United States Cities Research Articles

The impact of localized implementation: determining the cost-effectiveness of HIV prevention and care interventions across six United States cities

Effective interventions to reduce the public health burden of HIV/AIDS can vary in their ability to deliver value at different levels of scale and in different epidemiological contexts. Our objective was to determine the cost-effectiveness of HIV treatment and prevention interventions implemented at previously documented scales of delivery in six US cities with diverse HIV microepidemics. Dynamic HIV transmission model-based cost-effectiveness analysis. We identified and estimated previously documented scale of delivery and costs for 16 evidence-based interventions from the US CDC's Compendium of Evidence-Based Interventions and Best Practices for HIV Prevention. Using a model calibrated for Atlanta, Baltimore, Los Angeles, Miami, New York City and Seattle, we estimated averted HIV infections, quality-adjusted life years (QALY) gained and incremental cost-effectiveness ratios (healthcare perspective; 3% discount rate, 2018$US), for each intervention and city (10-year implementation) compared with the status quo over a 20-year time horizon. Increased HIV testing was cost-saving or cost-effective across cities. Targeted preexposure prophylaxis for high-risk MSM was cost-saving in Miami and cost-effective in Atlanta ($6123/QALY), Baltimore ($18 333/QALY) and Los Angeles ($86 117/QALY). Interventions designed to improve antiretroviral therapy initiation provided greater value than other treatment engagement interventions. No single intervention was projected to reduce HIV incidence by more than 10.1% in any city. Combination implementation strategies should be tailored to local epidemiological contexts to provide the most value. Complementary strategies addressing factors hindering access to HIV care will be necessary to meet targets for HIV elimination in the United States.

A mineralogical and chemical investigation of road dust in Philadelphia, PA, USA.

Road dust was investigated within Philadelphia, a major United States city with a long history of industrial activities, in order to determine pollution levels. Almost all of the investigated minor elements were enriched relative to the continental crust. Furthermore, mean concentrations of Cr, Co, Cu, and Pb were high compared with those reported in cities in other countries. Lead pollution should be investigated further in Philadelphia, where 8 of the 30 sample sites, including those heavily trafficked by civilians, were at or above the EPA's child safety threshold for Pb in bare soil. High Spearman correlations between Zn and Cu, Zn and Cr, Cu and Cr, and Sn and V, as well as factor analysis of minor elements suggests that the primary sources of these elements were anthropogenic. Potential sources included the breakdown of alloys, non-exhaust traffic emissions, paint, smelting, and industry. We found that higher organic content in road dust may be related to higher traffic densities, which could be due to tire-wear particles. Additionally, higher mean concentrations of Fe, Cr, Cu, and Zn were found at sites with elevated traffic densities. Land use impacted some of the elements not influenced by traffic density, including Co, Sn, and Pb. Bulk mineral content was similar across different land uses and traffic densities and, thus, did not appear to be influenced by these factors. Our research emphasized the complexity of road dust and utilized a more comprehensive approach than many previous studies. This study established fundamental groundwork for future risk assessment in Philadelphia, as it identified several key pollutants in the city. Overall, this assessment serves as an informative reference point for other formerly heavily industrialized cities in the USA and abroad.

Developing a method to estimate building height from Sentinel-1 data

Building height is one of the key variables in studying anthropogenic activities and built environments in the urban system. However, the information of urban building height over large areas is still limited due to the lack of available data. In this study, we developed an approach to estimate building height using the Sentinel-1 Ground Range Detected data. First, we proposed an indicator of VVH that integrates the dual-polarization information (i.e., VV and VH) from the Sentinel-1 synthetic aperture radar data. Second, we developed a building height model using the indicator of VVH and the reference building height from airborne light detection and ranging (LiDAR) images in seven cities in the United States (US). Third, we estimated building height of major cities with area larger than 500 km2 in the US using the developed model. The root mean square error between estimated and reference height is 1.5 m in seven study cities in the US. The comparison with the Laser observations from the Ice, Cloud, and land Elevation Satellite data in available footprints also indicates that the estimated building height from Sentinel-1 data is reliable. The estimated building height from Sentinel-1 data shows a better agreement with the reference data compared to the Advanced Land Observing Satellite data in seven US cities. Our results of building height in major US cities indicate that there are more cities with tall buildings in the Northeastern US compared to the Western and Southern US, with more aggregated tall buildings in central business districts of cities. The information of building height from this study is of great value in urban studies, such as estimating energy consumption and carbon emissions in urban areas.

