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• v.98(6); 2021 Dec

Health Data for New York City Overview: Advancing Health Equity through Policy-Relevant Collaborative Research

Michele calvo.

1 New York Academy of Medicine, New York City, NY USA

Elizabeth Kelman

2 Division of Epidemiology, New York City Department of Health and Mental Hygiene, New York City, NY USA

L. Hannah Gould

R. charon gwynn, lisa m. bates.

3 Columbia University Mailman School of Public Health, New York City, USA

Marivel Davila

4 Center for Health Equity and Community Wellness, New York City Department of Health and Mental Hygiene, New York City, NY USA

Francesca Gany

5 Memorial Sloan Kettering Cancer Center, New York City, NY USA

6 Weill Cornell Medical College, New York City, NY USA

David Siscovick

Introduction.

Actionable policy-relevant research is critical to improving population health and advancing health equity, as research provides an evidence base for the development of effective policies and programs. For academic researchers with an interest in addressing the upstream social and structural causes of health inequities, conducting this type of research remains a challenge. To maximize the utility of research findings, academic researchers need to collaborate with researchers with applied public health experience, including government and other stakeholders, but may not have the time and knowledge needed to navigate complex government bureaucracy. To influence policy and program development, academic researchers also must understand the broader, applied context, along with the skills needed to communicate relevant findings to decision-makers.

While large city health departments collect vast amounts of data and make efforts to expand access to those data, there remain real and perceived barriers to the effective and efficient use of these data for maximum policy and programmatic impact [ 1 , 2 ]. Applied public health researchers within a local health department may have limited access to expertise in advanced analytic methods or familiarity with agency data resources outside of their individual program. Health department employees often do not have adequate time for research, analysis, and writing, although research may be of interest and helpful to elevate careers.

There are an array of initiatives that aim to promote multi-institutional, multi-sectoral collaboration; expand access to available population health data; or provide mentorship for early- and mid-career academic researchers [ 3 , 4 ]. We hypothesized that a program that combined these core elements in the context of New York City (NYC), which has a diverse population, large urban health department, and many academic institutions, would provide a unique opportunity to advance actionable health equity-focused research.

In this issue of the Journal of Urban Health , we describe the development of Health Data for New York City (HD4NYC), which aims to advance policy-relevant, health equity-focused research by combining multi-institutional and interdisciplinary collaboration, access to data, and mentorship. We also describe select initial research products emerging from this new, unique program.

The Health Data for New York City Program

HD4NYC was launched by the New York Academy of Medicine (NYAM) and the New York City Department of Health and Mental Hygiene (Health Department) in March 2019, with funding from the Robert Wood Johnson Foundation. HD4NYC builds on the long-standing commitment of the Health Department to provide public access to its many data sources as well as existing collaborations between the Health Department and academic researchers. The goals of HD4NYC are to (a) produce actionable, policy-relevant research that will advance health equity and (b) advance the careers of a diverse group of early- and mid-career investigators from NYC metropolitan academic institutions and the Health Department.

HD4NYC is based on the research working group model that has been shown to foster multi-institutional collaboration, high impact research, and career development of early- and mid-career investigators in other settings, such as the Cardiovascular Health Study (CHS) and the the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) [ 5 , 6 ].

Our program differs in important ways from prior applications of the working group model:

• HD4NYC promotes collaboration between academic and applied public health researchers.
• HD4NYC facilitates access to a breadth of data sources, including Health Department survey and surveillance data.
• HD4NYC focuses on the complex and interrelated social, economic, and environmental drivers and consequences of health inequities.
• HD4NYC supports the translation of research findings into policy change.

The Health Department and NYAM provide shared leadership for the program and dedicated program staff, including a program coordinator at NYAM and a program coordinator and data manager at the Health Department. These roles support accessing and analyzing data, navigating the Heath Department, connecting to external stakeholders, project management, and other logistical and administrative needs. Each working group is co-led by senior mentors from the Health Department and an academic institution.

