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Full-Text Articles in Social and Behavioral Sciences

Health Is Wealth: The Correlation Of Wellness Programs & Productivity In Canada And The U.S., Madeline Wert Jul 2020

Health Is Wealth: The Correlation Of Wellness Programs & Productivity In Canada And The U.S., Madeline Wert

Business and Economics Summer Fellows

Does health impact the productivity of workers? Are there differences between the U.S. and Canada? Firms both in Canada and the U.S. deal with issues of presenteeism and absenteeism. Presenteeism is when an employee shows up to work but they are distracted by their own or a family member’s health issue. One response to reduce presenteeism and absenteeism are workplace wellness programs. Workplace wellness programs are facilitated programs by a firm to promote the health and wellbeing of their employees, which benefits the employer and the employees. There are additional incentives for U.S. employers to implement workplace wellness programs as …


Care Of Acute Conditions And Chronic Diseases In Canada And The United States: Rapid Systematic Review And Meta-Analysis, Keren M. Escobar, Dorian Murariu, Sharon Munro, Kevin M. Gorey Jan 2019

Care Of Acute Conditions And Chronic Diseases In Canada And The United States: Rapid Systematic Review And Meta-Analysis, Keren M. Escobar, Dorian Murariu, Sharon Munro, Kevin M. Gorey

Social Work Publications

This study tested the hypothesis that socioeconomically vulnerable Canadians with diverse acute conditions or chronic diseases have health care access and survival advantages over their counterparts in the USA. A rapid systematic review retrieved 25 studies (34 independent cohorts) published between 2003 and 2018. They were synthesized with a streamlined meta-analysis. Very low-income Canadian patients were consistently and highly advantaged in terms of health care access and survival compared with their counterparts in the USA who lived in poverty and/or were uninsured or underinsured. In aggregate and controlling for specific conditions or diseases and typically 4 to 9 comorbid factors …


Agroecology In Canada: Towards An Integration Of Agroecological Practice, Movement, And Science, Marney E. Isaac, S. Ryan Isakson, Bryan Dale, Charles Z. Levkoe, Sarah K. Hargreaves, V. Ernesto Méndez, Hannah Wittman, Colleen Hammelman, Jennifer C. Langill, Adam R. Martin, Erin Nelson, Michael Ekers, Kira A. Borden, Stephanie Gagliardi, Serra Buchanan, Sarah Archibald, Astrid Gálvez Ciani Sep 2018

Agroecology In Canada: Towards An Integration Of Agroecological Practice, Movement, And Science, Marney E. Isaac, S. Ryan Isakson, Bryan Dale, Charles Z. Levkoe, Sarah K. Hargreaves, V. Ernesto Méndez, Hannah Wittman, Colleen Hammelman, Jennifer C. Langill, Adam R. Martin, Erin Nelson, Michael Ekers, Kira A. Borden, Stephanie Gagliardi, Serra Buchanan, Sarah Archibald, Astrid Gálvez Ciani

College of Agriculture and Life Sciences Faculty Publications

This article surveys the current state of agroecology in Canada, giving particular attention to agroecological practices, the related social movements, and the achievements of agroecological science. In each of these realms, we find that agroecology emerges as a response to the various social and ecological problems associated with the prevailing industrial model of agricultural production that has long been promoted in the country under settler colonialism. Although the prevalence and prominence of agroecology is growing in Canada, its presence is still small and the support for its development is limited. We provide recommendations to achieve a more meaningful integration of …


Effectiveness Of Switching Smoking-Cessation Medications Following Relapse, Bryan W. Heckman, K. Michael Cummings, Karin A. Kasza, Ron Borland, Jessica L. Burris, Geoffrey T. Fong, Ann Mcneill, Matthew J. Carpenter Aug 2017

Effectiveness Of Switching Smoking-Cessation Medications Following Relapse, Bryan W. Heckman, K. Michael Cummings, Karin A. Kasza, Ron Borland, Jessica L. Burris, Geoffrey T. Fong, Ann Mcneill, Matthew J. Carpenter

Psychology Faculty Publications

Introduction—Nicotine dependence is a chronic disorder often characterized by multiple failed quit attempts (QAs). Yet, little is known about the sequence of methods used across multiple QAs or how this may impact future ability to abstain from smoking. This prospective cohort study examines the effectiveness of switching smoking-cessation medications (SCMs) across multiple QAs.

