Studies of life expectancy (LE) in small areas of cities are relatively common in high-income countries but rare in Latin American countries. Small-area estimation methods can help to describe and quantify inequities in LE between neighborhoods and their predictors. Our objective was to analyze the distribution and spatial patterning of LE across small areas of Ciudad Autónoma de Buenos Aires (CABA), Argentina, and its association with socioeconomic characteristics. As part of the SALURBAL project, we used georeferenced death certificates in 2015–2017 for CABA, Argentina. We used a spatial Bayesian Poisson model using the TOPALS method to estimate age- and sex-specific mortality rates. We used life tables to estimate LE at birth. We obtained data on neighborhood socioeconomic characteristics from the 2010 census and analyzed their associations. LE at birth was higher for women (median of across neighborhoods = 81.1 years) compared to men (76.7 years). We found a gap in LE of 9.3 (women) and 14.9 years (men) between areas with the highest and the lowest LE. Better socioeconomic characteristics were associated with higher LE. For example, mean differences in LE at birth in areas with highest versus lowest values of composite SES index were 2.79 years (95% CI: 2.30 to 3.28) in women and 5.61 years (95% CI: 4.98 to 6.24) in men. We found large spatial inequities in LE across neighborhoods of a large city in Latin America, highlighting the importance of place-based policies to address this gap.

We examined whether race/ethnic-specific social cohesion is associated with race/ethnic-specific HIV diagnosis rates using Bayesian space-time zero-inflated Poisson multivariable models, across 376 Census tracts. Social cohesion data were from the Southeastern Pennsylvania Household Health Survey, 2008—2015 and late HIV diagnosis data from eHARS system, 2009—2016. Areas where trust in neighbors reported by Black/African Americans was medium (compared to low) had lower rates of late HIV diagnosis among Black/African Americans (Relative Risk (RR)=0.52, 95% credible interval (CrI)= 0.34, 0.80). In contrast, areas where trust in neighbors reported by Black/African Americans were highest had lower late HIV diagnosis rates among Whites (RR=0.35, 95% CrI= 0.16, 0.76). Race/ethnic-specific differences in social cohesion may have implications for designing interventions aimed at modifying area-level social factors to reduce racial disparities in late HIV diagnosis.

Objectives To evaluate variability in life expectancy at birth in small areas, describe the spatial pattern of life expectancy, and examine associations between small-area socioeconomic characteristics and life expectancy in a mid-sized city of a middle-income country. Design Cross-sectional, using data from death registries (2015–2018) and socioeconomic characteristics data from the 2010 national population census. Participants/setting 40 898 death records in 99 small areas of the city of Córdoba, Argentina. We summarised variability in life expectancy at birth by using the difference between the 90th and 10th percentile of the distribution of life expectancy across small areas (P90-P10 gap) and evaluated associations with small-area socioeconomic characteristics by calculating a Slope Index of Inequality in linear regression. Primary outcome Life expectancy at birth. Results The median life expectancy at birth was 80.3 years in women (P90-P10 gap=3.2 years) and 75.1 years in men (P90-P10 gap=4.6 years). We found higher life expectancies in the core and northwest parts of the city, especially among women. We found positive associations between life expectancy and better small-area socioeconomic characteristics, especially among men. Mean differences in life expectancy between the highest versus the lowest decile of area characteristics in men (women) were 3.03 (2.58), 3.52 (2.56) and 2.97 (2.31) years for % adults with high school education or above, % persons aged 15–17 attending school, and % households with water inside the dwelling, respectively. Lower values of % overcrowded households and unemployment rate were associated with longer life expectancy: mean differences comparing the lowest versus the highest decile were 3.03 and 2.73 in men and 2.57 and 2.34 years in women, respectively. Conclusion Life expectancy is substantially heterogeneous and patterned by socioeconomic characteristics in a mid-sized city of a middle-income country, suggesting that small-area inequities in life expectancy are not limited to large cities or high-income countries. Data are available upon reasonable request. Interested parties could submit a proposal to SALURBAL to use the vital registration data at the small-area level and sign a data use agreement if approved. The SALURBAL project welcomes queries from anyone interested in learning more about its dataset and potential access to data. To learn more about SALURBAL’s dataset, visit <https://drexel.edu/lac/> or contact the project at salurbal@drexel.edu.

A holistic view of racial and gender disparities that simultaneously compares multiple groups can suggest associated underlying contextual factors. Therefore, to more comprehensively understand temporal changes in combined racial and gender disparities, we examine variations in the orders of county-level race-gender specific heart disease death rates by age group from 1973–2015. We estimated county-level heart disease death rates by race, gender, and age group (35–44, 45–54, 55–64, 65–74, 75–84, ≥ 85, and ≥ 35) from the National Vital Statistics System of the National Center for Health Statistics from 1973–2015. We then ordered these rates from lowest to highest for each county and year. The predominant national rate order (i.e., white women (WW) < black women (BW) < white men (WM) < black men (BM)) was most common in younger age groups. Inverted rates for black women and white men (WW<WM<BW<BM) was observed nationally only for ages 35–44, but was observed in at least some counties for all age groups < 75. From 1973 through 1979, national rates for black men aged ≥ 35 were lower than those for white men. This national observation was found in a minority of counties, primarily among ages 55–64 and 65–74. The observed rates orders and their differences over time and place suggest that social and economic forces may be driving trends in heart disease mortality. Learning more about the places and times that deviate from the predominant rate order can further inform our understanding of these macro-level drivers of heart disease mortality trends.

Despite mounting evidence that urban greenspace protects against mortality in adults, few studies have explored the relationship between greenspace and death among infants. Here, we describe results from an analysis of associations between greenness and infant mortality in Philadelphia, PA. We used images of the normalized difference vegetation index (NDVI), derived from processed satellite data, to estimate greenness density in each census tract. We linked these data with census tract level counts of total infant mortality cases (n = 963) and births (n = 113,610) in years 2010–2014, and used Bayesian spatial areal unit, conditional autoregressive models to estimate associations between greenness and infant mortality. The models included a set of random effects to account for spatial autocorrelation between neighboring census tracts. Infant mortality counts were modeled using a Poisson distribution, and the logarithm of total births in each census tract was specified as the offset term. The following variables were included as potential confounders and effect modifiers: percentage non-Hispanic black, percentage living below the poverty line, an indicator of housing quality, and population density. In adjusted models, the rate of infant mortality was 27% higher in less green compared to more green tracts (95% CI 1.02–1.59). These results contribute further evidence that greenspace may be a health promoting environmental asset.

OBJECTIVE: We examined the associations between the density of alcohol establishments and five types of nonviolent crime across urban neighborhoods. METHOD: Data from the city of Minneapolis, MN, in 2009 were aggregated and analyzed at the neighborhood level. We examined the association between alcohol establishment density and five categories of nonviolent crime: vandalism, nuisance crime, public alcohol consumption, driving while intoxicated, and underage alcohol possession/consumption. A Bayesian approach was used for model estimation accounting for spatial auto-correlation and controlling for relevant neighborhood demographics. Models were estimated for total alcohol establishment density and then separately for off-premise establishments (e.g., liquor and convenience stores) and on-premise establishments (e.g., bars and restaurants). RESULTS: We found positive associations between density and each crime category. The association was strongest for public consumption and weakest for vandalism. We estimated that a 3.3%-10.9% increase across crime categories would result from a 20% increase in neighborhood establishment density. Similar results were seen for on- and off-premise establishments, although the strength of the associations was lower for off-premise density. CONCLUSIONS: Our results indicate that communities should consider the potential increase in nonviolent crime associated with an increase in the number of alcohol establishments within neighborhoods.