Health and the built environment in United States cities: measuring associations using Google Street View-derived indicators of the built environment

BackgroundThe built environment is a structural determinant of health and has been shown to influence health expenditures, behaviors, and outcomes. Traditional methods of assessing built environment characteristics are time-consuming and difficult to combine or compare. Google Street View (GSV) images represent a large, publicly available data source that can be used to create indicators of characteristics of the physical environment with machine learning techniques. The aim of this study is to use GSV images to measure the association of built environment features with health-related behaviors and outcomes at the census tract level.MethodsWe used computer vision techniques to derive built environment indicators from approximately 31 million GSV images at 7.8 million intersections. Associations between derived indicators and health-related behaviors and outcomes on the census-tract level were assessed using multivariate regression models, controlling for demographic factors and socioeconomic position. Statistical significance was assessed at the α = 0.05 level.ResultsSingle lane roads were associated with increased diabetes and obesity, while non-single-family home buildings were associated with decreased obesity, diabetes and inactivity. Street greenness was associated with decreased prevalence of physical and mental distress, as well as decreased binge drinking, but with increased obesity. Socioeconomic disadvantage was negatively associated with binge drinking prevalence and positively associated with all other health-related behaviors and outcomes.ConclusionsStructural determinants of health such as the built environment can influence population health. Our study suggests that higher levels of urban development have mixed effects on health and adds further evidence that socioeconomic distress has adverse impacts on multiple physical and mental health outcomes.

Examining the distributional equity of urban tree canopy cover and ecosystem services across United States cities.

Examining the distributional equity of urban tree canopy cover (UTCC) has increasingly become an important interdisciplinary focus of ecologists and social scientists working within the field of environmental justice. However, while UTCC may serve as a useful proxy for the benefits provided by the urban forest, it is ultimately not a direct measure. In this study, we quantified the monetary value of multiple ecosystem services (ESD) provisioned by urban forests across nine U.S. cities. Next, we examined the distributional equity of UTCC and ESD using a number of commonly investigated socioeconomic variables. Based on trends in the literature, we predicted that UTCC and ESD would be positively associated with the variables median income and percent with an undergraduate degree and negatively associated with the variables percent minority, percent poverty, percent without a high school degree, percent renters, median year home built, and population density. We also predicted that there would be differences in the relationships between each response variable (UTCC and ESD) and the suite of socioeconomic predictor variables examined because of differences in how each response variable is derived. We utilized methods promoted within the environmental justice literature, including a multi-city comparative analysis, the incorporation of high-resolution social and environmental datasets, and the use of spatially explicit models. Patterns between the socioeconomic variables and UTCC and ESD did not consistently support our predictions, highlighting that inequities are generally not universal but rather context dependent. Our results also illustrated that although the variables UTCC and ESD had largely similar relationships with the predictor variables, differences did occur between them. Future distributional equity research should move beyond the use of proxies for environmental amenities when possible while making sure to consider that the use of ecosystem service estimates may result in different patterns with socioeconomic variables of interest. Based on our findings, we conclude that understanding and remedying the challenges associated with inequities requires an understanding of the local social-ecological system if larger sustainability goals are to be achieved.

“In This City of the Dead”: Charleston’s Magnolia Cemetery and Middle-Class Aspiration

Like many other cities in the antebellum United States, Charleston, South Carolina, faced the challenge of managing longstanding, overfilled, urban burial spaces in an area with a large population and high mortality rates. Although Charleston would seem to have been an ideal candidate for an early rural cemetery, Magnolia Cemetery was not opened outside the city until almost twenty years after Mount Auburn’s founding. In Charleston, the modernizing impulse illustrated by calls for cemetery reform came in to conflict with the city’s dominant upper class. The establishment of Magnolia Cemetery was undertaken by middle-class Charlestonians who hoped to use burial to create an alternative social hierarchy that existed parallel to Charleston’s rigid slaveholding aristocracy.

