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Mackenbach JD, Stuber JM, Beulens JWJ. Evidence on the effectiveness and equity of population-based policies to reduce the burden of type 2 diabetes: a narrative review. Diabetologia 2025; 68:281-294. [PMID: 39621105 PMCID: PMC11732888 DOI: 10.1007/s00125-024-06330-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Accepted: 10/15/2024] [Indexed: 01/15/2025]
Abstract
There is increasing evidence for the effectiveness of population-based policies to reduce the burden of type 2 diabetes. Yet, there are concerns about the equity effects of some policies, whereby socioeconomically disadvantaged populations are not reached or are adversely affected. There is a lack of knowledge on the effectiveness and equity of policies that are both population based (i.e. targeting both at-risk and low-risk populations) and low agency (i.e. not requiring personal resources to benefit from the policy). In this narrative review, we selected 16 policies that were both population based and low agency and reviewed the evidence on their effectiveness and equity. Substantial evidence suggests that fruit and vegetable subsidies, unhealthy food taxes, mass media campaigns, and school nutrition and physical activity education are effective in promoting healthier lifestyle behaviours. Less evidence was available for mandatory food reformulation, reduced portion sizes, marketing restrictions and restriction of availability and promotion of unhealthy products, although the available evidence suggested that these policies were effective in reducing unhealthy food choices. Effects could rarely be quantified across different studies due to substantial heterogeneity. There is an overall lack of evidence on equity effects of population-based policies, although available studies mostly concluded that the policies had favourable equity effects, with the exception of food-labelling policies. Each of the policies is likely to have a relatively modest effect on population-level diabetes risks, which emphasises the importance of combining different policy measures. Future research should consider the type of evidence needed to demonstrate the real-world effectiveness and equity of population-based diabetes prevention policies.
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Affiliation(s)
- Joreintje D Mackenbach
- Amsterdam UMC location Vrije Universiteit, Epidemiology and Data Science, Amsterdam, the Netherlands.
- Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
- Upstream Team, Amsterdam, the Netherlands.
| | - Josine M Stuber
- Amsterdam UMC location Vrije Universiteit, Epidemiology and Data Science, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
- Upstream Team, Amsterdam, the Netherlands
| | - Joline W J Beulens
- Amsterdam UMC location Vrije Universiteit, Epidemiology and Data Science, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
- Upstream Team, Amsterdam, the Netherlands
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Ganbaatar G, Ohashi M, Zaman MK, Azahar NM, Yamawaki K, Matsuo H, Pileap S, Nishiyama A, Inoue S, Yano Y. Space Prescription: Initiative to Improve Health and Well-being in Tokyo. J Atheroscler Thromb 2025; 32:1-10. [PMID: 39443132 PMCID: PMC11706967 DOI: 10.5551/jat.rv22028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2024] [Accepted: 08/26/2024] [Indexed: 10/25/2024] Open
Abstract
This review introduces "space prescribing," an innovative healthcare approach that incorporates the physical environment's role in promoting health beyond traditional clinical settings. Recognizing that individuals spend a significant amount of time outside clinical environments, this approach explores the therapeutic potential of natural and built environments in improving well-being and managing diseases, particularly cardiovascular and mental health conditions.Traditional healthcare models focus on treatments in hospital and clinic settings. However, evidence suggests that environmental factors profoundly influence health outcomes. Space prescribing recommends specific environments that encourage healthier lifestyles and enhance wellbeing. This concept includes social prescribing, in which healthcare professionals direct patients to community-based, non-medical activities such as art classes and sports, acknowledging that well-being transcends biological factors.This review also highlights "Cultural Ecosystem Services" (CES) in health through stress reduction, social connections, and physical activity. For cardiovascular health, elements such as green spaces and urban design are vital for managing conditions, such as hypertension and heart disease. Similarly, the configuration of indoor and outdoor spaces plays a crucial role in mental health. Therapeutic landscapes, including community gardens and culturally enriched urban areas, support mental health recovery, foster community engagement and reduce isolation.In conclusion, space prescribing advocates an integrated approach that considers the physical and social environments as fundamental components of health promotion. This strategy aims to mitigate health disparities and enhance the quality of life, while making health-enhancing activities accessible in urban and rural settings. Through this holistic approach, space prescribing has the potential to transform public health by strategically utilizing environmental designs to support health outcomes.
