Browsing School, Graduate by Subject "Public health"
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Neighborhood Disorder and Mental Health Outcomes Among a Sample of Baltimore City Residents: The Influence of Urban Parks, Social Cohesion, and Social ControlThe physical and social environments have increasingly received attention as key factors that explain health outcomes and health disparities for individuals. Recent studies have shown that being exposed to high levels of physical and social disorder (i.e., crime, vandalism, vacant buildings, drug activity) in the neighborhood environment can compromise mental health by generating fear, stress, anxiety and depression. Residents of urban disadvantaged neighborhoods are most at risk of exposure to disorder, and also experience higher rates of anxiety and depression, compared to those living in other settings. Some studies suggest green spaces (e.g., parks, gardens, tree canopy) and collective efficacy (i.e., social cohesion and informal social control) provide mental health benefits in the urban neighborhood environment. However, the relationships among these factors, and how they impact mental health in urban environments is complex, and research in this area is limited. The purpose of this study was to elucidate the relationships between these factors by first examining how one indicator of green space, proximity to parks, moderates the relationship between neighborhood disorder and mental health, and second testing whether social cohesion and informal social control mediate this relationship, for a sample of adults living in Baltimore City. Results from multilevel models demonstrated that neighborhood disorder was associated with anxiety and depression symptoms, consistent with theory and prior research. Proximity to parks did not moderate this relationship; however, social cohesion partially mediated the associations between disorder and both depression and anxiety, while social control partially mediated the association between disorder and anxiety, but not depression. Contrary to expectations, higher levels of perceived social control were linked to higher levels of anxiety symptoms. This study demonstrates that neighborhood conditions matter to individual mental health, and perceptions of the social environment act as an important pathway through which the environment influences mental health for Baltimore residents. More study is needed to understand the relationship between exposure to urban parks and mental health. Findings from this study contribute to our understanding of the social determinants of health, and provide further evidence that the neighborhood context is critical to the mental health of urban residents.
Potential for School-based Malaria Treatment to Reduce P. falciparum TransmissionSchool-age children bear an under-appreciated burden of malaria and are a key reservoir for the spread of P. falciparum. We conducted school-based cohort studies to measure the impact of treating students with positive malaria rapid diagnostic tests on subsequent gametocyte, the parasite stage required for human-to-mosquito transmission, prevalence and density. We concomitantly quantified the proportion of gametocyte burden in school-age children and compared it to that of other age groups in household-based surveys in the school catchment area. Treatment reduced the prevalence and density of gametocytes by 79% and 89%, respectively. Half of all gametocyte-containing infections were detected in school-age children. We estimated that school-based malaria treatment could reduce overall gametocyte prevalence in the community by 26% and 34% in the rainy and dry seasons, respectively. These results suggest that school-based malaria treatment could further decrease the burden of malaria in areas where malaria has remained entrenched despite current control measures.