Location of Violent Crime Relative to Trauma Resources in Detroit: Implications for Community Interventions.

IntroductionDetroit, Michigan, is among the leading United States cities for per-capita homicide and violent crime. Hospital- and community-based intervention programs could decrease the rate of violent-crime related injury but require a detailed understanding of the locations of violence in the community to be most effective.MethodsWe performed a retrospective geospatial analysis of all violent crimes reported within the city of Detroit from 2009–2015 comparing locations of crimes to locations of major hospitals. We calculated distances between violent crimes and trauma centers, and applied summary spatial statistics.ResultsApproximately 1.1 million crimes occurred in Detroit during the study period, including approximately 200,000 violent crimes. The distance between the majority of violent crimes and hospitals was less than five kilometers (3.1 miles). Among violent crimes, the closest hospital was an outlying Level II trauma center 60% of the time.ConclusionViolent crimes in Detroit occur throughout the city, often closest to a Level II trauma center. Understanding geospatial components of violence relative to trauma center resources is important for effective implementation of hospital- and community-based interventions and targeted allocation of resources.

A tale of three cities: Mercury in urban deciduous foliage and soils across land-uses in Poughkeepsie NY, Hartford CT, and Springfield MA USA.

Mercury is a global pollutant that harms human and wildlife health through chronic exposure. The role of urban forests in Hg biogeochemistry has been understudied in cities without historical mining or current coal combustion. This study aimed to quantify total Hg concentrations and pools in urban forests to determine whether adjacent land-use impacts Hg accumulation. Three cities in the northeastern United States were studied: Hartford, Connecticut; Poughkeepsie, New York; and Springfield, Massachusetts. We identified ~20 urban forests sites in a ~10km by ~10km grid for each city and sampled foliage and soil at each site. Foliage from Populus exhibited significantly lower Hg concentrations (15.6±2.1ngg-1) than mean foliar Hg concentrations (23.7±0.6ngg-1) but most deciduous genera had comparable concentrations. Average forest floor Hg concentrations (195±21ngg-1) and Hg pools (1.9±0.5mgm-2) were similar to previous, non-urban studies in the region. Average A horizon (182±19ngg-1) and B horizon (125±14ngg-1) Hg concentrations were double those of regional forest soils. Mineral soil Hg pools for the top 30cm (49±6mgm-2) averaged two to ten times higher than rural, montane forests in the region. Soil pH, LOI, and %clay were poorly correlated with mineral soil Hg concentrations. Instead, highest foliar and soil Hg concentrations and pools were in urban forests adjacent to high and medium intensity developed areas in Springfield and Hartford. To differentiate the impact of land-uses not captured by the National Land Cover Database (NLCD) system, we implemented new land-use categories. Industrial areas had highest foliar and soil Hg concentrations and pools of any land use. Our results show increasing land-use increases Hg accumulation in urban forests.

HIV Prevalence and Associated Risks in a Respondent-Driven Sample of Illicit Stimulant Users in a Southern United States City.

Stimulant abuse is a major contributor to HIV transmission in the United States, yet HIV prevalence among persons who use illicit stimulants remains unknown. We implemented respondent driven sampling (RDS) to estimate the prevalence of HIV infection in this high-risk population. We also examined RDS-adjusted rates of risk behaviors among HIV-positive and HIV-negative participants. Recruited from seven seeds, our sample of 387 participants was 46% female, 89% African American, and 45.94years old on average. Participants were predominantly non-injection cocaine users, had large networks of stimulant users, and reported an established relationship with their recruiter. The adjusted population proportion of HIV infection was 0.07 (0.04, 0.11). The majority of sexually active participants reported engagement in risk behaviors (73%), but rates generally did not differ by HIV status. Our results highlight that stimulant use is a risk factor for HIV infection. This study also demonstrates that RDS is a very effective strategy for reaching stimulant users in the community.

Health and Health-Related Resources in Newly Designated Federally Qualified Opportunity Zones: United States, 2012-2016.

