problems at the policy level. This, as a result, led to better CT which brought about greater accessibility to poor urban neighborhoods and more hands-on government engagement even though it operated only for a short period of time mainly to facilitate the entrance of the public transportation service.

Naloxone Saves Lives

In the Know| June 2023 Naloxone Saves Lives Steve Shafer, MD, FASA, Editor-in-Chief Steve Shafer, MD, FASA, Editor-in-Chief Search for other works by this author on: This Site PubMed Google Scholar ASA Monitor June 2023, Vol. 87, 1–4. https://doi.org/10.1097/01.ASM.0000938768.50606.d8 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn Email Cite Icon Cite Get Permissions Search Site Citation Steve Shafer; Naloxone Saves Lives. ASA Monitor 2023; 87:1–4 doi: https://doi.org/10.1097/01.ASM.0000938768.50606.d8 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentAll PublicationsASA Monitor Search Advanced Search Topics: naloxone, drugs, non-prescription Death from the COVID-19 pandemic was not limited to mortality from respiratory illness. According to the National Institute on Drug Abuse, more than 68,000 died from opioid overdose in 2020, and more than 80,000 died from opioid overdose in 2021 (asamonitor.pub/3mbLWqY). Surging opioid deaths is among the many causes of excess mortality associated with the SARS-CoV-2 pandemic. Investigators at the University of Wisconsin-Milwaukee used spatiotemporal analysis of opioid overdoses from 2017 through 2020 to causally link the rise in opioid overdoses to the onset of the pandemic (J Urban Health 2022;99:316-27). While all communities experienced an increase in opioid overdoses with the onset of the pandemic, Black and Hispanic communities in poor urban neighborhoods were disproportionately affected compared to affluent suburban White neighborhoods. The surge in opioid deaths is partly due to the growing street use of synthetic opioids. Two-thirds of overdose deaths in 2022 were... You do not currently have access to this content.

The Impact of the Pandemic on Poor Urban Neighborhoods: A Participatory Action Research Study of a "Favela" in Rio de Janeiro.

The pandemic provoked by the coronavirus disease 2019 (COVID-19) devastated poor urban neighborhoods across the world, particularly in the Global South, although empirical data on this remain limited. In this article, the authors present data collected through a mixed-methods, participatory action research approach on the impacts of the pandemic in Cidade de Deus, a "favela," or poor informal settlement, in Rio de Janeiro. The authors find that the indirect consequences of COVID-19, in particular economic and mental health problems, were experienced as more severe than the direct effects of the virus itself, despite high rates of infection and mortality. The study also revealed that residents relied heavily on one another through local systems of mutual aid to address immediate crises. These findings suggest that the pandemic provoked a complex and diverse set of challenges and actions in the economic, social, physical, and mental spheres of poor urban neighborhoods.

Indoor environmental exposures and obstructive lung disease phenotypes among children with asthma living in poor urban neighborhoods

Air trapping is an obstructive phenotype that has been associated with more severe and unstable asthma in children. Air trapping has been defined using pre- and postbronchodilator spirometry. The causes of air trapping are not completely understood. It is possible that environmental exposures could be implicated in air trapping in children with asthma. We investigated the association between indoor exposures and air trapping in urban children with asthma. Children with asthma aged 5 to 17 years living in Baltimore and enrolled onto the Environmental Control as Add-on Therapy for Childhood Asthma study were evaluated for air trapping using spirometry. Aeroallergen sensitization was assessed at baseline, and spirometry was performed at 0, 3, and6 months. Air trapping was defined as an FVC z score of lessthan -1.64 or a change in FVC with bronchodilation of ≥10% predicted. Logistic normal random effects models were used to evaluate associations of air trapping and indoor exposures. Airborne and bedroom floor mouse allergen concentrations were associated with air trapping but not airflow limitation (odds ratio 1.19, 95% confidence interval 1.02-1.37, P= .02 per 2-fold increase in airborne mouse allergen; odds ratio 1.23, 95% confidence interval 1.07-1.41, P= .003 per 2-fold increase in bedroom floor mouse allergen). Other indoor exposures (cockroach, cat, dog, dust mite, particulate matter, and nicotine) were not associated with air trapping or airflow limitation. Mouse allergen exposure, but not other indoor exposure, was associated with air trapping in urban children with asthma.

