Demographic change, segregation, and the emergence of peripheral spaces in St. Louis, Missouri

Prener, Christopher

doi:10.1016/j.apgeog.2021.102472

Cited by 7 publications

(3 citation statements)

References 32 publications

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“…However, collinearity between increasing social deprivation and the greater likelihood to smoke and identify as Black must be considered 28 . These findings might be specific to our institution and subject to regional bias, as geographic zones surrounding our hospital are quite segregated and racially homogenous 29 . When race and smoking status were removed from our models, social deprivation significantly predicted worse scores on each of the assessed PROMIS domains.…”

Section: Discussionmentioning

confidence: 94%

The Effect of Social Deprivation on Fracture-Healing and Patient-Reported Outcomes Following Intramedullary Nailing of Tibial Shaft Fractures

Hong

Clever

MacCormick

et al. 2022

Journal of Bone and Joint Surgery

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Background:Social deprivation is a state marked by limited access to resources due to poverty, discrimination, or other marginalizing factors. We investigated the links between social deprivation and orthopaedic trauma, including patient-reported outcomes, radiographic healing, and complication rates following intramedullary nailing of tibial shaft fractures.Methods:We retrospectively reviewed 229 patients who underwent intramedullary nailing of tibial shaft fractures at our Level-I trauma center. The Area Deprivation Index (ADI), a validated proxy for social deprivation, was used to group patients into the most deprived tercile (MDT), the intermediate deprived tercile (IDT), and the least deprived tercile (LDT) for outcome comparison. The Patient-Reported Outcomes Measurement Information System (PROMIS) was used to measure the domains of Physical Function (PF), Pain Interference (PI), Anxiety, and Depression, and radiographic healing was assessed with the Radiographic Union Scale in Tibial fractures (RUST) system.Results:On univariate analyses, patients from the MDT reported worse PF, PI, Anxiety, and Depression scores than those from the LDT within the first year of postoperative follow-up. On multivariable regression analysis, PROMIS score outcomes were influenced by age, race, and smoking status, but not by social deprivation tercile. Furthermore, residing in the MDT was associated with a 31% increase in time to radiographic union compared with the LDT (β = 0.27; p = 0.01).Conclusions:Following intramedullary nailing of tibial shaft fractures, social deprivation is associated with slower fracture-healing and potentially influences short-term PROMIS scores. These results warrant further investigation in additional patient populations with orthopaedic trauma and highlight the importance of developing interventions to reduce inequities faced by patients from low-resource settings.Level of Evidence:Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

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Section: Discussionmentioning

confidence: 94%

The Effect of Social Deprivation on Fracture-Healing and Patient-Reported Outcomes Following Intramedullary Nailing of Tibial Shaft Fractures

Hong

Clever

MacCormick

et al. 2022

Journal of Bone and Joint Surgery

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“…Nonetheless, the analysis shows that long‐term, cross‐racial relationships arose out of this grassroots, IGD program. As such, we have evidence that TTT is disrupting the segregated ways of being embedded in modern life (Menendian et al, 2021; Prener, 2021). Interestingly, part of TTT model involved social gatherings with participants and their families.…”

Section: Discussionmentioning

confidence: 85%

“…Life in most metropolitan areas in the United States is becoming more racially segregated (Menendian et al, 2021; Prener, 2021). Dr. King's 1963 comments about this still ring true: “For as long as there is residential segregation, there will be de facto segregation in every area of life” (King, 1963).…”

Section: Introductionmentioning

confidence: 99%

A grassroots antiracist program: The motivation and perceived growth of participants in a community‐based, intergroup dialogue program

Marcucci

Roberston²,

Morgan

et al. 2023

American J of Comm Psychol

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In the United States, racial segregation still organizes the social lives of most people. This segregation of social life continues reinforcing attitudes and behaviors that sustain racial injustice in the United States. Given the longstanding structural forces sustaining the segregated status quo, why do certain individuals seek out opportunities for ‘intentional integration’? And what happens when they do? This qualitative study interviewed racially diverse participants in a community‐developed, sustained, and strategic intergroup dialogue program called Touchy Topics Tuesday (TTT), located in St. Louis, Missouri. Overall, participants (N = 30) described three interwoven motivations for involvement in the program–a catalytic moment, a long‐term commitment mindset, and/or the influence of their social network. Of all these, participants' social network was the predominant motivating force for individuals across racial lines. Participants also reported three main categories of outcomes: intellectual growth, emotional growth, and relational growth. Each of these categories encompass both attitudinal and behavioral changes. The article interrogates these major findings in the context of the intergroup dialogue literature and studies of attitude change and psychotherapy.

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Dementia Risk and Social Determinants of Health Among Adults Racialized as Black: A Community-Based System Dynamics Perspective

Trani,

Hart,

Walker

et al. 2024

J. Racial and Ethnic Health Disparities

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Background The aging population in the USA is projected to increase significantly, with a corresponding rise in dementia cases, particularly among racial minorities. This study examines the key drivers of racial disparities in dementia risk among older Black adults in the St. Louis area, a region characterized by entrenched structural racism. Utilizing a Community-Based System Dynamics (CBSD) approach, we engaged cognitively normal Black adults (age ≥ 45) to explore the complex interplay of social and structural determinants of health (S/SDOH) affecting dementia risk. Methods Eight CBSD workshops were conducted, during which participants identified and analyzed various factors influencing dementia risk through group model-building techniques. These workshops revealed multiple reinforcing and balancing feedback loops, highlighting the intricate relationships between trauma, health literacy, social isolation, education, healthcare access, and systemic racism. Results There were 59 participants with an average age of 64, a majority of women (88%) and college-educated (15.9 years) residing in areas with moderately severe deprivation. The resulting Causal Loop Diagrams underscored the impact of poverty, discrimination, and limited access to quality education and healthcare on dementia risk across the lifespan. Participants proposed actionable interventions, including health information campaigns, community mobilization, and improvements in public transportation and healthcare accessibility. Conclusion This study emphasizes the necessity of addressing S/SDOH to mitigate dementia risk among Black Americans. The findings call for targeted public health initiatives and policy changes to improve socioeconomic conditions and reduce racial disparities in dementia outcomes.

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Demographic change, segregation, and the emergence of peripheral spaces in St. Louis, Missouri

Cited by 7 publications

References 32 publications

The Effect of Social Deprivation on Fracture-Healing and Patient-Reported Outcomes Following Intramedullary Nailing of Tibial Shaft Fractures

The Effect of Social Deprivation on Fracture-Healing and Patient-Reported Outcomes Following Intramedullary Nailing of Tibial Shaft Fractures

A grassroots antiracist program: The motivation and perceived growth of participants in a community‐based, intergroup dialogue program

Dementia Risk and Social Determinants of Health Among Adults Racialized as Black: A Community-Based System Dynamics Perspective

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