Cities

Urban Health: Is the City Infected?

Urban Health: Is the City Infected?
Medicine and Humanity. London: King's Fund,

Rodwin, V.G.
01/01/2001

The city is, at once, a center for disease and poor health and also a place for hope, cures and good health. From the earliest times, the city has attracted the poor and been the target of the plague, as well as war. Likewise, the health care industry has always been part of the economic base of cities - from Lourdes, in France, to Rochester, Minnesota, to megacities around the world. With its highly disproportionate share of health resources, e.g., hospitals, physicians, nurses and social services, the big city is a center of excellence in medicine. Yet, as Richard Horton, editor of The Lancet once noted, "For all of its rational efficiency and benevolent intent, the city is likely to be the death of us." Are cities socially infected breeding grounds for disease? Or do they represent critical spatial entities for promotion of population health? I propose to begin with a global view of urban health and disease and the challenge this poses for public health today. Next, I examine some evidence for the hypothesis that population health in cities is relatively poor. Finally, I suggest that the more pertinent question is not whether the city is unhealthy or healthy but rather the extent to which we can alleviate the problems posed by inequalities of income and wealth - in the city as well as outside of it.

Analysis of Selection Effects in New York City's Medicaid Managed Care Population

Analysis of Selection Effects in New York City's Medicaid Managed Care Population
Journal of Urban Health. (December 2000): 625-644. Dec

Billings, J., Mijanovich, T. & Cantor, J.
12/01/2000

It is becoming increasingly apparent that over the next several years the majority of Medicaid patients in many states will become enrolled in managed care plans, some voluntarily, but most as the result of mandatory initiatives. An important issue related to this development is the extent to which this movement to managed care is accompanied by serious selection effects, either across the board during the phase in or among individual plans or plan types with full-scale implementation. This paper examines selection effects in New York City between 1993 and 1997 during the voluntary enrollment period prior to implementation of mandatory enrollment pursuant to a Section 1115 waiver. No substantial selection bias was documented between patients entering managed care and those remaining in the fee-for-service system among the largest rate groups, although some selection effect was found among plans and plan types (with investor-owned plans enrolling patients with lower prior utilization and expenses).

Project Report: Population Aging and Longevity in World Cities

Project Report: Population Aging and Longevity in World Cities
Japan Foundation Center for Global Partnership Newsletter, Vol. 26, fall

Rodwin, V.G.
01/01/2000

Improvements in health care and declining birth rates have combined to create rapidly aging populations throughout the industrialized world. By 2020, for example, nearly seventeen percent of the US population is expected to be over the age of sixty-five. In Japan that mark has already been passed, with more than one-quarter of the population expected to be over sixty-five by 2020. At the same time, the world's population is increasingly concentrated in urban areas: the United Nations estimates that by 2025, sixty-one percent of the world's population will live in cities. As both urbanization and population aging increase, we will need models of how to accommodate this population shift and examples to emulate in dealing with these phenomena.

Racial/Ethnic Identity, Congruence with the Social Context, and the Transition to High School

Racial/Ethnic Identity, Congruence with the Social Context, and the Transition to High School
Journal of Adolescent Research, 15(5), 587-602,

French, S., Seidman, E., Allen, L. & Aber, J.L.
01/01/2000

The transition to high school may serve as a race/ethnicity consciousness-raising experience that stimulates the development of one's racial/ethnic identity depending on newcomers' racial/ethnic congruence with the student body and staff, as well as their perceived social transactions with the new school. The nature of this development was tested within samples of poor, urban, Black, White, and Latino students (n = 144). Racial/ethnic identity (group–esteem and exploration) and perceived transactions with school (academic hassles, participation, and social support) were assessed at the end of both the year prior to the transition and the transition year. The results suggested that changes over the transition to senior high school served as a race/ethnicity consciousness-raising experience for both Black and European American students but in dramatically different ways.

The Internet Backbone and the American Metropolis

The Internet Backbone and the American Metropolis
Information Society, Jan-March, Vol. 16 Issue 1, p35-47, 13p.

Moss, M. L. & Townsend, A.
01/01/2000

Despite the rapid growth of advanced telecommunications services, there is a lack of knowledge about the geographic diffusion of these new technologies. The Internet presents an important challenge to communications researchers, as it threatens to redefine the production and delivery of vital services including finance, retailing, and education. This article seeks to address the gap in the current literature by analyzing the development of Internet backbone networks in the United States between 1997 and 1999. We focus upon the intermetropolitan links that have provided transcontinental data transport services since the demise of the federally subsidized networks deployed in the 1970s and 1980s. We find that a select group of seven highly interconnected metropolitan areas consistently dominated the geography of national data networks, despite massive investment in this infrastructure over the study period. Furthermore, while prosperous and internationally oriented American cities lead the nation in adopting and deploying Internet technologies, interior regions and economically distressed cities have failed to keep up. As information-based industries and services account for an increasing share of economic activity, this evidence suggests that the Internet may aggravate the economic disparities among regions, rather than level them. Although the capacity of the backbone system has slowly diffused throughout the metropolitan system, the geographic structure of interconnecting links has changed little. Finally, the continued persistence of the metropolis as the center for telecommunications networks illustrates the need for a more sophisticated understanding of the interaction between societies and technological innovations.