Prevalence, Severity, Trajectory, and Predictors of Symptom Burdens Among Adolescents and Young Adults with Hodgkin Lymphoma: A Population-Based Cohort Study

Background: Though adolescents and young adults (AYA) with Hodgkin lymphoma (HL) experience high cure rates, previous studies suggest that this population experiences significant symptom burdens which contribute to poor quality of life. We thus aimed to characterize the prevalence, trajectory, and predictors of symptom burdens among a population-based cohort of AYA with HL. Methods: All Ontario, Canada AYA aged 15-29 years with a HL diagnosis between 2010-2018 were identified and linked to population-based healthcare databases. Symptom burdens were determined through linkage to Edmonton Symptom Assessment System-Revised (ESAS-r) scores, routinely obtained from Ontario cancer patients at the time of outpatient visits and collected provincially. For each symptom, multistate transition models estimated mean single-stay duration of specific severity states [none (0) vs. mild (1 vs. 2 vs. 3) vs. moderate (4-6) vs. severe (7-9)], trajectories, and associations with death. Logistic regression models determined patient, disease, and treatment-related variables associated with experiencing severe symptoms within the first year of diagnosis. Results: 672 AYA with HL and at least one ESAS-r score were included in the cohort, with a median age of 23 years [interquartile range (IQR) 21-26 years] and of whom 339 (50.4%) were male. The median number of ESAS scores in the first year of diagnosis was 9 (IQR 4-13). The most prevalent moderate or severe symptom was fatigue, impacting 66.1% of AYA during the first year after diagnosis. Moderate or severe fatigue remained prevalent throughout the year, and was reported by 48/214 (22.4%) ESAS-r screens in the last six weeks of the year. Severe fatigue was experienced by 29.8% of AYA, and was reported by 19/214 (8.9%) ESAS-r screens in the last six weeks of the year. Other prevalent moderate or severe symptoms included drowsiness (48.8% of AYA), anxiety (46.1%) and poor appetite (44.3%). Anxiety and fatigue were associated with the longest mean sojourn time in the severe state (0.8 months and 0.7 months respectively). Overall, AYA experiencing moderate symptoms were more likely to subsequently experience improvement vs. worsening symptoms. Female AYA were more likely to experience moderate or severe levels of most symptoms compared to males. For example, females were approximately twice as likely to report severe anxiety [adjusted odds ratio (aOR) 1.99, 95th confidence interval (95CI) 1.22-3.23], nausea (aOR 2.19, 95CI 1.13-4.25), and fatigue (aOR 1.69, 95CI 1.20-2.37). Presenting disease stage was not associated with severity of symptom burden for any symptom. Encouragingly, no consistent disparities in symptom burden were seen among AYA living in rural or poor urban neighborhoods, compared to AYA living in the richest urban neighbourhoods. Similarly, no consistent disparities were observed among AYA living in Northern Ontario. However, one exception to this broadly positive trend was that AYA in the poorest urban areas were more likely to report severe pain (aOR 2.93, 95CI 1.32-6.49). Conclusions: AYA with HL experience substantial symptom burdens. Cancer-related fatigue and anxiety are particularly prevalent both during and after treatment. Interventions targeting these symptoms are likely to have the most impact in improving quality of life in this population, particularly those that account for sex-based differences in reporting and prevalence.

Food and Revolution: Fighting Hunger in Nicaragua, 1960–1993

Food and Revolution: Fighting Hunger in Nicaragua, 1960–1993

Earth Observations and Statistics: Unlocking Sociodemographic Knowledge through the Power of Satellite Images

The continuous urbanisation in most Low-to-Middle-Income-Country (LMIC) cities is accompanied by rapid socio-economic changes in urban and peri-urban areas. Urban transformation processes, such as gentrification as well as the increase in poor urban neighbourhoods (e.g., slums) produce new urban patterns. The intersection of very rapid socio-economic and demographic dynamics are often insufficiently understood, and relevant data for understanding them are commonly unavailable, dated, or too coarse (resolution). Traditional survey-based methods (e.g., census) are carried out at low temporal granularity and do not allow for frequent updates of large urban areas. Researchers and policymakers typically work with very dated data, which do not reflect on-the-ground realities and data aggregation hide socio-economic disparities. Therefore, the potential of Earth Observations (EO) needs to be unlocked. EO data have the ability to provide information at detailed spatial and temporal scales so as to support monitoring transformations. In this paper, we showcase how recent innovations in EO and Artificial Intelligence (AI) can provide relevant, rapid information about socio-economic conditions, and in particular on poor urban neighbourhoods, when large scale and/or multi-temporal data are required, e.g., to support Sustainable Development Goals (SDG) monitoring. We provide solutions to key challenges, including the provision of multi-scale data, the reduction in data costs, and the mapping of socio-economic conditions. These innovations fill data gaps for the production of statistical information, addressing the problems of access to field-based data under COVID-19.

