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Vilcins D, Sly PD, Scarth P, Mavoa S. Green space in health research: an overview of common indicators of greenness. REVIEWS ON ENVIRONMENTAL HEALTH 2024; 39:221-231. [PMID: 36372560 DOI: 10.1515/reveh-2022-0083] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 10/29/2022] [Indexed: 06/16/2023]
Abstract
Human environments influence human health in both positive and negative ways. Green space is considered an environmental exposure that confers benefits to human health and has attracted a high level of interest from researchers, policy makers, and increasingly clinicians. Green space has been associated with a range of health benefits, such as improvements in physical, mental, and social wellbeing. There are different sources, metrics and indicators of green space used in research, all of which measure different aspects of the environment. It is important that readers of green space research understand the terminology used in this field, and what the green space indicators used in the studies represent in the real world. This paper provides an overview of the major definitions of green space and the indicators used to assess exposure for health practitioners, public health researchers, and health policy experts who may be interested in understanding this field more clearly, either in the provision of public health-promoting services or to undertake research.
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Affiliation(s)
- Dwan Vilcins
- Children's Health and Environment Program, The University of Queensland, Brisbane, Australia
| | - Peter D Sly
- Children's Health and Environment Program, The University of Queensland, Brisbane, Australia
| | - Peter Scarth
- School of Earth and Environmental Sciences, The University of Queensland, Brisbane, Australia
| | - Suzanne Mavoa
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
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Martin L, White MP, Elliott LR, Grellier J, Astell-Burt T, Bratman GN, Lima ML, Nieuwenhuijsen M, Ojala A, Roiko A, van den Bosch M, Fleming LE. Mechanisms underlying the associations between different types of nature exposure and sleep duration: An 18-country analysis. ENVIRONMENTAL RESEARCH 2024; 250:118522. [PMID: 38403148 DOI: 10.1016/j.envres.2024.118522] [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: 06/27/2023] [Revised: 01/17/2024] [Accepted: 02/17/2024] [Indexed: 02/27/2024]
Abstract
Whilst green space has been linked to healthier sleep outcomes, the roles of specific types of nature exposure, potential underlying mechanisms, and between-country variations in nature-sleep associations have received little attention. Drawing on cross-sectional survey data from an 18-country sample of adults (N = 16,077) the current study examined: 1) the relative associations between six different types of nature exposure (streetscape greenery, blue view from home, green space within 1 km, coast within 1 km, green space visits, blue space visits) and insufficient sleep (<6 h vs. 7-10 h per day); 2) whether these relationships were mediated by better mental wellbeing and/or physical activity; and 3) the consistency of these pathways among the different countries. After controlling for covariates, neighbourhood nature measures (green space, coast within 1 km) were not significantly associated with insufficient sleep; but nature visible from home (streetscape greenery, blue views) and recreational visits to green and blue spaces were each associated with less insufficient sleep. Significant nature-sleep associations were mediated, to varying degrees, by better mental wellbeing, but not self-reported physical activity. Country-level heterogeneity in the strength of nature-sleep associations was observed. Increasing nature visible from the home may represent a promising strategy for promoting healthier sleep duration at the population level, whilst nature-based interventions encouraging individuals to spend time in local green/blue spaces may be an appropriate target to assist individuals affected by insufficient sleep.
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Affiliation(s)
- Leanne Martin
- European Centre for Environment and Human Health, University of Exeter Medical School, UK.
| | - Mathew P White
- European Centre for Environment and Human Health, University of Exeter Medical School, UK; Cognitive Science HUB & Urban and Environmental Psychology Group, University of Vienna, Austria
| | - Lewis R Elliott
- European Centre for Environment and Human Health, University of Exeter Medical School, UK
| | - James Grellier
- European Centre for Environment and Human Health, University of Exeter Medical School, UK; Institute of Psychology, Jagiellonian University, Krakow, Poland
| | - Thomas Astell-Burt
- Population Wellbeing and Environment Research Lab (PowerLab), NSW, Australia; School of Health and Society, Faculty of Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia
| | - Gregory N Bratman
- School of Environmental and Forest Sciences, University of Washington, USA
| | - Maria L Lima
- Department of Social and Organizational Psychology, ISCTE - University Institute of Lisbon, Portugal
| | - Mark Nieuwenhuijsen
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Ann Ojala
- Natural Resources Institute Finland (Luke), Finland
| | - Anne Roiko
- School of Pharmacy & Medical Sciences, Griffith University, Australia
| | - Matilda van den Bosch
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; Natural Resources Institute Finland (Luke), Finland; School of Population and Public Health, University of British Columbia, Canada; Department of Forest and Conservation Sciences, University of British Columbia, Canada
| | - Lora E Fleming
- European Centre for Environment and Human Health, University of Exeter Medical School, UK
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Patwary MM, Sakhvidi MJZ, Ashraf S, Dadvand P, Browning MHEM, Alam MA, Bell ML, James P, Astell-Burt T. Impact of green space and built environment on metabolic syndrome: A systematic review with meta-analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 923:170977. [PMID: 38360326 DOI: 10.1016/j.scitotenv.2024.170977] [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: 12/07/2023] [Revised: 02/03/2024] [Accepted: 02/12/2024] [Indexed: 02/17/2024]
Abstract
Metabolic Syndrome presents a significant public health challenge associated with an increased risk of noncommunicable diseases such as cardiovascular conditions. Evidence shows that green spaces and the built environment may influence metabolic syndrome. We conducted a systematic review and meta-analysis of observational studies published through August 30, 2023, examining the association of green space and built environment with metabolic syndrome. A quality assessment of the included studies was conducted using the Office of Health Assessment and Translation (OHAT) tool. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) assessment was used to evaluate the overall quality of evidence. Our search retrieved 18 studies that met the inclusion criteria and were included in our review. Most were from China (n = 5) and the USA (n = 5), and most used a cross-sectional study design (n = 8). Nine studies (50 %) reported only green space exposures, seven (39 %) reported only built environment exposures, and two (11 %) reported both built environment and green space exposures. Studies reported diverse definitions of green space and the built environment, such as availability, accessibility, and quality, particularly around participants' homes. The outcomes focused on metabolic syndrome; however, studies applied different definitions of metabolic syndrome. Meta-analysis results showed that an increase in normalized difference vegetation index (NDVI) within a 500-m buffer was associated with a lower risk of metabolic syndrome (odds ratio [OR] = 0.90, 95%CI = 0.87-0.93, I2 = 22.3 %, n = 4). A substantial number of studies detected bias for exposure classification and residual confounding. Overall, the extant literature shows a 'limited' strength of evidence for green space protecting against metabolic syndrome and an 'inadequate' strength of evidence for the built environment associated with metabolic syndrome. Studies with more robust study designs, better controlled confounding factors, and stronger exposure measures are needed to understand better what types of green spaces and built environment features influence metabolic syndrome.
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Affiliation(s)
- Muhammad Mainuddin Patwary
- Environment and Sustainability Research Initiative, Khulna, Bangladesh; Environmental Science Discipline, Life Science School, Khulna University, Khulna, Bangladesh.
| | - Mohammad Javad Zare Sakhvidi
- Department of Occupational Health, School of Public Health, Yazd Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Sadia Ashraf
- Environmental Science Discipline, Life Science School, Khulna University, Khulna, Bangladesh
| | - Payam Dadvand
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Matthew H E M Browning
- Department of Parks, Recreation and Tourism Management, Clemson University, Clemson, SC, USA
| | - Md Ashraful Alam
- Department of Computational Diagnostic Radiology and Preventive Medicine, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan
| | - Michelle L Bell
- Yale School of the Environment, Yale University, New Haven, CT, United States
| | - Peter James
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA; Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Harvard University, Boston, MA, USA
| | - Thomas Astell-Burt
- School of Architecture, Design, and Planning, University of Sydney, Australia
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Dong J, Browning MHEM, Reuben A, McAnirlin O, Yuan S, Stephens C, Maisonet M, Zhang K, Hart JE, James P, Yeager R. The paradox of high greenness and poor health in rural Central Appalachia. ENVIRONMENTAL RESEARCH 2024; 248:118400. [PMID: 38309568 DOI: 10.1016/j.envres.2024.118400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 01/29/2024] [Accepted: 01/31/2024] [Indexed: 02/05/2024]
Abstract
While many studies have found positive correlations between greenness and human health, rural Central Appalachia is an exception. The region has high greenness levels but poor health. The purpose of this commentary is to provide a possible explanation for this paradox: three sets of factors overwhelming or attenuating the health benefits of greenness. These include environmental (e.g., steep typography and limited access to green space used for outdoor recreation), social (e.g., chronic poverty, declining coal industry, and limited access to healthcare), and psychological and behavioral factors (e.g., perceptions about health behaviors, healthcare, and greenness). The influence of these factors on the expected health benefits of greenness should be considered as working hypotheses for future research. Policymakers and public health officials need to ensure that greenness-based interventions account for contextual factors and other determinants of health to ensure these interventions have the expected health benefits.
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Affiliation(s)
- Jiaying Dong
- School of Architecture, Huaqiao University, Xiamen, China; Virtual Reality and Nature Lab, Department of Parks, Recreation & Tourism Management, Clemson University, Clemson, SC, USA
| | - Matthew H E M Browning
- Virtual Reality and Nature Lab, Department of Parks, Recreation & Tourism Management, Clemson University, Clemson, SC, USA.
| | - Aaron Reuben
- Department of Psychology & Neuroscience, Duke University, Durham, NC, USA
| | - Olivia McAnirlin
- Virtual Reality and Nature Lab, Department of Parks, Recreation & Tourism Management, Clemson University, Clemson, SC, USA
| | - Shuai Yuan
- Virtual Reality and Nature Lab, Department of Parks, Recreation & Tourism Management, Clemson University, Clemson, SC, USA
| | | | - Mildred Maisonet
- Biostatistics and Epidemiology Department, College of Public Health, East Tennessee State University, Johnson City, TN, USA
| | - Kuiran Zhang
- Virtual Reality and Nature Lab, Department of Parks, Recreation & Tourism Management, Clemson University, Clemson, SC, USA
| | - Jaime E Hart
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Peter James
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Ray Yeager
- Division of Environmental Medicine, Department of Medicine, University of Louisville, Louisville, KY, USA
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Gong Y, Kim EJ. Correlation Between Neighborhood Built Environment and Leisure Walking Time Around a Riverside Park. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2024; 17:227-244. [PMID: 38007717 DOI: 10.1177/19375867231213338] [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] [Indexed: 11/28/2023]
Abstract
OBJECTIVES This study aimed to investigate whether the distance to a riverside park and the neighborhood built environment are related to individuals' leisure walking time by examining the case of the Geumho riverside park in Daegu, South Korea. BACKGROUND Walking, being an inexpensive means of transportation with numerous health benefits, is influenced by the conditions of neighborhood built environments. METHODS A survey was conducted from October 12 to November 8, 2022, including 184 adults aged 18 years or older. The dependent variable was the total weekly minutes of leisure walking, and the independent variables included the neighborhood built environment measured objectively using geographic information systems as well as demographic/individual characteristics and health attitude data. Analysis of variance was conducted to determine whether leisure walking time differed depending on the distance to the riverside park, and regression analysis was conducted to examine the association between leisure walking time and the neighborhood built environment. RESULTS Individuals living within a quarter-mile of the park walked an average of 155 min per week for leisure, which was significantly more than those living further than 1 mile (mean = 85.14 min/week). Moreover, greater access to the park, higher crosswalk density, and a lower road density were associated with more leisure walking time for residents. CONCLUSIONS The findings of this study indicate that good access to riverside parks and pedestrian-centered neighborhood environments may be related to leisure walking among residents. These findings hold significance for urban planning and the formulation of public health policies.
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Affiliation(s)
- Youngeun Gong
- Korea Research Institute for Human Settlements, Sejong, Republic of Korea
| | - Eun Jung Kim
- Department of Urban Planning, Keimyung University, Daegu, Republic of Korea
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Robinson JM, Breed AC, Camargo A, Redvers N, Breed MF. Biodiversity and human health: A scoping review and examples of underrepresented linkages. ENVIRONMENTAL RESEARCH 2024; 246:118115. [PMID: 38199470 DOI: 10.1016/j.envres.2024.118115] [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: 11/20/2023] [Revised: 12/09/2023] [Accepted: 01/04/2024] [Indexed: 01/12/2024]
Abstract
Mounting evidence supports the connections between exposure to environmental typologies(such as green and blue spaces)and human health. However, the mechanistic links that connect biodiversity (the variety of life) and human health, and the extent of supporting evidence remain less clear. Here, we undertook a scoping review to map the links between biodiversity and human health and summarise the levels of associated evidence using an established weight of evidence framework. Distinct from other reviews, we provide additional context regarding the environment-microbiome-health axis, evaluate the environmental buffering pathway (e.g., biodiversity impacts on air pollution), and provide examples of three under- or minimally-represented linkages. The examples are (1) biodiversity and Indigenous Peoples' health, (2) biodiversity and urban social equity, and (3) biodiversity and COVID-19. We observed a moderate level of evidence to support the environmental microbiota-human health pathway and a moderate-high level of evidence to support broader nature pathways (e.g., greenspace) to various health outcomes, from stress reduction to enhanced wellbeing and improved social cohesion. However, studies of broader nature pathways did not typically include specific biodiversity metrics, indicating clear research gaps. Further research is required to understand the connections and causative pathways between biodiversity (e.g., using metrics such as taxonomy, diversity/richness, structure, and function) and health outcomes. There are well-established frameworks to assess the effects of broad classifications of nature on human health. These can assist future research in linking biodiversity metrics to human health outcomes. Our examples of underrepresented linkages highlight the roles of biodiversity and its loss on urban lived experiences, infectious diseases, and Indigenous Peoples' sovereignty and livelihoods. More research and awareness of these socioecological interconnections are needed.
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Affiliation(s)
- Jake M Robinson
- College of Science and Engineering, Flinders University, Bedford Park, SA, Australia.
| | - Andrew C Breed
- Epidemiology and One Health Section, Department of Agriculture, Water, and the Environment, Canberra, ACT, Australia; School of Veterinary Science, University of Queensland, Gatton, Qld, Australia
| | | | - Nicole Redvers
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Martin F Breed
- College of Science and Engineering, Flinders University, Bedford Park, SA, Australia
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Yao XI, Tong X, Shen C, Song Y, Sun S, Chen K, Shen H. Green space, genetic susceptibility, and risk of osteoporosis:a cohort study from the UK Biobank. CHEMOSPHERE 2024; 353:141632. [PMID: 38442776 DOI: 10.1016/j.chemosphere.2024.141632] [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: 11/13/2023] [Revised: 02/27/2024] [Accepted: 03/01/2024] [Indexed: 03/07/2024]
Abstract
OBJECTIVE This study aimed to investigate the effect of residential exposure to green space on the incident osteoporosis and further explore the modification effect of genetic susceptibility. METHODS Participants from the UK Biobank were followed from 2006 to 2010 (baseline) to December 31st, 2022. Using land use coverage, we evaluated exposure to residential surrounding green space, natural environment, and domestic gardens. We used the Cox regression to examine the association between the residential environment and incident osteoporosis. The interactive effects between polygenic risk score (PRS) of osteoporosis and residential environments on incident osteoporosis were investigated. RESULTS This study included 292,662 participants. Over a median follow-up period of 13.65 years, we documented 9177 incidents of osteoporosis. Per interquartile (IQR) increase in greenness and natural environment at a 300 m buffer was associated with a 4% lower risk of incident osteoporosis [HR = 0.96 (95% CI: 0.93, 0.99)] and [HR = 0.96 (95% CI: 0.93, 0.98)], respectively. We did not identify any interactive effects between genetic risk and residential environment on incident osteoporosis. CONCLUSIONS This study found that public greenness and natural environments could reduce the risk of incident osteoporosis regardless of genetic predisposition. Developing sustainable and publicly accessible natural environments might benefit populations' bone health.