Objectives. To characterize health and health-related resources in the new qualified opportunity zones (QOZs) relative to tracts not selected or not eligible for this federal investment incentive.Methods. We used tract-level data from the 498 largest cities in the contiguous United States (n = 24 409), categorized using designations from the Department of Treasury. We compiled data on population characteristics, health-related resources, and health from the American Community Survey, the National Establishment Time Series, the National Land Cover Dataset, and the US Small-Area Life Expectancy Estimates Project and the 500 Cities projects. We calculated means and SDs for ineligible, eligible (but not designated), and designated QOZ tracts.Results. In general, designated QOZ tracts had lower access to health care facilities, physical activity resources, and healthy food. They had a higher prevalence of unhealthy behaviors and worse health outcomes across most measures.Conclusions. By benchmarking conditions, we facilitate tracking and assessment of QOZ impacts.Public Health Implications. QOZ could spur unprecedented neighborhood change with substantial influence on health resources and outcomes. Public health collaboration and strategic local governance of QOZ will be crucial for yielding health benefits for existing residents.

Impact of climate change on outdoor thermal comfort in cities in united states

Since urban open spaces provide various benefits to the citizens, it is necessary to improve the outdoor thermal comfort in urban open spaces. However, global warming increases heat stress and at the same time decrease cold stress of outdoor spaces. The final impact of climate change on outdoor thermal comfort is not evident, and depends on the climate characteristics. This study investigated the influence of climate change on outdoor thermal comfort conditions of five selected cities (Minneapolis, New York City, San Francisco, Miami, and Las Vegas) with distinctive climate patterns in the United States. It is found that all cities suffered from deterioration in thermal comfort. This is because the increases in the heat stress rate were greater than the decreases in cold stress rate. In the 2080s, the greatest reduction in acceptable thermal stress rate happened in Miami from 44.7% to 21.3% under high emission scenario.

Controlling a Networked SIS Model via a Single Input over Undirected Graphs

This paper formulates and studies the problem of controlling a networked SIS model using a single input in which the network structure is described by a connected undirected graph. A necessary and sufficient condition on the values of curing and infection rates for the healthy state to be exponentially stable is obtained via the analysis of signed Laplacians when the control input is the curing budget of a single agent. In the case when the healthy state is stabilizable, an explicit expression for the minimum curing budget is provided. The utility of the algorithm is demonstrated using a simulation over a network of cities in the northeastern United States.

A A comparative study of urban occupational structures: Brazil and United States

This paper compares the occupational structure of cities in Brazil and United States aiming to evaluate the extent to which the economic structure of these urban agglomerations is associated with the different stages of development, specifically when comparing a rich country with a developing one. Using a harmonized occupational database and microdata from the Brazilian 2010 Demographic Census and the U.S. American Community Survey (2008-2012), results show that Brazilian cities have a stronger connection between population size, both with occupational structure and human capital distribution, than the one found for cities in the United States. These findings suggest a stronger primacy of large cities in Brazil’s urban network and a more unequal distribution of economic activity across cities when compared to USA, indicating a strong correlation between development and occupational structure.

Land snail dispersal, abundance and diversity on green roofs.

We present the first major systematic study of land snail diversity on green roofs. We surveyed 27 green roofs and the adjacent ground habitat in six major cities in the southeastern United States. We found a total of 18 species of land snails, with three considered to be non-native or invasive species. The majority of land snails encountered in surveys are widespread, generalist species, typically adapted to open habitats. Twelve of the land snails encountered are “greenhouse” species that are very commonly transported via the horticultural trade. Therefore, we infer that at least some land snail species are introduced to green roofs via initial green roof installation and associated landscaping. The major determinants of snail species richness and abundance are the size of each roof and the quality of green roof maintenance regime.

How should we measure the DBH of multi-stemmed urban trees?