Recruitment

We used multiple strategies to recruit a diverse pool of academic and Health Department investigators. We recruited investigators and co-leads within the Health Department via a variety of agency networks. Potential working group topic areas were identified based on applicants’ interests, agency priorities, and availability of Health Department data. After identifying possible working group topics, we invited leaders in health equity to nominate early career academic investigators, conducted an environmental scan, and sent email blasts. We assessed applicants on the following attributes: demonstrated commitment to health equity, policy-relevant research, and team science; analytical skills; and alignment of interest with the initial themes. For academic investigators, we also assessed publication and funding productivity. For Health Department investigators, we considered how HD4NYC would facilitate career growth and skill development, as well as the applicant’s program to ensure representation from across the agency.

We accepted 19 academic investigators and two academic co-leads into HD4NYC. These researchers represent 14 academic institutions in the NYC metropolitan area and have diverse expertise, including public health, medicine, nursing, engineering, and psychology. We accepted ten Health Department investigators and two co-leads from eight Health Department divisions into HD4NYC. After 2 years, 90% of the investigators remain engaged in the program.

Working Groups

We ultimately established two working groups: one focused on birth and childhood equity and the other focused on the health of marginalized populations. Each working group meets monthly to review research progress, obtain peer and co-lead feedback on research, and stay abreast of program goals. Working groups were further divided based on initial subthemes of interest, with three in each working group (six total). Subgroups meet on a biweekly or weekly basis to collaborate on research projects. The initial subgroups focused on the following topics: maternal/infant health, children’s environmental health, health of children from immigrant families, policy evaluation, stigma and discrimination, and criminal legal system-involved populations.

Data Access

HD4NYC facilitated orientation to Health Department data in several ways, such as creating one-page summaries of select Health Department surveys and surveillance systems; connecting researchers to key staff that manage datasets aligned with HD4NYC subthemes; and summarizing data access procedures. We supported data access by registering academic investigators as Health Department volunteers, allowing for access to Health Department buildings and computers. We also offered software trainings, arranged for remote data access, and facilitated the completion of Data Use Agreements. Finally, our data manager ran descriptive statistics to guide development of research questions and analytic plans.

Training and Mentorship

To support the professional development of investigators and enhance the quality and policy relevance of HD4NYC research, we hosted quarterly seminars that enabled investigators to interact with national and local health equity leaders, including prominent health equity researchers, directors of local community-based organizations, and representatives from potential funding mechanisms. Mentorship is a central component of the program for both Health Department and academic investigators. HD4NYC co-leads facilitate working group meetings, guide the development of research questions, review and provide feedback on project proposals and research products, and provide as-needed one-on-one or small group mentorship.

Stakeholder Engagement

We invited Health Department staff whose work aligned with investigator interests to join working group and subgroup meetings to inform project development. In some instances, they joined the projects as collaborators. While not explicit in the original program model, we quickly recognized the need to involve other governmental and community-based stakeholders in the collaborative research process. To start, we held a half-day stakeholder workshop, attended by invited representatives from community-based organizations and other city agencies whose work aligned with the initial six projects. HD4NYC subgroups have continued engagement in a variety of ways, including holding subsequent feedback sessions to interpret preliminary results, guest-presenting on coalition webinars, involving stakeholders in weekly project meetings, inviting stakeholders to co-author publications, and sharing findings in ways useful to community-based stakeholders (e.g., one-pagers).

We used a combination of surveys and focus groups to assess the appropriateness, effectiveness, efficiency, and impact of program components, and to identify gaps in the program and priorities for improving HD4NYC. Overall, the working group model and program components were reported as valuable. HD4NYC has produced publications of peer-reviewed manuscripts, a grant-funded ancillary study, and ongoing partnerships with community and governmental stakeholders. Reported limitations included a lack of funding for academic investigators and adequate resources and time for equitable community stakeholder engagement.

Overview of HD4NYC Research

We now provide an overview of the subset of HD4NYC research projects included in this special section. The enclosed papers address important upstream determinants of health including criminal justice, tobacco control, environmental exposures, and access to healthcare.