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Affiliation(s)
- Xiaoxin I Yao
- Department of Orthopaedics, The Eighth Affiliated Hospital, Sun Yat-Sen University, PR China; Department of Clinical Research, The Eighth Affiliated Hospital, Sun Yat-sen University, PR China
| | - Xinning Tong
- Department of Orthopaedics, The Eighth Affiliated Hospital, Sun Yat-Sen University, PR China
| | - Chen Shen
- MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK; National Institute for Health Research Health Protection Research Unit in Chemical and Radiation Threats and Hazards, Imperial College London, UK
| | - Yichang Song
- Department of Orthopaedics, The Eighth Affiliated Hospital, Sun Yat-Sen University, PR China
| | - Shengzhi Sun
- School of Public Health, Capital Medical University, Beijing, 100069, PR China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China.
| | - Keng Chen
- Department of Orthopaedics, The Eighth Affiliated Hospital, Sun Yat-Sen University, PR China.
| | - Huiyong Shen
- Department of Orthopaedics, The Eighth Affiliated Hospital, Sun Yat-Sen University, PR China; Department of Clinical Research, The Eighth Affiliated Hospital, Sun Yat-sen University, PR China.
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Sharifi Y, Sobhani S, Ramezanghorbani N, Payab M, Ghoreshi B, Djalalinia S, Nouri Ghonbalani Z, Ebrahimpur M, Eslami M, Qorbani M. Association of greenspaces exposure with cardiometabolic risk factors: a systematic review and meta-analysis. BMC Cardiovasc Disord 2024; 24:170. [PMID: 38509487 PMCID: PMC10953288 DOI: 10.1186/s12872-024-03830-1] [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: 12/15/2023] [Accepted: 03/05/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Cardiometabolic conditions are major contributors to the global burden of disease. An emerging body of evidence has associated access to and surrounding public open spaces (POS) and greenspace with cardiometabolic risk factors, including obesity, body mass index (BMI), hypertension (HTN), blood glucose (BG), and lipid profiles. This systematic review aimed to synthesize this evidence. METHODS This systematic review was conducted based on the PRISMA guidelines. Four electronic databases including Web of Science, PubMed, Scopus, and Google Scholar were searched for eligible articles published until July 2023. All observational studies which assessed the association of greenspace and POS with cardiometabolic risk factors including obesity, BMI, HTN, BG, and lipid profiles were included and reviewed by two authors independently. Heterogeneity between studies was assessed using the I2 index and Cochrane's Q test. Random/fixed effect meta-analyses were used to combine the association between greenspace exposure with cardiometabolic risk factors. RESULTS Overall, 118 relevant articles were included in our review. The majority of the articles were conducted in North America or Europe. In qualitative synthesis, access or proximity to greenspaces or POS impacts BMI and blood pressure or HTN, BG, and lipid profiles via various mechanisms. According to the random effect meta-analysis, more access to greenspace was significantly associated with lower odds of HTN (odds ratio (OR): 0.81, 95% confidence intervals (CIs): 0.61-0.99), obesity (OR: 0.83, 95% CIs: 0.77-0.90), and diabetes (OR:0.79, 95% CI: 0.67,0.90). CONCLUSIONS Findings of this systematic review and meta-analysis suggested that greenspace accessibility is associated with some cardiometabolic risk factors. Improving greenspace accessibility could be considered as one of the main strategies to reduce cardiometabolic risk factors at population level.
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Affiliation(s)
- Yasaman Sharifi
- Department of Radiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sahar Sobhani
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Nahid Ramezanghorbani
- Department of Development and Coordination Scientific Information and Publications, Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran
| | - Moloud Payab
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Behnaz Ghoreshi
- Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Shirin Djalalinia
- Development of Research & Technology Center, Ministry of Health and Medical Education, Tehran, Iran
| | - Zahra Nouri Ghonbalani
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Mahbube Ebrahimpur
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maysa Eslami
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.
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Mizen A, Thompson DA, Watkins A, Akbari A, Garrett JK, Geary R, Lovell R, Lyons RA, Nieuwenhuijsen M, Parker SC, Rowney FM, Song J, Stratton G, Wheeler BW, White J, White MP, Williams S, Rodgers SE, Fry R. The use of Enhanced Vegetation Index for assessing access to different types of green space in epidemiological studies. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2024:10.1038/s41370-024-00650-5. [PMID: 38424359 DOI: 10.1038/s41370-024-00650-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 01/24/2024] [Accepted: 01/24/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND Exposure to green space can protect against poor health through a variety of mechanisms. However, there is heterogeneity in methodological approaches to exposure assessments which makes creating effective policy recommendations challenging. OBJECTIVE Critically evaluate the use of a satellite-derived exposure metric, the Enhanced Vegetation Index (EVI), for assessing access to different types of green space in epidemiological studies. METHODS We used Landsat 5-8 (30 m resolution) to calculate average EVI for a 300 m radius surrounding 1.4 million households in Wales, UK for 2018. We calculated two additional measures using topographic vector data to represent access to green spaces within 300 m of household locations. The two topographic vector-based measures were total green space area stratified by type and average private garden size. We used linear regression models to test whether EVI could discriminate between publicly accessible and private green space and Pearson correlation to test associations between EVI and green space types. RESULTS Mean EVI for a 300 m radius surrounding households in Wales was 0.28 (IQR = 0.12). Total green space area and average private garden size were significantly positively associated with corresponding EVI measures (β = < 0.0001, 95% CI: 0.0000, 0.0000; β = 0.0001, 95% CI: 0.0001, 0.0001 respectively). In urban areas, as average garden size increases by 1 m2, EVI increases by 0.0002. Therefore, in urban areas, to see a 0.1 unit increase in EVI index score, garden size would need to increase by 500 m2. The very small β values represent no 'measurable real-world' associations. When stratified by type, we observed no strong associations between greenspace and EVI. IMPACT It is a widely implemented assumption in epidiological studies that an increase in EVI is equivalent to an increase in greenness and/or green space. We used linear regression models to test associations between EVI and potential sources of green reflectance at a neighbourhood level using satellite imagery from 2018. We compared EVI measures with a 'gold standard' vector-based dataset that defines publicly accessible and private green spaces. We found that EVI should be interpreted with care as a greater EVI score does not necessarily mean greater access to publicly available green spaces in the hyperlocal environment.
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Affiliation(s)
- Amy Mizen
- Swansea University Medical School, Swansea University, Swansea, UK.
| | | | - Alan Watkins
- Swansea University Medical School, Swansea University, Swansea, UK
| | - Ashley Akbari
- Swansea University Medical School, Swansea University, Swansea, UK
| | - Joanne K Garrett
- European Centre for Environment and Human Health, University of Exeter Medical School, University of Exeter, Truro, UK
| | - Rebecca Geary
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | - Rebecca Lovell
- European Centre for Environment and Human Health, University of Exeter Medical School, University of Exeter, Truro, UK
| | - Ronan A Lyons
- Swansea University Medical School, Swansea University, Swansea, UK
| | - Mark Nieuwenhuijsen
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Sarah C Parker
- Swansea University Medical School, Swansea University, Swansea, UK
| | - Francis M Rowney
- School of Geography, Earth and Environmental Sciences, University of Plymouth, Plymouth, UK
| | | | - Gareth Stratton
- ASTEM Research Centre, Faculty of Science and Engineering, Swansea University, Swansea, UK
| | - Benedict W Wheeler
- European Centre for Environment and Human Health, University of Exeter Medical School, University of Exeter, Truro, UK
| | - James White
- Centre for Trials Research, School of Medicine, Cardiff University, Cardiff, UK
| | - Mathew P White
- European Centre for Environment and Human Health, University of Exeter Medical School, University of Exeter, Truro, UK
- Cognitive Science Hub, University of Vienna, Vienna, Austria
| | | | - Sarah E Rodgers
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | - Richard Fry
- Swansea University Medical School, Swansea University, Swansea, UK
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Wang Y, Shi X, Hong H, Chang Q. How does multiscale greenspace exposure affect human health? Evidence from urban parks in the central city of Beijing. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2024; 353:120253. [PMID: 38335596 DOI: 10.1016/j.jenvman.2024.120253] [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: 11/27/2023] [Revised: 01/26/2024] [Accepted: 01/28/2024] [Indexed: 02/12/2024]
Abstract
While the health benefits of exposure to urban greenspace have been widely discussed at different spatial scales, the comprehensive health effects of multiscale greenspace exposure are far from understood. There is a lack of quantified evidence when conducting cost-effective greenspace management practices for promoting human health and well-being. This study proposed a conceptual model that links objective and subjective greenspace exposure metrics at different spatial scales with self-rated health of residents. The model attempted to deconstruct and explore the associations between multiscale greenspace exposure and human health, and a cross-sectional study was conducted to examine the model. Taking urban parks in the central city of Beijing as case study area, the objective greenspace exposure metrics at both the site and subdistrict scales were spatial explicitly assessed, and the subjective exposure metrics and self-rated health status of 1017 respondents were obtained through questionnaire survey and spatial positioning. The results of multiple regression analyses and path analyses suggested that greenspace exposure metrics at both site and subdistrict scales were significantly associated with the respondents' self-rated health status, with the exposure metrics at the site scale being more important than those at the subdistrict scale in affecting human health. The contribution of urban parks to self-rated physical and mental health of respondents varied across spatial scales. Specifically, the aesthetic value of urban parks at site scale contributed the most to mental health by promoting respondents' resting behaviors in urban parks, and the density of urban parks at subdistrict scale had the most significant effects on self-rated physical health by increasing the usage frequency of urban parks. Findings of this study can contribute to understanding the complex associations between urban greenspace and human health from a multiscale perspective, and are also expected to provide quantified information for health-oriented urban greenspace planning and management practices.
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Affiliation(s)
- Yanan Wang
- School of Architecture, Yantai University, Yantai, 264005, China; Department of Landscape Architecture, College of Horticulture, China Agricultural University, Beijing, 100193, China
| | - Xiaoxiao Shi
- Department of Landscape Architecture, College of Horticulture, China Agricultural University, Beijing, 100193, China
| | - Hailin Hong
- Department of Landscape Architecture, College of Horticulture, China Agricultural University, Beijing, 100193, China
| | - Qing Chang
- Department of Landscape Architecture, College of Horticulture, China Agricultural University, Beijing, 100193, China.
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11
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Goldney J, Henson J, Edwardson CL, Khunti K, Davies MJ, Yates T. Long-term ambient air pollution exposure and prospective change in sedentary behaviour and physical activity in individuals at risk of type 2 diabetes in the UK. J Public Health (Oxf) 2024; 46:e32-e42. [PMID: 38103023 PMCID: PMC10901272 DOI: 10.1093/pubmed/fdad263] [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] [Received: 06/12/2023] [Revised: 11/24/2023] [Accepted: 11/27/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Air pollution may be a risk factor for physical inactivity and sedentary behaviour (SED) through discouraging active lifestyles, impairing fitness and contributing to chronic diseases with potentially important consequences for population health. METHODS Using generalized estimating equations, we examined the associations between long-term particulate matter with diameter ≤2.5 μm (PM2.5), ≤10 μm (PM10) and nitrogen dioxide (NO2) and annual change in accelerometer-measured SED, moderate-to-vigorous physical activity (MVPA) and steps in adults at risk of type 2 diabetes within the Walking Away from Type 2 Diabetes trial. We adjusted for important confounders including social deprivation and measures of the built environment. RESULTS From 808 participants, 644 had complete data (1605 observations; 64.7% men; mean age 63.86 years). PM2.5, NO2 and PM10 were not associated with change in MVPA/steps but were associated with change in SED, with a 1 ugm-3 increase associated with 6.38 (95% confidence interval: 0.77, 12.00), 1.52 (0.49, 2.54) and 4.48 (0.63, 8.34) adjusted annual change in daily minutes, respectively. CONCLUSIONS Long-term PM2.5, NO2 and PM10 exposures were associated with an annual increase in SED: ~11-22 min/day per year across the sample range of exposure (three standard deviations). Future research should investigate whether interventions to reduce pollution may influence SED.
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Affiliation(s)
- Jonathan Goldney
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Gwendolen Rd, Leicester LE5 4PW, UK
| | - Joseph Henson
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Gwendolen Rd, Leicester LE5 4PW, UK
- NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and University of Leicester, Gwendolen Rd, Leicester LE5 4PW, UK
| | - Charlotte L Edwardson
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Gwendolen Rd, Leicester LE5 4PW, UK
- NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and University of Leicester, Gwendolen Rd, Leicester LE5 4PW, UK
| | - Kamlesh Khunti
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Gwendolen Rd, Leicester LE5 4PW, UK
- NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and University of Leicester, Gwendolen Rd, Leicester LE5 4PW, UK
- Leicester Real World Evidence Unit, Leicester Diabetes Centre, University of Leicester, Gwendolen Rd, Leicester LE5 4PW, UK
| | - Melanie J Davies
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Gwendolen Rd, Leicester LE5 4PW, UK
- NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and University of Leicester, Gwendolen Rd, Leicester LE5 4PW, UK
| | - Thomas Yates
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Gwendolen Rd, Leicester LE5 4PW, UK
- NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and University of Leicester, Gwendolen Rd, Leicester LE5 4PW, UK
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12
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Browning MHEM, Locke DH, Konijnendijk C, Labib SM, Rigolon A, Yeager R, Bardhan M, Berland A, Dadvand P, Helbich M, Li F, Li H, James P, Klompmaker J, Reuben A, Roman LA, Tsai WL, Patwary M, O'Neil-Dunne J, Ossola A, Wang R, Yang B, Yi L, Zhang J, Nieuwenhuijsen M. Measuring the 3-30-300 rule to help cities meet nature access thresholds. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 907:167739. [PMID: 37832672 PMCID: PMC11090249 DOI: 10.1016/j.scitotenv.2023.167739] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 10/04/2023] [Accepted: 10/09/2023] [Indexed: 10/15/2023]
Abstract
The 3-30-300 rule offers benchmarks for cities to promote equitable nature access. It dictates that individuals should see three trees from their dwelling, have 30 % tree canopy in their neighborhood, and live within 300 m of a high-quality green space. Implementing this demands thorough measurement, monitoring, and evaluation methods, yet little guidance is currently available to pursue these actions. To overcome this gap, we employed an expert-based consensus approach to review the available ways to measure 3-30-300 as well as each measure's strengths and weaknesses. We described seven relevant data and processes: vegetation indices, street level analyses, tree inventories, questionnaires, window view analyses, land cover maps, and green space maps. Based on the reviewed strengths and weaknesses of each measure, we presented a suitability matrix to link recommended measures with each component of the rule. These recommendations included surveys and window-view analyses for the '3 component', high-resolution land cover maps for the '30 component', and green space maps with network analyses for the '300 component'. These methods, responsive to local situations and resources, not only implement the 3-30-300 rule but foster broader dialogue on local desires and requirements. Consequently, these techniques can guide strategic investments in urban greening for health, equity, biodiversity, and climate adaptation.
