United States Metropolitan Areas Research Articles

The Divided House: Does Racial Segregation Predict Far-Right Protest in United States Metropolitan Areas?

The Divided House: Does Racial Segregation Predict Far-Right Protest in United States Metropolitan Areas?

Second‐Trimester Ultrasound Receipt Mediates the Relationship Between Public Insurance and Prenatal Diagnosis of a Congenital Heart Defect

ABSTRACTObjectiveTo delineate the mechanism behind insurance‐related disparities in the prenatal diagnosis of a congenital heart defect (CHD).MethodsThis was a retrospective analysis of electronic health records of pregnant individuals whose infants received CHD surgery between 2019 and 2020 in the third‐largest United States metropolitan area. The outcome was whether a prenatal diagnosis was received. The exposure was the pregnant individual's insurance status. The mediator was second‐trimester ultrasound receipt. Control variables included sociodemographic and clinical characteristics of the pregnant individual and infant. The relationships between exposure, mediator, and outcome were quantified using mediation analysis with multivariable fixed‐effects regression.ResultsIn total, 496 pregnant individuals met inclusion criteria; 215 (43.3%) were publicly insured and 305 (61.5%) had prenatal diagnosis. In bivariate regressions, public insurance was associated with a 12.6% lower probability (CI 3%–21%) of prenatal diagnosis. In multivariable models, public insurance was associated with 13.2% lower probability (CI 2%–25%) of second‐trimester ultrasound receipt but was no longer associated with prenatal diagnosis after adjusting for second‐trimester ultrasound receipt, suggesting a possible mediation effect. Mediation analysis confirmed that second‐trimester ultrasound receipt mediated 39% of the relationship between public insurance and prenatal diagnosis.ConclusionAn appreciable portion of insurance‐related differences in prenatal CHD diagnosis is due to the lower frequency of second‐trimester ultrasound receipt among those with public insurance.

Representation of Racially Minoritized Patients on Dermatology Private Practice Websites.

Images on the homepages of private practice dermatology websites often do not reflect the racial diversity of the metropolitan area in which each practice is located. A Google Maps scraper (Apify) was used to identify websites for private practices in 27 United States metropolitan areas selected from the 2020 U.S. Census list of 100 largest areas where non-white individuals makeup more than 50% of the population. Homepages from the top ten websites listed by the search engine were analyzed for images, use of non-English language, and mention of "Skin of Color" or "Ethnic Skin." One hundred seventeen websites were included. Two mentioned "Skin of Color" or "Ethnic Skin"; seven mentioned a non-English language. A significantly lower percentage of non-white-presenting patients (p < 0.001) and providers (p < 0.001) were pictured on the selected dermatology websites than reported in the Census. These findings suggest that the images on the homepages of private practice dermatology websites were not reflective of the racial diversity of the metropolitan area in which each practice is located. Private practice dermatologists should be mindful of how their services are represented online, as it may dissuade potential minoritized patients from seeking dermatologic care.

Water, sanitation and hygiene insecurity predict abscess incidence among people who inject drugs in a binational US–Mexico metropolitan area: A longitudinal cohort study

IntroductionPeople who inject drugs (PWID) are at high risk of developing injection-related infections, including abscesses. Access to water, sanitation, and hygiene (WASH) are key human rights and services; yet these services have been underexplored as predictors of abscesses among PWID. MethodsLongitudinal analysis was employed among a cohort of PWID to determine if WASH insecurity (lack of access) was associated with abscess incidence in the Tijuana, Mexico and San Diego, United States metropolitan area during 24-months of follow-up survey data from 2020 to 2023. We calculated abscess prevalence at baseline and tracked the incidence of new abscesses among individuals without an abscess during the previous visit. Time dependent Cox regression modeling was employed with variance clustered by participant to characterize the relationship between WASH insecurity and abscess incidence. ResultsAt baseline, hand hygiene insecurity, bathing insecurity in the previous six months and open defecation in the last week, were reported by 60 %, 54 % and 38 % of participants, respectively; 21 % reported an abscess in the last six months. The incidence of abscesses was 24.4 (95 %CI: 21.1–27.6) per 100 person-years. After adjusting for covariates, the hazard of developing an abscess remained significantly elevated among individuals using non-improved (with risk of contamination) water sources (e.g., surface water) for preparing drugs (adjusted HR [adjHR]: 1.49 [95 %CI: 1.01–2.21], experiencing bathing insecurity (adjHR: 1.59 [95 %CI: 1.12–2.24]) and open defecation (adjHR: 1.65 [95 %CI: 1.16–2.35]). ConclusionsPWID in the Tijuana-San Diego metropolitan area reported facing high rates of insecurity accessing WASH services. Abscess incidence was higher (four to nine times) than observed rate among PWID cohorts in other settings. Access to continuously available toilet facilities, bathing infrastructure, and safe water sources for preparing drugs for injection could prevent abscesses among PWID. Accessible WASH infrastructure should be ensured among PWID communities and promoted as a key component of harm reduction infrastructure.