Criminal Legal System

There is mounting evidence that criminal legal system policies and practices differentially impact some racial and ethnic groups, such as Black and Latinx communities; these differences may contribute to health inequities [ 7 ]. Thompson, Baquero, and colleagues examined experiences of policing and criminal legal system policies and their associations with physical, mental, and behavioral health outcomes (poor physical and mental health, serious psychological distress, and binge drinking). The study found that those stopped by the police, abused by the police, and those experiencing discrimination reported higher levels of adverse health outcomes, and these associations were most commonly observed among Black NYC residents and residents ages 24–44. This study strengthens the body of literature around health and policing by examining validated and comprehensive measures of health at the individual level in a representative sample of NYC residents. These findings may inform ongoing policy discussions in NYC and nationally regarding policing and criminal legal system reforms [ 8 ].

Menthol Cigarette Ban

Well-timed, rigorous policy evaluations can provide evidence to make equity-informed policy decisions and inform the prioritization of resources. Li and colleagues constructed a micro-simulation model to predict cardiovascular disease outcomes and related healthcare cost savings if a menthol ban was implemented in NYC. The model projected that a menthol ban policy would result in substantial reductions in cases of myocardial infarction and stroke among adult smokers in NYC overall, and subgroup analyses suggested even greater reductions in adverse cardiovascular outcomes among women, specifically Black women [ 9 ].

Maternal Healthcare

There is growing evidence that limited access to healthcare for populations that are marginalized is an important determinant of health. In NYC, half of all births are to immigrant mothers, yet there is little research available on immigrant maternal healthcare utilization. Maru, Glenn, and colleagues collaborated closely with community stakeholders to examine utilization of maternal healthcare services before, during, and after pregnancy among immigrant mothers in NYC from 2016 to 2018. The authors found lower utilization of preconception healthcare and dental cleaning during pregnancy among immigrant women, particularly among immigrants that recently arrived to the USA. The authors also found substantial variation by region of origin. These findings can help target efforts to address inequities in maternal healthcare access. The investigators are collaborating with government and community stakeholders to translate their findings into policy and practice [ 10 ].

Socioenvironmental Contributors to Childhood Asthma

While many environmental exposures and socioeconomic factors are known to increase the risk of asthma exacerbations – the leading cause of pediatric hospitalizations and emergency department visits in NYC – they are not commonly studied together. Bajwa, Khan, and colleagues used cluster analysis that grouped children based on socioenvironmental and housing factors at individual and neighborhood levels to better understand the major patterns of these exposures and their relationship to asthma exacerbations. The authors found three neighborhood level factors that predominantly drove cluster formation and differed in asthma outcomes: renting homes, high-density buildings, and older buildings. This information may help target interventions to reduce asthma disparities among children in the city [ 11 ].

HD4NYC research projects not included in this issue also address important determinants and consequences of health inequities, such as bullying among LGBTQ youth of color and trends in health service utilization among children from immigrant families.

We have successfully developed and launched a unique public-private partnership that combines collaboration, access to data, and mentoring, using a working group model, to advance health equity research and promote the careers of early- and mid-career academic and applied public health researchers. Working groups focused on marginalized populations and birth and childhood equity established six subtheme groups that have conducted rigorous and impactful research utilizing 10 datasets from the Health Department and other agencies, most in collaboration with community stakeholders. The reports included in this issue reflect the initial products of four of the subtheme groups. In April 2021, the Robert Wood Johnson Foundation awarded a grant to continue HD4NYC for a third year. During this time, we have formed a new working group on COVID-19 health inequities and are focusing on strengthening community engagement, translating research findings for policy change, and sustaining collaborative research.

Acknowledgements

We would like to thank the Health Data for New York City investigators and collaborators for their contributions to the program.

Health Data for New York City (HD4NYC) is funded by the Robert Wood Johnson Foundation and led by the New York Academy of Medicine and the New York City Department of Health and Mental Hygiene. HD4NYC is a multi-institutional research platform that seeks to advance health equity by producing actionable, policy-relevant research and promoting the careers of academic and applied public health researchers.