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Affiliation(s)
- M H E M Browning
- Virtual Reality and Nature Lab, Department of Parks, Recreation and Tourism Management, Clemson University, Clemson, SC 29631, USA.
| | - D H Locke
- USDA Forest Service, Northern Research Station, Baltimore Field Station, Suite 350, 5523 Research Park Drive, Baltimore, MD 21228, USA.
| | - C Konijnendijk
- Nature Based Solutions Institute - Dutch Office, Zeist, the Netherlands
| | - S M Labib
- Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Utrecht, the Netherlands
| | - A Rigolon
- Department of City and Metropolitan Planning, The University of Utah, Salt Lake City, UT 84112, USA
| | - R Yeager
- Division of Environmental Medicine, School of Medicine, University of Louisville, Louisville, KY 40202, USA
| | - M Bardhan
- Virtual Reality and Nature Lab, Department of Parks, Recreation and Tourism Management, Clemson University, Clemson, SC 29631, USA; Environment and Sustainability Research Initiative, Khulna 9208, Bangladesh
| | - A Berland
- Department of Geography and Meteorology, Ball State University, Muncie, IN 47306, USA
| | - P Dadvand
- ISGlobal, Doctor Aiguader 88, 08003 Barcelona, Spain; Universitat Pompeu Fabra (UPF), Doctor Aiguader 88, 08003 Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Melchor Fernández Almagro, 3-5, 28029 Madrid, Spain
| | - M Helbich
- Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Utrecht, the Netherlands
| | - F Li
- Virtual Reality and Nature Lab, Department of Parks, Recreation and Tourism Management, Clemson University, Clemson, SC 29631, USA
| | - H Li
- College of Physical Education, Southwest University, Chongqing 400715, China
| | - P James
- Harvard T.H. Chan School of Public Health, Boston, MA, USA; Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - J Klompmaker
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - A Reuben
- Department of Psychology & Neuroscience, Duke University, Durham, NC, 27705, USA
| | - L A Roman
- USDA Forest Service, Pacific Southwest Research Station & Northern Research Station, 4995 Canyon Crest Dr., Riverside, CA 92507, USA
| | - W-L Tsai
- Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, NC, USA
| | - M Patwary
- Environment and Sustainability Research Initiative, Khulna 9208, Bangladesh; Environmental Science Discipline, Life Science School, Khulna University, Khulna 9208, Bangladesh
| | - J O'Neil-Dunne
- Spatial Analysis Lab, Rubenstein School of Environment and Natural Resources, University of Vermont, Burlington, VT, USA
| | - A Ossola
- Department of Plant Sciences, University of California Davis, Davis, CA, 95616, USA; School of Ecosystem and Forest Science, University of Melbourne, VIC, Australia
| | - R Wang
- Centre for Public Health, Queen's University Belfast, Northern Ireland, UK
| | - B Yang
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China
| | - L Yi
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - J Zhang
- College of Landscape Architecture, Nanjing Forestry University, Nanjing, China
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13
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Chipman JW, Shi X, Gilbert‐Diamond D, Khatchikian C, Baker ER, Nieuwenhuijsen M, Karagas MR. Greenspace and Land Cover Diversity During Pregnancy in a Rural Region, and Associations With Birth Outcomes. GEOHEALTH 2024; 8:e2023GH000905. [PMID: 38264534 PMCID: PMC10804422 DOI: 10.1029/2023gh000905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 11/17/2023] [Accepted: 11/20/2023] [Indexed: 01/25/2024]
Abstract
Beneficial effects on health outcomes have been observed from exposure to spaces with substantial green vegetation ("greenspace"). This includes studies of greenspace exposure on birth outcomes; however, these have been conducted largely in urban regions. We characterized residential exposure to greenspace and land cover diversity during pregnancy in rural northern New England, USA, investigating whether variation in greenspace or diversity related to newborn outcomes. Five landscape variables (greenspace land cover, land cover diversity, impervious surface area, tree canopy cover, and the Normalized Difference Vegetation Index) were aggregated within six circular zones of radii from 100 to 3,000 m around residential addresses, and distance to conservation land was measured, providing a total of 31 greenspace and diversity metrics. Four birth outcomes along with potentially confounding variables were obtained from 1,440 participants in the New Hampshire Birth Cohort Study. Higher greenspace land cover up to 3,000 m was associated with larger newborn head circumference, while impervious surface area (non-greenspace) had the opposite association. Further, birth length was positively associated with land cover diversity. These findings support beneficial health impacts of greenspace exposure observed in urban regions for certain health outcomes, such as newborn head circumference and length but not others such as birthweight and gestational age. Further our results indicate that larger radius buffer zones may be needed to characterize the rural landscape. Vegetation indices may not be interchangeable with other greenspace metrics such as land cover and impervious surface area in rural landscapes.
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Affiliation(s)
| | - Xun Shi
- Department of GeographyDartmouth CollegeHanoverNHUSA
| | - Diane Gilbert‐Diamond
- Department of EpidemiologyGeisel School of Medicine at DartmouthLebanonNHUSA
- Children's Environmental Health and Disease Prevention Research Center at DartmouthHanoverNHUSA
| | - Camilo Khatchikian
- Department of EpidemiologyGeisel School of Medicine at DartmouthLebanonNHUSA
| | - Emily R. Baker
- Department of Obstetrics and GynecologyDartmouth Hitchcock Medical CenterLebanonNHUSA
| | | | - Margaret R. Karagas
- Department of EpidemiologyGeisel School of Medicine at DartmouthLebanonNHUSA
- Children's Environmental Health and Disease Prevention Research Center at DartmouthHanoverNHUSA
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14
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Korpisaari M, Puhakka S, Farrahi V, Niemelä M, Tulppo MP, Ikäheimo T, Korpelainen R, Lankila T. Physical activity, residential greenness, and cardiac autonomic function. Scand J Med Sci Sports 2024; 34:e14505. [PMID: 37767772 DOI: 10.1111/sms.14505] [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] [Received: 03/29/2023] [Revised: 08/14/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023]
Abstract
PURPOSE This population-based study examines the associations between physical activity (PA), residential environmental greenness, and cardiac health measured by resting short-term heart rate variability (HRV). METHODS Residential greenness of a birth cohort sample (n = 5433) at 46 years was measured with normalized difference vegetation index (NDVI) by fixing a 1 km buffer around each participant's home. Daily light PA (LPA), moderate PA (MPA), vigorous PA (VPA), and the combination of both (MVPA) were measured using a wrist-worn accelerometer for 14 days. Resting HRV was measured with a heart rate monitor, and generalized additive modeling (GAM) was used to examine the association between PA, NDVI, and resting HRV. RESULTS In nongreen areas, men had less PA at all intensity levels compared to men in green areas. Women had more LPA and total PA and less MPA, MVPA, and VPA in green residential areas compared to nongreen areas. In green residential areas, men had more MPA, MVPA, and VPA than women, whereas women had more LPA than men. GAM showed positive linear associations between LPA, MVPA and HRV in all models. CONCLUSIONS Higher LPA and MVPA were significantly associated with increased HRV, irrespective of residential greenness. Greenness was positively associated with PA at all intensity levels in men, whereas in women, a positive association was found for LPA and total PA. A positive relationship of PA with resting HRV and greenness with PA was found. Residential greenness for promoting PA and heart health in adults should be considered in city planning.
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Affiliation(s)
- Maija Korpisaari
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr., Oulu, Finland
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
- Geography Research Unit, Faculty of Science, University of Oulu, Oulu, Finland
- Research Unit of Health Sciences and Technology, University of Oulu, Finland
| | - Soile Puhakka
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr., Oulu, Finland
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
- Geography Research Unit, Faculty of Science, University of Oulu, Oulu, Finland
| | - Vahid Farrahi
- Research Unit of Health Sciences and Technology, University of Oulu, Finland
- Institute for Sport and Sport Sciences, TU Dortmund University, Dortmund, Germany
| | - Maisa Niemelä
- Research Unit of Health Sciences and Technology, University of Oulu, Finland
- Centre for Wireless Communications, University of Oulu, Finland
| | - Mikko P Tulppo
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
- Research Unit of Biomedicine and Internal Medicine, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Tiina Ikäheimo
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
- UiT The Arctic University of Norway, Tromsø, Norway
| | - Raija Korpelainen
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr., Oulu, Finland
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Tiina Lankila
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr., Oulu, Finland
- Geography Research Unit, Faculty of Science, University of Oulu, Oulu, Finland
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15
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Fiffer MR, Li H, Iyer HS, Nethery RC, Sun Q, James P, Yanosky JD, Kaufman JD, Hart JE, Laden F. Associations between air pollution, residential greenness, and glycated hemoglobin (HbA1c) in three prospective cohorts of U.S. adults. ENVIRONMENTAL RESEARCH 2023; 239:117371. [PMID: 37839528 PMCID: PMC10873087 DOI: 10.1016/j.envres.2023.117371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 10/05/2023] [Accepted: 10/09/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND While studies suggest impacts of individual environmental exposures on type 2 diabetes (T2D) risk, mechanisms remain poorly characterized. Glycated hemoglobin (HbA1c) is a biomarker of glycemia and diagnostic criterion for prediabetes and T2D. We explored associations between multiple environmental exposures and HbA1c in non-diabetic adults. METHODS HbA1c was assessed once in 12,315 women and men in three U.S.-based prospective cohorts: the Nurses' Health Study (NHS), Nurses' Health Study II (NHSII), and Health Professionals Follow-up Study (HPFS). Residential greenness within 270 m and 1,230 m (normalized difference vegetation index, NDVI) was obtained from Landsat. Fine particulate matter (PM2.5) and nitrogen dioxide (NO2) were estimated from nationwide spatiotemporal models. Three-month and one-year averages prior to blood draw were assigned to participants' addresses. We assessed associations between single exposure, multi-exposure, and component scores from Principal Components Analysis (PCA) and HbA1c. Fully-adjusted models built on basic models of age and year at blood draw, BMI, alcohol use, and neighborhood socioeconomic status (nSES) to include diet quality, race, family history, smoking status, postmenopausal hormone use, population density, and season. We assessed interactions between environmental exposures, and effect modification by population density, nSES, and sex. RESULTS Based on HbA1c, 19% of participants had prediabetes. In single exposure fully-adjusted models, an IQR (0.14) higher 1-year 1,230 m NDVI was associated with a 0.27% (95% CI: 0.05%, 0.49%) lower HbA1c. In basic component score models, a SD increase in Component 1 (high loadings for 1-year NDVI) was associated with a 0.19% (95% CI: 0.04%, 0.34%) lower HbA1c. CI's crossed the null in multi-exposure and fully-adjusted component score models. There was little evidence of associations between air pollution and HbA1c, and no evidence of effect modification. CONCLUSIONS Among non-diabetic adults, environmental exposures were not consistently associated with HbA1c. More work is needed to elucidate biological pathways between the environment and prediabetes.
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Affiliation(s)
- Melissa R Fiffer
- Harvard T.H. Chan School of Public Health, Department of Environmental Health, Boston, MA, USA; University of Illinois Chicago, Children's Environmental Health Initiative, Chicago, IL, USA.
| | - Huichu Li
- Harvard T.H. Chan School of Public Health, Department of Environmental Health, Boston, MA, USA
| | - Hari S Iyer
- Harvard T.H. Chan School of Public Health, Department of Epidemiology, Boston, MA, USA; Dana-Farber Cancer Institute, Division of Population Sciences, Boston, MA, USA; Rutgers Cancer Institute of New Jersey, Section of Cancer Epidemiology and Health Outcomes, New Brunswick, NJ, USA
| | - Rachel C Nethery
- Harvard T.H. Chan School of Public Health, Department of Biostatistics, Boston, MA, USA
| | - Qi Sun
- Harvard T.H. Chan School of Public Health, Department of Epidemiology, Boston, MA, USA; Harvard T.H. Chan School of Public Health, Department of Nutrition, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Peter James
- Harvard T.H. Chan School of Public Health, Department of Environmental Health, Boston, MA, USA; Harvard Medical School and Harvard Pilgrim Health Care Institute, Department of Population Medicine, Boston, MA, USA
| | - Jeff D Yanosky
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, USA
| | - Joel D Kaufman
- Department of Epidemiology, University of Washington, Seattle, USA; Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, USA
| | - Jaime E Hart
- Harvard T.H. Chan School of Public Health, Department of Environmental Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Francine Laden
- Harvard T.H. Chan School of Public Health, Department of Environmental Health, Boston, MA, USA; Harvard T.H. Chan School of Public Health, Department of Epidemiology, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
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16
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Wilt GE, Roscoe CJ, Hu CR, Mehta UV, Coull BA, Hart JE, Gortmaker S, Laden F, James P. Minute level smartphone derived exposure to greenness and consumer wearable derived physical activity in a cohort of US women. ENVIRONMENTAL RESEARCH 2023; 237:116864. [PMID: 37648192 PMCID: PMC11146007 DOI: 10.1016/j.envres.2023.116864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 07/31/2023] [Accepted: 08/08/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND Inconsistent results have been found in the literature on associations of greenness, or vegetation quantity, and physical activity. However, few studies have assessed associations between mobility-based greenness and physical activity from mobile health data from smartphone and wearable devices with fine spatial and temporal resolution. METHODS We assessed mobility-based greenness exposure and wearable accelerometer data from participants in the US-based prospective Nurses' Health Study 3 cohort Mobile Health (mHealth) Substudy (2018-2020). We recruited 500 female participants with instructions to wear devices over four 7-day sampling periods equally spaced throughout the year. After restriction criteria there were 337 participants (mean age 36 years) with n = 639,364 unique observations. Normalized Difference Vegetation Index (NDVI) data were derived from 30 m x 30 m Landsat-8 imagery and spatially joined to GPS points recorded every 10 min. Fitbit proprietary algorithms provided physical activity summarized as mean number of steps per minute, which we averaged during the 10-min period following a GPS-based greenness exposure assessment. We utilized Generalized Additive Mixed Models to examine associations (every 10 min) between greenness and physical activity adjusting for neighborhood and individual socioeconomic status, Census region, season, neighborhood walkability, daily mean temperature and precipitation. We assessed effect modification through stratification and interaction models and conducted sensitivity analyses. RESULTS Mean 10-min step count averaged 7.0 steps (SD 14.9) and greenness (NDVI) averaged 0.3 (SD 0.2). Contrary to our hypotheses, higher greenness exposure was associated non-linearly with lower mean steps per minute after adjusting for confounders. We observed statistically significant effect modification by Census region and season. DISCUSSION We utilized objective physical activity data at fine temporal and spatial scales to present novel estimates of the association between mobility-based greenness and step count. We found higher levels of greenness were inversely associated with steps per minute.
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Affiliation(s)
- Grete E Wilt
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States.
| | - Charlotte J Roscoe
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Division of Population Sciences, Dana Farber Cancer Institute, Boston, MA, United States
| | - Cindy R Hu
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Unnati V Mehta
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Brent A Coull
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Jaime E Hart
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Steven Gortmaker
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Francine Laden
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Peter James
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, United States
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17
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Geary RS, Thompson DA, Garrett JK, Mizen A, Rowney FM, Song J, White MP, Lovell R, Watkins A, Lyons RA, Williams S, Stratton G, Akbari A, Parker SC, Nieuwenhuijsen MJ, White J, Wheeler BW, Fry R, Tsimpida D, Rodgers SE. Green-blue space exposure changes and impact on individual-level well-being and mental health: a population-wide dynamic longitudinal panel study with linked survey data. PUBLIC HEALTH RESEARCH 2023; 11:1-176. [PMID: 37929711 DOI: 10.3310/lqpt9410] [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] [Indexed: 11/07/2023] Open
Abstract
Background Cross-sectional evidence suggests that living near green and blue spaces benefits mental health; longitudinal evidence is limited. Objectives To quantify the impact of changes in green and blue spaces on common mental health disorders, well-being and health service use. Design A retrospective, dynamic longitudinal panel study. Setting Wales, UK. Participants An e-cohort comprising 99,682,902 observations of 2,801,483 adults (≥ 16 years) registered with a general practice in Wales (2008-2019). A 5312-strong 'National Survey for Wales (NSW) subgroup' was surveyed on well-being and visits to green and blue spaces. Main outcome measures Common mental health disorders, general practice records; subjective well-being, Warwick-Edinburgh Mental Well-being Scale. Data sources Common mental health disorder and use of general practice services were extracted quarterly from the Welsh Longitudinal General Practice Dataset. Annual ambient greenness exposure, enhanced vegetation index and access to green and blue spaces (2018) from planning and satellite data. Data were linked within the Secure Anonymised Information Linkage Databank. Methods Multilevel regression models examined associations between exposure to green and blue spaces and common mental health disorders and use of general practice. For the National Survey for Wales subgroup, generalised linear models examined associations between exposure to green and blue spaces and subjective well-being and common mental health disorders. Results and conclusions Our longitudinal analyses found no evidence that changes in green and blue spaces through time impacted on common mental health disorders. However, time-aggregated exposure to green and blue spaces contrasting differences between people were associated with subsequent common mental health disorders. Similarly, our cross-sectional findings add to growing evidence that residential green and blue spaces and visits are associated with well-being benefits: Greater ambient greenness (+ 1 enhanced vegetation index) was associated with lower likelihood of subsequently seeking care for a common mental health disorder [adjusted odds ratio (AOR) 0.80, 95% confidence interval, (CI) 0.80 to 0.81] and with well-being with a U-shaped relationship [Warwick-Edinburgh Mental Well-being Scale; enhanced vegetation index beta (adjusted) -10.15, 95% CI -17.13 to -3.17; EVI2 beta (quadratic term; adj.) 12.49, 95% CI 3.02 to 21.97]. Those who used green and blue spaces for leisure reported better well-being, with diminishing extra benefit with increasing time (Warwick-Edinburgh Mental Well-being Scale: time outdoors (hours) beta 0.88, 95% CI 0.53 to 1.24, time outdoors2 beta -0.06, 95% CI -0.11 to -0.01) and had 4% lower odds of seeking help for common mental health disorders (AOR 0.96, 95% CI 0.93 to 0.99). Those in urban areas benefited most from greater access to green and blue spaces (AOR 0.89, 95% CI 0.89 to 0.89). Those in material deprivation benefited most from leisure time outdoors (until approximately four hours per week; Warwick-Edinburgh Mental Well-being Scale: time outdoors × in material deprivation: 1.41, 95% CI 0.39 to 2.43; time outdoors2 × in material deprivation -0.18, 95% CI -0.33 to -0.04) although well-being remained generally lower. Limitations Longitudinal analyses were restricted by high baseline levels and limited temporal variation in ambient greenness in Wales. Changes in access to green and blue spaces could not be captured annually due to technical issues with national-level planning datasets. Future work Further analyses could investigate mental health impacts in population subgroups potentially most sensitive to local changes in access to specific types of green and blue spaces. Deriving green and blue spaces changes from planning data is needed to overcome temporal uncertainties. Funding This project was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme (Project number 16/07/07) and will be published in full in Public Health Research; Vol. 11, No. 10. Sarah Rodgers is part-funded by the NIHR Applied Research Collaboration North West Coast.