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Affiliation(s)
- Gantsetseg Ganbaatar
- NCD Epidemiology Research Center, Shiga University of Medical Science, Shiga, Japan
- Department of Public Health and Traditional Medicine, Darkhan-Uul Medical School of Mongolian National University of Medical Sciences, Darkhan-Uul, Mongolia
| | - Mizuki Ohashi
- NCD Epidemiology Research Center, Shiga University of Medical Science, Shiga, Japan
| | - Mazuin Kamarul Zaman
- Centre for Dietetics Studies, Faculty of Health Sciences, Universiti Teknologi MARA Cawangan Selangor, Puncak Alam, Selangor, Malaysia
| | - Nazar Mohd Azahar
- Department of Medical Laboratory Technology, Faculty of Health Sciences, Universiti Teknologi MARA, Cawangan Pulau Pinang, Kampus Bertam, Pulau Pinang, Malaysia
| | | | | | - Suon Pileap
- Department of Pharmacology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Akira Nishiyama
- Department of Pharmacology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Shigeru Inoue
- MITSUBISHI ESTATE CO., LTD, Tokyo, Japan
- Geidai PARK (Geidai Platform of Arts and Knowledge for the Future), Tokyo University of the Arts, Tokyo, Japan
| | - Yuichiro Yano
- Department of General Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
- Center for Medical Innovation, Institute of Science Tokyo, Tokyo, Japan
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Mahani A, Lyeo JS, Fung A, Husack K, Muhajarine N, Diener T, Brown C. Barriers to integration of health and equity into urban design policies in Regina, Saskatchewan. Health Promot Int 2024; 39:daae184. [PMID: 39657149 DOI: 10.1093/heapro/daae184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2024] Open
Abstract
Although there is extensive literature on the impact of urban design on health, little is known about the barriers to integrating health into urban design policies. As cities increasingly lead efforts to improve health equity and population health, understanding the perspectives and experiences of municipal actors on health and equity is essential. To address this gap, we conducted semi-structured interviews with 30 stakeholders engaged with urban design policy- and decision-making at the City of Regina in Saskatchewan, Canada. We analysed our data using a qualitative thematic framework. Our research uncovered a lack of shared understanding of health among municipal actors. Interviewees identified several barriers to integrating health and equity in urban design policies, including inaccessibility of evidence; insufficient resourcing; fragmented governance structure; limited legal power of local governments in Canada; a deeply ingrained culture of individualism and lack of representation. Our findings underscore the importance of adopting an integrated and holistic approach for healthy and equitable urban design. As urbanization continues to bring a greater share of the world's population into urban areas, it is crucial to understand how municipal governance can foster environments that promote residents' well-being.
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Affiliation(s)
- Akram Mahani
- Johnson Shoyama Graduate School of Public Policy (JSGS), University of Regina, 2155 College Ave., Regina, Saskatchewan S4P 4V5, Canada
- Saskatchewan Population Health and Evaluation Research Unit (SPHERU), University of Regina and University of Saskatchewan, Saskatchewan, Canada
| | - Joonsoo Sean Lyeo
- Johnson Shoyama Graduate School of Public Policy (JSGS), University of Regina, 2155 College Ave., Regina, Saskatchewan S4P 4V5, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College St., Toronto, Ontario M5T 3M7, Canada
| | - Agnes Fung
- Dalla Lana School of Public Health, University of Toronto, 155 College St., Toronto, Ontario M5T 3M7, Canada
| | - Kelly Husack
- City of Regina, Community Well-being Branch, 2476 Victoria Ave., Regina, Saskatchewan S4P 3C8, Canada
- REACH Edmonton Council for Safe Communities, Community Initiatives (Data & Evaluation), 901-10025 106 St., Edmonton, Alberta T5J 1G4, Canada
| | - Nazeem Muhajarine
- Saskatchewan Population Health and Evaluation Research Unit (SPHERU), University of Regina and University of Saskatchewan, Saskatchewan, Canada
- Department of Community Health and Epidemiology, College of Medicine, E wing - Health Sciences 104 Clinic Place, University of Saskatchewan, Saskatoon, Saskatchewan S7N-2Z4, Canada
| | - Tania Diener
- Department of Community Health and Epidemiology, College of Medicine, E wing - Health Sciences 104 Clinic Place, University of Saskatchewan, Saskatoon, Saskatchewan S7N-2Z4, Canada
- Public Health and Preventive Medicine, Saskatchewan Health Authority, 2110 Hamilton St., Regina, Saskatchewan S4P 2E3, Canada
| | - Chelsea Brown
- Population Health, Saskatchewan Health Authority, 2110 Hamilton St., Regina, Saskatchewan S4P2E3, Canada
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Iovino P, Obbia P, De Luca V, Donnoli C, Patumi L, Leonardini L, Palummeri E, Ruatta M, Basso AM, Longobucco Y, Rasero L, Liotta G, Illario M. Development and Preliminary Psychometric Testing of a Brief Tool to Measure Medication Adherence in Older Populations. Clin Interv Aging 2024; 19:1765-1772. [PMID: 39494367 PMCID: PMC11531711 DOI: 10.2147/cia.s480480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2024] [Accepted: 10/14/2024] [Indexed: 11/05/2024] Open
