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Medical Facilities in the Neighborhood and Incidence of Sudden Cardiac Arrest

Goh, Charlene E.; Mooney, Stephen J.; Siscovick, David S.; Lemaitre, Rozenn N.; Hurvitz, Philip; Sotoodehnia, Nona; Kaufman, Tanya K.; Zulaika, Garazi; Lovasi, Gina S. (2018). Medical Facilities in the Neighborhood and Incidence of Sudden Cardiac Arrest. Resuscitation, 130, 118 – 123.

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Abstract

Background: Medical establishments in the neighborhood, such as pharmacies and primary care clinics, may play a role in improving access to preventive care and treatment and could explain previously reported neighborhood variations in sudden cardiac arrest (SCA) incidence and survival. Methods: The Cardiac Arrest Blood Study Repository is a population-based repository of data from adult cardiac arrest patients and population-based controls residing in King County, Washington. We examined the association between the availability of medical facilities near home with SCA risk, using adult (age 18-80) Seattle residents experiencing cardiac arrest (n = 446) and matched controls (n = 208) without a history of heart disease. We also analyzed the association of major medical centers near the event location with emergency medical service (EMS) response time and survival among adult cases (age 18+) presenting with ventricular fibrillation from throughout King County (n = 1537). The number of medical facilities per census tract was determined by geocoding business locations from the National Establishment Time-Series longitudinal database 1990-2010. Results: More pharmacies in the home census tract was unexpectedly associated with higher odds of SCA (OR: 1.28, 95% CI: 1.03, 1.59), and similar associations were observed for other medical facility types. The presence of a major medical center in the event census tract was associated with a faster EMS response time (-53 s, 95% CI: -84, -22), but not with short-term survival. Conclusions: We did not observe a protective association between medical facilities in the home census tract and SCA risk, orbetween major medical centers in the event census tract and survival.

Keywords

Cardiac Arrest; Medical Care; Emergency Medical Services; Ventricular Fibrillation; Heart Diseases; Patients; Medical Facilities; Neighborhood; Observational Study; Sudden Cardiac Arrest; Survival; Ambulance Response-times; Socioeconomic-status; Association; Care; Resuscitation; Disparities; Population; Provision; Disease

Motorcycle Taxi Programme is Associated with Reduced Risk of Road Traffic Crash among Motorcycle Taxi Drivers in Kampala, Uganda

Muni, Kennedy; Kobusingye, Olive; Mock, Charlie; Hughes, James P.; Hurvitz, Philip M.; Guthrie, Brandon. (2019). Motorcycle Taxi Programme is Associated with Reduced Risk of Road Traffic Crash among Motorcycle Taxi Drivers in Kampala, Uganda. International Journal Of Injury Control & Safety Promotion, 26(3), 294 – 301.

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Abstract

SafeBoda is a transportation company that provides road safety training and helmets to its motorcycle taxi drivers in Kampala. We sought to determine whether risk of road traffic crash (RTC) was lower in SafeBoda compared to regular (non-SafeBoda) motorcycle taxi drivers during a 6-month follow-up period. We collected participant demographic and behavioural data at baseline using computer-assisted personal interview, and occurrence of RTC every 2 months using text messaging and telephone interview from a cohort of 342 drivers. There were 85 crashes (31 in SafeBoda and 54 in regular drivers) during follow-up. Over the 6-month follow-up period, SafeBoda drivers were 39% less likely to be involved in a RTC than regular drivers after adjusting for age, possession of a driver's license, and education (RR: 0.61, 95% CI: 0.39-0.97, p = .04). These findings suggest that the SafeBoda programme results in safer driving and fewer RTCs among motorcycle taxi drivers in Kampala.

