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There are 16.9 million Americans living in poverty in the suburbs-more than in cities or rural communities. Despite recent increases in suburban poverty, the perception of the suburbs as areas of uniform affluence remains, and there has been little research into health care barriers experienced by people living in these areas. The objectives of this study were to compare patterns of insurance coverage and health care access in suburban, urban, and rural areas using national survey data from 2005 to 2015 and to compare outcomes by geography before and after the Affordable Care Act took effect. We found that nearly 40 percent of the uninsured population lived in suburban areas. Though unadjusted rates of health care access were better in suburban areas, compared to urban and rural communities, this advantage was greatly reduced after income and other demographics are accounted for. Overall, a substantial portion of the US population residing in the suburbs lacked health insurance and experienced difficulties accessing care. Increased policy attention is needed to address these challenges for vulnerable populations living in the suburbs.

With limited US federal leadership on closing and re-opening strategies to mitigate the COVID-19 pandemic, cities and states were left to enact their own policies. This article examines two key sets of policies—in-person learning in public elementary schools and indoor dining—across 30 of the largest US cities in the summer, fall, and winter of 2020. We review indoor dining and in-person elementary education policy decisions between 1 May 2020 and 14 December 2020 across 30 US cities. We review the public health evidence, political power, and jurisdictional challenges that cities faced, and the policy implications of these factors. Overwhelmingly, indoor dining re-opened in cities while in-person elementary schools were kept closed; indoor dining re-opened in all cities in fall 2020, while only 40% of public elementary schools re-opened for in-person instruction. Looking ahead to fully bringing students back for in-person learning, and considering future potential community outbreaks, this retrospective analysis can help inform city and state governments on policy decisions around indoor dining and reopening/closing schools for in-person learning.

Despite a proliferation of research on neighborhood effects on health, how neighborhood economic development, in the form of gentrification, affects health and well-being in the USA is poorly understood, and no systematic assessment of the potential health impacts has been conducted. Further, we know little about whether health impacts differ for residents of neighborhoods undergoing gentrification versus urban development, or other forms of neighborhood socioeconomic ascent. We followed current guidelines for systematic reviews and present data on the study characteristics of the 22 empirical articles that met our inclusion criteria and were published on associations between gentrification, and similar but differently termed processes (e.g., urban regeneration, urban development, neighborhood upgrading), and health published between 2000 and 2018. Our results show that impacts on health vary by outcome assessed, exposure measurement, the larger context-specific determinants of neighborhood change, and analysis decisions including which reference and treatment groups to examine. Studies of the health impacts of gentrification, urban development, and urban regeneration describe similar processes, and synthesis and comparison of their results helps bridge differing theoretical approaches to this emerging research. Our article helps to inform the debate on the impacts of gentrification and urban development for health and suggests that these neighborhood change processes likely have both detrimental and beneficial effects on health. Given the influence of place on health and the trend of increasing gentrification and urban development in many American cities, we discuss how future research can approach understanding and researching the impacts of these processes for population health.

Paid sick leave provides workers with paid time off to receive COVID-19 vaccines and to recover from potential vaccine adverse effects. We hypothesized that Us cities with paid sick leave would have higher COVID-19 vaccination coverage and narrower coverage disparities than those without such policies. Using county-level vaccination data and paid sick leave data from thirty-seven large US cities in 2021, we estimated the association between city-level paid sick leave policies and vaccination coverage in the working-age population and repeated the analysis using coverage in the population ages sixty-five and older as a negative control. We also examined associations by neighborhood social vulnerability. Cities with a paid sick leave policy had 17 percent higher vaccination coverage than cities without such a policy. We found stronger associations between paid sick leave and vaccination in the most socially vulnerable neighborhoods compared with the least socially vulnerable ones, and no association in the population ages sixty-five and older. Paid sick leave policies are associated with higher COVID-19 vaccination coverage and narrower coverage disparities. Increasing access to these policies may help increase vaccination and reduce inequities in coverage.