Abstract
Purpose Chronic diseases in older age are major sources of burden for healthcare systems. Compliance with medications is the key to treatment success for these patients, especially for frail individuals living in community settings. However, adherence to long-term medications in this population is not optimal, which leads to the need for frequent screening of compliance within large-scale public health surveys. In this context, a brief, simple and valid measure capturing medication adherence is not yet available. This study aims to develop and psychometrically test the Therapeutic Adherence Scale, a brief four-item tool that measures medication adherence in community-dwelling older adults affected by chronic diseases. Methods We conducted a three-phase process of instrument development, content validity assessment and psychometric testing. Results Of the candidate nine items derived from a review of the literature, only four were deemed essential to capture intentional and nonintentional nonadherence. These items underwent structural validity, convergent and known-groups validity, and internal consistency on a sample of 269 participants (mean age = 7.91 years, SD = 7.26). Confirmatory factor analysis confirmed satisfactory fit indices (RMSEA = 0.000, CFI = 1.00, TLI = 1.00). Scores of the TAS were higher for those perceiving loneliness (ρ = 0.33, p < 0.001), those declaring memory loss in the last year (ρ = 0.29, p < 0.001), and those exhibiting worse mental quality of life (ρ = -0.15, p = 0.03) compared with the other groups. Cronbach's alpha and split-half reliability coefficients were acceptable, with values of 0.68 and 0.77, respectively. Conclusion The Therapeutic Adherence Scale is a brief, valid and reliable self-report measure of medication adherence that can be used in practice and research to screen patients living in community settings. This tool is also free to use, which contributes to advancing knowledge on the field of medication adherence of older adults affected by chronic diseases.
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Affiliation(s)
- Paolo Iovino
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Paola Obbia
- Directorate of Health Professions, Local Health Agency Cuneo 1, Cuneo, Italy
| | - Vincenzo De Luca
- Department of Public Health, Federico II University of Naples, Naples, Italy
| | - Clara Donnoli
- Department of Biomedicine and Prevention, Tor Vergata University of Rome, Rome, Italy
| | - Lola Patumi
- Programma Mattone Internazionale Salute, ULSS 4 Veneto Orientale Local Health Agency, San Donà di Piave (VE), Italy
| | - Lisa Leonardini
- Programma Mattone Internazionale Salute, ULSS 4 Veneto Orientale Local Health Agency, San Donà di Piave (VE), Italy
| | | | - Manuela Ruatta
- Directorate of Health Professions, Local Health Agency Cuneo 1, Cuneo, Italy
| | | | - Yari Longobucco
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Laura Rasero
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Giuseppe Liotta
- Department of Biomedicine and Prevention, Tor Vergata University of Rome, Rome, Italy
| | - Maddalena Illario
- Department of Public Health, Federico II University of Naples, Naples, Italy
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Dyer GMC, Khomenko S, Adlakha D, Anenberg S, Behnisch M, Boeing G, Esperon-Rodriguez M, Gasparrini A, Khreis H, Kondo MC, Masselot P, McDonald RI, Montana F, Mitchell R, Mueller N, Nawaz MO, Pisoni E, Prieto-Curiel R, Rezaei N, Taubenböck H, Tonne C, Velázquez-Cortés D, Nieuwenhuijsen M. Exploring the nexus of urban form, transport, environment and health in large-scale urban studies: A state-of-the-art scoping review. ENVIRONMENTAL RESEARCH 2024; 257:119324. [PMID: 38844028 DOI: 10.1016/j.envres.2024.119324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 05/30/2024] [Accepted: 05/31/2024] [Indexed: 06/15/2024]
Abstract
BACKGROUND As the world becomes increasingly urbanised, there is recognition that public and planetary health relies upon a ubiquitous transition to sustainable cities. Disentanglement of the complex pathways of urban design, environmental exposures, and health, and the magnitude of these associations, remains a challenge. A state-of-the-art account of large-scale urban health studies is required to shape future research priorities and equity- and evidence-informed policies. OBJECTIVES The purpose of this review was to synthesise evidence from large-scale urban studies focused on the interaction between urban form, transport, environmental exposures, and health. This review sought to determine common methodologies applied, limitations, and future opportunities for improved research practice. METHODS Based on a literature search, 2958 articles were reviewed that covered three themes of: urban form; urban environmental health; and urban indicators. Studies were prioritised for inclusion that analysed at least 90 cities to ensure broad geographic representation and generalisability. Of the initially identified studies, following expert consultation and exclusion criteria, 66 were included. RESULTS The complexity of the