Emotion Regulation Moderates Associations between Discrimination and Cannabis Use Patterns among Sexual Minority Young Adult Women.

Sexual minority young adults (SMYAs) experience discrimination and have high cannabis use prevalence. Discrimination may be associated with cannabis use, including hazardous use and co-use with tobacco, depending on emotion regulation and gender. Fall 2020 survey data assessed discrimination, use frequency of emotion regulation strategies (i.e., cognitive reappraisal, expressive suppression), current cannabis use, hazardous use, and cannabis-tobacco dual use among SMYAs (age 18-34) in 6 United States metropolitan areas (women: n=450, M age =24.1, SD=4.7, 69.6% bisexual, 18.2% lesbian/gay, 12.2% other; men: n=254, M age=24.7, SD=4.5, 33.5% bisexual, 54.3% gay, 12.2% other). Multivariable logistic regression examined the moderating roles of cognitive reappraisal and expressive suppression on associations of discrimination with cannabis use outcomes, stratified by gender and adjusted for age, race and ethnicity, and employment. Among SMYA women, 89.5% experienced any discrimination; 53.1% reported current cannabis use, of whom 49.4% and 47.7% reported hazardous use and cannabis-tobacco dual use, respectively. Adjusting for sociodemographics, experiencing greater discrimination was associated with greater odds of hazardous cannabis use (aOR=1.08, 95% CI [1.02, 1.15]) and cannabis-tobacco dual use (aOR=1.04, 95% CI [1.01, 1.08]) among SMYA women with greater use of expressive suppression. Among SMYA men, 83.9% experienced any discrimination; 49.2% reported current cannabis use, of whom 55.2% and 44.0% reported hazardous use and cannabis-tobacco dual use. Discrimination and emotion regulation were unrelated to cannabis use outcomes among men. Conclusions: Given high rates of discrimination experiences among SMYAs, emotion regulation skills training may empower SMYAs, particularly women, to cope with discrimination without using cannabis.

Urban heat island impacts on heat-related cardiovascular morbidity: A time series analysis of older adults in US metropolitan areas

Many United States (US) cities are experiencing urban heat islands (UHIs) and climate change-driven temperature increases. Extreme heat increases cardiovascular disease (CVD) risk, yet little is known about how this association varies with UHI intensity (UHII) within and between cities. We aimed to identify the urban populations most at-risk of and burdened by heat-related CVD morbidity in UHI-affected areas compared to unaffected areas. ZIP code-level daily counts of CVD hospitalizations among Medicare enrollees, aged 65–114, were obtained for 120 US metropolitan statistical areas (MSAs) between 2000 and 2017. Mean ambient temperature exposure was estimated by interpolating daily weather station observations. ZIP codes were classified as low and high UHII using the first and fourth quartiles of an existing surface UHII metric, weighted to each have 25% of all CVD hospitalizations. MSA-specific associations between ambient temperature and CVD hospitalization were estimated using quasi-Poisson regression with distributed lag non-linear models and pooled via multivariate meta-analyses. Across the US, extreme heat (MSA-specific 99th percentile, on average 28.6 °C) increased the risk of CVD hospitalization by 1.5% (95% CI: 0.4%, 2.6%), with considerable variation among MSAs. Extreme heat-related CVD hospitalization risk in high UHII areas (2.4% [95% CI: 0.4%, 4.3%]) exceeded that in low UHII areas (1.0% [95% CI: −0.8%, 2.8%]), with upwards of a 10% difference in some MSAs. During the 18-year study period, there were an estimated 37,028 (95% CI: 35,741, 37,988) heat-attributable CVD admissions. High UHII areas accounted for 35% of the total heat-related CVD burden, while low UHII areas accounted for 4%. High UHII disproportionately impacted already heat-vulnerable populations; females, individuals aged 75–114, and those with chronic conditions living in high UHII areas experienced the largest heat-related CVD impacts. Overall, extreme heat increased cardiovascular morbidity risk and burden in older urban populations, with UHIs exacerbating these impacts among those with existing vulnerabilities.