Keywords

Motorcyclists; Motorcycle Helmets; Text Messages; Telephone Interviewing; Motorcycles; Kampala (uganda); Uganda; Boda-boda; Crash; Injury; Road Safety; Injuries; Burden; Riders; Kenya; Traffic Accidents; Transportation; Risk Management; Crashes; Demographics; Transportation Safety; Short Message Service; Traffic; Traffic Accidents & Safety; Roads; Risk Reduction; Taxicabs; Protective Equipment; Drivers Licenses; Kampala Uganda

Associations of Household Income with Health-Related Quality of Life Following a Colorectal Cancer Diagnosis Varies with Neighborhood Socioeconomic Status

Robinson, Jamaica R. M.; Phipps, Amanda, I; Barrington, Wendy E.; Hurvitz, Philip M.; Sheppard, Lianne; Malen, Rachel C.; Newcomb, Polly A. (2021). Associations of Household Income with Health-Related Quality of Life Following a Colorectal Cancer Diagnosis Varies with Neighborhood Socioeconomic Status. Cancer Epidemiology Biomarkers & Prevention, 30(7), 1366 – 1374.

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Abstract

Background: Existing evidence indicates household income as a predictor of health-related quality of life (HRQoL) following a colorectal cancer diagnosis. This association likely varies with neighborhood socioeconomic status (nSES), but evidence is limited. Methods: We included data from 1,355 colorectal cancer survivors participating in the population-based Puget Sound Colorectal Cancer Cohort (PSCCC). Survivors reported current annual household income; we measured HRQoL via the Functional Assessment of Cancer Therapy - Colorectal (FACT-C) tool. Using neighborhood data summarized within a 1-km radial buffer of Census block group centroids, we constructed a multidimensional nSES index measure. We employed survivors' geocoded residential addresses to append nSES score for Census block group of residence. With linear generalized estimating equations clustered on survivor location, we evaluated associations of household income with differences in FACT-C mean score, overall and stratified by nSES. We used separate models to explore relationships for wellbeing subscales. Results: We found lower household income to be associated with clinically meaningful differences in overall FACT-C scores [<$30K: -13.6; 95% confidence interval (CI): -16.8 to -10.4] and subscale wellbeing after a recent colorectal cancer diagnosis. Relationships were slightly greater in magnitude for survivors living in lower SES neighborhoods. Conclusions: Our findings suggest that recently diagnosed lower income colorectal cancer survivors are likely to report lower HRQoL, and modestly more so in lower SES neighborhoods. Impact: The findings from this work will aid future investigators' ability to further consider the contexts in which the income of survivors can be leveraged as a means of improving HRQoL

Keywords

Built Environment Factors; Functional Assessment; Fact-c; Population-density; Physical-activity; Survivors; Care; Disparities; Impact; Mortality

Urban Form Lab

The Urban Form Lab (UFL) research aims to affect policy and to support approaches to the design and planning of more livable environments. The UFL specializes in geospatial analyses of the built environment using multiple micro-scale data in Geographic Information Systems (GIS). Current research includes the development of novel GIS routines for performing spatial inventories and analyses of the built environment, and of spatially explicit sampling techniques. Projects address such topics as land monitoring, neighborhood and street design, active transportation, non-motorized transportation safety, physical activity, and access to food environments. 

Research at the UFL has been supported by the U.S. and Washington State Departments of Transportation, the Centers for Disease Control and Prevention, the Robert Wood Johnson Foundation, the National Institutes of Health, and local agencies.

The Urban Form Lab is directed by Anne Vernez Moudon, Dr es Sc, a leading researcher and educator in quantifying the properties of the built environment as related to health and transportation behaviors. Philip M. Hurvitz, PhD, a veteran of geographic information science and data processing, leads data management and GIS work.