Methods—Adult smokers (aged ≥ 18 years) participating in International Tobacco Control surveys in the United Kingdom, U.S., Canada, and Australia (N=795) who: (1) completed two consecutive surveys between 2006 and 2011; (2) initiated a QA at least 1 month before each survey; and (3) provided …


Hippocampal Neurogenesis And Volume In Migrating And Wintering Semipalmated Sandpipers (Calidris Pusilla)., Nara Gyzely De Morais Magalhães, Cristovam Guerreiro Diniz, Daniel Guerreiro Diniz, Ediely Pereira Henrique, Patrick Douglas Corrêa Pereira, Isis Ananda Matos Moraes, Mauro André Damasceno De Melo, David Francis Sherry, Cristovam Wanderley Picanço Diniz Jan 2017

Hippocampal Neurogenesis And Volume In Migrating And Wintering Semipalmated Sandpipers (Calidris Pusilla)., Nara Gyzely De Morais Magalhães, Cristovam Guerreiro Diniz, Daniel Guerreiro Diniz, Ediely Pereira Henrique, Patrick Douglas Corrêa Pereira, Isis Ananda Matos Moraes, Mauro André Damasceno De Melo, David Francis Sherry, Cristovam Wanderley Picanço Diniz

Brain and Mind Institute Researchers' Publications

Long distance migratory birds find their way by sensing and integrating information from a large number of cues in their environment. These cues are essential to navigate over thousands of kilometers and reach the same breeding, stopover, and wintering sites every year. The semipalmated sandpiper (Calidris pusilla) is a long-distance migrant that breeds in the arctic tundra of Canada and Alaska and winters on the northeast coast of South America. Its fall migration includes a 5,300-kilometer nonstop flight over the Atlantic Ocean. The avian hippocampus has been proposed to play a central role in the integration of multisensory spatial information …


Smoking On The Margins: A Comprehensive Analysis Of A Municipal Outdoor Smoke-Free Policy, Ann Pederson, Chizimuzo T. C. Okoli, Natalie Hemsing, Renée O'Leary, Amanda T. Wiggins, Wendy Rice, Joan L. Bottorff, Lorraine Greaves Aug 2016

Smoking On The Margins: A Comprehensive Analysis Of A Municipal Outdoor Smoke-Free Policy, Ann Pederson, Chizimuzo T. C. Okoli, Natalie Hemsing, Renée O'Leary, Amanda T. Wiggins, Wendy Rice, Joan L. Bottorff, Lorraine Greaves

Nursing Faculty Publications

Background: This study examined the formulation, adoption, and implementation of a ban on smoking in the parks and beaches in Vancouver, Canada.

Methods: Informed by Critical Multiplism, we explored the policy adoption process, support for and compliance with a local bylaw prohibiting smoking in parks and on beaches, experiences with enforcement, and potential health equity issues through a series of qualitative and quantitative studies.

Results: Findings suggest that there was unanimous support for the introduction of the bylaw among policy makers, as well as a high degree of positive public support. We observed that smoking initially declined following the ban’s …


Promoting Hiv Testing For Gay And Bisexual Men: An Evaluation Of The 2011-2012 Campaign In Toronto And Ottawa, Barry D. Adam, Sandra Gardner, Carol Major, Diana Campbell, Lucia Light, Jason Globerman Jan 2016

Promoting Hiv Testing For Gay And Bisexual Men: An Evaluation Of The 2011-2012 Campaign In Toronto And Ottawa, Barry D. Adam, Sandra Gardner, Carol Major, Diana Campbell, Lucia Light, Jason Globerman

Sociology, Anthropology, and Criminology Publications

This paper reports on a social marketing campaign directed toward high-risk men who have sex with men (MSM) in Toronto and Ottawa to: encourage testing for HIV and syphilis; improve knowledge about HIV transmission, seroconversion symptoms, and the HIV window period; and heighten awareness of syphilis transmission and its relationship to facilitating HIV transmission. Evaluation data were collected from a large-scale online pre-and post-campaign survey of sexually active MSM and from laboratory testing data. Men who turned up to be tested also filled out an exit survey. The campaign websites attracted some 15,000 unique visitors, 54% of whom had an …