Interparental conflict and adolescent emotional security across family structures.

This study investigated whether interparental conflict was differentially related to forms of emotional security (i.e., family, interparental, parent-child) and whether forms of emotional security were differentially associated with mental health problems for adolescents in married versus divorced/separated families. Participants were 1032 adolescents (ages 10-15; 51% male, 49% female; 82% non-Hispanic White, 9% Black/African American, 5% Hispanic, 2% Asian or Pacific Islander, 2% Native American) recruited from a public school in a middle-class suburb of a United States metropolitan area. We used multiple group multivariate path analysis to assess (1) associations between interparental conflict and multiple measures of emotional insecurity (i.e., family, interparental, and parent-child), (2) associations between measures of emotional insecurity and internalizing and externalizing problems, and (3) moderation effects of parent-child relationships. The patterns of association were similar across family structures. A high-quality parent-child relationship did not mitigate the harmful effects of interparental conflict on emotional insecurity or mental health problems. Findings suggest that regardless of family structure, emotional security across multiple family systems may be a critical target for intervention to prevent youth mental health problems, in addition to interventions that reduce conflict and improve parent-child relationships.

Does hospital location matter? Association of neighborhood socioeconomic disadvantage with hospital quality in US metropolitan settings.

An aspect of a hospital's location, such as its degree of socioeconomic disadvantage, could potentially affect quality ratings of the hospital; yet, few studies have granularly explored this relationship in United States (US) metropolitan areas characterized by a wide breadth of socioeconomic disparities across neighborhoods. An understanding of the effect of neighborhood socioeconomic disadvantage on hospital quality of care is informative for targeting resources in poor neighborhoods. We assessed the association of neighborhood socioeconomic disadvantage with hospital quality of care across several areas of quality (including mortality, readmission, safety, patient experience, effectiveness of care, summary and overall star rating) in US metropolitan areas. Hospitals in the most disadvantaged neighborhoods, compared to hospitals in the least disadvantaged neighborhoods, had worse mortality scores, readmission scores, safety of care scores, patient experience of care scores, effectiveness of care scores, summary scores and overall star rating. Timeliness of care and efficient use of imaging scores were not strongly associated with neighborhood socioeconomic disadvantage; although, future studies are needed to validate this finding. Policymakers could target innovative strategies for improving neighborhood socioeconomic conditions in more disadvantaged areas, as this may improve hospital quality.

Patient Demographics are Associated with Differences in Prehospital Pain Management Among Trauma Patients

Objective: Disparities have been observed in the treatment of pain in emergency department patients. However, few studies have evaluated such disparities in emergency medical services (EMS). We describe pain medication administration for trauma indications in an urban EMS system and how it varies with patient demographics. Methods: We performed a retrospective review of the electronic medical records of adult patients transported for isolated trauma (without accompanying medical complaint) from 1/1/18 to 6/30/2020 by a third service EMS agency in a major United States metropolitan area. We performed descriptive statistics on epidemiology, type of pain medications administered, and pain scores. Kruskall-Wallis and chi-square or Fisher’s exact tests were used to compare continuous and categorical variables, respectively. We constructed a logistic regression model to estimate the odds of nontreatment of pain by age, race, sex, transport interval, pain score, and Glasgow Coma Scale (GCS) score for patients with pain scores of at least four on a one to ten scale, the threshold for pain treatment per the EMS protocol. Results: Of 32,463 EMS patients with traumatic injuries included in the analysis, 40% (12,881/32,463) were African American, 50% (16,284/32,463) were female, the median age was 27 years (IQR 45-64), and the median initial pain score was 5 (IQR 2-8). Fifteen percent (4,989/32,463) received any analgesic. Initial pain scores were significantly higher for African American and female patients. African American patients were less likely to receive analgesia compared to White and Hispanic patients (19% versus 25% and 23%, respectively, p < 0.0001). Adjusting for age, pain score, transport interval, and GCS, African American compared to White, and female compared to male patients were less likely to be treated for pain, OR 1.59 (95% CI 1.47-1.72) and OR 1.20 (95% CI 1.11-1.28), respectively. Conclusion: Among patients with isolated traumatic injuries treated in a single, urban EMS system, African American and female patients were less likely to receive analgesia than White or male patients. Analgesics were given to a small percentage of patients who were eligible for treatment by protocol, and intravenous opioids were used in the vast majority patients who received treatment.