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Affiliation(s)
- Rebecca S Geary
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | | | - Joanne K Garrett
- European Centre for Environment and Human Health, University of Exeter Medical School, University of Exeter, Truro, UK
| | - Amy Mizen
- Department of Health Data Science, Swansea University, Swansea, UK
| | - Francis M Rowney
- European Centre for Environment and Human Health, University of Exeter Medical School, University of Exeter, Truro, UK
| | - Jiao Song
- Department of Health Data Science, Swansea University, Swansea, UK
| | - Mathew P White
- European Centre for Environment and Human Health, University of Exeter Medical School, University of Exeter, Truro, UK
| | - Rebecca Lovell
- European Centre for Environment and Human Health, University of Exeter Medical School, University of Exeter, Truro, UK
| | - Alan Watkins
- Department of Health Data Science, Swansea University, Swansea, UK
| | - Ronan A Lyons
- Department of Health Data Science, Swansea University, Swansea, UK
| | | | | | - Ashley Akbari
- Department of Health Data Science, Swansea University, Swansea, UK
| | - Sarah C Parker
- Department of Health Data Science, Swansea University, Swansea, UK
| | | | - James White
- Centre for Trials Research, School of Medicine, Cardiff University, Cardiff, UK
| | - Benedict W Wheeler
- European Centre for Environment and Human Health, University of Exeter Medical School, University of Exeter, Truro, UK
| | - Richard Fry
- Department of Health Data Science, Swansea University, Swansea, UK
| | - Dialechti Tsimpida
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | - Sarah E Rodgers
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
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18
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Gailey S. Changes in Residential Greenspace and Birth Outcomes among Siblings: Differences by Maternal Race. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6790. [PMID: 37754649 PMCID: PMC10531468 DOI: 10.3390/ijerph20186790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/06/2023] [Accepted: 08/19/2023] [Indexed: 09/28/2023]
Abstract
Growing research investigates the perinatal health benefits of greenspace in a mother's prenatal environment. However, evidence of associations between residential greenspace and birth outcomes remains mixed, limiting the relevance this work holds for urban policy and greening interventions. Past research relies predominantly on cross-sectional designs that are vulnerable to residential selection bias, and rarely tests effect modification by maternal race/ethnicity, which may contribute to heterogeneous findings. This study uses a rigorous, longitudinal sibling comparison design and maternal fixed effect analyses to test whether increases in maternal exposure to residential greenspace between pregnancies precede improved birth outcomes among non-Hispanic (NH) white (n = 247,285) and Black (n = 54,995) mothers (mean age = 28 years) who had at least two consecutive live births in California between 2005 and 2015. Results show that increases in residential greenspace correspond with higher birthweight (coef. = 75.49, 95% CI: 23.48, 127.50) among Black, but not white (coef. = -0.51, 95% CI: -22.90, 21.90), infants. Additional analyses suggest that prior evidence of perinatal benefits associated with residential greenspace among white mothers may arise from residential selection; no such bias is observed for Black mothers. Taken together, these findings support urban greening initiatives in historically under-resourced neighborhoods. Efforts to evenly distribute residential greenspace may reduce persistent racial disparities in birth outcomes, an important step towards promoting health equity across the life course.
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Affiliation(s)
- Samantha Gailey
- Department of Forestry, Michigan State University, East Lansing, MI 48824, USA;
- Department of Public Health, Michigan State University, Flint, MI 48502, USA
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19
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Mouly TA, Mishra GD, Hystad P, Nieuwenhuijsen M, Knibbs LD. Residential greenspace and anxiety symptoms among Australian women living in major cities: A longitudinal analysis. ENVIRONMENT INTERNATIONAL 2023; 179:108110. [PMID: 37607424 DOI: 10.1016/j.envint.2023.108110] [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: 12/06/2022] [Revised: 07/08/2023] [Accepted: 07/20/2023] [Indexed: 08/24/2023]
Abstract
Despite an increasing number of studies demonstrating the potential mental health benefits of greenspace, few longitudinal studies have been reported. We aimed to assess associations between two metrics of residential greenspace exposure and anxiety symptoms in a cohort of Australian women living in major cities. Our study comprised 3,938 women, born between 1973 and 78. Anxiety symptoms in the previous month were assessed at follow-up every three years during 2003-2018, using the anxiety subscale of the Goldberg Anxiety and Depression Scale. The three-month seasonal average normalized difference vegetation index (NDVI) was estimated from 30 m Landsat satellite images in a 500 m buffer (NDVI500m) around participants' address at each survey (higher NDVI indicates more green vegetation). The annual fractional cover of non-photosynthesising vegetation was estimated (fNPV500m, with higher values indicating greater levels of dead leaf litter or dry grass). A generalised estimating equation assessed associations between greenspace measures and anxiety symptoms (as odds ratios [ORs]), adjusting for repeated outcomes and individual-level covariates. Additional analyses focused on women experiencing substantial changes in between-survey exposure due to moving, and adjusting for nitrogen dioxide (NO2) and fine particulate matter (PM2.5) exposure, among others. A standard deviation (SD) (0.12 units) increase in NDVI500m was significantly associated with lower odds of anxiety symptoms (OR: 0.96, 95% CI: 0.93-0.99) in the adjusted model. An SD (5.2%) increase in annual fNPV500m was consistent with the direction expected for that exposure, but not significant in the adjusted model (OR: 1.03, 95% CI: 0.99-1.07). NDVI500m was modestly attenuated when air pollutants were adjusted for, while fNPV500m only became significant when PM2.5 was adjusted for. Between-survey contrasts had no clear effect for NDVI500m. Moving to a higher fNPV500m area, compared with a similar fNPV500m area, was consistently associated with anxiety symptoms (OR: 1.15, 95% CI: 1.02-1.31). NDVI500m was generally associated with lower odds of anxiety symptoms, while fNPV500m was generally associated with higher odds of anxiety, depending on the covariates considered.
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Affiliation(s)
- Tafzila A Mouly
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia.
| | - Gita D Mishra
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia.
| | - Perry Hystad
- College of Public Health and Human Sciences, Oregon State University, Corvallis Oregon, USA.
| | - Mark Nieuwenhuijsen
- Institute for Global Health (ISGlobal), Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
| | - Luke D Knibbs
- School of Public Health, The University of Sydney, New South Wales, Australia; Public Health Research Analytics and Methods for Evidence, Public Health Unit, Sydney Local Health District, Camperdown, New South Wales, Australia.
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20
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Song Y, Li H, Yu H. Effects of green space on physical activity and body weight status among Chinese adults: a systematic review. Front Public Health 2023; 11:1198439. [PMID: 37546310 PMCID: PMC10399589 DOI: 10.3389/fpubh.2023.1198439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 06/29/2023] [Indexed: 08/08/2023] Open
Abstract
Background Green space may provide many benefits to residents' health behaviors and body weight status, but the evidence is still relatively scattered among Chinese adults. The purpose of this study was to review the scientific evidence on the effects of green space on physical activity (PA) and body weight status among Chinese adults. Methods A keyword and reference search was conducted in Pubmed, Web of Science, MEDLINE, and PsycINFO. Studies examining the associations between green space and PA, body mass index (BMI) among Chinese adults were included. The quality of the included literature was evaluated using the National Institutes of Health's Observational Cohort and Cross-Sectional Study Quality Assessment Tool. Results A total of 31 studies were included that met the inclusion criteria, including 25 studies with a cross-sectional design, 3 studies with a longitudinal design, and 3 studies with an experimental design. Street-level green view index and green space accessibility were found to be positively associated with PA, but negatively associated with BMI. In most studies, there was a correlation between green space ratio in local areas and BMI. In addition, green space interventions were effective in increasing PA and decreasing BMI among Chinese adults. In contrast, further evidence is needed to support the association between the design characteristics of green space and PA and BMI. Conclusion Preliminary evidence suggests that green space has a positive effect on PA and BMI among Chinese adults. However, there are contradictory findings, and future studies adopting longitudinal and quasi-experimental studies are needed to further explore the causal relationship between green space and PA and BMI to provide a relevant theoretical basis for policymakers.
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Affiliation(s)
| | | | - Hongjun Yu
- Department of Physical Education, Tsinghua University, Beijing, China
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21
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Gullón P, Fontán-Vela M, Díez J, Nieuwenhuijsen M, Rojas-Rueda D, Escobar F, Franco M. Who benefits from green spaces? Surrounding greenness and incidence of cardiovascular disease in a population-based electronic medical records cohort in Madrid. Int J Hyg Environ Health 2023; 252:114221. [PMID: 37421937 DOI: 10.1016/j.ijheh.2023.114221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 05/06/2023] [Accepted: 07/03/2023] [Indexed: 07/10/2023]
Abstract
The objective was to study the association between surrounding greenness and the incidence of cardiovascular diseases (CVD) with a four years follow-up in almost half a million high CVD-risk women and men, as well as its differential effect by area-level deprivation in Madrid. We analyzed 2015-2018 primary healthcare electronic medical records for 437,513 high CVD risk individuals representing more than 95% of the population of that age range residing in Madrid. The outcome variable was any cardiovascular event. We measured surrounding residence greenness at 200 m, 300 m, 500 m, and 1000 m through the Normalized Difference Vegetation Index (NDVI). We assessed socioeconomic deprivation through a census-based deprivation index. We estimated the 4-year relative risk of CVD by an increase in 0.1 units of NDVI and then stratified the models by quintiles of deprivation (Q5 the most deprived). We found that for every increase in 0.1 units of NDVI at 1000 m there was a 16% decrease in CVD risk (RR = 0.84 95% CI 0.75-0.94). CVD risk for the remaining distance exposures (at 200 m, 300 m, and 500 m) were none statistically significant. In general, the protective effect of green spaces was present in medium-deprivation areas and males, but the associations were inconsistent across deprivation levels. This study highlights the relevance of evaluating the interaction between physical and social urban components to further understand possible population prevention approaches for cardiovascular diseases. Future studies should focus on the mechanisms of context-specific interactions between social inequalities and green spaces' effects on health.
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Affiliation(s)
- Pedro Gullón
- Public Health and Epidemiology Research Group, School of Medicine and Health Sciences, Universidad de Alcala, Alcala de Henares, 28871, Madrid, Spain; Centre for Urban Research, RMIT University, Melbourne, Australia.
| | - Mario Fontán-Vela
- Public Health and Epidemiology Research Group, School of Medicine and Health Sciences, Universidad de Alcala, Alcala de Henares, 28871, Madrid, Spain; Instituto de Lengua, Literatura y Antropología, Centro Superior de Investigaciones Sociológicas, Ministerio de Ciencia e Innovación, Spain
| | - Julia Díez
- Public Health and Epidemiology Research Group, School of Medicine and Health Sciences, Universidad de Alcala, Alcala de Henares, 28871, Madrid, Spain
| | - Mark Nieuwenhuijsen
- ISGlobal, Center for Research in Environmental Epidemiology (CREAL), 08036, Barcelona, Spain; Universitat Pompeu Fabra (UPF), 08002, Barcelona, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - David Rojas-Rueda
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA; Colorado School of Public Health, Colorado State University, Fort Collins, CO, USA
| | - Francisco Escobar
- Department of Geology, Geography and Environmental Sciences, University of Alcalá, Calle Colegios 2, Alcalá de Henares, 28801, Madrid, Spain
| | - Manuel Franco
- Public Health and Epidemiology Research Group, School of Medicine and Health Sciences, Universidad de Alcala, Alcala de Henares, 28871, Madrid, Spain; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md, 21205-2217, USA
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22
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Sun Y, Molitor J, Benmarhnia T, Avila C, Chiu V, Slezak J, Sacks DA, Chen JC, Getahun D, Wu J. Association between urban green space and postpartum depression, and the role of physical activity: a retrospective cohort study in Southern California. LANCET REGIONAL HEALTH. AMERICAS 2023; 21:100462. [PMID: 37223828 PMCID: PMC10201204 DOI: 10.1016/j.lana.2023.100462] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 01/26/2023] [Accepted: 02/13/2023] [Indexed: 05/25/2023]
Abstract
Background Little research exists regarding the relationships between green space and postpartum depression (PPD). We aimed to investigate the relationships between PPD and green space exposure, and the mediating role of physical activity (PA). Methods Clinical data were obtained from Kaiser Permanente Southern California electronic health records in 2008-2018. PPD ascertainment was based on both diagnostic codes and prescription medications. Maternal residential green space exposures were assessed using street view-based measures and vegetation types (i.e., street tree, low-lying vegetation, and grass), satellite-based measures [i.e., Normalized Difference Vegetation Index (NDVI), land-cover green space, and tree canopy cover], and proximity to the nearest park. Multilevel logistic regression was applied to estimate the association between green space and PPD. A causal mediation analysis was performed to estimate the proportion mediated by PA during pregnancy in the total effects of green space on PPD. Findings In total, we included 415,020 participants (30.2 ± 5.8 years) with 43,399 (10.5%) PPD cases. Hispanic mothers accounted for about half of the total population. A reduced risk for PPD was associated with total green space exposure based on street-view measure [500 m buffer, adjusted odds ratio (OR) per interquartile range: 0.98, 95% CI: 0.97-0.99], but not NDVI, land-cover greenness, or proximity to a park. Compared to other types of green space, tree coverage showed stronger protective effects (500 m buffer, OR = 0.98, 95% CI: 0.97-0.99). The proportions of mediation effects attributable to PA during pregnancy ranged from 2.7% to 7.2% across green space indicators. Interpretation Street view-based green space and tree coverage were associated with a decreased risk of PPD. The observed association was primarily due to increased tree coverage, rather than low-lying vegetation or grass. Increased PA was a plausible pathway linking green space to lower risk for PPD. Funding National Institute of Environmental Health Sciences (NIEHS; R01ES030353).
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Affiliation(s)
- Yi Sun
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Environmental and Occupational Health, Program in Public Health, University of California, Irvine, CA, USA
| | - John Molitor
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
| | - Tarik Benmarhnia
- Scripps Institution of Oceanography, University of California, San Diego, La Jolla, USA
| | - Chantal Avila
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Vicki Chiu
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Jeff Slezak
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - David A. Sacks
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
- Department of Obstetrics and Gynecology, University of Southern California, Keck School of Medicine, Los Angeles, CA, USA
| | - Jiu-Chiuan Chen
- Departments of Population & Public Health Sciences and Neurology, University of Southern California, Los Angeles, CA, USA
| | - Darios Getahun
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA
| | - Jun Wu
- Department of Environmental and Occupational Health, Program in Public Health, University of California, Irvine, CA, USA
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23
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Masdor NA, Abu Bakar MF, Hod R, Mohammed Nawi A. Green space exposure and colorectal cancer: A systematic review. Heliyon 2023; 9:e15572. [PMID: 37153430 PMCID: PMC10160744 DOI: 10.1016/j.heliyon.2023.e15572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 04/14/2023] [Accepted: 04/14/2023] [Indexed: 05/09/2023] Open
Abstract
Green space has been linked to colorectal cancer, but the evidence is still limited and inconclusive. This review aimed to investigate the relationship between green space and CRC. The studies were searched using three primary journal databases: PubMed, Scopus, and Web of Science. The retrieved citations were screened, and data from articles about GS exposure and CRC were extracted. The Newcastle-Ottawa Quality Assessment Form for Cohort Studies was used to evaluate the studies' quality. Five of the 1792 articles identified were eligible for the final review, which included five cohort studies published between 2017 and 2022. Each one article from the United States, the United Kingdom, France, Belgium, and Germany and All studies are of high quality. Four studies reported CRC incidence and one study reported CRC mortality from GS exposure. There was no significant association between GS attributes (Normalized Difference Vegetation Index (NDVI), surrounding greenness, surrounding green area, proximity to GS (agricultural lands, urban GSs, and forests), and count of recreational facilities and parks) with CRC. Only one study discovered that a healthier ecosystem was linked to a lower CRC risk. Although the evidence is still limited, the findings may indicate the presence of other factors in the relationship between GS and CRC. Future research should continue to focus on the variation of GS and the factors that influence it. Specific attention to the development of GS has the potential to produce benefits while mitigating cancer risk.
