Evidence on ethnic enclave-health associations for Asian Americans is limited due to an inconsistent definition of ethnic enclave. The authors aimed to establish a robust criterion for defining Asian enclaves in New York City (NYC) and assessed the association between enclave residence and health outcomes among Asian American adults. Data came from 2009-12 NYC Community Health Surveys and 2008-12 American Community Survey. Asian enclave was defined as an area with high dissimilarity and isolation scores as well as high concentration of Asians. Five of 55 NYC community districts were identified as Asian enclaves. After controlling for confounding, enclave residence was associated with positive perception of general health with borderline significance (prevalence ratio = 1.06, 95% CI = 0.98, 1.15), but not with current smoking, hypertension, and diabetes. Ethnic enclave residence in urban areas may not produce a substantial impact on chronic health outcomes for Asian Americans beyond individual-level factors.
Purpose Interpersonal racial discrimination is associated with poor health. Social relationships may moderate the impact of discrimination and represent modifiable behaviors that can be targeted by public health interventions. We described citywide associations between self-reported racial discrimination and health-related quality of life among the overall New York City (NYC) adult residential population and by four main race/ethnicity groups and explored whether social relationships moderated health effects of discrimination. Methods We analyzed cross-sectional survey data from 2335 adults weighted to be representative of the NYC population. We measured exposures to lifetime interpersonal racial discrimination in nine domains using a modified version of the Experiences of Discrimination scale. We performed unadjusted and adjusted regression analyses on four self-rated healthrelated quality of life outcomes including general health, physical health, mental health, and limitations from physical or mental health. Results Overall, 47% [95% CI 44.5, 50.3] of respondents reported having experienced racial discrimination in at least one domain. In the overall population, significant associations with racial discrimination were noted in adjusted models for poor physical health, poor mental health, and limitations by poor physical and mental health. Among those exposed to racial discrimination, the risk of experiencing poor mental health was lower among those who had contact with family or friends outside their household at least once a week, compared with those who had less frequent social contact. ConclusionThis study provides evidence that social relationships may moderate the impact of racial discrimination on mental health and should be integrated into health promotion efforts.
ObjectiveHurricane Sandy made landfall on October 29, 2012, causing a coastal storm surge and extensive flooding, which led to the closure of several health care facilities in New York City (NYC) and prolonged interruptions in service delivery. The impact on mental health–related emergency department (ED) and inpatient hospital service utilization was studied.MethodsData came from the New York Statewide Planning and Research Cooperative System. We obtained mental health–related data among NYC residents from 2010 to 2013. Patients were grouped into 5 geographic areas, including service areas of closed hospitals, the Hurricane Sandy evaluation zone, and all of NYC. The Farrington method was used to detect increases in ED visits and hospitalizations for the post-Sandy period.ResultsOpen hospitals experienced a substantial increase in psychiatric ED visits from patients living in the service areas of closed hospitals. This surge in psychiatric ED visits persisted for 4 to 6 months after Hurricane Sandy. However, the increase in psychiatric hospitalizations was observed for 1 to 3 months.ConclusionsSeveral NYC hospitals received a substantially larger number of ED patients from service areas of closed hospitals after Hurricane Sandy, unlike other hospitals that experienced a decrease. Because of potential surges in the number of psychiatric ED visits, resource allocation to hospitals should be considered. (Disaster Med Public Health Preparedness. 2016;10:512–517)
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