Changes in warehouse spatial patterns and rental prices: Are they related? Exploring the case of US metropolitan areas

In this paper, two hypotheses are explored linking urban characteristics to the spatial structure of warehouses: (i) the location of warehouses (central places or peripheral areas) is closely related to the land/rent values of these facilities; and (ii) logistics sprawl is higher in cities with a high differential between land/rent values in city centers and peripheral areas. For that, we have considered warehouse real estate and urban data for 46 United States metropolitan areas to analyze the urban spatial structure and the relationship among urban variables, warehouse location, and rental prices. We deliver an exploratory analysis among the 46 metropolitan areas. The main results are (i) it is essential to classify metropolitan portions of urban space into a typology to perform studies that consider different regions; (ii) warehouse location and rent prices are related to the concentration of urban activity; (iii) logistics sprawl is not significantly related to differential warehouse rental prices in the database that we explored.

Urban Heat Islands and Heat-Related Cardiovascular Morbidity Among Adults Aged 65+ in US Metropolitan Areas

BACKGROUND AND AIM. Extreme heat increases the risk of hospitalization due to cardiovascular disease (CVD). The United States (US) population largely resides in urban areas where climate change is projected to increase temperatures, yet little is known about this association across urban heat islands (UHIs). We aimed to identify the urban populations most at risk of and burdened by heat-related CVD morbidity. METHODS. We obtained daily counts of CVD hospital admissions (HAs) for Medicare enrollees (aged 65+) in 120 metropolitan areas (MSAs) in the contiguous US between 2000-2017. Daily average temperatures were estimated through the interpolation of monitor observations. A measure of UHI intensity was estimated from satellite-derived temperatures in urban vs. non-urban areas. We used quasi-Poisson regression with distributed-lag, non-linear models to estimate MSA-specific associations and pooled these estimates with multivariate meta-analyses. Stratified analyses were performed by UHI intensity quartile. We also calculated the number of CVD HAs attributable to heat in each MSA. RESULTS. Overall, extreme heat (99th percentile, ~28.6&amp;#xb0;C) was associated with a 3.0% [1.4%, 4.6%] increase in CVD HA risk relative to the minimum hospitalization temperature (MHT) (91st percentile, ~25.4&amp;#xb0;C). MSA-specific risks showed substantial differences, with higher risk in MSAs with lower annual average temperatures. We estimate that 1.6% (31,498) of CVD HAs on days above the MHT were attributable to heat. Although the interquartile risk differences were not significant, the highest quartile of UHI intensity was responsible for 47% (14,636) of all heat-attributable CVD HAs. CONCLUSIONS. Our results show that extreme heat increases the risk of CVD HAs among older adults in US urban areas, with considerable variation between cities. Areas with higher UHI intensity had the highest heat-related burden, indicating a potentially vulnerable subset of the urban population. This abstract does not necessarily reflect EPA policy. KEYWORDS. Extreme heat, cardiovascular morbidity, urban heat islands

The United States Urban Hierarchy: An Update

The sole well-recognized United States (US) urban hierarchy articulation essentially is outdated, even though selected recent work seeks to upgrade it. The primary goal of this paper is to update it in a definitive and comprehensive fashion. This paper describes the conceptual framework underlying such observed orderings, itemizes certain strengths and weaknesses of the existing articulation, and then posits a justifiable renovated US urban hierarchy. Next, recapped analyses expose both contiguity and urban hierarchy spatial autocorrelation components of the upper tiers of the 2020 US metropolitan area population rank size distribution. Noteworthy is that these descriptions entail positive-negative spatial autocorrelation mixtures. Inventoried output from the research efforts leading to this paper includes: a contemporary US urban hierarchy articulation that should prove serviceable for at least the next few decades; and, an apparatus providing a practical contribution for improving cultural, environmental, and social aspects of systems of cities through, for example, better cost containment and more efficient/effective delivery of urban public health services and utilization/consumption. The Earth's scientists need this category of tool to incorporate into methodology combating negative effects of globalization that materialize via spatial diffusion.

