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Institution

Centre for Research on Inner City Health

About: Centre for Research on Inner City Health is a based out in . It is known for research contribution in the topics: Population & Mental health. The organization has 263 authors who have published 573 publications receiving 22573 citations.


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Journal ArticleDOI
01 Jul 2016-BMJ Open
TL;DR: Significant associations between HIV-related stigma and higher rates of depression, lower social support and lower levels of adherence to antiretroviral medications and access to and usage of health and social services are found.
Abstract: Objective To conduct a systematic review and series of meta-analyses on the association between HIV-related stigma and health among people living with HIV. Data sources A structured search was conducted on 6 electronic databases for journal articles reporting associations between HIV-related stigma and health-related outcomes published between 1996 and 2013. Study eligibility criteria Controlled studies, cohort studies, case-control studies and cross-sectional studies in people living with HIV were considered for inclusion. Outcome measures Mental health (depressive symptoms, emotional and mental distress, anxiety), quality of life, physical health, social support, adherence to antiretroviral therapy, access to and usage of health/social services and risk behaviours. Results 64 studies were included in our meta-analyses. We found significant associations between HIV-related stigma and higher rates of depression, lower social support and lower levels of adherence to antiretroviral medications and access to and usage of health and social services. Weaker relationships were observed between HIV-related stigma and anxiety, quality of life, physical health, emotional and mental distress and sexual risk practices. While risk of bias assessments revealed overall good quality related to how HIV stigma and health outcomes were measured on the included studies, high risk of bias among individual studies was observed in terms of appropriate control for potential confounders. Additional research should focus on elucidating the mechanisms behind the negative relationship between stigma and health to better inform interventions to reduce the impact of stigma on the health and well-being of people with HIV. Conclusions This systematic review and series of meta-analyses support the notion that HIV-related stigma has a detrimental impact on a variety of health-related outcomes in people with HIV. This review can inform the development of multifaceted, intersectoral interventions to reduce the impact of HIV-related stigma on the health and well-being of people living with HIV.

497 citations

Journal ArticleDOI
TL;DR: Simulation studies are used to assess the effect of varying sample size at both the individual and group level on the accuracy of the estimates of the parameters and variance components of multilevel logistic regression models, and suggest that low prevalent events require larger sample sizes.
Abstract: Background Many studies conducted in health and social sciences collect individual level data as outcome measures. Usually, such data have a hierarchical structure, with patients clustered within physicians, and physicians clustered within practices. Large survey data, including national surveys, have a hierarchical or clustered structure; respondents are naturally clustered in geographical units (e.g., health regions) and may be grouped into smaller units. Outcomes of interest in many fields not only reflect continuous measures, but also binary outcomes such as depression, presence or absence of a disease, and self-reported general health. In the framework of multilevel studies an important problem is calculating an adequate sample size that generates unbiased and accurate estimates.

355 citations

Journal ArticleDOI
27 Oct 2009-BMJ
TL;DR: Reducing the excessively high rates of premature mortality in this population would require interventions to address deaths related to smoking, alcohol, and drugs, and mental disorders and suicide, among other causes.
Abstract: Objective To examine mortality in a representative nationwide sample of homeless and marginally housed people living in shelters, rooming houses, and hotels. Design Follow-up study. Setting Canada 1991-2001. Participants 15 100 homeless and marginally housed people enumerated in 1991 census. Main outcome measures Age specific and age standardised mortality rates, remaining life expectancies at age 25, and probabilities of survival from age 25 to 75. Data were compared with data from the poorest and richest income fifths as well as with data for the entire cohort Results Of the homeless and marginally housed people, 3280 died. Mortality rates among these people were substantially higher than rates in the poorest income fifth, with the highest rate ratios seen at younger ages. Among those who were homeless or marginally housed, the probability of survival to age 75 was 32% (95% confidence interval 30% to 34%) in men and 60% (56% to 63%) in women. Remaining life expectancy at age 25 was 42 years (42 to 43) and 52 years (50 to 53), respectively. Compared with the entire cohort, mortality rate ratios for men and women, respectively, were 11.5 (8.8 to 15.0) and 9.2 (5.5 to 15.2) for drug related deaths, 6.4 (5.3 to 7.7) and 8.2 (5.0 to 13.4) for alcohol related deaths, 4.8 (3.9 to 5.9) and 3.8 (2.7 to 5.4) for mental disorders, and 2.3 (1.8 to 3.1) and 5.6 (3.2 to 9.6) for suicide. For both sexes, the largest differences in mortality rates were for smoking related diseases, ischaemic heart disease, and respiratory diseases. Conclusions Living in shelters, rooming houses, and hotels is associated with much higher mortality than expected on the basis of low income alone. Reducing the excessively high rates of premature mortality in this population would require interventions to address deaths related to smoking, alcohol, and drugs, and mental disorders and suicide, among other causes.

337 citations

Journal ArticleDOI
TL;DR: This systematic review provides evidence for the effectiveness of interventions to improve diabetes care among socially disadvantaged populations and identifies key intervention features that may predict success.
Abstract: OBJECTIVE—To identify and synthesize evidence about the effectiveness of patient, provider, and health system interventions to improve diabetes care among socially disadvantaged populations. RESEARCH DESIGN AND METHODS—Studies that were included targeted interventions toward socially disadvantaged adults with type 1 or type 2 diabetes; were conducted in industrialized countries; were measured outcomes of self-management, provider management, or clinical outcomes; and were randomized controlled trials, controlled trials, or before-and-after studies with a contemporaneous control group. Seven databases were searched for articles published in any language between January 1986 and December 2004. Twenty-six intervention features were identified and analyzed in terms of their association with successful or unsuccessful interventions. RESULTS—Eleven of 17 studies that met inclusion criteria had positive results. Features that appeared to have the most consistent positive effects included cultural tailoring of the intervention, community educators or lay people leading the intervention, one-on-one interventions with individualized assessment and reassessment, incorporating treatment algorithms, focusing on behavior-related tasks, providing feedback, and high-intensity interventions (>10 contact times) delivered over a long duration (≥6 months). Interventions that were consistently associated with the largest negative outcomes included those that used mainly didactic teaching or that focused only on diabetes knowledge. CONCLUSIONS—This systematic review provides evidence for the effectiveness of interventions to improve diabetes care among socially disadvantaged populations and identifies key intervention features that may predict success. These types of interventions would require additional resources for needs assessment, leader training, community and family outreach, and follow-up.

335 citations

Journal ArticleDOI
TL;DR: The daily stress of living in a neighborhood where residential mobility and material deprivation prevail is associated with depression, and the possibility that women might be more reactive to chronic stressors manifested in higher risk of depression was explored.

299 citations


Authors

Showing all 263 results

NameH-indexPapersCitations
Patricia O'Campo7431818092
Rahim Moineddin5940412689
Kwame McKenzie5727311755
Stephen W. Hwang5728411445
Richard H. Glazier502147442
Kamran Khan471358677
Paul S. Links462238697
Sean B. Rourke441679641
Jeffrey S Hoch432485897
Rosane Nisenbaum421646164
James R. Dunn401226248
Sam Tsemberis39846910
Eric Latimer351195414
Kelly K O'Brien3514615318
Mark H. Yudin341843163
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Performance
Metrics
No. of papers from the Institution in previous years
YearPapers
20214
20204
20194
201811
201716
201682