Hivpositive People's Perspectives On Canadian Criminal Law And Non-Disclosure, Barry D. Adam, Jason Globerman, Richard Elliott, Patrice Corriveau, Ken English, Sean Rourke Jan 2016

Hivpositive People's Perspectives On Canadian Criminal Law And Non-Disclosure, Barry D. Adam, Jason Globerman, Richard Elliott, Patrice Corriveau, Ken English, Sean Rourke

Sociology, Anthropology, and Criminology Publications

The largest survey to date of people living with HIV regarding attitudes toward criminalization of HIV non-disclosure, this study investigates: sources of legal information available to HIV-positive people; perceptions of how criminal prosecutions and media coverage affect understanding of rights and responsibilities of self and others; and where HIV-positive people themselves stand on the role the criminal justice system should play. While mainstream media constructions of criminal iconography do affect PHA views, those who have higher levels of formal education, are active in the dating scene, and have been living longer with HIV hold less punitive views than those who …


Canadian Nurse Leaders' Experiences With And Perceptions Of Moral Distress: An Interpretive Descriptive Study, Jodi-Rae Kortje Jan 2016

Canadian Nurse Leaders' Experiences With And Perceptions Of Moral Distress: An Interpretive Descriptive Study, Jodi-Rae Kortje

Antioch University Dissertations & Theses

Moral distress in nursing has been studied across many care contexts, yet there is a paucity of research on the experience among health care leaders.The purpose of this study was to understand the experiences and perceptions of moral distress in nurse leaders.This study used an interpretive description approach interviewing 32 Canadian nurse leaders about their experiences and perceptions of moral distress within their role as a leader and nurse.A constant comparative and thematic analysis process revealed three thematic patterns:(a) leaders suffer moral distress in similar and different ways from their employees; (b) relationships matter in the midst of coping and …


Colon Cancer Care And Survival: Income And Insurance Are More Predictive In The Usa, Community Primary Care Physician Supply More So In Canada, Kevin M. Gorey, Sindu M. Kanjeekal, Frances C. Wright, Caroline Hamm, Isaac N. Luginaah, Emma Bartfay, Guangyong Zou, Erc J. Holowaty, Nancy L. Richter Oct 2015

Colon Cancer Care And Survival: Income And Insurance Are More Predictive In The Usa, Community Primary Care Physician Supply More So In Canada, Kevin M. Gorey, Sindu M. Kanjeekal, Frances C. Wright, Caroline Hamm, Isaac N. Luginaah, Emma Bartfay, Guangyong Zou, Erc J. Holowaty, Nancy L. Richter

Social Work Publications

Background: Our research group advanced a health insurance theory to explain Canada’s cancer care advantages over America. The late Barbara Starfield theorized that Canada’s greater primary care-orientation also plays a critically protective role. We tested the resultant Starfield-Gorey theory by examining the effects of poverty, health insurance and physician supplies, primary care and specialists, on colon cancer care in Ontario and California.

Methods: We analyzed registry data for people with non-metastasized colon cancer from Ontario (n = 2,060) and California (n = 4,574) diagnosed between 1996 and 2000 and followed to 2010. We obtained census tract-based socioeconomic data from population …


The Association Of Different Types Of Bullying With The Mental Health Of Children And Teens From The United States, France, And Canada, Christina Fisher Jul 2015

The Association Of Different Types Of Bullying With The Mental Health Of Children And Teens From The United States, France, And Canada, Christina Fisher

Media and Communication Studies Summer Fellows

Bullying continues to trouble youths around the world, sometimes with devastating effects for victims’ mental health. This suggests an ongoing need for awareness, intervention and tolerance for everyone involved. This study, a literature review, explored the extent of these mental health effects found in 50 studies of victims, bullies, and bully-victims, those who are victims of bullying and who also bully others, in the United States, France, and Canada (Willard, 2007). Particular attention was paid to the impact that gender, age, ethnicity, and the LGBTQ community had on researchers’ findings. Findings show that 25.9% to 33% of students in these …


Slides: Best Management Practices For Oil And Gas Development And Comparative Water Quality Database Of Regulations Relating To Shale Oil And Gas, Matt Samelson, University Of Colorado Boulder. Getches-Wilkinson Center For Natural Resources, Energy, And The Environment. Intermountain Oil And Gas Bmp Project Mar 2014