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Michele Calvo and Elizabeth Kelman contributed equally to this work.

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When and where the solar eclipse will be crossing the U.S.

A total solar eclipse will grace the skies over North America on Monday, one of the most hotly anticipated sky-watching events in recent years.

Weather permitting , millions of people in Mexico, 15 U.S. states and eastern Canada will have the chance to see the moon slip between Earth and sun, temporarily blocking the sun’s light .

The total solar eclipse will be visible along a “path of totality” that measures more than 100 miles wide and extends across the continent. Along that path, the moon will fully obscure the sun, causing afternoon skies to darken for a few minutes.

In all other parts of the continental U.S., a partial solar eclipse will be visible, with the moon appearing to take a bite out of the sun. Exactly how big a bite depends on the location.

The first spot in North America that will experience totality on Monday is on Mexico’s Pacific coast at around 11:07 a.m. PT, according to NASA .

After moving northeast across Mexico, the eclipse’s path travels through Texas, Oklahoma, Arkansas, Missouri, Illinois, Kentucky, Indiana, Ohio, Pennsylvania, New York, Vermont, New Hampshire and Maine. Slivers of Michigan and Tennessee will also be able to witness totality if conditions are clear.

In Canada, the eclipse will be visible in parts of southern Ontario, Quebec, New Brunswick, Prince Edward Island and Cape Breton, at the eastern end of Nova Scotia.

The timing of the eclipse and the duration of totality varies by location. Most places will experience around 2 minutes of darkness, but the longest periods of totality are typically in the center of the eclipse’s path.

This year, the longest stretch of totality will last 4 minutes and 28 seconds in an area northwest of Torreón, Mexico.

Below is a list of timings for some U.S. cities along the path of totality, according to NASA .

• Dallas: Partial eclipse begins at 12:23 p.m. CT and totality at 1:40 p.m. CT.
• Idabel, Oklahoma: Partial eclipse begins at 12:28 p.m. CT and totality at 1:45 p.m. CT.
• Little Rock, Arkansas: Partial eclipse begins at 12:33 p.m. CT and totality at 1:51 p.m. CT.
• Poplar Bluff, Missouri: Partial eclipse begins at 12:39 p.m. CT and totality at 1:56 p.m. CT.
• Paducah, Kentucky: Partial eclipse begins at 12:42 p.m. CT and totality at 2:00 p.m. CT.
• Carbondale, Illinois: Partial eclipse begins at 12:42 p.m. CT and totality at 1:59 p.m. CT.
• Evansville, Indiana: Partial eclipse begins at 12:45 p.m. CT and totality at 2:02 p.m. CT.
• Cleveland: Partial eclipse begins at 1:59 p.m. ET and totality at 3:13 p.m.
• Erie, Pennsylvania: Partial eclipse begins at 2:02 p.m. ET and totality at 3:16 p.m. ET.
• Buffalo, New York: Partial eclipse begins at 2:04 p.m. ET and totality at 3:18 p.m.
• Burlington, Vermont: Partial eclipse begins at 2:14 p.m. ET and totality at 3:26 p.m. ET.
• Lancaster, New Hampshire: Partial eclipse begins at 2:16 p.m. ET and totality at 3:27 p.m.
• Caribou, Maine: Partial eclipse begins at 2:22 p.m. ET and totality at 3:32 p.m. ET.

Other resources can also help you figure out when the various phases of the eclipse will be visible where you live, including NationalEclipse.com and TimeandDate.com .

If you plan to watch the celestial event, remember that it’s never safe to look directly at the sun, including through binoculars, telescopes or camera lenses. Special eclipse glasses are required to safely view solar eclipses and prevent permanent eye damage.

Denise Chow is a reporter for NBC News Science focused on general science and climate change.

Magnitude 5.8 Earthquake Strikes Myanmar, EMSC Says

(Reuters) - A magnitude 5.8 earthquake struck Myanmar on Friday, the European Mediterranean Seismological Centre (EMSC) said.