Foresters use diameter at breast height (DBH) to estimate timber volumes, quantify ecosystem services, and predict other biometrics that would be difficult to directly measure. But DBH has numerous problems, including a range of “breast heights” and challenges with applying this standard to divergent tree forms. Our study focuses on street trees that fork between 30 and 137 cm of height (hereafter “multi-stemmed trees”), which researchers have identified as particularly challenging in the ongoing development of urban allometric models, as well as consistency in measurements across space and time. Using a mixed methods approach, we surveyed 25 urban forestry practitioners in twelve cities in the northeastern United States (US) about the measurement and management of multi-stemmed street trees, and intensively measured 569 trees of three frequently planted and commonly multi-stemmed genera (Malus, Prunus, and Zelkova) in Philadelphia, PA, US. Specifically, we measured stem diameter at several distances above the ground: at the root collar, at 30 cm, just below the fork (which occurred between 30 and 137 cm), and at 137 cm (up to six stems following established protocols). Survey responses indicated that current mensuration practices are burdensome, that practitioners employ alternatives to the current protocols for measuring at 137 cm, and that small-statured, frequently multi-stemmed trees are an increasing proportion of street tree populations. Analysis of field data did not find substantial differences between methods of measurement with regard to predictive power for total height and average crown width. Alternatives to the current protocols for measuring at 137 cm have other advantages, including time required, ease of measurement, simplicity, and capacity to compare measurements between trees and over time. For trees that fork between 30 and 137 cm, we recommend taking a single diameter measurement at a lower height—either just below the fork or at 30 cm. Diameter measurements at 30 cm better serve researchers seeking to consistently measure radial growth over time, whereas diameter below the fork may suit practitioners who do not need fine resolution in trunk measurements.

Prescription-strength topical corticosteroids available over the counter: Cross-sectional study of 80 stores in 13 United States cities

Prescription-strength topical corticosteroids available over the counter: Cross-sectional study of 80 stores in 13 United States cities

White oak and red maple tree ring analysis reveals enhanced productivity in urban forest patches

Many aspects of the urban environment have the potential to affect tree growth and physiology in forest patches, including higher temperatures, elevated CO2 concentrations, and modified soil biogeochemistry from increased nutrient and heavy metal inputs. However, these changes in tree growth are likely to vary by species and across urban areas, reflecting the local environmental conditions associated with the idiosyncratic trajectory of development in a city. Here, we examine growth rates of two dominant native tree species (white oak (Quercus alba L.) and red maple (Acer rubrum L.)) across urban and reference forest sites of three major cities in the eastern United States (New York, NY (NYC); Philadelphia, PA; and Baltimore, MD). We also characterized soil physical and chemical properties around each tree and monitored air temperature over three growing seasons at each site. Throughout the growing season, the urban sites had consistently warmer daytime and nighttime temperatures than reference sites. Urban forest patch soils also had elevated calcium, magnesium, and heavy metal concentrations compared to reference forest soils. Urban vs. reference tree growth rates varied by species, by city, and over time. Despite differences in the two native species’ ecophysiology, both grew more rapidly in the urban environment than at nearby reference sites, particularly in recent decades. Over the entire 145-year tree ring record analyzed, white oak basal area increment was significantly higher in urban trees compared to reference trees. Changes in the relative production of white oak earlywood and latewood between site types in each city and over time may relate to precipitation patterns. Perhaps due to their ability to persist in a wide variety of environmental conditions, mature trees of both species appear to be acclimating to urban forest patch conditions of the eastern U.S. and in some cases are experiencing enhanced growth rates compared to trees in nearby reference forests. An understanding of past and present growth rates of trees in urban forest patches can provide insight into future ecosystem functioning of these urban green spaces as well as that of more rural ecosystems experiencing environmental change factors similar to those associated with urbanization.

HIV Testing and ART Adherence Among Unstably Housed Black Men Who Have Sex with Men in the United States.

Black men who have sex with men (BMSM) have the highest HIV incidence rate among all MSM in the United States (US), and are also disproportionately affected by homelessness and housing instability. However, little is known about the effects of homelessness on the HIV testing and care continuum for BMSM. Between 2014 and 2017, the Promoting Our Worth, Equality, and Resilience (POWER) study collected data and offered HIV testing to 4184 BMSM at Black Pride events in six US cities. Bivariate analyses were used to assess differences in sociodemographics and healthcare access between BMSM who self-reported homelessness and those who did not. Multivariable logistic regression models were used to assess differences in HIV testing by homelessness status. Finally, bivariate and multivariable models were used to assess differences in HIV care continuum and treatment adherence outcomes by homelessness status. 615 (12.1%) BMSM in our sample experienced homelessness in the last 12months. BMSM who self-reported homelessness had higher odds of receiving an HIV test in the past 6months compared to their stably housed counterparts. BMSM who self-reported homelessness had higher odds of reporting difficulty taking ART and of missing a dose in the past week compared to stably housed BMSM. Findings suggest that HIV testing outreach and treatment-related services targeting unstably housed BMSM may be effective. Future community-based research is needed to investigate how homelessness and housing instability affect ART adherence, and how this population may experience success in HIV testing and adherence despite economic and social marginalization.