Why are charging stations associated with electric vehicle adoption? Untangling effects in three United States metropolitan areas

Many policies to support battery electric vehicle (BEV) adoption involve roll-out of public charging stations. While greater density of public charging stations is correlated with higher BEV adoption, the mechanisms underlying this effect are not well understood. We use a sample of 1467 online survey respondents living in the metropolitan areas of Los Angeles, Dallas/Fort Worth, and Atlanta in the United States to investigate three potential mechanisms through which greater public charging station density could shape BEV adoption intent. These three potential mechanisms are lower range anxiety, lower perceived mobility restriction, and more positive pro-BEV subjective norms. Multiple regression with ordinary least squares is used to investigate associations between charging station density and adoption intent. Multiple mediation analysis is then used to evaluate the three potential mechanisms for impact of charging station density on BEV adoption intent, and indicates that greater perceived subjective norms in support of BEVs explain much of the association between charger density and adoption intent. Range anxiety plays a smaller and less robust role as a mechanism, while perceived mobility restriction has no direct or indirect effect on BEV adoption intent. That is, we found no indication that BEV adoption intent is influenced by expectations that BEVs are unable to meet mobility needs. Findings indicate that norms are particularly important for investments in charging infrastructure to translate to more BEVs on the road.

Ecological Impacts of Altered Stream Hydrogeomorphic Characteristics Extend Beyond the Channel Boundary: Evidence From Urban Streams of Columbus, OH, United States

Urbanization in stream catchments can have strong effects on stream channel hydrogeomorphic features including channel dimensions, channel-floodplain connectivity, and flood regime. However, the consequences of hydrogeomorphic alterations on aquatic-terrestrial subsidy dynamics are largely unexplored. We examined the associations among hydrogeomorphic characteristics, emergent aquatic insect assemblages, and the density and trophic dynamics of riparian spiders of the family Tetragnathidae at 23 small urban stream reaches in the Columbus, OH (United States) Metropolitan Area. Naturally abundant stable isotopes of 13C and 15N were used to quantify the relative contribution of aquatically derived energy (i.e., nutritional pathways deriving from algae) to tetragnathid spiders and their trophic position. Bankfull discharge was negatively related to both emergence rate and family richness. On average, tetragnathid spiders relied on aquatically derived energy for 36% of their nutrition, with the greatest reliance found for spiders next to channels with wider flood-prone widths and proportionally fewer emergent insects of the family Chironomidae. Mean emergent aquatic insect reliance on aquatically derived energy was 32% and explained 44% of the variation in tetragnathid aquatically derived energy. A positive relationship between δ13C of tetragnathid spiders and emergent insects provides additional evidence of tetragnathid reliance on emergent insects. Mean tetragnathid trophic position was 2.85 and was positively associated with channel sinuosity and negatively associated with aquatic insect emergence rate. Sinuosity was also positively related to aquatically derived energy of emergent aquatic insects; as well as emergent insect family richness; % Ephemeroptera, Plecoptera, and Trichoptera (EPT); and aquatic insect emergence rate; implicating instream habitat-mediated shifts in emergent aquatic insect communities as an indirect mechanistic link between hydrogeomorphic processes and spiders. Our findings underscore that the impacts of stream hydrogeomorphic alterations can cascade into terrestrial food webs. These results suggest that monitoring and restoration of fluvial geomorphic form and function (e.g., sinuosity, slope, and hydrology) confer benefits to both aquatic and terrestrial riparian ecosystems in urban catchments.

Investigating the performance of models estimating NO2 and PM2.5 in the US metropolitan areas and their environmental inequality and vulnerable people areas

ABSTRACT The study explores the effects of incorporating satellite-based estimates and kriging based on land use regression (LUR) on the ability to predict NO2 and PM2.5 concentrations in the urban cores of the Metropolitan Statistical Areas (MSAs) located on the continental United States (US). We determined that satellite-based estimates and kriging combined with LUR resulted in the lowest averaged error values and spatially unbiased error distributions for predicting NO2, while kriging combined with LUR, but without satellite-based estimates, resulted in the lowest averaged error values and spatially unbiased error distributions for predicting PM2.5. Satellite-based estimates have a marginal effect on discerning PM2.5 concentrations. Using predicted data, we identified the relationship between various demographic factors and concentrations of these pollutants. While median income and percentage of whites are only associated with PM2.5, the percentage of children is associated with both NO2 and PM2.5.

