Research & Reports

Journal of Urban Health Research

Despite well-studied associations of state firearm laws with lower state- and county-level firearm homicide, there is a shortage of studies investigating differences in the effects of distinct state firearm law categories on various cities within the same state using identical methods. We examined associations of 5 categories of state firearm laws—pertaining to buyers, dealers, domestic violence, gun type/trafficking, and possession—with city-level firearm homicide, and then tested differential associations by city characteristics. In large US cities, state-level gun type/trafficking, possession, and dealer laws were associated with lower firearm homicide rates, but buyers and domestic violence laws were not. State firearm laws may have differential effects on firearm homicides based on city characteristics, and city-wide policies to enhance socioeconomic drivers may add benefits of firearm laws.

Byoungjun Kim, PhD, Lorna E. Thorpe, PhD, MPH, Ben R. Spoer, PhD, MPH, Andrea R. Titus, PhD, MPP, Julian Santaella-Tenorio, DrPH, MSc, Magdalena Cerdá, DrPH, Marc N. Gourevitch, MD, MPH, Ellicott C. Matthay, PhD, MPH

2023 National League of Cities' Capstone Challenge

Redlining and other discriminatory housing practices have left an indelible mark on communities across the country, consequentially creating long-term barriers to wealth-building for Black households. Cities and communities are seeking approaches to reverse the long-lasting negative impact of redlining by using policymaking, program design and implementation, or community engagement to create equitable opportunities for health and well-being for all residents. The City Health Dashboard team worked with representatives from three city governments – Charlottesville, VA; Houston, TX; and Rochester, NY for the 2023 Capstone Challenge.

Samantha Breslin, MPA, Dana Duong, MPH, Isabel Nelson, MPH, Taylor Lampe, MPH, Yuruo Li, PhD

Journal of Urban Health Research

Access to and utilization of consumer credit remains an understudied social determinant of health. We examined associations between a novel, small-area, multidimensional credit insecurity index (CII), and the prevalence of self-reported frequent mental distress across US cities in 2020. In adjusted models, credit-insecure tracts had a modestly higher prevalence of frequent mental distress, compared to credit-assured tracts. Associations were most pronounced in the Midwest. The CII, a novel indicator of community financial well-being, may be an independent predictor of neighborhood health in US cities and could illuminate policy targets to improve access to desirable credit products and downstream health outcomes.

Andrea R. Titus, PhD, MPP, Yuruo Li, PhD, Claire Kramer Mills, PhD, Benjamin Spoer, PhD, MPH, Taylor Lampe, MPH, Byoungjun Kim, PhD, Marc N. Gourevitch, MD, MPH, Lorna E. Thorpe, PhD

Despite higher chronic disease prevalence, minoritized populations live in highly walkable neighborhoods in US cities more frequently than non-minoritized populations. We investigated whether city-level racial residential segregation (RRS) was associated with city-level walkability, stratified by population density, possibly explaining this counterintuitive association. Median walkability increased across increasing quartiles of population density, as expected. Higher Black-White and Latino-White segregation was associated with higher walkability; associations varied in strength across strata of population density. RRS undergirds the observed association between walkability and minoritized populations, especially in higher population density cities.

Stakeholders need data on health and drivers of health parsed to the boundaries of essential policy-relevant geographies. US Congressional Districts are an example of a policy-relevant geography which generally lack health data. One strategy to generate Congressional District heath data metric estimates is to aggregate estimates from other geographies. We refine a method to aggregate health metric estimates from one geography to another, using a population weighted approach.

Ben R. Spoer, PhD, MPH, Alexander S. Chen, MPH, Taylor M. Lampe, MPH, Isabel S. Nelson, MPH, Anne Vierse, MS, Noah V. Zazanis, MPH, Byoungjun Kim, PhD, Lorna E. Thorpe, PhD, Subu V. Subramanian, PhD, Marc N. Gourevitch, PhD

American Journal of Preventative Medicine

The purpose of this study is to examine the associations between built environments and life expectancy across a gradient of urbanicity in the U.S. After adjusting for key social characteristics, several built environment characteristics were salient risk factors for decreased life expectancy in the U.S., with some measures showing differential effects by urbanicity. Planning and policy efforts should be tailored to local contexts.

Byoungjun Kim PhD MUP, Ben R. Spoer PhD, Andrea R. Titus PhD MPP, Alexander Chen MPH, George D. Thurston ScD, Marc N. Gourevitch MD MPH, Lorna E. Thorpe PhD

Science Direct

Broadband access is an essential social determinant of health, the importance of which was made apparent during the COVID-19 pandemic. We sought to understand disparities in broadband access within cities and identify potential solutions to increase urban access.

Yurou Li PhD, Ben R. Spoer PhD MPH, Taylor M. Lampe MPH, Pei Yang Hsieh MPH, Isabel S. Nelson MPH, Anne Vierse MS, Lorna E. Thorpe PhD, Marc N. Gourevitch MD MPH

Public Health Reports

The COVID-19 pandemic restructured university learning environments while also underscoring the need for granular local health data. This paper describes how the University of Memphis School of Public Health used the City Health Dashboard to enrich students’ learning of applying data to community health policy. By facilitating students’ engagement with population needs, assets, and capacities that affect communities’ health—key components of the master of public health accreditation process—the Dashboard supports in-person and virtual learning at undergraduate and graduate levels and is recommended as a novel and rigorous data source for public health trainees.

Rebecca H. Ofrane, MPH, Samantha Breslin, MPA, Shoshanna Levine, DrPH, Marc N. Gourevitch, MD, MPH, and Marian Levy, DrPH, RD

American Journal of Public Health

In response to rapidly changing societal conditions stemming from the COVID-19 pandemic, we summarize data sources with potential to produce timely and spatially granular measures of physical, economic, and social conditions relevant to public health surveillance, and we briefly describe emerging analytic methods to improve small-area estimation.

Lorna E. Thorpe PhD, Rumi Chunara PhD, Tim Roberts MLS, MPH, Nicholas Pantaleo MPH, Caleb Irvine MPH, Sarah Conderino MS, Yuruo Li PhD, Pei Yang Hsieh MPH, Marc N. Gourevitch MD, MPH, Shoshanna Levine DrPH, Rebecca Ofrane MPH, Benjamin Spoer PhD, MPH

Health and Place

The objectives of this paper are to present the Dashboard's COVID Local Risk Index (CLRI), a measure of city- and neighborhood-level risk for SARS COV-2 infection and poor outcomes, and validate it using sub-city SARS COV-2 outcome data from 47 large U.S. cities. Results show that the CLRI CLRI is a valid tool for assessing sub-city risk of SARS COV-2 infection and illness severity. City stakeholders can use the CLRI, publicly available on the City Health Dashboard, to guide COVID resource allocation.

Ben R. Spoer, Edwin McCulley, Taylor M. Lampe, Pei Yang Hsieh, Alexander Chen, Rebecca Ofrane, Heather Rollins, Lorna E.Thorpe, Usama Bilal, Marc N. Gourevitch