Preference for drugs containing fentanyl from a cross-sectional survey of people who use illicit opioids in three United States cities

BackgroundDeath from fentanyl-related overdose is now a leading cause of mortality among US adults. We sought to characterize fentanyl preference among street-based people who use drugs (PWUD). MethodsCross-sectional surveys were administered to PWUD (N = 308) who illicitly used heroin or prescription opioids in the prior six months. Recruitment occurred in 2017 in three US east coast cities with high overdose mortality: Baltimore, Boston, and Providence. Our main outcome was preference for fentanyl (yes/no); exposures included sociodemographics, drug use, and overdose history. Pearson’s χ2, Shapiro-Wilk-Mann rank-sum tests, and tiered log-binomial regression determined sociodemographic and exposure-related factors associated with fentanyl preference. ResultsPreference for nonmedical use of fentanyl was reported by 27% (n = 83) of the sample. Fentanyl preference was associated with non-Hispanic white race (adjusted risk ratio (ARR) = 1.68, 95% confidence interval (CI):1.18–2.40), daily illicit drug use (aRR = 2.2, CI:1.71–2.87), and overdose ≥1 year ago (aRR = 1.33, CI:1.18–1.50). Age (in decades; aRR = 0.77, CI:0.61–0.98) and overdose <1 year ago (aRR = 0.92, CI:0.87–0.97) were associated with a decreased likelihood of preference. In our model excluding sociodemographics, initiating opioid use with non-prescribed opioids was associated with fentanyl preference (aRR = 1.48, CI:1.26-1.73). ConclusionIn three cities with high levels of opioid use and overdose, a quarter of street based PWUD reported preferring fentanyl. An opioid use age cohort effect and disproportionate access to prescription opioids by race could be contributing to preference. Frequency of opioid use, not route of administration, was associated with preference. Our data demonstrate the need to consider preferences for fentanyl when targeting services and interventions for PWUD.

High Levels of Syndemics and Their Association with Adherence, Viral Non-suppression, and Biobehavioral Transmission Risk in Miami, a U.S. City with an HIV/AIDS Epidemic.

Miami is a Southeastern United States (U.S.) city with high health, mental health, and economic disparities, high ethnic/racial diversity, low resources, and the highest HIV incidence and prevalence in the country. Syndemic theory proposes that multiple, psychosocial comorbidities synergistically fuel the HIV/AIDS epidemic. People living with HIV/AIDS in Miami may be particularly affected by this due to the unique socioeconomic context. From April 2017 to October 2018, 800 persons living with HIV/AIDS in a public HIV clinic in Miami completed an interviewer-administered behavioral and chart-review cross-sectional assessment to examine the prevalence and association of number of syndemics (unstable housing, low education, depression, anxiety, binge drinking, drug use, violence, HIV-related stigma) with poor ART adherence, unsuppressed HIV viral load (≥ 200 copies/mL), and biobehavioral transmission risk (condomless sex in the context of unsuppressed viral load). Overall, the sample had high prevalence of syndemics (M = 3.8), with almost everyone (99%) endorsing at least one. Each syndemic endorsed was associated with greater odds of: less than 80% ART adherence (aOR 1.64, 95% CI 1.38, 1.98); having unsuppressed viral load (aOR 1.16, 95% CI 1.01, 1.33); and engaging in condomless sex in the context of unsuppressed viral load (1.78, 95% CI 1.30, 2.46). The complex syndemic of HIV threatens to undermine the benefits of HIV care and are important to consider in comprehensive efforts to address the disproportionate burden of HIV/AIDS in the Southern U.S. Achieving the 90-90-90 UNAIDS and the recent U.S. "ending the epidemic" targets will require efforts addressing the structural, social, and othersyndemic determinants of HIV treatment and prevention.