urban ecosystem on health was evidenced from the context dependent effects of urban form variables on environmental exposures and health. Compact city designs were generally advantageous for reducing harmful environmental exposure and promoting health, with some exceptions. Methodological heterogeneity was indicative of key urban research challenges; notable limitations included exposure and health data at varied spatial scales and resolutions, limited availability of local-level sociodemographic data, and the lack of consensus on robust methodologies that encompass best research practice. CONCLUSION Future urban environmental health research for evidence-informed urban planning and policies requires a multi-faceted approach. Advances in geospatial and AI-driven techniques and urban indicators offer promising developments; however, there remains a wider call for increased data availability at local-levels, transparent and robust methodologies of large-scale urban studies, and greater exploration of urban health vulnerabilities and inequities.
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Affiliation(s)
- Georgia M C Dyer
- Barcelona Institute for Global Health (ISGlobal), Doctor Aiguader 88, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Doctor Aiguader 88, 08003, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Melchor Fern'andez Almagro, 3-5, 28029, Madrid, Spain
| | - Sasha Khomenko
- Barcelona Institute for Global Health (ISGlobal), Doctor Aiguader 88, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Doctor Aiguader 88, 08003, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Melchor Fern'andez Almagro, 3-5, 28029, Madrid, Spain
| | - Deepti Adlakha
- Delft University of Technology, Mekelweg 5, 2628, Delft, Netherlands
| | - Susan Anenberg
- Environmental and Occupational Health Department, George Washington University, Milken Institute School of Public Health, 20052, New Hampshire Avenue, Washington, District of Colombia, United States
| | - Martin Behnisch
- Leibniz Institute of Ecological Urban and Regional Development, Weberpl 1, 01217, Dresden, Germany
| | - Geoff Boeing
- University of Southern California, 90007, Los Angeles, United States
| | - Manuel Esperon-Rodriguez
- Hawkesbury Institute for the Environment, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia; School of Science, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Antonio Gasparrini
- Environment & Health Modelling (EHM) Lab, Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, WC1E 7HT, London, United Kingdom
| | - Haneen Khreis
- MRC Epidemiology Unit, Cambridge University, CB2 0AH, Cambridge, United Kingdom
| | - Michelle C Kondo
- USDA-Forest Service, Northern Research Station, 100 North 20th Street, Ste 205, 19103, Philadelphia, PA, United States
| | - Pierre Masselot
- Environment & Health Modelling (EHM) Lab, Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, WC1E 7HT, London, United Kingdom
| | - Robert I McDonald
- The Nature Conservancy, 4245 North Fairfax Drive Arlington, 22203, Virginia, United States
| | - Federica Montana
- Barcelona Institute for Global Health (ISGlobal), Doctor Aiguader 88, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Doctor Aiguader 88, 08003, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Melchor Fern'andez Almagro, 3-5, 28029, Madrid, Spain
| | - Rich Mitchell
- Institute of Health and Wellbeing, University of Glasgow, 90 Byres Road, Glasgow, G20 0TY, United Kingdom
| | - Natalie Mueller
- Barcelona Institute for Global Health (ISGlobal), Doctor Aiguader 88, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Doctor Aiguader 88, 08003, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Melchor Fern'andez Almagro, 3-5, 28029, Madrid, Spain
| | - M Omar Nawaz
- Environmental and Occupational Health Department, George Washington University, Milken Institute School of Public Health, 20052, New Hampshire Avenue, Washington, District of Colombia, United States
| | - Enrico Pisoni
- European Commission, Joint Research Centre (JRC), 2749, Ispra, Italy
| | | | - Nazanin Rezaei
- University of California Santa Cruz, 1156 High Street, 95064, California, United States
| | - Hannes Taubenböck
- German Aerospace Centre (DLR), Earth Observation Center (EOC), 82234, Oberpfaffenhofen, Germany; Institute for Geography and Geology, Julius-Maximilians-Universität Würzburg, 97074, Würzburg, Germany
| | - Cathryn Tonne
- Barcelona Institute for Global Health (ISGlobal), Doctor Aiguader 88, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Doctor Aiguader 88, 08003, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Melchor Fern'andez Almagro, 3-5, 28029, Madrid, Spain
| | - Daniel Velázquez-Cortés
- Barcelona Institute for Global Health (ISGlobal), Doctor Aiguader 88, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Doctor Aiguader 88, 08003, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Melchor Fern'andez Almagro, 3-5, 28029, Madrid, Spain
| | - Mark Nieuwenhuijsen
- Barcelona Institute for Global Health (ISGlobal), Doctor Aiguader 88, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Doctor Aiguader 88, 08003, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Melchor Fern'andez Almagro, 3-5, 28029, Madrid, Spain.