The allometric propagation of COVID-19 is explained by human travel.

We analyzed the number of cumulative positive cases of COVID-19 as a function of time in countries around the World. We tracked the increase in cases from the onset of the pandemic in each region for up to 150 days. We found that in 81 out of 146 regions the trajectory was described with a power-law function for up to 30 days. We also detected scale-free properties in the majority of sub-regions in Australia, Canada, China, and the United States (US). We developed an allometric model that was capable of fitting the initial phase of the pandemic and was the best predictor for the propagation of the illness for up to 100 days. We then determined that the power-law COVID-19 exponent correlated with measurements of human mobility. The COVID-19 exponent correlated with the magnitude of air passengers per country. This correlation persisted when we analyzed the number of air passengers per US states, and even per US metropolitan areas. Furthermore, the COVID-19 exponent correlated with the number of vehicle miles traveled in the US. Together, air and vehicular travel explained 70% of the variability of the COVID-19 exponent. Taken together, our results suggest that the scale-free propagation of the virus is present at multiple geographical scales and is correlated with human mobility. We conclude that models of disease transmission should integrate scale-free dynamics as part of the modeling strategy and not only as an emergent phenomenological property.

Distribution of High-Volume Ankle Replacement Surgeons in United States Metropolitan Areas.

Ankle osteoarthritis is increasing, thus creating greater demand for high-volume total ankle arthroplasty (TAA) surgeons. The Medicare Provider Utilization and Payment Data Public Use File (MPUPD-PUF) provides volume and reimbursement data for procedures performed by physicians participating in Medicare. This study analyzes surgeon prevalence, surgeon distribution, and factors affecting surgeon prevalence in metropolitan areas. The MPUPD-PUF was reviewed from 2012 to 2015, and data were extracted for physicians performing ≥11 TAA procedures. Physicians in metropolitan areas (population >1 million) were grouped together, and reimbursement, number of high-volume surgeons, and procedures were calculated. Presence of an American Orthopaedic Foot and Ankle Society (AOFAS) fellowship program was analyzed for associations with high-volume TAA surgeons. Fifty-three surgeons performed ≥11 TAA procedures (1,960 total) covered by Medicare. Of these surgeons, 66% practice in metropolitan areas with a population >1 million. Fifty-one percent of US major metropolitan areas contained no surgeon who submitted >10 traditional Medicare claims for TAA. Areas with an AOFAS fellowship had nominally more TAA claims submitted. The distribution of high-volume TAA surgeons among major metropolitan areas in the United States is highly unequal. Analyzing the data with this method aids in targeting TAA surgeons to currently underserved areas. Level IV: Retrospective-comparative study.

Perceptions of Dietary Acculturation Among Mexican Immigrant Women Residing in a Southwestern US Metropolitan Area

Abstract Objectives Dietary acculturation consists of adopting food culture after migration to a host country. The purpose of this study was to describe how Mexican-born women perceive factors which contributed to their changes in dietary habits after migrating to the United States (US). Methods Fifteen self-identified Mexican women (41 ± 7 years old) residing in a Southwestern US metropolitan area and who had lived in the US for &amp;gt;1 year participated in semi-structured interviews conducted in Spanish. Interview guides, developed from a constructivist perspective, asked about the US food culture, changes in dietary habits, loss or maintenance of native food culture, and the incorporation of elements of the new food culture. Interview audio recordings were transcribed verbatim and analyzed based on pre-established theoretical categories using MAXQDA 2018. Results Half of the participants worked full time (53%) and had a household income of less than $2000/month (53%). When comparing the US food culture to that of Mexico, the majority of participants perceived greater availability and access to fast food (n = 9). Some participants identified feeling pressure for purchasing larger amounts of food to save money (n = 2). Only one participant associated high intake of fresh and nutritious food with the US food culture. Some participants perceived having more competing demands for time, resulting in not having enough time to prepare household meals (n = 3). Women referred to having maintained the consumption of meat, multiple ingredients (e.g., tortillas, limes, chili peppers), and products of Mexican traditional cuisine (n = 15), but having lost flavors (n = 11), commensality (n = 8), ways of preparation (n = 7), food freshness (n = 3) and smells (n = 1). Even though vegetables and trendy-health products were reported as newly incorporated elements in the diet (n = 7), participants also reported the incorporation of frozen (n = 2) and pre-cooked products (n = 2), which they considered are characteristic from the US diet. Conclusions Findings suggest that dietary acculturation among Mexican immigrant women is a complex process. This points to the importance of considering the cultural aspects of diet when designing strategies to improve diet and health for this group. Funding Sources CONACYT, Mexico and Program for Transborder Communities.