Slides: Best Management Practices For Oil And Gas Development And Comparative Water Quality Database Of Regulations Relating To Shale Oil And Gas, Matt Samelson, University Of Colorado Boulder. Getches-Wilkinson Center For Natural Resources, Energy, And The Environment. Intermountain Oil And Gas Bmp Project

Fracking, Water Quality and Public Health: Examining Current Laws and Regulations (March 20)

Presenter: Matt Samelson, J.D., Attorney, Consultant for Intermountain Oil and Gas Best Management Practices (BMP) Project, Getches-Wilkinson Center for Natural Resources, Energy and the Environment, University of Colorado Law School

34 slides


Impacts Of The Criminalization On The Everyday Lives Of People Living In With Hiv In Canada, Barry D. Adam, Richard Elliott, Patrice Corriveau, Ken English Jan 2014

Impacts Of The Criminalization On The Everyday Lives Of People Living In With Hiv In Canada, Barry D. Adam, Richard Elliott, Patrice Corriveau, Ken English

Sociology, Anthropology, and Criminology Publications

As part of a study on the social consequences of the criminal justice system on people living with HIV or AIDS (PHAs) in Canada, this article focuses on how heightened public identification of HIV with criminal matters is having wide ranging effects on perceived personal security and in particular on negotiating potential romantic and sexual interactions. As articulated by the Supreme Court of Canada, the courts have been enforcing a requirement that HIV-positive people disclose their sero-status to prospective partners, relying on the notion that “through deterrence it [the Criminal Code] will protect and serve to encourage honesty, frankness and …


Better Colon Cancer Care For Extremely Poor Canadian Women Compared With American Women, Kevin M. Gorey, Isaac N. Luginaah, Emma Bartfay, Guangyong Zou, Sundus Haji-Jama, Eric J. Holowaty, Caroline Hamm, Sindu M. Kanjeekal, Fraces C. Wright, Madhan K. Balagurusamy, Nancy L. Richter Jan 2013

Better Colon Cancer Care For Extremely Poor Canadian Women Compared With American Women, Kevin M. Gorey, Isaac N. Luginaah, Emma Bartfay, Guangyong Zou, Sundus Haji-Jama, Eric J. Holowaty, Caroline Hamm, Sindu M. Kanjeekal, Fraces C. Wright, Madhan K. Balagurusamy, Nancy L. Richter

Social Work Publications

Extremely poor Canadian women were recently observed to be largely advantaged on most aspects of breast cancer care as compared with similarly poor, but much less adequately insured, women in the United States. This historical study systematically replicated the protective effects of single- versus multipayer health care by comparing colon cancer care among cohorts of extremely poor women in California and Ontario between 1996 and 2011. The Canadian women were again observed to have been largely advantaged. They were more likely to have received indicated surgery and chemotherapy, and their wait times for care were significantly shorter. Consequently, the Canadian …


Practice Effects In A Longitudinal, Multi-Center Alzheimer's Disease Prevention Clinical Trial, Erin L. Abner, Brandon C. Dennis, Melissa J. Mathews, Marta S. Mendiondo, Allison Caban-Holt, Richard J. Kryscio, Frederick A. Schmitt, John J. Crowley Nov 2012

Practice Effects In A Longitudinal, Multi-Center Alzheimer's Disease Prevention Clinical Trial, Erin L. Abner, Brandon C. Dennis, Melissa J. Mathews, Marta S. Mendiondo, Allison Caban-Holt, Richard J. Kryscio, Frederick A. Schmitt, John J. Crowley

Sanders-Brown Center on Aging Faculty Publications

BACKGROUND: Practice effects are a known threat to reliability and validity in clinical trials. Few studies have investigated the potential influence of practice on repeated screening measures in longitudinal clinical trials with a focus on dementia prevention. The current study investigates whether practice effects exist on a screening measure commonly used in aging research, the Memory Impairment Screen (MIS).