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24
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Loef B, Herber GCM, Wong A, Janssen NAH, Hoekstra J, Picavet HSJ, Verschuren WMM. Predictors of healthy physiological aging across generations in a 30-year population-based cohort study: the Doetinchem Cohort Study. BMC Geriatr 2023; 23:107. [PMID: 36823523 PMCID: PMC9948415 DOI: 10.1186/s12877-023-03789-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 02/01/2023] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND Predicting healthy physiological aging is of major interest within public health research. However, longitudinal studies into predictors of healthy physiological aging that include numerous exposures from different domains (i.e. the exposome) are scarce. Our aim is to identify the most important exposome-related predictors of healthy physiological aging over the life course and across generations. METHODS Data were used from 2815 participants from four generations (generation 1960s/1950s/1940s/1930s aged respectively 20-29/30-39/40-49/50-59 years old at baseline, wave 1) of the Doetinchem Cohort Study who were measured every 5 years for 30 years. The Healthy Aging Index, a physiological aging index consisting of blood pressure, glucose, creatinine, lung function, and cognitive functioning, was measured at age 46-85 years (wave 6). The average exposure and trend of exposure over time of demographic, lifestyle, environmental, and biological exposures were included, resulting in 86 exposures. Random forest was used to identify important predictors. RESULTS The most important predictors of healthy physiological aging were overweight-related (BMI, waist circumference, waist/hip ratio) and cholesterol-related (using cholesterol lowering medication, HDL and total cholesterol) measures. Diet and educational level also ranked in the top of important exposures. No substantial differences were observed in the predictors of healthy physiological aging across generations. The final prediction model's performance was modest with an R2 of 17%. CONCLUSIONS Taken together, our findings suggest that longitudinal cardiometabolic exposures (i.e. overweight- and cholesterol-related measures) are most important in predicting healthy physiological aging. This finding was similar across generations. More work is needed to confirm our findings in other study populations.
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Affiliation(s)
- Bette Loef
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
| | - Gerrie-Cor M. Herber
- grid.31147.300000 0001 2208 0118Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Albert Wong
- grid.31147.300000 0001 2208 0118Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Nicole A. H. Janssen
- grid.31147.300000 0001 2208 0118Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Jurriaan Hoekstra
- grid.31147.300000 0001 2208 0118Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - H. Susan J. Picavet
- grid.31147.300000 0001 2208 0118Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - W. M. Monique Verschuren
- grid.31147.300000 0001 2208 0118Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands ,grid.5477.10000000120346234Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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25
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Teixeira A, Gabriel R, Martinho J, Oliveira I, Santos M, Pinto G, Moreira H. Distance to Natural Environments, Physical Activity, Sleep, and Body Composition in Women: An Exploratory Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3647. [PMID: 36834342 PMCID: PMC9967458 DOI: 10.3390/ijerph20043647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 02/13/2023] [Accepted: 02/15/2023] [Indexed: 06/18/2023]
Abstract
A growing body of evidence indicates that living close to nature is associated with better health and well-being. However, the literature still lacks studies analyzing the benefits of this proximity for sleep and obesity, particularly in women. The purpose of this study was to explore how distance to natural spaces is reflected in women's physical activity, sleep, and adiposity levels. The sample consisted of 111 adult women (37.78 ± 14.70). Accessibility to green and blue spaces was assessed using a geographic-information-system-based method. Physical activity and sleep parameters were measured using ActiGraph accelerometers (wGT3X-BT), and body composition was assessed using octopolar bioimpedance (InBody 720). Nonlinear canonical correlation analysis was used to analyze the data. Our findings reveal that women living in green spaces close to their homes had lower levels of obesity and intra-abdominal adiposity. We also demonstrated that a shorter distance to green spaces seemed to correlate with better sleep onset latency. However, no relationship was found between physical activity and sleep duration. In relation to blue spaces, the distance to these environments was not related to any health indicator analyzed in this study.
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Affiliation(s)
- Andreia Teixeira
- Department of Sports Science, Exercise and Health, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
| | - Ronaldo Gabriel
- Department of Sports Science, Exercise and Health, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
- Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), Institute for Innovation, Capacity Building and Sustainability of Agri-Food Production (Inov4Agro), University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
| | - José Martinho
- Department of Geology, Geociencies Centre (CGeo), University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
| | - Irene Oliveira
- Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), Institute for Innovation, Capacity Building and Sustainability of Agri-Food Production (Inov4Agro), University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
- Department of Mathematics, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
- Center for Computational and Stochastic Mathematics (CEMAT-IST), Instituto Superior Técnico, University of Lisbon, 1049-001 Lisbon, Portugal
| | - Mário Santos
- Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), Institute for Innovation, Capacity Building and Sustainability of Agri-Food Production (Inov4Agro), University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
- Laboratory of Fluvial and Terrestrial Ecology, Innovation and Development Center, University of Trás-os-Montes e Alto Douro, 5000-801 Vila Real, Portugal
- Laboratory of Ecology and Conservation, Federal Institute of Education, Science and Technology of Maranhão, Rua do Comercio, 100, Buriticupu 65393-000, MA, Brazil
| | - Graça Pinto
- Department of Sports Science, Exercise and Health, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
- Center in Sports Sciences, Health Sciences and Human Development (CIDESD), University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
| | - Helena Moreira
- Department of Sports Science, Exercise and Health, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
- Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), Institute for Innovation, Capacity Building and Sustainability of Agri-Food Production (Inov4Agro), University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
- Center in Sports Sciences, Health Sciences and Human Development (CIDESD), University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
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Turunen AW, Halonen J, Korpela K, Ojala A, Pasanen T, Siponen T, Tiittanen P, Tyrväinen L, Yli-Tuomi T, Lanki T. Cross-sectional associations of different types of nature exposure with psychotropic, antihypertensive and asthma medication. Occup Environ Med 2023; 80:111-118. [PMID: 36646464 PMCID: PMC9887361 DOI: 10.1136/oemed-2022-108491] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 12/05/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Exposure to natural environments is thought to be beneficial for human health, but the evidence is inconsistent. OBJECTIVE To examine whether exposure to green and blue spaces in urban environments is associated with mental and physical health in Finland. METHODS The Helsinki Capital Region Environmental Health Survey was conducted in 2015-2016 in Helsinki, Espoo and Vantaa in Finland (n=7321). Cross-sectional associations of the amounts of residential green and blue spaces within 1 km radius around the respondent's home (based on the Urban Atlas 2012), green and blue views from home and green space visits with self-reported use of psychotropic (anxiolytics, hypnotics and antidepressants), antihypertensive and asthma medication were examined using logistic regression models. Indicators of health behaviour, traffic-related outdoor air pollution and noise and socioeconomic status (SES) were used as covariates, the last of these also as a potential effect modifier. RESULTS Amounts of residential green and blue spaces or green and blue views from home were not associated with medications. However, the frequency of green space visits was associated with lower odds of using psychotropic medication (OR=0.67, 95% CI 0.55 to 0.82 for 3-4 times/week; 0.78, 0.63 to 0.96 for ≥5 times/week) and antihypertensive (0.64, 0.52 to 0.78; 0.59, 0.48 to 0.74, respectively) and asthma (0.74, 0.58 to 0.94; 0.76, 0.59 to 0.99, respectively) medication use. The observed associations were attenuated by body mass index, but no consistent interactions with SES indicators were observed. CONCLUSIONS Frequent green space visits, but not the amounts of residential green or blue spaces, or green and blue views from home, were associated with less frequent use of psychotropic, antihypertensive and asthma medication in urban environments.
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Affiliation(s)
- Anu W Turunen
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - Jaana Halonen
- Department of Health Security, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Kalevi Korpela
- Faculty of Social Sciences (Psychology), Tampere University, Tampere, Finland
| | - Ann Ojala
- Bioeconomy and Environment, Natural Resources Institute, Helsinki, Finland
| | - Tytti Pasanen
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - Taina Siponen
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - Pekka Tiittanen
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - Liisa Tyrväinen
- Bioeconomy and Environment, Natural Resources Institute, Helsinki, Finland
| | - Tarja Yli-Tuomi
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - Timo Lanki
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland,Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland,School of Medicine, University of Eastern Finland, Kuopio, Finland
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Zhou W, Wang Q, Kadier A, Wang W, Zhou F, Li R, Ling L. The role of residential greenness levels, green land cover types and diversity in overweight/obesity among older adults: A cohort study. ENVIRONMENTAL RESEARCH 2023; 217:114854. [PMID: 36403655 DOI: 10.1016/j.envres.2022.114854] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 10/27/2022] [Accepted: 11/17/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Few studies have investigated the effects of greenness exposure, green land cover types and diversity and their interaction with particulate matter (PM) to adiposity. METHOD Cohort data were collected from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Baseline data on greenness levels, green land cover types and diversity were assessed by the Normalized Difference Vegetation Index (NDVI), three greenery types (trees, shrublands and grassland) and Shannon's diversity index, respectively. Body mass index (BMI) and waist circumference (WC) were separately used as dependent variables and represented for peripheral overweight/obesity and central obesity, respectively. The mixed Cox model with random intercept was used to estimate the effects of greenness levels, types and diversity on overweight/obesity using single and multiple exposure models. We also examined the interaction of PM and the aforementioned indicators on overweight/obesity on both additive and multiplicative scales. RESULTS Single exposure models showed that higher levels of residential greenness, tree coverage and ratio of trees to shrublands/grassland were inversely associated with peripheral overweight/obesity and central obesity. An increase in shrublands, grassland and diversity of green was related to lower odds of peripheral overweight/obesity. Multiple exposure models confirmed the association between greenness levels and peripheral overweight/obesity. Males, educated participants and elderly who lived in southern regions and areas with cleaner air environments acquired more benefits from greenspace exposure. Single and multiple exposure models indicated that an antagonistic effect of increasing PM and decreasing greenness levels on peripheral overweight/obesity and central obesity. Single exposure models showed the potential interaction of tree coverage, ratio of trees to grassland and PM2.5 exposures on the risk of peripheral overweight/obesity. CONCLUSION Increasing residential greenness and diversity of green were associated with healthy weight status. The relationship between greenery and overweight/obesity varied, and the effects of greenspace exposure on overweight/obesity were associated with air pollution.
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Affiliation(s)
- Wensu Zhou
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Qiong Wang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Aimulaguli Kadier
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Wenjuan Wang
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Fenfen Zhou
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Rui Li
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Li Ling
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China; Clinical Research Design Division, Clinical Research Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.
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An analytical model for spatial developing of sports places and spaces. JOURNAL OF FACILITIES MANAGEMENT 2023. [DOI: 10.1108/jfm-03-2022-0026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Purpose
In terms of the use of sports places and spaces, per capita is a determining parameter for the status and perspective of the future. Although there are many uses for the per capita indicator in sports places, there are no consistent scientific and methodological methods for calculating it. Therefore, this study aims to provide an analytical model to determine the per capita index of sports places and spaces.
Design/methodology/approach
One of the matters that can be considered as the basic information required to develop and construct sports facilities is determination of per capita, which can be used as the most vital information to plan and develop this type of urban utilities. In the history of contemporary urbanization, the use of the per capita concept is one of Reinhard Laumeister’s innovations, a founder of modern urban engineering in Germany, hence, the use of per capita was triggered in 1876, almost 133 years ago.
Findings
The underlying information of the research in two spatial and descriptive sections was analyzed in the geographic information systems (GIS) software. After the division and network distribution of the boundary by the Thiessen Networks analytic function in the Arc GIS, per capita of each polygon was separately calculated using the presented formula and the population of the related blocks
Originality/value
Finally, with the qualitative per capita achieved in the previous stage, the study area was classified based on the need for the development of indoor pools to three, privileged, semi-privileged and deprived spectrums.
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Air pollution, greenness and risk of overweight among middle-aged and older adults: A cohort study in China. ENVIRONMENTAL RESEARCH 2023; 216:114372. [PMID: 36170901 DOI: 10.1016/j.envres.2022.114372] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 08/31/2022] [Accepted: 09/15/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND Exposure to air pollution may increase the risk of obesity, but living in greener space may reduce this risk. Epidemiological evidence, however, is inconsistent. METHODS Using data from the China Health and Retirement Longitudinal Study (2011-2015), we conducted a nationwide cohort study of 7424 adults. We measured overweight/obesity according to body mass index. We used annual average ground-level air pollutants, including ozone (O3), nitrogen dioxide (NO2), and particulate matter with aerodynamic diameters ≤2.5 μm (PM2.5), to demonstrate air pollution levels. We used the Normalized difference vegetation index (NDVI) to measure greenness exposure. We used time-varying Cox proportional hazard regression models to analyze the connections among air pollution, greenness, and the development of overweight/obesity in middle-aged and older adults in China. We also conducted mediation analyses to examine the mediating effects of air pollution. RESULTS We found that lower risk of overweight/obesity was associated with more greenness exposure and lower levels of air pollution. We identified that an interquartile increment in NDVI was correlated with a lower hazard ratio (HR) of becoming overweight or obese (HR = 0.806, 95% confidence interval [CI]: 0.754-0.862). Although a 10 μg/m3 increase in PM2.5 and NO2 was correlated with higher risks (HR = 1.049, 95% CI = 1.022-1.075, HR = 1.376, 95% CI = 1.264-1.499). Effects of PM2.5 on being overweight or obese were stronger in men than in women. According to the mediation analysis, PM2.5 and NO2 mediated 8.85% and 19.22% of the association between greenness and being overweight or obese. CONCLUSIONS An increased risk of being overweight or obese in middle-aged and older adults in China was associated with long-term exposure to higher levels of PM2.5 and NO2. This risk was reduced through NDVI exposure, and the associations were partially mediated by air pollutants. To verify these findings, fine-scale studies are needed.
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Li H, Hart JE, Mahalingaiah S, Nethery RC, James P, Bertone-Johnson E, Eliassen AH, Laden F. Environmental Exposures and Anti-Müllerian Hormone: A Mixture Analysis in the Nurses' Health Study II. Epidemiology 2023; 34:150-161. [PMID: 36455251 PMCID: PMC9720700 DOI: 10.1097/ede.0000000000001547] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
BACKGROUND Previous studies have linked environmental exposures with anti-Müllerian hormone (AMH), a marker of ovarian reserve. However, associations with multiple environment factors has to our knowledge not been addressed. METHODS We included a total of 2,447 premenopausal women in the Nurses' Health Study II (NHSII) who provided blood samples during 1996-1999. We selected environmental exposures linked previously with reproductive outcomes that had measurement data available in NHSII, including greenness, particulate matter, noise, outdoor light at night, ultraviolet radiation, and six hazardous air pollutants (1,3-butadiene, benzene, diesel particulate matter, formaldehyde, methylene chloride, and tetrachloroethylene). For these, we calculated cumulative averages from enrollment (1989) to blood draw and estimated associations with AMH in adjusted single-exposure models, principal component analysis (PCA), and hierarchical Bayesian kernel machine regression (BKMR). RESULTS Single-exposure models showed negative associations of AMH with benzene (percentage reduction in AMH per interquartile range [IQR] increase = 5.5%, 95% confidence interval [CI] = 1.0, 9.8) and formaldehyde (6.1%, 95% CI = 1.6, 10). PCA identified four major exposure patterns but only one with high exposure to air pollutants and light at night was associated with lower AMH. Hierarchical BKMR pointed to benzene, formaldehyde, and greenness and suggested an inverse joint association with AMH (percentage reduction comparing all exposures at the 75th percentile to median = 8.2%, 95% CI = 0.7, 15.1). Observed associations were mainly among women above age 40. CONCLUSIONS We found exposure to benzene and formaldehyde to be consistently associated with lower AMH levels. The associations among older women are consistent with the hypothesis that environmental exposures accelerate reproductive aging.