Background Health and health disparities vary substantially by geography, including geopolitical boundaries such as United States congressional districts. Every ten years congressional districts for the House of Representatives are redistricted, but occasionally the Courts step in and force states to redistrict gerrymandered congressional maps. Analyses of court mandated redistricting decisions often focus on the distribution of voters by political party and race, but less is known about how health and health disparities are distributed across congressional districts before and after redistricting. In this analysis, we examine how the magnitude of disparities varied between and within congressional districts in Pennsylvania, before and after the state Supreme Court of Pennsylvania’s decision ordering a redistricting in 2018 that produced less politically gerrymandered districts. Methods Using georeferenced vital statistics data from 2013–2015 (before the redistricting), we explore levels of and disparities in infant mortality rates (IMR) and deaths of despair (DoD) using boundaries from before (Congresses 113–115) and after (Congress 116) this redistricting. Results Using consistent mortality data (2013–2015) and boundaries from before and after the 2018 redistricting, we find that after redistricting disparities in infant mortality and deaths of despair between congressional districts were slightly wider for all educational groups except for those with less than a high school degree, and slightly narrower for all racial-ethnic groups other than for Hispanic and non-Hispanic White populations, compared with before redistricting. Conclusions Understanding how disparities vary between and within districts after redistricting can inform our understanding of the relationships between geopolitical boundaries, election processes, and health disparities.

Objectives. To examine racial/ethnic disparities in COVID-19 outcomes between Hispanics and Whites across 27 US jurisdictions whose health departments are members of the Big Cities Health Coalition (BCHC). Methods. Using surveillance data from the BCHC COVID-19 dashboard as of mid-June 2021, we computed crude incidence, age-adjusted hospitalization and mortality, and full vaccination coverage rates for Hispanics and Whites by city. We estimated relative and absolute disparities cumulatively and for 2020 and 2021 and explored associations between city-level social vulnerability and the magnitude of disparities. Results. In most of the cities with available COVID-19 incidence data, rates among Hispanics were 2.2 to 6.7 times higher than those among Whites. In all cities, Hispanics had higher age-adjusted hospitalization (1.5–8.6 times as high) and mortality (1.4–6.2 times as high) rates. Hispanics had lower vaccination coverage in all but 1 city. Disparities in incidence and hospitalizations narrowed in 2021, whereas disparities in mortality remained similar. Disparities in incidence, hospitalization, mortality, and vaccination rates were wider in cities with lower social vulnerability. Conclusions. A deeper exploration of racial/ethnic disparities in COVID-19 outcomes is essential to understand and prevent disparities among marginalized communities. (Am J Public Health. 2022;112(7): 1034–1044. https://doi.org/10.2105/AJPH.2022.306809 )

Objectives. To describe the creation of an interactive dashboard to advance the understanding of the COVID-19 pandemic from an equity and urban health perspective across 30 large US cities that are members of the Big Cities Health Coalition (BCHC). Methods. We leveraged the Drexel‒BCHC partnership to define the objectives and audience for the dashboard and developed an equity framework to conceptualize COVID-19 inequities across social groups, neighborhoods, and cities. We compiled data on COVID-19 trends and inequities by race/ethnicity, neighborhood, and city, along with neighborhood- and city-level demographic and socioeconomic characteristics, and built an interactive dashboard and Web platform to allow interactive comparisons of these inequities across cities. Results. We launched the dashboard on January 21, 2021, and conducted several dissemination activities. As of September 2021, the dashboard included data on COVID-19 trends for the 30 cities, on inequities by race/ethnicity in 21 cities, and on inequities by neighborhood in 15 cities. Conclusions. This dashboard allows public health practitioners to contextualize racial/ethnic and spatial inequities in COVID-19 across large US cities, providing valuable insights for policymakers. (Am J Public Health. 2022;112(6):904–912. https://doi.org/10.2105/AJPH.2021.306708 )

There is literature on scientific legal research methods4-6 and some consensus on the basic elements of good practice,7 but the extent of their adoption was unmeasured until 2024 when Pepin et al. reviewed 177 studies published between 2009 and 2019 evaluating the health impact of law.8 The Pepin et al. review exposed substantial deficiencies in the reporting of legal measurement methods. DEVELOPING REPORTING STANDARDS OF RESEARCH ON LAW An interdisciplinary and international group of researchers engaged with scientific legal measurement-including experts in law, epidemiology, health services research, health policy, political science, and economics-convened at the Center for Public Health Law Research at Temple University in May 2024. Following the general approach to guideline development in the EQUATOR Network, the group discussed and reached agreement on three key points: that the current state of reporting in research studies was suboptimal, that there was a body of methodological literature and research experience on which a standard could be based, and that a formal reporting standard would improve transparency. [...]this editorial serves not only as the call for the development of a standard but also as an invitation to the broader public health research community to participate in its development.