METHODS: The PREADViSE trial is a clinical intervention study evaluating the efficacy of vitamin E and selenium for Alzheimer's disease prevention. Participants are screened annually for incident dementia with the MIS. Participants with baseline and three consecutive follow-ups who made less …


Breast Cancer Care In Canada And The United States: Ecological Comparisons Of Extremely Impoverished And Affluent Urban Neighborhoods, Kevin M. Gorey Jan 2010

Breast Cancer Care In Canada And The United States: Ecological Comparisons Of Extremely Impoverished And Affluent Urban Neighborhoods, Kevin M. Gorey

Social Work Publications

This study examined the differential effect of extreme impoverishment on breast cancer care in urban Canada and the United States. Ontario and California registry-based samples diagnosed between 1998 and 2000 were followed until 2006. Extremely poor and affluent neighborhoods were compared. Poverty was associated with non-localized disease, surgical and radiation therapy (RT) waits, non-receipt of breast conserving surgery, RT and hormonal therapy, and shorter survival in California, but not in Ontario. Extremely poor Ontario women were consistently advantaged on care indices over their California counterparts. More inclusive health insurance coverage in Canada seems the most plausible explanation for such Canadian …


The Determinants Of First Nation And Inuit Health: A Critical Population Health Approach, Chantelle A.M. Richmond, Nancy A. Ross Jun 2009

The Determinants Of First Nation And Inuit Health: A Critical Population Health Approach, Chantelle A.M. Richmond, Nancy A. Ross

Aboriginal Policy Research Consortium International (APRCi)

Environmental dispossession disproportionately affects the health of Canada’s Aboriginal population, yet little is known about how its effects are sustained over time. We use a critical population health approach to explore the determinants of health in rural and remote First Nation and Inuit communities, and to conceptualize the pathways by which environmental dispossession affects these health determinants. We draw from narrative analysis of interviews with 26 Community Health Representa- tives (CHRs) from First Nation and Inuit communities across Canada. CHRs identified six health determinants: balance, life control, education, material resources, social resources, and environmental/ cultural connections. CHRs articulated the role …


Breast Cancer Survival In Canada And The Usa: Meta-Analytic Evidence Of A Canadian Advantage In Low-Income Areas, Kevin M. Gorey Jan 2009

Breast Cancer Survival In Canada And The Usa: Meta-Analytic Evidence Of A Canadian Advantage In Low-Income Areas, Kevin M. Gorey

Social Work Publications

BACKGROUND: This study tested the hypothesis that relatively poor Canadian women with breast cancer have a survival advantage over their counterparts in the USA.

METHODS: Seventy-eight independent retrospective cohort (incidence between 1984 and 2000, followed until 2006) outcomes were synthesized. Fixed effects meta-regression models compared women with breast cancer in low-income areas of Canada and the USA.

RESULTS: Low-income Canadian women were advantaged on survival [rate ratio (RR) = 1.14; 95% confidence interval (CI) 1.13-1.15] and their advantage was even larger among women <65 years of age who are not yet eligible for Medicare coverage in the USA (RR = 1.21, 95% CI 1.18-1.24). Canadian advantages were also larger for node positive breast cancer, which may present with greater clinical and managerial discretion (RR = 1.40, 95% CI 1.30-1.50), and smaller when Hawaii, the state providing the most Canadian-like access, was the US comparator (RR = 1.12, 95% CI 1.01-1.20).

CONCLUSIONS: More inclusive health care insurance coverage in Canada vs the USA, particularly among each country's relatively …


Is American Health Care Uniquely Inefficient?, Alan M. Garber, Jonathan Skinner Sep 2008

Is American Health Care Uniquely Inefficient?, Alan M. Garber, Jonathan Skinner

Dartmouth Scholarship

No abstract provided.


Silence, Assent And Hiv Risk, Barry D. Adam, Winston Husbands, James Murray, John Maxwell Aug 2008

Silence, Assent And Hiv Risk, Barry D. Adam, Winston Husbands, James Murray, John Maxwell

Sociology, Anthropology, and Criminology Publications

Based on interviews with 34 men, almost all of whom have unprotected sex with men most or all of the time, this paper documents the interactional process, narrative elements, and meaning construction in situations of ‘bareback’ sex. Narratives show the differentiated cultural capital circulating among distinct circuits of gay and bisexual men that define the taken-for-granted rules of conduct for sexual interactions and give rise to high risk situations. Many of the positive men speak of being part of a social environment where ‘everybody knows’ a set of rules whereby sex without condoms can happen as a default circumstance to …


Effects Of The Criminalization Of Hiv Transmission In Cuerrier On Men Reporting Unprotected Sex With Men, Barry D. Adam, Richard Elliott, Winston Husbands, James Murray, John Maxwell Jan 2008