The quake was at a depth of 10 km (6.2 miles), EMSC said.

(Reporting by Nilutpal Timsina in Bengaluru)

Copyright 2024 Thomson Reuters .

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Tags: Myanmar , India , earthquakes

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Why Taiwan Was So Prepared for a Powerful Earthquake

Decades of learning from disasters, tightening building codes and increasing public awareness may have helped its people better weather strong quakes.

Search-and-rescue teams recover a body from a leaning building in Hualien, Taiwan. Thanks to improvements in building codes after past earthquakes, many structures withstood Wednesday’s quake. Credit...

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By Chris Buckley ,  Meaghan Tobin and Siyi Zhao

Photographs by Lam Yik Fei

Chris Buckley reported from the city of Hualien, Meaghan Tobin from Taipei, in Taiwan.

• April 4, 2024

When the largest earthquake in Taiwan in half a century struck off its east coast, the buildings in the closest city, Hualien, swayed and rocked. As more than 300 aftershocks rocked the island over the next 24 hours to Thursday morning, the buildings shook again and again.

But for the most part, they stood.

Even the two buildings that suffered the most damage remained largely intact, allowing residents to climb to safety out the windows of upper stories. One of them, the rounded, red brick Uranus Building, which leaned precariously after its first floors collapsed, was mostly drawing curious onlookers.

The building is a reminder of how much Taiwan has prepared for disasters like the magnitude-7.4 earthquake that jolted the island on Wednesday. Perhaps because of improvements in building codes, greater public awareness and highly trained search-and-rescue operations — and, likely, a dose of good luck — the casualty figures were relatively low. By Thursday, 10 people had died and more than 1,000 others were injured. Several dozen were missing.

“Similar level earthquakes in other societies have killed far more people,” said Daniel Aldrich , a director of the Global Resilience Institute at Northeastern University. Of Taiwan, he added: “And most of these deaths, it seems, have come from rock slides and boulders, rather than building collapses.”

Across the island, rail traffic had resumed by Thursday, including trains to Hualien. Workers who had been stuck in a rock quarry were lifted out by helicopter. Roads were slowly being repaired. Hundreds of people were stranded at a hotel near a national park because of a blocked road, but they were visited by rescuers and medics.

On Thursday in Hualien city, the area around the Uranus Building was sealed off, while construction workers tried to prevent the leaning structure from toppling completely. First they placed three-legged concrete blocks that resembled giant Lego pieces in front of the building, and then they piled dirt and rocks on top of those blocks with excavators.

“We came to see for ourselves how serious it was, why it has tilted,” said Chang Mei-chu, 66, a retiree who rode a scooter with her husband Lai Yung-chi, 72, to the building on Thursday. Mr. Lai said he was a retired builder who used to install power and water pipes in buildings, and so he knew about building standards. The couple’s apartment, near Hualien’s train station, had not been badly damaged, he said.

“I wasn’t worried about our building, because I know they paid attention to earthquake resistance when building it. I watched them pour the cement to make sure,” Mr. Lai said. “There have been improvements. After each earthquake, they raise the standards some more.”

It was possible to walk for city blocks without seeing clear signs of the powerful earthquake. Many buildings remained intact, some of them old and weather-worn; others modern, multistory concrete-and-glass structures. Shops were open, selling coffee, ice cream and betel nuts. Next to the Uranus Building, a popular night market with food stalls offering fried seafood, dumplings and sweets was up and running by Thursday evening.

Earthquakes are unavoidable in Taiwan, which sits on multiple active faults. Decades of work learning from other disasters, implementing strict building codes and increasing public awareness have gone into helping its people weather frequent strong quakes.

Not far from the Uranus Building, for example, officials had inspected a building with cracked pillars and concluded that it was dangerous to stay in. Residents were given 15 minutes to dash inside and retrieve as many belongings as they could. Some ran out with computers, while others threw bags of clothes out of windows onto the street, which was also still littered with broken glass and cement fragments from the quake.