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Li M, Li Y, Liu Z, Hystad P, Rangarajan S, Tse LA, Lear SA, Ma Y, Chen M, Han G, Li R, Yusuf S, Liu L, Hu B, Li W. Associations of perceived built environment characteristics using NEWS questionnaires with all-cause mortality and major cardiovascular diseases: The prospective urban rural epidemiology (PURE)-China study. ENVIRONMENT INTERNATIONAL 2024; 187:108627. [PMID: 38636273 DOI: 10.1016/j.envint.2024.108627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 03/31/2024] [Accepted: 04/02/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND Despite increased literature focusing on the role of the built environment (BE) in health, few cohort studies have quantitatively analyzed neighborhood walkability environment in relation to the risk of death and cardiovascular disease (CVD). This longitudinal study aimed at evaluating the association between perceived BE attributeswith mortality and major CVD based on the Prospective Urban Rural Epidemiology study in China (PURE-China). METHODS The PURE-China study recruited 47,931 participants aged 35-70 years from 12 provinces of China between 2005 and 2009. The perceived BE information, including land use, street, aesthetics, and safety, was collected using the neighborhood environment walkability scale (NEWS) questionnaire, with higher scores indicating a more favorable rating. Two primary outcomes are all-cause mortality and major CVD event. The Cox frailty model with random intercepts was used to assess the association between the perceived total BE/subscales score and outcomes. RESULTS Of 32,163 participants included in this study, 19,253 (59.9 %) were women, and the mean (SD) age was 51.0 (9.5) years. After a median follow-up period of 11.7 years (IQR 9.4 - 12.2), we observed that one standard deviation higher of combined BE scores was related to a lower risk of all-cause mortality (HR = 0.85; 95 %CI, 0.80-0.90), and major CVD events (HR = 0.95; 95 %CI, 0.90-0.99). The subscales of perceived BE were related to a lower risk, although a few were not significant. Land use mix-diversity and safety from crime were the two most significant subscales. Stronger risks were observed among urban and female participants. CONCLUSION Favorable perceived BE characteristics were linked with a lower risk of all-cause mortality and major CVD events in Chinese population, especially in urban areas and females. Our findings can be used by policymakers to take action to mitigate the adverse effect of poor community conditions on health, such as improving local amenities and transport connectivity, providing building paths for walking, running and cycling.
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Affiliation(s)
- Mengya Li
- Medical Research & Biometrics Center, National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences Beijing, China
| | - Yang Li
- Medical Research & Biometrics Center, National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences Beijing, China; Interventional Center of Valvular Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Zhiguang Liu
- Clinical Trial Unit, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Perry Hystad
- School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, United States
| | - Sumathy Rangarajan
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Lap Ah Tse
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR
| | - Scott A Lear
- Faculty of Health Sciences, Simon Fraser University, Vancouver, BC, Canada
| | - Yuanting Ma
- Dongguan Street Community Health Service Center, Xining, Qinghai Province, China
| | - Mengxin Chen
- Medical Research & Biometrics Center, National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences Beijing, China
| | - Guoliang Han
- Medical Research & Biometrics Center, National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences Beijing, China
| | - Ruotong Li
- Medical Research & Biometrics Center, National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences Beijing, China
| | - Salim Yusuf
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Lisheng Liu
- Beijing Hypertension League Institute, Beijing, China.
| | - Bo Hu
- Medical Research & Biometrics Center, National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences Beijing, China.
| | - Wei Li
- Medical Research & Biometrics Center, National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences Beijing, China.
