People, places and policies – trying to account for health inequalities in impoverished neighbourhoods

Feldman, Peter; Warr, Deborah; Tacticos, Theonie; Kelaher, Margaret

doi:10.1111/j.1753-6405.2009.00333.x

Cited by 10 publications

(10 citation statements)

References 43 publications

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“…[29] Although, like us, Blackman et al[23] showed improvement in mental health after the urban renewal program, others have not been able to demonstrate this. [20-22] The most likely explanation is that compositional factors, which also have important influences on health,[30] are not, or are inadequately, addressed by urban renewal programs. Residents of neighbourhoods targeted for urban renewal often suffer from multiple deprivations, including poor housing conditions, and any interventions to improve health and well-being should also target other social determinants of health, for example, education and unemployment.…”

Section: Discussionmentioning

confidence: 99%

A pre-and-post study of an urban renewal program in a socially disadvantaged neighbourhood in Sydney, Australia

et al. 2012

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BackgroundUrban renewal programs aim to target both the physical and social environments to improve the social capital, social connectedness, sense of community and economic conditions of residents of the neighbourhoods. We evaluated the impact of an urban renewal program on the health and well-being of residents of a socially disadvantaged community in south-western Sydney, Australia.MethodsPre- and post-urban renewal program surveys were conducted with householders by trained interviewers. The urban renewal program was conducted over 16 months and consisted of internal upgrades (including internal painting; replacement of kitchens, bathrooms and carpets; general maintenance), external upgrades (including property painting; new fencing, carports, letterboxes, concrete driveways, drainage and landscaping), general external maintenance, and social interventions such as community engagement activities, employment initiatives, and building a community meeting place. The questionnaire asked about demographic characteristics, self-reported physical activity, psychological distress, self-rated health, and perceptions of aesthetics, safety and walkability in the neighbourhood. We used the paired chi-square test (McNemars test) to compare paired proportions. A Bonferroni corrected p-value of <0.0013 denoted statistical significance.ResultsFollowing the urban renewal program we did not find statistically significant changes in perceptions of aesthetics, safety and walkability in the neighbourhood. However, post-urban renewal, more householders reported there were attractive buildings and homes in their neighbourhood (18% vs 64%), felt that they belonged to the neighbourhood (48% vs 70%), that their area had a reputation for being a safe place (8% vs 27%), that they felt safe walking down their street after dark (52% vs 85%), and that people who came to live in the neighbourhood would be more likely to stay rather than move elsewhere (13% vs 54%). Changes in psychological distress and self-rated health were not statistically significant.ConclusionsWe found an increase, in the short-term, in the proportion of householders reporting improvements in some aspects of their immediate neighbourhood following the urban renewal program. It will be important to repeat the survey in the future to determine whether these positive changes are sustained.

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Section: Discussionmentioning

confidence: 99%

A pre-and-post study of an urban renewal program in a socially disadvantaged neighbourhood in Sydney, Australia

et al. 2012

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“…17,18 This is also true for Australia despite this country's relatively high overall wealth and the availability of free basic health care. [19][20][21] The reasons are complex and include practical barriers related to low income, 22 poor social resources, 23 poor health literacy, 24 perceived stigma, or previous unsatisfactory interaction with the medical system. 25 Our analyses used the residential address (postal code) at the time of clinic attendance to ascertain the Disadvantage Index.…”

Section: Found Anmentioning

confidence: 99%

Mind the gap: Multiple events and lengthy delays before presentation with a “first seizure”

et al. 2015

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SUMMARYObjective: Up to half of patients assessed for suspected new-onset epileptic seizures report previous undiagnosed events. This suggests that delay to timely and expert assessment is a major issue. Very little is known about the degree of delay or nature of the undiagnosed events, impacting on our understanding of new-onset epilepsy. In this study we aimed to examine events that occur before presentation, as well as the extent and risk factors for delay to assessment. Method: Included in this retrospective study were 220 patients diagnosed at the First Seizure Clinic (Austin Health, Australia) between 2003 and 2006 with an epileptic index seizure. Patients with a prior diagnosis of epileptic seizures were excluded. Chart review was undertaken, including detailed interviews conducted by an epileptologist at first assessment. Logistic regression assessed risk factors for delay from first event to presentation, including event characteristics, socioeconomic disadvantage, employment, and distance to medical facility. Results: Forty-one percent (n = 90) of patients had one or more event before their index seizure. Of these, 50% had multiple or more than five prior events and 28% experienced one or more convulsive event before the index seizure. Of the total 220 patients, 36% had delayed presentation >4 weeks, 21% delayed >6 months, and 14% delayed >2 years. First events without convulsions or features likely to disrupt behaviour were strongly associated with delay (p = <0.001). Relative socioeconomic disadvantage was also associated with delay to presentation (p = 0.04). Significance: Our findings suggest a gap in early diagnosis and care in a sizable proportion of new-onset cases, despite a "first world" urban environment and the availability of free basic medical care. Delay appears particularly likely when events are nonconvulsive or low-impact, suggesting that these seizure types may be underrepresented in studies of new-onset epilepsy. This has implications for our understanding of the incidence, evolution, impact, and treatment response of new-onset epilepsy.

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“…Using qualitative and quantitative data from surveys of residents of 13 impoverished neighbourhoods in Victoria, this paper explores two related issues in order to develop improved understanding of potentially health‐impairing aspects of local physical and social environments: residents’ perceptions of their neighbourhood environments and their self‐reported health status. The paper builds on an analysis of the same data sets that suggested that contextual factors in neighbourhood environments may be contributing to differences in self‐reported health status between residents living in socially‐disadvantaged neighbourhoods and those living outside these neighbourhoods 19 . In this paper, we consider neighbourhood contexts of incivilities and disorders from two angles.…”

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confidence: 99%

Sources of stress in impoverished neighbourhoods: insights into links between neighbourhood environments and health

Warr

Feldman

Tacticos

et al. 2009

Australian and New Zealand Journal of Public Health

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People, places and policies – trying to account for health inequalities in impoverished neighbourhoods

Abstract: Objective: We consider associations between individual, household and arealevel characteristics and self-reported health.

Cited by 10 publications

References 43 publications

A pre-and-post study of an urban renewal program in a socially disadvantaged neighbourhood in Sydney, Australia

A pre-and-post study of an urban renewal program in a socially disadvantaged neighbourhood in Sydney, Australia

Mind the gap: Multiple events and lengthy delays before presentation with a “first seizure”

Sources of stress in impoverished neighbourhoods: insights into links between neighbourhood environments and health

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