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Papers by Robert Fullilove

Environment and Planning A: Economy and Space, 1995

Empirical and theoretical analyses based on observed patterns of incidence of AIDS and tuberculos... more Empirical and theoretical analyses based on observed patterns of incidence of AIDS and tuberculosis, on rates of poverty, and on statistics describing a ‘Markov infection’ driven by the ‘commuting field’ around Manhattan, strongly suggest that urban and suburban epicenters within a twenty-four-county metropolitan region, covering eighteen million people and more than 7600 square miles, may be significantly and increasingly linked to outlying affluent areas through a process driven by fundamental social, geographic, and economic structures. AIDS and TB rates outside the epicenter of New York City are found to display similar patterns of spread in space and time, and have been strongly coupled to rates of infection within it for some time, a circumstance which will continue and may intensify as ‘heterosexual AIDS’ becomes more predominant and as multiple drug-resistant forms of TB evolve within disintegrating inner city minority communities. The work reported here, involving a relativ...

Archives of Psychiatric Nursing, 2011

American Journal of Public Health, 2020

Journal of Urban Health, 2013

Public Health Reports, 2022

American Journal of Public Health, 2021

C102. PATIENT AND FAMILY-CENTERED CARE AT THE END OF LIFE, 2020

American Journal of Public Health, 2019

Nutrition Today, 2018

We developed a 6-week social media campaign using the Nutrition Education DESIGN Procedure to hei... more We developed a 6-week social media campaign using the Nutrition Education DESIGN Procedure to heighten awareness of the need to reduce consumption of high-fat and high-sugar, or “energy-dense,” foods among young women. Between 1 and 3 posts were published each week over 6 weeks, and results suggest that such social marketing approaches can successfully reach target populations.

The State of Black America, 1985

Harvard Journal of African American Public Policy, Jun 22, 2005

ABSTRACT In this paper, we argue that a disproportionate concentration of HIV/AIDS cases in many ... more ABSTRACT In this paper, we argue that a disproportionate concentration of HIV/AIDS cases in many African American communities signals a significant collapse in the social structure of those affected communities. Specifically, the open, extensive sale and use of illicit drugs and high rates of unprotected sex--all of which serve as the foundation for HIV infection--are the "symptoms" of the loss of important social controls within affected communities. The solution to this set of problems requires more than interventions tailored to individuals at risk. The structural problems that created the epidemic must be addressed with equal, if not greater, vigor. INTRODUCTION AIDS represents the end stage of HIV disease or, more commonly, HIV/AIDS. An AIDS diagnosis signals a significant level of deterioration of an individual's immune system and an increased likelihood that a variety of potentially fatal conditions will ensue. In this paper, we argue that a disproportionate concentration of HIV/AIDS cases in many African American communities signals, analogously, a significant collapse in the social structure of those affected communities. Specifically, the open, extensive sale and use of illicit drugs and high rates of unprotected sex--all of which serve as the foundation for HIV infection--are the "symptoms" of the loss of important social controls within affected communities. We also argue that public health interventions designed to change individual risk behaviors or to promote large-scale testing and treatment programs for individuals at risk will not suffice to decrease HIV infection rates in such communities. If further destruction is to be prevented, programs and policies designed to reverse the community decline that facilitates exposure to HIV/AIDS must be implemented as well. Changing the "structure of risk"--the goal of what are termed "structural interventions"--must become a priority for those in government who are charged with the responsibility of leading HIV prevention efforts (Sumartojo 2000). Understanding the historical factors that transformed African American neighborhoods that once boasted of considerable social cohesiveness into HIV-risk environments is also critical. We suggest that one policy--a government-initiated structural intervention--that had drastic negative consequences in poor communities of color was the implementation of approximately 1,600 urban renewal projects in African American communities between 1950 and 1970 (Fullilove 2004). We argue that the long-term social and economic consequences of these programs resulted in a process of deterioration that ultimately affected the health of individual residents by destroying their neighborhoods and weakening the social networks that connected them to their families and to their neighbors. HIV PREVENTION CIRCA 2005 The public health approach to AIDS is significantly influenced by what we will term the medical approach to HIV prevention and treatment. This approach focuses on the individual as the target of prevention campaigns as well as the target of medical treatments. The logic of such an approach is evident. It is the individual who becomes HIV infected, and the infection must be treated by tailoring medical interventions to all of the particular manifestations of HIV disease in each patient. Hence, many of the HIV prevention interventions in the United States are increasingly similar to the approaches we use to treat individual cases of many illnesses; namely, we test and we treat. Analogously, testing and treatment have been the leading themes in the efforts of the U.S. Public Health Service to prevent and treat HIV/AIDS here in the United States since the year 2000. Specifically, in 2003, the U.S. Centers for Disease Control and Prevention (CDC) initiated a program entitled Advancing HIV Prevention (CDC 2003). Advancing HIV Prevention seeks to make HIV testing a routine part of medical care and implement new models for diagnosing HIV infections outside of traditional medical settings. …