Using Satellite Data to Guide Urban Poverty Reduction

Poverty reduction in low‐ and middle‐income countries is increasingly an urban challenge, and a challenge that continues to be constrained by lack of data, including data on the spatial distribution of poverty within cities. Utilizing existing household survey data in combination with Convolutional Neural Networks (CNN) applied to high‐resolution satellite images of cities, this study shows that existing data can generate detailed neighborhood‐level maps providing key targeting information for an anti‐poverty program. The approach is highly automatic, applicable at scale, and cost‐effective. The method also provides direct support for policy development, as illustrated by the case study, where the Government of Mozambique is implementing an urban social safety net program, targeting poor urban neighborhoods, utilizing the estimated poverty maps.

Learning Loss During the Covid-19 Pandemic in Poor Urban Neighborhoods

Learning Loss During the Covid-19 Pandemic in Poor Urban Neighborhoods

Poverty and Digital Divide: A Study in Urban Poor Neighborhoods

Literature suggests that the penetration of digital technology may create a digital divide, particularly for groups that lack resources and the capacity to access technology. This study is keen to examine the poverty and digital divide, particularly in urban poor areas. There are two research objectives. Firstly, to examine the digital diffusion and digital literacy within poor urban neighborhoods in the City of Magelang, Central Java, Indonesia. Secondly, to understand the variation of digital diffusion and digital literacy across areas (with different levels of poverty), age groups, genders and occupations. The data is collected from surveys focused on measuring the access to information, digital diffusion and the use of technology among the poor. This study found that there is a digital divide problem among people in urban areas, especially among people with low incomes. Moreover, the diffusion is dominated by certain groups such as younger people and females. Furthermore, digital literacy among the poor is low. The policy implication is to improve access for digital diffusion and provide assistance to improve digital literacy skills.

Conflicting experiences of health and habitus in a poor urban neighbourhood: A Bourdieusian ethnography.

An ethnographic study of health and wellbeing was undertaken in a deprived urban neighbourhood in the UK Midlands. Drawing on Bourdieu's concepts of habitus, capital and field, we discerned three different, even conflicting, ways of understanding and acting on health: (i) older adults discussed their wellbeing in relation to the local context or field, walking the dog, helping at the community centre and visiting the off licence, (ii) young professionals and students who lived in the neighbourhood were oriented towards leisure facilities, career opportunities and supermarkets outside of the neighbourhood, disdaining local facilities and (iii) community activists and carers discussed health in terms of providing for others but not themselves. Bourdieu is frequently used in medical sociology to highlight how poor people's lifestyle is constrained by their habitus; we suggest paying more attention to its both enabling and differentiating contradictions as well as the constraints it entails. Empirically and in terms of health promotion findings suggest that supposedly healthy activities, such as going to the gym, may also be a means of rejecting the local community; similarly, older people's pottering about in the neighbourhood, which is not usually recognised as a healthy activity, may enhance wellbeing in this context.

Moving medicine inside the neighborhood

This article focuses on the spatial significance of health care access, analyzing how state health programs effected sociospatial transformations in poor urban neighborhoods in Caracas, Venezuela. Starting in 2003, the leftist state constructed a parallel public health system to shift biomedical care from hospital emergency rooms to small clinics in neighborhood settings, arguing that it would improve the quality and accessibility of medical care for the poor. The new national health program, Barrio Adentro (Inside the Neighborhood), explicitly reorganized public medicine according to the pragmatic and symbolic significance of place. This article, based on fifteen months of ethnographic research in central Caracas, focuses on the meanings of these new health spaces for patients. Patients viewed the placement of clinics – and doctors – in barrios and working-class neighborhoods not only as logistically necessary but also as a moral and political commitment on the part of doctors and on the part of the state that employed them. In a context of marked spatial segregation along class lines, the placement of doctors ‘inside the neighborhood’ was symbolically significant because it marked such communities as deserving of services and challenged longstanding divisions between marginalized and privileged social groups in Caracas.

Sanitation dynamics: toilet acquisition and its economic and social implications in rural and urban contexts

Abstract This paper uses primary micro-data from Indian households residing in rural villages and poor urban neighbourhoods to shed light on household sanitation decision-making. We use a theoretical economic model to reduce the dimensionality and complexity of this process. Beyond the most commonly analysed motivator, health, we consider economic and non-pecuniary benefits. We provide empirical evidence that each of these margins matter, and do so in both rural and urban contexts, and discuss how our findings can be explored in sanitation policy and programme design.

Managing the COVID-19 pandemic in poor urban neighborhoods: The case of Accra and Johannesburg.