Effects Of The Criminalization Of Hiv Transmission In Cuerrier On Men Reporting Unprotected Sex With Men, Barry D. Adam, Richard Elliott, Winston Husbands, James Murray, John Maxwell

Sociology, Anthropology, and Criminology Publications

This paper reports on the perceptions and practices of men who have frequent unprotected sex with men in a socio-legal environment defined by the 1998 decision of the Supreme Court of Canada in R. v. Cuerrier. HIV-positive people are increasingly finding themselves in court since Cuerrier and many are trying to take account of legal reasoning in their own conduct. The judicial construction of behaviour likely to transmit HIV relies on a set of presumptions concerning individual responsibility, rational and contractual interaction, and consenting adults that raise a series of ambiguities and uncertainties among HIV-positive people attempting to implement …


The Health Insurance Debate In Canada: Lessons For The United States?, Mary Anne Bobinski Jan 2007

The Health Insurance Debate In Canada: Lessons For The United States?, Mary Anne Bobinski

Faculty Articles

This Essay begins with an intentionally ambiguous title. Are comparisons to Canada relevant and useful for policy-makers in the United States and, if so, what lessons can we learn? Part II of this Essay highlights some of the risks and benefits of cross-border comparisons between the United States and Canada. In Part III, I analyze some of the key data points often cited in comparing the two health care systems. Part IV explores the current Canadian debate about private health insurance. Finally, in Part V, I focus on the lessons from Canada for the health insurance debate in the United …


Carotenoid, Vitamin A, Vitamin C, And Vitamin E Intake And Risk Of Ovarian Cancer: A Prospective Cohort Study, Stephanie A. Navarro Silvera, Meera Jain, Geoffrey R. Howe, Anthony B. Miller, Thomas E. Rohan Feb 2006

Carotenoid, Vitamin A, Vitamin C, And Vitamin E Intake And Risk Of Ovarian Cancer: A Prospective Cohort Study, Stephanie A. Navarro Silvera, Meera Jain, Geoffrey R. Howe, Anthony B. Miller, Thomas E. Rohan

Department of Public Health Scholarship and Creative Works

It is thought that oxidative stress resulting to repeated ovulation may increase the risk of ovarian cancer by inducing DNA damage (1). Consumption of antioxidants may, therefore, decrease ovarian cancer risk by counteracting oxidative stress and the resultant DNA damage (2, 3). Currently, the epidemiologic evidence regarding associations between antioxidants and risk of ovarian cancer is mixed (4-12). Of the two prospective studies, Kushi et al. (4) and Fairfield et al. (7) both reported no association between β-carotene and ovarian cancer risk. In addition, Fairfield et al. …


Levels Of Citation Of Nonhuman Animal Studies Conducted At A Canadian Research Hospital, Anne Innis Dagg, Troy K. Seidle Jan 2004

Levels Of Citation Of Nonhuman Animal Studies Conducted At A Canadian Research Hospital, Anne Innis Dagg, Troy K. Seidle

Experimentation Collection

The publication of scientific articles that receive few or no citations raises questions of the appropriate use of resources as well as ethics. In the case of animal research, the ethics issue extends beyond human patients to nonhuman animals, as the research subjects them to pain and, typically, to death. This study is a citation analysis of animal research conducted at Toronto's Hospital for Sick Children (HSC). Of the 594 publications (1990 to 1995) on animal research by affiliates of HSC, 29% received Iower than 10 citations in a 10-year period. We compare the research history of 13 "best" and …


Prevalent Low Income Status In Canadian And United States Metropolitan Areas, 1980 And 1990, Kevin M. Gorey Jan 1998

Prevalent Low Income Status In Canadian And United States Metropolitan Areas, 1980 And 1990, Kevin M. Gorey

Social Work Publications

As compared to Toronto’s poor people, three to four-fold as many of upstate New York’s poor live in severely impoverished neighborhoods, areas where 40% or more of the residents have annual incomes below the federally established low income or poverty criterion. However, the prevalence of such extremely degraded living conditions increased similarly (two-fold) on both sides of the Canadian-US border during the 1980s. This urban problem, of the concentration of poor people, seems to predominantly be an inner-city problem in the US, whereas it was found to be nearly equivalently extant in the inner-city, mid-suburban and outlying suburban areas of …