Light rail development with or without gentrification?: Neighborhood perspectives on changing sense of place in Denver, Colorado

The growing and continued popularity of light rail transit systems in major United States metropolitan areas is leading to growing research on land use impacts, value generation, and contributions to gentrification. While various studies explore the fiscal and environmental influences of light rail transit development in the Denver Metropolitan Area, only recently have scholars turned their attention to gentrification and social influences. This paper analyzes how one station shapes residents' sense of place, providing more nuanced understandings of the role light rail and transit-oriented development affects perceptions of neighborhood character and place attachment. We argue that gentrification can be measured and understood not only quantitatively, but also by how people feel light rail influences their attachment to place. Residents within half a mile of the Evans Light Rail Station were randomly and anonymously surveyed with a series of demographic questions and asked to provide their experiences, observations, and opinions. With 166 household responses, we examine residents' perceptions of Evans Station and sense of place to investigate relationships between factors such as race, age, income, education, length of residency, and walking distance from the light rail station. Analysis of their responses creates a more nuanced understanding of the ways that light rail contributes to positive, neutral, and negative emotions associated with gentrification ranging from appreciation of increased accessibility, younger residents, increased property values, and new commercial development to complaints about increased density, higher rents, traffic, noise, and loss of community.

Interaction Patterns of Men Who Have Sex With Men on a Geosocial Networking Mobile App in Seven United States Metropolitan Areas: Observational Study.

BackgroundThe structure of the sexual networks and partnership characteristics of young black men who have sex with men (MSM) may be contributing to their high risk of contracting HIV in the United States. Assortative mixing, which refers to the tendency of individuals to have partners from one’s own group, has been proposed as a potential explanation for disparities.ObjectiveThe objective of this study was to identify the age- and race-related search patterns of users of a diverse geosocial networking mobile app in seven metropolitan areas in the United States to understand the disparities in sexually transmitted infection and HIV risk in MSM communities.MethodsData were collected on user behavior between November 2015 and May 2016. Data pertaining to behavior on the app were collected for men who had searched for partners with at least one search parameter narrowed from defaults or used the app to send at least one private chat message and used the app at least once during the study period. Newman assortativity coefficient (R) was calculated from the study data to understand assortativity patterns of men by race. Pearson correlation coefficient was used to assess assortativity patterns by age. Heat maps were used to visualize the relationship between searcher’s and candidate’s characteristics by age band, race, or age band and race.ResultsFrom November 2015 through May 2016, there were 2,989,737 searches in all seven metropolitan areas among 122,417 searchers. Assortativity by age was important for looking at the profiles of candidates with correlation coefficients ranging from 0.284 (Birmingham) to 0.523 (San Francisco). Men tended to look at the profiles of candidates that matched their race in a highly assortative manner with R ranging from 0.310 (Birmingham) to 0.566 (Los Angeles). For the initiation of chats, race appeared to be slightly assortative for some groups with R ranging from 0.023 (Birmingham) to 0.305 (Los Angeles). Asian searchers were most assortative in initiating chats with Asian candidates in Boston, Los Angeles, New York, and San Francisco. In Birmingham and Tampa, searchers from all races tended to initiate chats with black candidates.ConclusionsOur results indicate that the age preferences of MSM are relatively consistent across cities, that is, younger MSM are more likely to be chatted with and have their profiles viewed compared with older MSM, but the patterns of racial mixing are more variable. Although some generalizations can be made regarding Web-based behaviors across all cities, city-specific usage patterns and trends should be analyzed to create targeted and localized interventions that may make the most difference in the lives of MSM in these areas.