Without a vaccine, practicing social distancing and protective hygiene are the most effective measures to curb the spread of COVID-19. In order to understand how the urban poor mitigate their risk of infection, we conducted a survey with more than 1,400 poor households in two of the African cities with the most COVID-19 infections, Accra and Greater Johannesburg, early in the pandemic, during lockdowns of public life. We find that many of the urban poor already engage in the appropriate hygienic behavior and follow social distancing rules. However, despite citywide lockdowns, about 25-40% of people still report attending large gatherings, 10-20% report receiving guests at home, and 30-35% report leaving the house more than once per week. Lack of cooperation with governmental regulations seems to be more related to a lack of infrastructure or poverty rather than unwillingness to engage in behavioral change. Interestingly, even with the stricter lockdown in South Africa, people are at least equally likely to deviate from social distancing rules. Our results indicate that more South African respondents perceive their government's actions as too extreme and underestimate COVID-19 cases in their country. About half of the sample in both countries report knowing (mainly through TV) about current COVID-19 case numbers. Most participants know that coughing is a symptom, but only half mention fever and difficulty breathing, and very few people mention tiredness. Ghanaians seem to be somewhat better informed. While lack of information is an issue, misinformation appears to be limited. We conclude that a costly shutdown of public life is only effective-and might even be prevented-with a well-informed population, who perceives their government's actions as appropriate and who has access to the infrastructure required to follow WHO safety regulations.

Joint action as a practice of memory transmission in a poor urban neighborhood of Santiago, Chile.

In Latin America, one of the key tasks of Community and Liberation Psychology has been to recover the memories of marginalized and excluded communities that have experienced multiple pasts marked by political violence. In Chile, researchers have focused on poor urban neighborhoods, where the question of how memories are transmitted in areas where conflicts and violence are still present has been overlooked. In this context, the following article aims to analyze the ways in which memories are transmitted in a neighborhood that has a long organizational history in the struggle against social inequalities; whileat the same time being classified as a critical area by the state due to its current levels of violence and social conflict. The researchers led a 3-year case study from an ethnographic perspective, and applied a collaborative methodology that brought together the research team and the members of a territorial organization. The analysis is based on 72 interviews, 5 conversation groups and ethnographic observation. The data was analyzed using discourse analysis. The results revealed that the main form of memory transmission is not based on intergenerational narratives of the past, but rather on joint action; namely, dialogical practices among neighborhood residents that generate an ethos; a common way of life.

Language Acculturation and Social Capital Among Migrants in James Town, Accra

This study examines the relative effects of language acculturation on social capital accumulation in the context of a poor urban neighborhood in Accra, Ghana. Acculturation is a fluid concept with multiple dimensions. Generally, it has been described as the extent to which migrants adopt the customs and values of their host populations. The fluidity of the concept has led to different ways of measurement. While a number of studies have assessed acculturation using dimensions such as assimilation, integration, marginalization, and separation to understand migrants lived experiences, there is paucity of research on the impact of language acculturation on social capital formation. Language barrier has been found to be associated with adaptation difficulties among migrants while higher language competency is associated with well-being factors such as lower anxiety and depression. In this study, in the internal migration context, we examine if Ga language competency predicts social capital accumulation among 301 migrants. Using a semi-structured survey questionnaire, we elicited information about migrants' fluency in the Ga language and social capital variables from which a social capital index was created. Using Chi-square tests and one-way ANOVA, at the bivariate level we fitted an ordinal logit regression model. We found that better Ga language fluency is associated with higher social capital. Religiosity (the extent to which the individual practices their religious beliefs) and marital status were significant predictors of social capital. It was concluded that low and high language acculturation was linked to poor and high self-rated health status of migrants in Jamestown. Keywords: Blended mode, online, Sakai LMS, interactivity, student learning DOI: 10.7176/JLLL/68-06 Publication date: May 31 st 2020

Caregiver depression is associated with hair cortisol in a low-income sample of preschool-aged children

BackgroundCaregiver depression and child temperamental characteristics such as effortful control have been associated with child dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis. Hair cortisol concentrations (HCC) has been increasingly adopted as an integrated marker of HPA axis activity. This study examined the associations between caregiver depressive symptoms, caregiver social support, child effortful control, and child HCC in a sample of a high-risk, low-income preschool-aged children. Methods154 caregivers comprised mostly of mothers and their children (2-to-5 years) who were enrolled in a birth cohort study conducted in poor urban neighborhoods of São Paulo, Brazil. Through personal interviews at their homes, caregivers provided ratings of their psychosocial experiences and of their child’s behavior. Hair was sampled from children with at least a 3-cm hair length. ResultsIn a multivariable regression analysis, an unadjusted model showed child age to be negatively associated with HCC (β = -0.32, p < .001). The adjusted model, which accounted for child age and sex, showed a positive relationship between caregiver depressive symptoms and HCC (β = 0.22, p < .01). Caregiver social support and child effortful control were not associated with HCC. ConclusionsThe elevated HCC among children with caregivers reporting greater depression risk is consistent with prior findings showing elevated HCC among children exposed to persistent stress. Stabilization of child HCC may be occurring within preschool children given the negative association between HCC and age. Greater research is needed to determine whether the effects of caregiver social support and effortful control can be captured through HCC.