Urban@UW helps BE labs collaborate

The Urban@UW initiative brings together labs that study urban issues from across the University of Washington. Urban@UW works with scholars, policymakers, and community stakeholders in order to strengthen the connection between research and solutions to urban issues through cross-disciplinary and cross-sector collaborative research. Key functions of Urban@UW include amplifying public awareness of ongoing projects, connecting researchers with outside constituencies, providing staff and administrative support services, and providing pilot funding and fundraising assistance. Multiple BE labs are involved, including the Northwest…

New UW Data Collaborative connects BE researchers with restricted data

The University of Washington Data Collaborative (UWDC) is now offering services to researchers across campus, including BE researchers Gregg Colburn at the Runstad Department of Real Estate and the Urban Form Lab. Housed at the Center for Studies in Demography & Ecology, UWDC provides infrastructure to access restricted data in a secure and sophisticated computing environment. Data sets available to researchers cover health records, polling data, business and consumer data, and real estate data. Researchers interested in accessing these data…

Anne Vernez-Moudon

Anne Vernez Moudon is Professor Emerita of Architecture, Landscape Architecture, and Urban Design and Planning at the University of Washington, Seattle. She is President of the International Seminar on Urban Morphology (ISUF), an international and interdisciplinary organization of scholars and practitioners; a Faculty Associate at the Lincoln Institute of Land Policy, in Cambridge, MA; a Fellow of the Urban Land Institute in Washington, D.C.; and a National Advisor to the Robert Wood Johnson Foundation program on Active Living Policy and Environmental Studies.

Dr. Moudon holds a B.Arch. (Honors) from the University of California, Berkeley, and a Doctor ès Science from the Ecole Polytechnique Fédérale of Lausanne, Switzerland. Her work focuses on urban form analysis, land monitoring, neighborhood and street design, and non-motorized transportation. Her current research is supported by the U.S. and Washington State departments of Transportation, the Puget Sound Regional Council, the Federal Highway Administration, and the Centers for Disease Control and Prevention.

Her published works include Built for Change: Neighborhood Architecture in San Francisco (MIT Press 1986), Public Streets for Public Use (Columbia University Press 1991), and Monitoring Land Supply with Geographic Information Systems (with M. Hubner, John Wiley & Sons, 2000). She also published several monographs, such as Master-Planned Communities: Shaping Exurbs in the 1990 ( with B. Wiseman and K.J. Kim, distributed by the APA Bookstore, 1992) and Urban Design: Reshaping Our Cities (with W. Attoe, University of Washington, College of Architecture and Urban Planning, 1995).

Dr. Moudon has been an active participant in The Mayors’ Institute on City Design since 1992. She has consulted for many communities nationally and internationally to develop urban design guidelines for new construction which respect the character of the existing landscape and built environment and which support non-motorized transportation. She has worked with planning officials, design professionals, and neighborhood groups in the Puget Sound as well as in San Francisco, CA, Toronto and Montreal, Canada, Stockholm, Sweden, among others. She taught courses and conducted seminars in urban design, planning, and housing in Japan, Korea, China, Mexico, Brazil, Venezuela, Colombia, France, the United Kingdom, and Switzerland.

Philip Hurvitz

Phil Hurvitz is a research scientist with a primary appointment in the UW Center for Studies in Demography and Ecology, and is an Affiliate Associate Professor in Urban Design & Planning in the University of Washington College of Built Environments Urban Form Lab. He received his PhD in 2010, and has been on the faculty since 2012. He specializes in the objective measurement and analysis of the built environment using GIScience methodology. His current research investigates the relationship between health-related behaviors and built environment at fine spatial and temporal scales. Using new-generation devices that measure activity and location in real time, the data are being used to find associations between the types of activities people engage in and the types of environments people use as they go about their daily lives. He collaborates with researchers specializing in nutritional epidemiology, exercise physiology, rehabilitation medicine, and psychology for the purpose of understanding the relationships between built environment, diet, and physical activity. Phil received a Master of Forest Resources degree in 1994 at the UW College of Forest Resources where he helped develop and implement a GIS for the Makah Indian Nation. His Bachelor’s degree (1983) is from Seattle University in Humanities. Prior to his current appointment, he worked as a GIS specialist for the College of Forest Resources, the City of SeaTac, the Seattle Water Department, and an instructor at the University of Washington and Green River Community College.