abstract: 'Background Transportation vulnerability (defined as lack of

  personal/public transportation access) is particularly prevalent in

  areas with high racial/ethnic segregation where communities typically

  lack proximity to quality education, jobs, healthy food, playgrounds,

  and medical care. Prior research has shown an association between

  residential segregation and youth cardiovascular health, although little

  work has examined the effects of transportation vulnerability on this

  relationship. Methods Longitudinal mixed methods were used to compare

  the effects of transportation vulnerability on the association between

  changes in exposure to residential segregation (defined as the uneven

  geographic distribution of minorities) and five cardiovascular health

  outcomes across sex in minority youth for up to four consecutive years

  of participation in an afterschool fitness program during 2010-2018 (n =

  2742; Miami-Dade County, Florida, US). Results After accounting for

  child race/ethnicity, age, year, and poverty, girls with high

  transportation vulnerability and reduced exposure to segregation (vs.

  increased or no change in segregation) showed the most improvements

  across all outcomes, including body mass index percentile (26\% (95\% CI

  23.84, 28.30)), sum of skinfold thicknesses (18\% (95\% CI 14.90,

  20.46)), run time (17\% (95\% CI 14.88, 18.64)), systolic blood pressure

  percentile (15\% (95\% CI 11.96, 17.08)), and diastolic blood pressure

  percentile (12\% (95\% CI 9.09, 14.61)). Conclusion Transportation

  inequities related to concentrated racial/ethnic segregation may be an

  important factor in reducing disparities in youth cardiovascular health,

  particularly among girls. These study findings provide important

  longitudinal evidence in support of health interventions to reduce

  transportation vulnerability for racial/ethnic minority youth in

  underserved areas.'
affiliation: 'D''Agostino, EM (Corresponding Author), Duke Univ, Dept Family Med \&
  Community Hlth, Sch Med, 2200 W Main St,Off 623,6th Fl, Durham, NC 27705 USA.

  D''Agostino, EM (Corresponding Author), Miami Dade Cty Dept Pk Recreat \& Open Spaces,
  275 NW 2nd St, Miami, FL 33128 USA.

  D''Agostino, Emily M., Duke Univ, Dept Family Med \& Community Hlth, Sch Med, 2200
  W Main St,Off 623,6th Fl, Durham, NC 27705 USA.

  D''Agostino, Emily M.; Patel, Hersila H.; Hansen, Eric, Miami Dade Cty Dept Pk Recreat
  \& Open Spaces, 275 NW 2nd St, Miami, FL 33128 USA.

  Mathew, M. Sunil; Messiah, Sarah E., Univ Miami, Miller Sch Med, Dept Pediat, 1601
  NW 12th Ave, Miami, FL 33136 USA.

  Mathew, M. Sunil; Messiah, Sarah E., Univ Texas Hlth Sci Ctr, Sch Publ Hlth, Dallas,
  TX USA.

  Messiah, Sarah E., Childrens Hlth Syst Texas, Ctr Pediat Populat Hlth, Dallas, TX
  USA.

  Messiah, Sarah E., UTHlth Sci Ctr Sch Publ Hlth, Dallas, TX USA.'
author: D'Agostino, Emily M. and Patel, Hersila H. and Hansen, Eric and Mathew, M.
  Sunil and Messiah, Sarah E.
author-email: emily.m.dagostino@duke.edu
author_list:
- family: D'Agostino
  given: Emily M.
- family: Patel
  given: Hersila H.
- family: Hansen
  given: Eric
- family: Mathew
  given: M. Sunil
- family: Messiah
  given: Sarah E.
da: '2023-09-28'
doi: 10.1007/s40615-020-00821-8
earlyaccessdate: SEP 2020
eissn: 2196-8837
files: []
issn: 2197-3792
journal: JOURNAL OF RACIAL AND ETHNIC HEALTH DISPARITIES
keywords: 'Cardiovascular health; Fitness; Health disparities; Racial; ethnic

  segregation; Transportation vulnerability; Youth'
keywords-plus: 'PHYSICAL-ACTIVITY; RESIDENTIAL SEGREGATION; RACIAL DISPARITIES; BUILT

  ENVIRONMENT; LAND-USE; NEIGHBORHOOD; RISK; BEHAVIOR; OBESITY; FITNESS'
language: English
month: JUN
number: '3'
number-of-cited-references: '75'
orcid-numbers: 'D''Agostino, DrPH, MS, MEd, MA, Emily/0000-0003-0468-4836

  Messiah, Sarah/0000-0001-6685-2175'
pages: 618-629
papis_id: 58e8ff313c9231d5ac77334bc0e7110e
ref: Dagostino2021longitudinaleffects
researcherid-numbers: 'Hansen, Eric/JEF-6566-2023

  D''Agostino, Emily/IUO-1837-2023

  '
times-cited: '8'
title: Longitudinal Effects of Transportation Vulnerability on the Association Between
  Racial/Ethnic Segregation and Youth Cardiovascular Health
type: article
unique-id: WOS:000565504400001
usage-count-last-180-days: '0'
usage-count-since-2013: '8'
volume: '8'
web-of-science-categories: Public, Environmental \& Occupational Health
year: '2021'