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Affiliation(s)
- Huichu Li
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Jaime E. Hart
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Shruthi Mahalingaiah
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Rachel C. Nethery
- Department of Biostatistics, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Peter James
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA
- Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Elizabeth Bertone-Johnson
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, USA
- Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, USA
| | - A. Heather Eliassen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Francine Laden
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
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31
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Gailey S. Moving to greener pastures: Health selection into neighborhood green space among a highly mobile and diverse population in California. Soc Sci Med 2022; 315:115411. [PMID: 36399985 PMCID: PMC10224763 DOI: 10.1016/j.socscimed.2022.115411] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 08/11/2022] [Accepted: 09/27/2022] [Indexed: 01/26/2023]
Abstract
Global urbanization has sparked substantial environmental, public health, and social science research on the importance of conserving and propagating natural environments. A large subset of this work focuses on the benefits of green space for health. An often-overlooked methodological concern when examining relations between green space and health, however, involves residential self-selection. The selective movement of individuals into greener neighborhoods on the basis of preexisting health and correlated social factors may bias associations, particularly in cross-sectional studies, which predominate existing green space/health research. To quantify the extent of residential self-selection bias, this study used a longitudinal sibling comparison design with repeated individual and neighborhood measures to estimate associations between pre-move health factors, including maternal body mass index (BMI) and infant birthweight, and post-move neighborhood green space in a residentially mobile sample of mothers in California, 2007 to 2015 (n = 288,333). Results show that better health before moving predicted higher levels of neighborhood green space after moving, providing evidence of health selection. Findings also indicate some support for differential health selection into neighborhood green space by race/ethnicity, including that evidence of selection emerges for white and Hispanic, but not Black, mothers. However, weak relations between pre-move individual factors and post-move neighborhood green space across analyses suggest that potential bias due to residential self-selection appears relatively minimal in a large, diverse, and highly mobile sample of families in California. Findings support calls to increase green space in historically marginalized neighborhoods as a means to promote environmental and health equity.
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Affiliation(s)
- Samantha Gailey
- Minnesota Population Center, University of Minnesota, Twin Cities, USA.
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32
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Blas-Miranda NB, Lozada-Tequeanes AL, Miranda-Zuñiga JA, Jimenez MP. Green Space Exposure and Obesity in the Mexican Adult Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15072. [PMID: 36429792 PMCID: PMC9690096 DOI: 10.3390/ijerph192215072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 11/11/2022] [Accepted: 11/14/2022] [Indexed: 06/16/2023]
Abstract
Green space or natural vegetation may reduce obesity risk by increasing opportunities for physical activity or reducing stress and exposure to other pollutants. Obesity prevalence in Mexico is ranked among the highest in the world. However, research on the association between green space and obesity in Mexico is lacking. We used data from the National Nutrition Survey in Mexico (2018-2019), a nationally representative sample of Mexican adults. The analytical sample included participants between 20-59 years of age (n = 12,631). We assessed exposure to green space using a 30 m resolution Landsat satellite Normalized Difference Vegetation Index (NDVI) from 2018. Linear regression models examined associations between NDVI and body mass index (BMI), adjusting for confounders. The mean age of the study sample was 38 (SD 0.19) years. Participants living in areas with the highest green space exposure had the lowest education level (53.51%) and socioeconomic status (28.38%) and were located in central (33.01%), south (30.37%), and rural areas (21.05%). Higher residential exposure to green space was associated with a mean decrease in BMI of -1.1 kg/m2 (95% CI: -1.59, -0.68). This is one of the first studies in Latin America to suggest a protective association between green space and obesity among Mexican adults.
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Affiliation(s)
- Nabetse Baruc Blas-Miranda
- Nutrition and Health Research Center (CINyS), National Institute of Public Health of Mexico (INSP), Cuernavaca 62100, Mexico
| | - Ana Lilia Lozada-Tequeanes
- Nutrition and Health Research Center (CINyS), National Institute of Public Health of Mexico (INSP), Cuernavaca 62100, Mexico
- Research Center of Nutrition and Health, National Institute of Public Health, Av. Universidad 655, Col. Sta. Ma. Ahuacatitlán, Cuernavaca 62100, Mexico
| | | | - Marcia P. Jimenez
- Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118, USA
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Harden SR, Schuurman N, Keller P, Lear SA. Neighborhood Characteristics Associated with Running in Metro Vancouver: A Preliminary Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14328. [PMID: 36361206 PMCID: PMC9658309 DOI: 10.3390/ijerph192114328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 10/30/2022] [Accepted: 10/31/2022] [Indexed: 06/16/2023]
Abstract
Running can improve physical health and psychological wellbeing. However, the characteristics of conducive running environments are relatively unknown. This study determines neighborhood factors that attract running and explores how age and gender mediate built environment preferences. Spatial patterns of runners in Metro Vancouver were identified using crowdsourced fitness data from Strava, a popular application for tracking physical activities. The influence of socio-economic status (SES), green and/or blue space, and urbanicity on route popularity was assessed using a Generalized Linear Model (GLM). The influence of these neighborhood variables was also calculated for runners by age and gender. The results show high neighborhood SES, the presence of green and/or blue space, and high population density are associated with increased running activities in all age and gender groups. This study contributes a novel approach to understanding conducive running environments by demonstrating the utility of crowdsourced data in combination with data about urban environments. The patterns of this large group of runners can be used to inform planning for cities that promote running, as well as seek to encourage equal participation among different ages and genders.
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Affiliation(s)
- Stella R. Harden
- Faculty of Environment, Simon Fraser University, 8888 University Drive, Burnaby, BC V5A 1S6, Canada
| | - Nadine Schuurman
- Faculty of Environment, Simon Fraser University, 8888 University Drive, Burnaby, BC V5A 1S6, Canada
| | - Peter Keller
- Faculty of Environment, Simon Fraser University, 8888 University Drive, Burnaby, BC V5A 1S6, Canada
| | - Scott A. Lear
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC V5A 1S6, Canada
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Zhang H, Zhu A, Liu L, Zeng Y, Liu R, Ma Z, Liu M, Bi J, Ji JS. Assessing the effects of ultraviolet radiation, residential greenness and air pollution on vitamin D levels: A longitudinal cohort study in China. ENVIRONMENT INTERNATIONAL 2022; 169:107523. [PMID: 36137427 DOI: 10.1016/j.envint.2022.107523] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 08/12/2022] [Accepted: 09/12/2022] [Indexed: 06/16/2023]
Abstract
Vitamin D metabolism is essential in aging and can be affected by multiple environmental factors. However, most studies conducted single exposure analyses. We aim to assess the individual and combined effects of ultraviolet (UV) radiation, residential greenness, fine particulate matter (PM2.5), and ozone (O3) on vitamin D levels in a national cohort study of older adults in China. We used the 2012 and 2014 Chinese Longitudinal Healthy Longevity Survey data, and measured the environmental exposure in the same year. We interpolated the UV radiation from monitoring stations, measured residential greenness through satellite-derived Normalized Difference Vegetation Index (NDVI), modeled PM2.5 with satellite data, and estimated O3 using machine learning. We dichotomized serum 25-hydroxy vitamin D (25(OH)D), the primary circulating form of vitamin D, into non-deficiency (≥50 nmol/L) and deficiency (<50 nmol/L) categories. We used the generalized estimating equation for analysis, adjusted for sociodemographic information, lifestyle, physical condition, and season of blood draw, and calculated joint odds ratios based on the Cumulative Risk Index. We also explored the interaction between interested exposures, modification of participants' characteristics, and potential mediation. We included 1,336 participants, with a mean age of 83 at baseline. In single exposure models, the odds ratios of vitamin D deficiency (VDD) for per interquartile range increase in UV radiation, NDVI, PM2.5, and O3 and decrease were 0.39 (95 % CI:0.33,0.46), 0.90 (0.81,1.00), 1.65 (1.53,1.78), 1.67 (1.46,1.92), respectively. UV radiation mediated nearly 48 % and 78 % of the relationship between VDD and PM2.5 and O3, respectively. The association between UV radiation and VDD was stronger in females than men (OR: 2.25 vs 1.22). UV radiation, residential greenness can protect against VDD, while, PM2.5 and O3 increase the risk of VDD. UV radiation partly mediated the association between air pollution and VDD.
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Affiliation(s)
- Haofan Zhang
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing, China.
| | - Anna Zhu
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (D.K.F.Z.), 69120 Heidelberg, Germany.
| | - Linxin Liu
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Yi Zeng
- Center for Healthy Aging and Development Studies, Raissun Institute for Advanced Studies, National School of Development, Peking University, Beijing 100871, China; Center for the Study of Aging and Human Development and Geriatrics Division, Medical School of Duke University, Durham, NC 27705, USA.
| | - Riyang Liu
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing, China.
| | - Zongwei Ma
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing, China.
| | - Miaomiao Liu
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing, China.
| | - Jun Bi
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing, China.
| | - John S Ji
- Vanke School of Public Health, Tsinghua University, Beijing, China.
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Liao L, Du M. Associations between Greenspaces and Individual Health: A Longitudinal Study in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13353. [PMID: 36293933 PMCID: PMC9602607 DOI: 10.3390/ijerph192013353] [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: 09/13/2022] [Revised: 10/13/2022] [Accepted: 10/14/2022] [Indexed: 06/16/2023]
Abstract
Using a longitudinal survey in China, this study identifies the effect of greenspaces on individual health in the aspects of self-rated health, mental health, feeling physical discomfort, and being hospitalized. The normalized difference vegetation index (NDVI) is used to measure the greenery cover of each city, and findings show that higher NDVI leads to the improvement of personal self-rated health status, and it also decreases the probability of being hospitalized, having symptoms of physical discomfort, and being lost in bad mood. The positive health effect of NDVI in the city is much more significant and larger for the middle-aged, the elderly, and the low-educated. The evidence of the three possible channels through which the NDVI of each city shows a positive correlation with individual physical and mental health is found. The increased NDVI in the city encourages residents to foster healthier habits (e.g., decreasing smoking or drinking, increasing sleeping hours), improves air quality and reduces air pollution in each city, and promotes the social cohesion of people, and so the health status of residents is enhanced. This study implies that increasing greenspaces in the city is an effective strategy to improve social welfare and residents' health.
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Affiliation(s)
- Liping Liao
- School of Public Finance and Taxation, Guangdong University of Finance and Economics, Guangzhou 510320, China
- Center for the People’s Fiscal Development, Guangdong University of Finance and Economics, Guangzhou 510320, China
| | - Minzhe Du
- School of Economics and Management, South China Normal University, Guangzhou 510006, China
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36
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Jiang J, Xiang Z, Liu F, Li N, Mao S, Xie B, Xiang H. Associations of residential greenness with obesity and BMI level among Chinese rural population: findings from the Henan Rural Cohort Study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:74294-74305. [PMID: 35635662 DOI: 10.1007/s11356-022-20268-0] [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: 12/19/2021] [Accepted: 04/11/2022] [Indexed: 06/15/2023]
Abstract
In recent years, increasing evidence supports the notion that obesity risk is affected by residential greenness. However, limited studies have been established in low- and middle-income countries, especially in China. The study aimed to evaluate the associations of residential greenness with obesity and body mass index (BMI) level in Chinese rural-dwelling adults. A total of 39,259 adults from the Henan Rural Cohort Study (HRCS) were included in the analyses. According to the guideline for prevention and control of overweight and obesity in Chinese adults, obesity was defined as BMI ≥ 28 kg/m2. Residential greenness was measured by satellite-based normalized difference vegetation index (NDVI) and enhanced vegetation index (EVI). Generalized linear mixed models were used to study the associations between exposure to residential greenness with obesity and BMI level. Higher residential greenness was significantly correlated with lower odds of obesity and BMI level. For example, in the full-adjusted analyses, an interquartile range (IQR) increase in EVI500-m was linked with reduced odds of obesity (OR = 0.77, 95%CI 0.72-0.82) and BMI level (β = - 0.41 kg/m2, 95%CI - 0.48 to - 0.33 kg/m2). Mediation analyses showed air pollution and physical activity could be potential mediators in these associations. Besides, we found that the association of NDVI500-m with BMI was stronger in females and low-income populations. Higher residential greenness was associated with a lower prevalence of obesity and BMI level, particularly among females and the low-income population. These relationships were partially mediated by reducing air pollution and increasing physical activity.
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Affiliation(s)
- Jie Jiang
- Department of Global Health, School of Public Health, Wuhan University, Wuhan, 430071, Hubei, China
- Global Health Institute, Wuhan University, Wuhan, 430071, Hubei, China
| | - Zixi Xiang
- Department of Global Health, School of Public Health, Wuhan University, Wuhan, 430071, Hubei, China
- Global Health Institute, Wuhan University, Wuhan, 430071, Hubei, China
| | - Feifei Liu
- Department of Global Health, School of Public Health, Wuhan University, Wuhan, 430071, Hubei, China
- Global Health Institute, Wuhan University, Wuhan, 430071, Hubei, China
| | - Na Li
- Department of Global Health, School of Public Health, Peking University, Beijing, 100871, China
| | - Shuyuan Mao
- The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, China
| | - Bo Xie
- School of Urban Design, Wuhan University, Wuhan, 430072, Hubei, China
| | - Hao Xiang
- Department of Global Health, School of Public Health, Wuhan University, Wuhan, 430071, Hubei, China.
- Global Health Institute, Wuhan University, Wuhan, 430071, Hubei, China.
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Sadler RC, Wojciechowski TW, Buchalski Z, Smart M, Mulheron M, Todem D. Validating a geospatial healthfulness index with self-reported chronic disease and health outcomes. Soc Sci Med 2022; 311:115291. [PMID: 36088720 PMCID: PMC9968825 DOI: 10.1016/j.socscimed.2022.115291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 04/28/2022] [Accepted: 08/10/2022] [Indexed: 10/15/2022]
Abstract
Leveraging community engagement from past research may yield frameworks on which to build new inquiries. We previously integrated community voice into the development of a healthfulness index to increase awareness of social determinants of health in the built environment and inform deployment of public health interventions in the Flint (Michigan, USA) Center for Health Equity Solutions. Here we combine the healthfulness index with self-reported chronic disease and health outcomes (n = 12,279) from a community-based healthcare entity, the Genesee Health Plan. The healthfulness index purports to predict how health-promoting a neighborhood is based on many spatially varying characteristics; by linking our health plan data to this index, we validate the effectiveness of the healthfulness index. After geocoding all enrollees and joining their healthfulness scores, we conducted a series of logistic regressions to compare the relationship between self-reported outcomes and healthfulness. Matching the two intervention projects of our center (revolving around healthy eating & physical activity in project 1 and mental health sustainment & substance use prevention in project 2), our analyses also focused on classes of outcomes related to a) cardiovascular disease and b) mental health. In only select cases, higher (better) healthfulness scores from each project were independently associated with better cardiovascular and mental health outcomes, controlling for age, race, and sex. Generally, however, healthfulness did not add predictive strength to the association between health and sociodemographic covariates. Even so, the use of composite healthfulness indices to describe the health-promoting or degrading qualities of a neighborhood could be valuable in identifying differences in health outcomes. Future researchers could further explore healthcare claims datasets to increase understanding of the links between healthfulness and health outcomes. This and future work will be valuable in advocacy toward additional healthfulness indices to aid other communities in enriching understanding between the built environment and health.
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Affiliation(s)
| | | | | | - Mieka Smart
- Division of Public Health, Michigan State University, USA
| | - Megan Mulheron
- Division of Public Health, Michigan State University, USA
| | - David Todem
- Department of Epidemiology and Biostatistics, Michigan State University, USA
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Yu L, Li T, Yang Z, Zhang X, Xu L, Wu Y, Yu Z, Shen P, Lin H, Shui L, Tang M, Jin M, Chen K, Wang J. Long-term exposure to residential surrounding greenness and incidence of diabetes: A prospective cohort study. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 310:119821. [PMID: 35870530 DOI: 10.1016/j.envpol.2022.119821] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 06/27/2022] [Accepted: 07/18/2022] [Indexed: 06/15/2023]
Abstract
Exposure to residential greenness might affect population health through increasing physical activity and social engagement, improving mental health, and reducing harmful environmental exposure. However, evidence on the association of greenness with risk of diabetes is still controversial. In this study, we recruited a total of 22,535 participants aged ≥18 years from Yinzhou District, Ningbo, Zhejiang Province, China to investigate the associations between residential greenness and risk of diabetes incidence. Residential greenness was estimated using Normalized Difference Vegetation Index (NDVI), Enhanced Vegetation Index (EVI), and Vegetation Continuous Field (VCF). We also calculated cumulative average NDVI, EVI and VCF values, and changes in NDVI, EVI and VCF during the follow-up period. We used Cox proportional hazards models controlling for demographic characteristics, lifestyles, individual socioeconomic status, history of diseases and particulate matter with an aerodynamic diameter ≤2.5 μm (PM2.5) to examine hazard ratios (HRs) and 95% confidence intervals (95% CIs) and assessed physical activity, body mass index (BMI) or PM2.5 as potential mediators. During 84,992.64 person-years of follow-up, a total of 1,154 incident cases of diabetes occurred. In multivariable models, living in the highest quartile of cumulative average NDVI, EVI and VCF within 250-m buffer was associated with 57% (HR = 0.43, 95% CI: 0.36, 0.52), 62% (HR = 0.38, 95% CI: 0.32, 0.45), and 55% (HR = 0.45, 95% CI: 0.38, 0.54) reduction in diabetes risk compared with the lowest quartile, respectively. Results remained similar for NDVI, EVI, and VCF within 500-m and 1000-m buffers. Stratified analyses showed stronger association for residential greenness and diabetes among older people. The association between greenness and diabetes did not appear to be mediated by physical activity, PM2.5 or BMI. Our findings suggested that higher residential greenness was significantly associated with lower risk of diabetes.