Our Communities, Our Sexual Health: Awareness and Prevention for African Americans, 2015

Many feel that the number of high school students electing to enter careers in science and engine... more Many feel that the number of high school students electing to enter careers in science and engineering is shrinking and that the United States needs to improve the potential pool in order to remain competitive in the international technology and research areas. This report attempts to describe the dimensions of the problem this nation faces in producing enough scientists and engineers, and how images of science may affect whether American students choose careers in science. Literature is surveyed in various areas including: (1) "Images of Science"; (2) "Measuring Attitudes to Science"; (3) "Structural (Non-Attitudinal) Factors in Science Career Choice" (including tracking, family factors, and factors affecting career choice); (4) "Media, Youth and Career Choice"; (5) "School Achievement in Science and Mathematics" (including the math crisis, and peers, academic aptitude and academic achievement); and (6) "Excellence, Academic Ac...

AIDS clinical review

To better combat the AIDS epidemic research is needed on the sexual behaviors and practices of ma... more To better combat the AIDS epidemic research is needed on the sexual behaviors and practices of major race and gender subgroups. This paper considers race and gender effects in the overall risk and means of HIV transmission. Supplementing a literature review of 191 articles published over the period 1964-89 social sexual histories were obtained for a number of Black adults from San Francisco. Data were collected in 7 interviews of groups each of 7-10 people assembled according to age sex sexual orientation and IV-drug use status. Interview questions probed the initiation of coitus coital and noncoital sexuality safe sex practice knowledge about safe sex gender roles sexual orientation childhood sexual activity family/race/social class drug use and economic instability and risk for AIDS. Important differences were observed in sexual attitudes and behaviors related to race and gender. The paper however notes that little is known about the development of sexual orientation and same-sex sexual behavior childhood sexuality and sexual behavior in the context of drug use. Despite these limitations the research suggests that women have less power than men in negotiating sexual relationships racial effects on sexual attitudes and behaviors are attenuated when examined by education and social class and social factors such as education and employment have strong effects on sexuality. Stable socially integrated communities are called for to establish and maintain protective sexuality.

Perceptual and Motor Skills

Issues: A large percentage of current HIV/AIDS diagnoses among African Americans result from HIV ... more Issues: A large percentage of current HIV/AIDS diagnoses among African Americans result from HIV infections acquired during young adulthood. In addition, men with a history of arrest and/or incarceration may be at high-risk for HIV infection. Therefore, it is important to provide HIV education and testing to recently arrested and/or incarcerated young adult black men. Community-Based Participatory Research (CBPR) methods are especially useful in creating testing programs for high-risk populations. CBPR promotes a sense of community ownership', resulting in more effective identification of factors that influence testing and enhanced program sustainability. Description: Preliminary discussions with our community partners identified recently arrested and/or incarcerated young adult black men as an important target group for HIV education and testing materials. Our goal is to develop gender-specific and culturally-tailored materials that promote HIV testing among recently arrested a...