Blacks & Puerto Ricans in New York City: The Reconfiguration of Race & Racism

Blacks & Puerto Ricans in New York City: The Reconfiguration of Race & Racism
in Latinos and Blacks in U.S. Cities, John Betancur and Douglas Gill (eds.) (Garland Press, NY 1999).

Stafford, W.W.& Bonilla, F.
10/01/1999

This edited collection examines joint efforts by Latinos and African Americans to confront problems faced by populations of both groups in urban settings (in particular, socioeconomic disadvantage and concentration in inner cities). The essays address two major issues: experiences and bases for collaboration and contention between the two groups; and the impact of urban policies and initiatives of recent decades on Blacks and Latinos in central cities.

Lives on the Line: American Families and the Struggle to Make Ends Meet

Lives on the Line: American Families and the Struggle to Make Ends Meet
Boulder, CO: Westview Press.

Shirk, M., Bennett, N. & Aber, J.L.
01/01/1999

Almost half of the nation's children live in officially defined poverty or near-poverty. Putting a human face on this and other statistics, the authors present a disturbing and provocative composite portrait of 10 families struggling to make ends meetAfour white, two Hispanic, three black and one Hawaiian/Samoan. Bennett and Aber, both directors of Columbia University's National Center for Children in Poverty, and freelance journalist Shirk (a veteran St. Louis Post-Dispatch reporter), identify three factorsAteen parenthood, low educational achievement and temporary or low-wage workAthat they call "the 'Bermuda Triangle' of family poverty." Add the associated risks of domestic violence, poor child care and damage to early brain development from malnutrition, preventable birth complications, environmental toxins, etc., and readers will begin to see why poverty cuts across urban, suburban and rural areas. A few of the parents profiled here battle drug addiction; one gambles; several suffer from disabling depression; one single mother bravely raises a severely disabled five-year-old son afflicted with spastic quadriplegic cerebral palsy and a 234-pound, 12-year-old daughter. In almost all the profiled families, one or both parents work, contradicting the widespread stereotype of the poor as lazy or irresponsible. In a succinct closing chapter, the authors call for a combination of public- and private-sector measures to help prevent or reduce child poverty. The issues they raise should fuel election-year debate.

The Risk and Protective Function of Perceived Family and Peer Microsystems Among Urban Adolescents in Poverty

The Risk and Protective Function of Perceived Family and Peer Microsystems Among Urban Adolescents in Poverty
American Journal of Community Psychology, 27, 211-237.

Seidman, E., Chesir-Terna, D., Friedman, J.L., Yoshikawa, H., Allen, L.A., Roberts, A. & Aber, J.L.
01/01/1999

Utilized a pattern-based approach to discover the different constellations of perceived social transactions separately for family and peer systems and explored the risk and protective functions of these microsystem profiles for both depression and antisocial behavior among a sample of ethnically and racially diverse urban adolescents living in poverty. Measures of perceived social support, involvement and hassles with family and peers, as well as perceived social acceptance and peers' values were entered into two sets of iterative cluster analyses to identify distinct profiles of family and peer transactions. From each of the perceived family and peer transactional analyses, six replicated profiles emerged. Several of the profiles were consistent with expectations from prior literature such as Enmeshing families and Rejecting peer networks, while others were novel and intriguing such as Entangling peers. Family profiles were consistent in their risk and protective associations for both depression and antisocial behavior, while the peer profiles varied in their effects for each developmental outcome. For example, the Rejecting peer profile placed adolescents at increased risk for depression but protected them from antisocial behavior. Implications for future research and preventive intervention are discussed.

Issues of Climate Change and Its Impacts on the Infrastructure in the Metro East Coast (MEC) Region of the US

Issues of Climate Change and Its Impacts on the Infrastructure in the Metro East Coast (MEC) Region of the US
Report of the MEC Infrastructure Working Group, Columbia University, March .

Jacob, K. & Zimmerman, R.
01/01/1998

The infrastructure of the Metro East Coast region (MEC, with New York City at its core) is the largest, oldest, densest, and busiest in the nation. It serves some 20 million people and built assets exceed $1 trillion. Currently there is considerable stress on the system with key problems identified as: undercapacity, underinvestment, inconsistent management suburban sprawl, and lack of long-term integrated region-wide planning. These problems are exacerbated by fragmentation of governance across competing jurisdictions. Unclear funding mechanisms, spotty economic performance, and deferred infrastructure maintenance are severe stress factors. Spatial and functional inter-connectedness between different types of infrastructure allows failures to cascade through the system - at times even shutting down substantial segments, all at a high societal cost. A special problem is lack of a farsighted solid waste management strategy. Despite these severe stresses, the system somehow manages to deliver essential services to a large population.

 

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