One of its residents, Chen Ching-ming, a preacher at a church next door, said he thought the building might be torn down. He was able to salvage a TV and some bedding, which now sat on the sidewalk, and was preparing to go back in for more. “I’ll lose a lot of valuable things — a fridge, a microwave, a washing machine,” he said. “All gone.”

Requirements for earthquake resistance have been built into Taiwan’s building codes since 1974. In the decades since, the writers of Taiwan’s building code also applied lessons learned from other major earthquakes around the world, including in Mexico and Los Angeles, to strengthen Taiwan’s code.

After more than 2,400 people were killed and at least 10,000 others injured during the Chi-Chi quake of 1999, thousands of buildings built before the quake were reviewed and reinforced. After another strong quake in 2018 in Hualien, the government ordered a new round of building inspections. Since then, multiple updates to the building code have been released.

“We have retrofitted more than 10,000 school buildings in the last 20 years,” said Chung-Che Chou, the director general of the National Center for Research on Earthquake Engineering in Taipei.

The government had also helped reinforce private apartment buildings over the past six years by adding new steel braces and increasing column and beam sizes, Dr. Chou said. Not far from the buildings that partially collapsed in Hualien, some of the older buildings that had been retrofitted in this way survived Wednesday’s quake, he said.

The result of all this is that even Taiwan’s tallest skyscrapers can withstand regular seismic jolts. The capital city’s most iconic building, Taipei 101, once the tallest building in the world, was engineered to stand through typhoon winds and frequent quakes. Still, some experts say that more needs to be done to either strengthen or demolish structures that don’t meet standards, and such calls have grown louder in the wake of the latest earthquake.

Taiwan has another major reason to protect its infrastructure: It is home to the majority of production for the Taiwan Semiconductor Manufacturing Company, the world’s largest maker of advanced computer chips. The supply chain for electronics from smartphones to cars to fighter jets rests on the output of TSMC’s factories, which make these chips in facilities that cost billions of dollars to build.

The 1999 quake also prompted TSMC to take extra steps to insulate its factories from earthquake damage. The company made major structural adjustments and adopted new technologies like early warning systems. When another large quake struck the southern city of Kaohsiung in February 2016, TSMC’s two nearby factories survived without structural damage.

Taiwan has made strides in its response to disasters, experts say. In the first 24 hours after the quake, rescuers freed hundreds of people who were trapped in cars in between rockfalls on the highway and stranded on mountain ledges in rock quarries.

“After years of hard work on capacity building, the overall performance of the island has improved significantly,” said Bruce Wong, an emergency management consultant in Hong Kong. Taiwan’s rescue teams have come to specialize in complex efforts, he said, and it has also been able to tap the skills of trained volunteers.

Taiwan’s resilience also stems from a strong civil society that is involved in public preparedness for disasters.

Ou Chi-hu, a member of a group of Taiwanese military veterans, was helping distribute water and other supplies at a school that was serving as a shelter for displaced residents in Hualien. He said that people had learned from the 1999 earthquake how to be more prepared.

“They know to shelter in a corner of the room or somewhere else safer,” he said. Many residents also keep a bag of essentials next to their beds, and own fire extinguishers, he added.

Around him, a dozen or so other charities and groups were offering residents food, money, counseling and childcare. The Tzu Chi Foundation, a large Taiwanese Buddhist charity, provided tents for families to use inside the school hall so they could have more privacy. Huang Yu-chi, a disaster relief manager with the foundation, said nonprofits had learned from earlier disasters.

“Now we’re more systematic and have a better idea of disaster prevention,” Mr. Huang said.

Mike Ives contributed reporting from Seoul.

Chris Buckley , the chief China correspondent for The Times, reports on China and Taiwan from Taipei, focused on politics, social change and security and military issues. More about Chris Buckley

Meaghan Tobin is a technology correspondent for The Times based in Taipei, covering business and tech stories in Asia with a focus on China. More about Meaghan Tobin

Siyi Zhao is a reporter and researcher who covers news in mainland China for The Times in Seoul. More about Siyi Zhao

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