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7
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Felici A, Peduzzi G, Giorgolo F, Spinelli A, Calderisi M, Monreale A, Farinella R, Pellungrini R, Canzian F, Campa D. The local environment and germline genetic variation predict cancer risk in the UK Biobank prospective cohort. ENVIRONMENTAL RESEARCH 2024; 241:117562. [PMID: 37944693 DOI: 10.1016/j.envres.2023.117562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 10/27/2023] [Accepted: 10/30/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND There is a growing body of evidence on the effect of the local environment exposure on cancer susceptibility. Nonetheless, several of the associations remain controversial. Moreover, our understanding of the possible interaction between the local environment and the genetic variability is still very limited. OBJECTIVE The aim of this study was to clarify the role of the local environment and its possible interplay with genetics on common cancers development. METHODS Using the UK Biobank (UKBB) prospective cohort, we selected 12 local environment exposures: nitrogen oxides, nitrogen dioxides, particulate matter (10 and 2.5 μm), noise pollution, urban traffic, living distance from the coast, percentage of greenspace, natural environment, water, and domestic garden within 1000 m from the residential coordinates of each participant. All these exposures were tested for association with 17 different types of cancer for a total of 53,270 cases and 302,645 controls. Additionally, a polygenic score (PGS) was computed for each cancer, to test possible gene-environment interactions. Finally, mediation analyses were carried out. RESULTS Thirty-six statistically significant associations considering multiple testing (p < 2.19 × 10-4) were observed. Among the novel associations we observed that individuals living farther from the coast had a higher risk of developing prostate cancer (OR = 1.13, CI95% = 1.06-1.20, P = 1.98 × 10-4). This association was partially mediated by physical activity (indirect effect (IE) = -8.48 × 10-7) and the time spent outdoor (IE = 9.07 × 10-6). All PGSs showed statistically significant associations. Finally, genome-environment interaction analysis showed that local environment and genetic variability affect cancer risk independently. DISCUSSION Living close to the coast and air pollution were associated with a decreased risk of prostate cancer and skin melanoma, respectively. These findings from the UKBB support the role of the local environment on cancer development, which is independent from genetics and may be mediated by several lifestyle factors.
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Affiliation(s)
| | | | | | | | | | - Anna Monreale
- Department of Computer Science, University of Pisa, Pisa, Italy
| | | | | | - Federico Canzian
- Genomic Epidemiology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Daniele Campa
- Department of Biology, University of Pisa, Pisa, Italy.
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8
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Koohsari MJ, McCormack GR, Nakaya T, Yasunaga A, Fuller D, Nagai Y, Oka K. The Metaverse, the Built Environment, and Public Health: Opportunities and Uncertainties. J Med Internet Res 2023; 25:e43549. [PMID: 36780208 PMCID: PMC9972199 DOI: 10.2196/43549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 12/20/2022] [Accepted: 01/11/2023] [Indexed: 02/14/2023] Open
Abstract
There has been a growing interest in the "metaverse," and discourse about how this platform may contribute to different fields of science is already beginning to emerge. In this paper, we discuss key opportunities and uncertainties about how a metaverse might contribute to advancing knowledge in the interdisciplinary field of the built environment and public health aimed at reducing noncommunicable diseases.
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Affiliation(s)
- Mohammad Javad Koohsari
- School of Knowledge Science, Japan Advanced Institute of Science and Technology, Nomi, Japan
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Gavin R McCormack
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
- School of Architecture, Planning and Landscape, University of Calgary, Calgary, AB, Canada
| | - Tomoki Nakaya
- Graduate School of Environmental Studies, Tohoku University, Sendai, Japan
| | - Akitomo Yasunaga
- Faculty of Liberal Arts and Sciences, Bunka Gakuen University, Tokyo, Japan
| | - Daniel Fuller
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatchewan, SK, Canada
| | - Yukari Nagai
- School of Knowledge Science, Japan Advanced Institute of Science and Technology, Nomi, Japan
| | - Koichiro Oka
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
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