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Affiliation(s)
- Luhua Yu
- Department of Epidemiology and Biostatistics at School of Public Health and National Clinical Research Center for Child Health of the Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Tiezheng Li
- Department of Epidemiology and Biostatistics at School of Public Health and National Clinical Research Center for Child Health of the Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Zongming Yang
- Department of Epidemiology and Biostatistics at School of Public Health and National Clinical Research Center for Child Health of the Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Xinhan Zhang
- Department of Epidemiology and Biostatistics at School of Public Health and the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Lisha Xu
- Department of Epidemiology and Biostatistics at School of Public Health and National Clinical Research Center for Child Health of the Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Yonghao Wu
- Department of Epidemiology and Biostatistics at School of Public Health and National Clinical Research Center for Child Health of the Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Zhebin Yu
- Department of Epidemiology and Biostatistics at School of Public Health and the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Peng Shen
- Department of Chronic Disease and Health Promotion, Yinzhou District Center for Disease Control and Prevention, Ningbo, 315040, China
| | - Hongbo Lin
- Department of Chronic Disease and Health Promotion, Yinzhou District Center for Disease Control and Prevention, Ningbo, 315040, China
| | - Liming Shui
- Yinzhou District Health Bureau of Ningbo, Ningbo, 315040, China
| | - Mengling Tang
- Department of Epidemiology and Biostatistics at School Public Health and the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Mingjuan Jin
- Department of Epidemiology and Biostatistics at School of Public Health and the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Kun Chen
- Department of Epidemiology and Biostatistics at School of Public Health and the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Jianbing Wang
- Department of Epidemiology and Biostatistics at School of Public Health and National Clinical Research Center for Child Health of the Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China.
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Zare Sakhvidi MJ, Yang J, Mehrparvar AH, Dzhambov AM, Ebrahimi A, Dadvand P, Jacquemin B. Exposure to greenspace and cancer incidence, prevalence, and mortality: A systematic review and meta-analyses. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 838:156180. [PMID: 35618130 DOI: 10.1016/j.scitotenv.2022.156180] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 05/11/2022] [Accepted: 05/19/2022] [Indexed: 06/15/2023]
Abstract
We conducted a systematic review and meta-analysis of the available literature on the association between greenspace exposure and all-sites and site-specific cancer incidence, prevalence, and mortality in adults. We searched PubMed, Scopus, and Web of Science for original articles published, without language restriction until September 2021. We assessed the risk of bias in each study and the overall quality of evidence for exposure-outcome pairs that were reported in two or more studies. Out of the 18 included studies, cross-sectional studies were the most common study design (n = 8), and most of the studies were conducted in Europe (n = 8). In terms of risk of bias, the majority of cohorts (four out of six) and case-control studies (three out of four) were of good or very good quality, and cross-sectional studies were mostly (five out of eight) of poor quality. Outcomes (incidence, prevalence, mortality) on different cancer sites were reported: lung cancer (n = 9), prostate cancer (n = 4), breast cancer (n = 4), skin cancer (n = 3), colorectal cancer (n = 2), all-sites cancer (n = 2), brain cancer (n = 1), mouth and throat cancer (n = 1), and esophageal cancer (n = 1). The meta-analyses for the breast, lung, and prostate cancer incidence did not show statistically significant associations (for example for breast cancer: hazard ratio = 0.83; 95% confidence interval: 0.47-1.48). For skin cancer, the available evidence suggests that greenspace could be a potential risk factor. For the other cancers, the evidence was non-conclusive. The overall quality of evidence of all of the exposure-outcome pairs was very low. Given the wide confidence interval of the pooled estimates and very low quality of evidence, the findings should be interpreted with caution. Future large and longitudinal studies are needed to assess the potential association of greenspace exposure with cancers, considering types and quality of greenspace, evaluation of cancer sub-types, and adjustment for a sufficient set of covariates.
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Affiliation(s)
- Mohammad Javad Zare Sakhvidi
- Occupational Health Department, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran; Univ Rennes, INSERM, EHESP, IRSET (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, F-35000 Rennes, France
| | - Jun Yang
- School of Public Health, Guangzhou Medical University, Guangzhou 511436, China
| | | | - Angel M Dzhambov
- Department of Hygiene, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - AliAsghar Ebrahimi
- Environmental Health Department, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Payam Dadvand
- ISGlobal, Doctor Aiguader 88, 08003 Barcelona, Spain; Universitat Pompeu Fabra (UPF), Doctor Aiguader 88, 08003 Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Melchor Fernández Almagro, 3-5, 28029 Madrid, Spain
| | - Bénédicte Jacquemin
- Univ Rennes, INSERM, EHESP, IRSET (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, F-35000 Rennes, France.
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Zhang J, Cui J, Astell-Burt T, Shi W, Peng J, Lei L, Xin X, Zhang J, Feng X, Jiang Y, Ma J. Weekly green space visit duration is positively associated with favorable health outcomes in people with hypertension: Evidence from Shenzhen, China. ENVIRONMENTAL RESEARCH 2022; 212:113228. [PMID: 35398313 DOI: 10.1016/j.envres.2022.113228] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 03/04/2022] [Accepted: 03/29/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Studies from high income 'western' countries indicate that green space visit duration is associated with better health. However, scant comparable research has been done in developing countries with rapid urbanization and on the potential health impacts of specific green infrastructure. OBJECTIVE Associations between green space visit duration, green infrastructure and various health outcomes were assessed in hypertensive patients. METHODS A stratified multi-stage cluster random sampling method was applied to select 1116 patients with hypertension aged 35 years or older in Shenzhen, China. Face-to-face survey, physical examination and laboratory biochemical tests were applied to obtain information. Binary logistic regressions with restricted cubic splines were used to explore the degree of linearity in associations between green space visit duration and the following health outcomes: central obesity; diabetes; blood pressure; dyslipidemia; poor physical health; poor mental health. Models were adjusted for age, sex, education, marital status, occupation, and socioeconomic status. Further analysis was made for presence of the following health promoting green infrastructure: health knowledge promotion areas; walking trails; fitness areas; group exercise venues. RESULTS Each additional 30 min green space visitation was linearly associated with lower odds of self-reported poor mental health [OR (95%CI): 0.937 (0.891-0.985)], self-reported poor physical health [OR (95%CI): 0.918 (0.872-0.966)], and central obesity [OR (95%CI): 0.951 (0.907-0.997)]. Odds of poor mental health [OR (95%CI): 0.886 (0.788-0.997)], poor physical health [OR (95%CI): 0.882 (0.782-0.996)] and central obesity [OR (95%CI): 0.855 (0.765-0.955)] were founded to decrease with a greater number of health promoting green infrastructure. CONCLUSION More time spent in green space and with more types of green infrastructure were favourably associated with central obesity, and physical and mental health in people with hypertension.
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Affiliation(s)
- Jingwen Zhang
- School of Population Medicine and Public Health, Peking Union Medical College and the Chinese Academy of Medical Sciences, Beijing, China; Shijiazhuang Municipal Bureau of Statistics, Shijiazhuang, Hebei Province, China
| | - Jia Cui
- School of Population Medicine and Public Health, Peking Union Medical College and the Chinese Academy of Medical Sciences, Beijing, China
| | - Thomas Astell-Burt
- School of Population Medicine and Public Health, Peking Union Medical College and the Chinese Academy of Medical Sciences, Beijing, China; Population Wellbeing and Environment Research Lab (PowerLab), School of Health and Society, Faculty of Arts, Social Sciences, and Humanities, University of Wollongong, Wollongong, Australia; Menzies Centre for Health Policy, University of Sydney, Sydney, Australia; National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Wenhui Shi
- Division of Non-communicable Disease and Aging Health Management, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ji Peng
- Department of Chronic Non-communication Disease Control and Prevention, Shenzhen Center for Chronic Disease Control, Shenzhen, China
| | - Lin Lei
- Department of Chronic Non-communication Disease Control and Prevention, Shenzhen Center for Chronic Disease Control, Shenzhen, China
| | - Xin Xin
- Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Juan Zhang
- School of Population Medicine and Public Health, Peking Union Medical College and the Chinese Academy of Medical Sciences, Beijing, China.
| | - Xiaoqi Feng
- Population Wellbeing and Environment Research Lab (PowerLab), School of Health and Society, Faculty of Arts, Social Sciences, and Humanities, University of Wollongong, Wollongong, Australia; Menzies Centre for Health Policy, University of Sydney, Sydney, Australia; National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
| | - Yu Jiang
- School of Population Medicine and Public Health, Peking Union Medical College and the Chinese Academy of Medical Sciences, Beijing, China
| | - Jixiang Ma
- Shandong Center for Disease Control and Prevention, Shandong, China
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Mehrabadi S, Miri M, Najafi ML, Ghalenovi M, Adli A, Pajohanfar NS, Ambrós A, Dovlatabadi A, Estiri EH, Abroudi M, Alonso L, Bazghandi MS, Dadvand P. Green space exposure during pregnancy and umbilical cord blood levels of liver enzymes. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:68432-68440. [PMID: 35545744 DOI: 10.1007/s11356-022-20568-5] [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: 12/23/2021] [Accepted: 04/28/2022] [Indexed: 06/15/2023]
Abstract
Evidence has suggested better pregnancy outcomes due to exposure to greenspace; however, the studies on such an association with the level of liver enzymes in the cord blood are still nonexistent. Hence, this study investigated the relationship between exposure to greenspace during the entire pregnancy and gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) levels in cord blood samples. We selected 150 pregnant women from our pregnancy cohort in Sabzevar, Iran (2018). Greenspace exposure was characterized based on (i) residential distance to green space, (ii) time spent in public/private green spaces, (iii) residential surrounding greenspace, (iv) visual access to greenspace, and (v) number of indoor natural pot plants at home. We developed linear regression models to investigate the adjusted associations of greenspace exposure with enzyme levels. Each one interquartile range (IQR) increase in the residential surrounding greenspace (100 m buffer) was related to a reduction of -12.58 (U/L) (95% CI -22.86, -2.29), -3.35 (U/L) (95% CI -5.50, -1.20), and -0.57 (U/L) (95% CI -1.12, -0.02) in the levels of GGT, AST, and ALT, respectively. Moreover, a similar association was observed for the time the participants spent in green spaces. A decrease in the residential distance to large green spaces was related with lower cord blood levels of AST, ALT, and GGT. Having a window with greenspace view at home was significantly related to lower AST level. The results for the indoor plant pots were not conclusive. Our findings suggested an inverse relationship between greenspace exposure during pregnancy and cord blood levels of liver enzymes. Further studies in other settings and populations are needed to confirm our findings.
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Affiliation(s)
- Saide Mehrabadi
- Department of Midwifery, School of Nursing, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Mohammad Miri
- Non-Communicable Diseases Research Center, Department of Environmental Health, School of Health, Sabzevar University of Medical Sciences, Sabzevar, Iran.
| | - Moslem Lari Najafi
- Pharmaceutical Sciences and Cosmetic Products Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Mina Ghalenovi
- Department of Midwifery, School of Nursing, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Abolfazl Adli
- Cellular and Molecular Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Nasim Sadat Pajohanfar
- Department of Midwifery, School of Nursing, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Albert Ambrós
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Afishin Dovlatabadi
- Non-Communicable Diseases Research Center, Department of Environmental Health, School of Health, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Elahe Hasannejad Estiri
- Non-Communicable Diseases Research Center, Department of Environmental Health, School of Health, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Mina Abroudi
- Cellular and Molecular Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Lucia Alonso
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Malihe Sadat Bazghandi
- Cellular and Molecular Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Payam Dadvand
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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Nigg C, Niessner C, Burchartz A, Woll A, Schipperijn J. The geospatial and conceptual configuration of the natural environment impacts the association with health outcomes and behavior in children and adolescents. Int J Health Geogr 2022; 21:9. [PMID: 35953832 PMCID: PMC9366780 DOI: 10.1186/s12942-022-00309-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 07/25/2022] [Indexed: 11/10/2022] Open
Abstract
Background Studies investigating associations between natural environments and health outcomes or health behaviors in children and adolescents yielded heterogenous results to date. This may be the result of different geospatial configurations of the natural environment and confounding characteristics of the study population. Thus, we investigated how the relationship between the natural environment and mental health, muscular fitness, and physical activity varies depending on the geospatial configuration of nature and children’s and adolescents’ characteristics. Methods Data were derived from the German Motorik-Modul (MoMo) cohort study (2018–2020) that investigates physical activity, muscular fitness, and health parameters in a national sample of children and adolescents (N = 2843) between four and 17 years (Mage = 10.46 ± 3.49 years; 48.3% girls). Mental health was assessed via questionnaire, muscular fitness via standing long jump, and physical activity with 7-day accelerometer measurement. Using geographic information systems, land cover, and land use data, three different nature definitions were applied. Both circular buffers (100–1000 m) and street-network buffers (1000–5000 m) were created for each of the nature definitions. Associations were explored with linear regression models, and interaction analysis was used to investigate how those relationships vary by gender, age, and socio-economic status. Results The relationship between the three outcomes and the natural environment varied considerably depending on the nature definition, buffer size, and buffer type, as well as socio-demographic characteristics. Specifically, when comparing youth with a high socio-economic status to those with a medium socio-economic status, smaller circular buffer distances were related to less physical activity, but larger street-network buffer distances were related to greater mental health problems. Distinct relationships also occurred for youth with low socio-economic status in those relationships, with the pattern being less clear. Conclusions For future health research studies that investigate the role of the natural environment, we argue for the development of an a-priori model that integrates both geospatial considerations (nature definition, buffer type, and buffer size) and conceptual considerations (health outcome/behavior, sample characteristics) based on potentially underlying mechanisms that link the natural environment and the health outcome or behavior under investigation to theoretically underpin the geospatial configuration of the natural environment. Supplementary Information The online version contains supplementary material available at 10.1186/s12942-022-00309-0.
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Affiliation(s)
- Carina Nigg
- Institute of Sport Science, University of Bern, Bremgartenstrasse 145, 3012, Bern, Switzerland. .,Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131, Karlsruhe, Germany.
| | - Claudia Niessner
- Institute of Sport Science, University of Bern, Bremgartenstrasse 145, 3012, Bern, Switzerland
| | - Alexander Burchartz
- Institute of Sport Science, University of Bern, Bremgartenstrasse 145, 3012, Bern, Switzerland
| | - Alexander Woll
- Institute of Sport Science, University of Bern, Bremgartenstrasse 145, 3012, Bern, Switzerland
| | - Jasper Schipperijn
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense, Denmark
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Brito H, Brymer E, Araújo D. An ecological dynamics perspective on designing urban nature environments for wellbeing and health-enhancing physical activity. Front Public Health 2022; 10:877208. [PMID: 35968417 PMCID: PMC9363900 DOI: 10.3389/fpubh.2022.877208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 07/07/2022] [Indexed: 11/13/2022] Open
Abstract
The latest World Health Organization report on green and blue space and mental health (2021) calls for greater, and better, urban nature environments, i. e., “wilder” urban parks, tree-laden sidewalks, and overall presence of nature in the urban environment. Evidence shows that living close to and interacting with nature promotes benefits to numerous health and well-being indicators. The present article narratively reviews what are the aspects of urban nature environments that enhance health and wellbeing markers, which aspects are preferred among users and visitors of urban nature environments, and how can the benefits for health and wellbeing be understood from a theoretical perspective. Finally, guided by the ecological dynamics framework, suggestions are put forward on how designers and planners of urban nature environments can consider affordances to promote physical activity behavior, health and wellbeing; and how exercise and health researchers and professionals may channel the interaction of individuals with the nature environment in their interventions and programs.
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Affiliation(s)
- Henrique Brito
- CIPER, Faculdade de Motricidade Humana, University of Lisbon, Lisbon, Portugal
- *Correspondence: Henrique Brito
| | - Eric Brymer
- Faculty of Health, Southern Cross University, Lismore, NSW, Australia
| | - Duarte Araújo
- CIPER, Faculdade de Motricidade Humana, University of Lisbon, Lisbon, Portugal
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Jiang Y, Kang Zhuo BM, Guo B, Zeng PB, Guo YM, Chen GB, Wei J, He RF, Li ZF, Zhang XH, Wang ZY, Li X, Wang L, Zeng CM, Chen L, Xiao X, Zhao X. Living near greenness is associated with higher bone strength: A large cross-sectional epidemiological study in China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 831:155393. [PMID: 35461937 DOI: 10.1016/j.scitotenv.2022.155393] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 04/15/2022] [Accepted: 04/15/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Living near green spaces may benefit various health outcomes. However, no studies have investigated the greenness-bone linkage in the general population. Moreover, to which extent ambient air pollution (AAP), physical activity (PA), and body mass index (BMI) mediate this relationship remains unclear. We aimed to explore the association between greenness and bone strength and the potential mediating roles of AAP, PA, and BMI in Chinese adults. METHODS This cross-sectional analysis enrolled 66,053 adults from the China Multi-Ethnic Cohort in 2018-2019. The normalized difference vegetation index (NDVI) and enhanced vegetation index (EVI) were employed to define residential greenness. The calcaneus quantitative ultrasound index (QUI) was used to indicate bone strength. Multiple linear regression models and mediation analyses were used to estimate the residential greenness-bone strength association and potential pathways operating through AAP (represented by PM2.5 [particulate matter <2.5 μm in diameter]), PA, and BMI. Stratification analyses were performed to identify susceptible populations. RESULTS Higher residential exposure to greenness was significantly associated with an increase in QUI, with changes (95% confidence interval) of 3.28 (3.05, 3.50), 3.57 (3.34, 3.80), 2.68 (2.46, 2.90), and 2.93 (2.71, 3.15) for every interquartile range increase in NDVI500m, NDVI1000m, EVI500m, and EVI1000m, respectively. Sex, urbanicity, annual family income, smoking, and drinking significantly modified the association of greenness-bone strength, with more remarkable associations in males, urban residents, subjects from wealthier families, smokers, and drinkers. For the NDVI500m/EVI500m-QUI relationship, the positive mediating roles of PM2.5 and PA were 6.70%/8.50 and 2.43%/2.69%, respectively, whereas those negative for BMI and PA-BMI were 0.88%/1.06% and 0.05%/0.05%, respectively. CONCLUSION Living in a greener area may predict higher bone strength, particularly among males, urban residents, wealthier people, smokers, and drinkers. AAP, PA, BMI, and other factors may partially mediate the positive association. Our findings underscore the importance of optimizing greenness planning and management policies.
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Affiliation(s)
- Ye Jiang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Bai Ma Kang Zhuo
- Division of Pulmonary Diseases, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, China; School of Medicine, Tibet University, Lhasa, Tibet, China
| | - Bing Guo
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Pei-Bin Zeng
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yu-Ming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Gong-Bo Chen
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Jing Wei
- Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, MD, USA
| | - Rui-Feng He
- Tibet Center for Disease Control and Prevention, Lhasa, Tibet, China
| | - Zhi-Feng Li
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
| | - Xue-Hui Zhang
- School of public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Zi-Yun Wang
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, Guizhou, China
| | - Xuan Li
- Jianyang Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Lei Wang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Chun-Mei Zeng
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lin Chen
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xiong Xiao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China.
| | - Xing Zhao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
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Wensu Z, Wenjuan W, Fenfen Z, Wen C, Li L. The effects of greenness exposure on hypertension incidence among Chinese oldest-old: a prospective cohort study. Environ Health 2022; 21:66. [PMID: 35820901 PMCID: PMC9277785 DOI: 10.1186/s12940-022-00876-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 06/27/2022] [Indexed: 06/13/2023]
Abstract
BACKGROUND Although the oldest-old (those aged over 80 years) are vulnerable to environmental factors and have the highest prevalence of hypertension, studies focusing on greenness exposure and the development of hypertension among them are insufficient. The aim of this study was to explore the association between residential greenness and hypertension in the oldest-old population. METHODS This cohort study included data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). The oldest-old were free of hypertension at baseline (2008), and hypertension events were assessed by follow-up surveys in 2011, 2014, and 2018. The one-year averages of the normalized difference vegetation index (NDVI) and enhanced vegetation index (EVI) at 500-m buffer before the interview year of incident hypertension or last censoring interview were collected at the level of 652 residential units (district or county). The linear or nonlinear association between greenness and hypertension incidence was analyzed using the Cox proportional hazards model with penalized splines. The linear links between greenness and hypertension incidence were determined using the Cox proportional hazards model included a random effect term. RESULTS Among 5253 participants, the incidence rate of hypertension was 7.25 (95% confidence interval [CI]: 6.83-7.67) per 100 person-years. We found a nonlinear association between greenness exposure and hypertension risk, and the exposure-response curve showed that 1 change point existed. We examined the linear effect of greenness on hypertension by categorizing the NDVI/EVI into low and high-level exposure areas according to the change point. We found more notable protective effects of each 0.1-unit increase in greenness on hypertension incidence for participants living in the high-level greenness areas (hazard ratio (HR) = 0.60; 95% CI: 0.53-0.70 for NDVI; HR = 0.46; 95% CI: 0.37-0.57 for EVI). In contrast, no significant influence of greenness exposure on hypertension risk was found for participants living in the low-level greenness areas (HR = 0.77; 95% CI: 0.38-1.55 for NDVI; HR = 0.73; 95% CI: 0.33-1.63 for EVI). CONCLUSIONS Greenness exposure is nonlinearly associated with hypertension risk among the oldest-old, presenting its relationship in an inverse "U-shaped" curve. Greenness is a protective factor that decreases the risk of hypertension.
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Affiliation(s)
- Zhou Wensu
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Wang Wenjuan
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Zhou Fenfen
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Chen Wen
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China.
| | - Ling Li
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China.
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Loef B, Wong A, Janssen NAH, Strak M, Hoekstra J, Picavet HSJ, Boshuizen HCH, Verschuren WMM, Herber GCM. Using random forest to identify longitudinal predictors of health in a 30-year cohort study. Sci Rep 2022; 12:10372. [PMID: 35725920 PMCID: PMC9209521 DOI: 10.1038/s41598-022-14632-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 06/09/2022] [Indexed: 11/09/2022] Open
Abstract
Due to the wealth of exposome data from longitudinal cohort studies that is currently available, the need for methods to adequately analyze these data is growing. We propose an approach in which machine learning is used to identify longitudinal exposome-related predictors of health, and illustrate its potential through an application. Our application involves studying the relation between exposome and self-perceived health based on the 30-year running Doetinchem Cohort Study. Random Forest (RF) was used to identify the strongest predictors due to its favorable prediction performance in prior research. The relation between predictors and outcome was visualized with partial dependence and accumulated local effects plots. To facilitate interpretation, exposures were summarized by expressing them as the average exposure and average trend over time. The RF model's ability to discriminate poor from good self-perceived health was acceptable (Area-Under-the-Curve = 0.707). Nine exposures from different exposome-related domains were largely responsible for the model's performance, while 87 exposures seemed to contribute little to the performance. Our approach demonstrates that ML can be interpreted more than widely believed, and can be applied to identify important longitudinal predictors of health over the life course in studies with repeated measures of exposure. The approach is context-independent and broadly applicable.
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Affiliation(s)
- Bette Loef
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA, Bilthoven, The Netherlands.
| | - Albert Wong
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA, Bilthoven, The Netherlands
| | - Nicole A H Janssen
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA, Bilthoven, The Netherlands
| | - Maciek Strak
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA, Bilthoven, The Netherlands
| | - Jurriaan Hoekstra
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA, Bilthoven, The Netherlands
| | - H Susan J Picavet
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA, Bilthoven, The Netherlands
| | - H C Hendriek Boshuizen
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA, Bilthoven, The Netherlands
- Wageningen University and Research, Wageningen, The Netherlands
| | - W M Monique Verschuren
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA, Bilthoven, The Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Gerrie-Cor M Herber
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA, Bilthoven, The Netherlands
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Exploring Environmental Health Inequalities: A Scientometric Analysis of Global Research Trends (1970-2020). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127394. [PMID: 35742642 PMCID: PMC9223819 DOI: 10.3390/ijerph19127394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/11/2022] [Accepted: 06/14/2022] [Indexed: 11/18/2022]
Abstract
Environmental health inequalities (EHI), understood as differences in environmental health factors and in health outcomes caused by environmental conditions, are studied by a wide range of disciplines. This results in challenges to both synthesizing key knowledge domains of the field. This study aims to uncover the global research status and trends in EHI research, and to derive a conceptual framework for the underlying mechanisms of EHI. In total, 12,320 EHI publications were compiled from the Web of Science core collection from 1970 to 2020. Scientometric analysis was adopted to characterize the research activity, distribution, focus, and trends. Content analysis was conducted for the highlight work identified from network analysis. Keyword co-occurrence and cluster analysis were applied to identify the knowledge domain and develop the EHI framework. The results show that there has been a steady increase in numbers of EHI publications, active journals, and involved disciplines, countries, and institutions since the 2000s, with marked differences between countries in the number of published articles and active institutions. In the recent decade, environment-related disciplines have gained importance in addition to social and health sciences. This study proposes a framework to conceptualize the multi-facetted issues in EHI research referring to existing key concepts.
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48
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Lam TM, Wang Z, Vaartjes I, Karssenberg D, Ettema D, Helbich M, Timmermans EJ, Frank LD, den Braver NR, Wagtendonk AJ, Beulens JWJ, Lakerveld J. Development of an objectively measured walkability index for the Netherlands. Int J Behav Nutr Phys Act 2022; 19:50. [PMID: 35501815 PMCID: PMC9063284 DOI: 10.1186/s12966-022-01270-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 03/10/2022] [Indexed: 12/03/2022] Open
Abstract
Background Walkability indices have been developed and linked to behavioural and health outcomes elsewhere in the world, but not comprehensively for Europe. We aimed to 1) develop a theory-based and evidence-informed Dutch walkability index, 2) examine its cross-sectional associations with total and purpose-specific walking behaviours of adults across socioeconomic (SES) and urbanisation strata, 3) explore which walkability components drive these associations. Methods Components of the index included: population density, retail and service density, land use mix, street connectivity, green space, sidewalk density and public transport density. Each of the seven components was calculated for three Euclidean buffers: 150 m, 500 m and 1000 m around every 6-digit postal code location and for every administrative neighbourhood in GIS. Componential z-scores were averaged, and final indices normalized between 0 and 100. Data on self-reported demographic characteristics and walking behaviours of 16,055 adult respondents (aged 18–65) were extracted from the Dutch National Travel Survey 2017. Using Tobit regression modelling adjusted for individual- and household-level confounders, we assessed the associations between walkability and minutes walking in total, for non-discretionary and discretionary purposes. By assessing the attenuation in associations between partial indices and walking outcomes, we identified which of the seven components drive these associations. We also tested for effect modification by urbanization degree, SES, age and sex. Results In fully adjusted models, a 10% increase in walkability was associated with a maximum increase of 8.5 min of total walking per day (95%CI: 7.1–9.9). This association was consistent across buffer sizes and purposes of walking. Public transport density was driving the index’s association with walking outcomes. Stratified results showed that associations with minutes of non-discretionary walking were stronger in rural compared to very urban areas, in neighbourhoods with low SES compared to high SES, and in middle-aged (36–49 years) compared to young (18–35 years old) and older adults (50–65 years old). Conclusions The walkability index was cross-sectionally associated with Dutch adult’s walking behaviours, indicating its validity for further use in research. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-022-01270-8.
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Affiliation(s)
- Thao Minh Lam
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, Amsterdam Public Health research institute, Boelelaan 1089a, 1081HV, Amsterdam, Netherlands. .,Upstream Team, Vrije Universiteit, Amsterdam, Netherlands.
| | - Zhiyong Wang
- Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Princetonlaan 8a, 3584, Utrecht, CB, Netherlands
| | - Ilonca Vaartjes
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.,Global Geo Health Data Center, University Medical Center Utrecht & Utrecht University, Utrecht, Netherlands
| | - Derek Karssenberg
- Global Geo Health Data Center, University Medical Center Utrecht & Utrecht University, Utrecht, Netherlands.,Department of Physical Geography, Utrecht University, Princetonlaan 8a, 3584, Utrecht, CB, Netherlands
| | - Dick Ettema
- Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Princetonlaan 8a, 3584, Utrecht, CB, Netherlands
| | - Marco Helbich
- Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Princetonlaan 8a, 3584, Utrecht, CB, Netherlands
| | - Erik J Timmermans
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Lawrence D Frank
- Department of Urban Studies and Planning, UC San Diego, La Jolla, San Diego, USA.,Urban Design 4 Health, Inc, Rochester, NY, USA
| | - Nicolette R den Braver
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, Amsterdam Public Health research institute, Boelelaan 1089a, 1081HV, Amsterdam, Netherlands.,Upstream Team, Vrije Universiteit, Amsterdam, Netherlands
| | - Alfred J Wagtendonk
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, Amsterdam Public Health research institute, Boelelaan 1089a, 1081HV, Amsterdam, Netherlands.,Upstream Team, Vrije Universiteit, Amsterdam, Netherlands
| | - Joline W J Beulens
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, Amsterdam Public Health research institute, Boelelaan 1089a, 1081HV, Amsterdam, Netherlands.,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.,Upstream Team, Vrije Universiteit, Amsterdam, Netherlands
| | - Jeroen Lakerveld
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, Amsterdam Public Health research institute, Boelelaan 1089a, 1081HV, Amsterdam, Netherlands.,Upstream Team, Vrije Universiteit, Amsterdam, Netherlands
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Van Den Eeden SK, H E M Browning M, Becker DA, Shan J, Alexeeff SE, Thomas Ray G, Quesenberry CP, Kuo M. Association between residential green cover and direct healthcare costs in Northern California: An individual level analysis of 5 million persons. ENVIRONMENT INTERNATIONAL 2022; 163:107174. [PMID: 35306251 DOI: 10.1016/j.envint.2022.107174] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 02/17/2022] [Accepted: 03/07/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND AND OBJECTIVE Prior studies have shown higher green cover levels are associated with beneficial health outcomes. We sought to determine if residential green cover was also associated with direct healthcare costs. METHODS We linked residential Normalized Difference Vegetation Index (NDVI) satellite data for 5,189,303 members of Kaiser Permanente Northern California (KPNC) to direct individual healthcare costs for 2003-2015. Using generalized linear regression to adjust for confounding, we examined the association between direct healthcare costs and green cover within250, 500, and 1000 meters (m) of an individual's residence. Costs were determined from an internal cost accounting system that captures administrative and patient care costs for each clinical encounter. Sensitivity analyses included adjustments for comorbidity and an alternative measure of green cover, tree canopy. RESULTS We observed a significant inverse association between higher levels of residential green cover and lower direct healthcare costs. The relative rate of total cost for the highest compared to the lowest decile of NDVI was 0.92 (95% CI 0.90-0.93) for the 500 m buffer. The association was robust to adjustment from a broad array of confounders, found at each buffer size, and largely driven by hospitalization, and emergency department visits. Individuals in the top decile of residential green cover had adjusted healthcare costs of $374.04 (95% CI $307.31-$439.41) per person per year less than individuals living in the bottom or least green decile. Sensitivity analyses including tree canopy cover as the green space measure yielded similar findings. Analyses that included adjustment for comorbidity were consistent with the hypothesis that green cover reduces healthcare costs by improving health status. CONCLUSION Green cover was associated with lower direct healthcare costs, raising the possibility that residential greening can have a significant healthcare cost impact across the population.
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Affiliation(s)
| | - Matthew H E M Browning
- Department of Parks, Recreation and Tourism Management, Clemson University, Clemson, SC, USA
| | - Douglas A Becker
- Natural Resources and Environmental Sciences, University of Illinois, Urbana-Champaign, IL, USA
| | - Jun Shan
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Stacey E Alexeeff
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - G Thomas Ray
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | | | - Ming Kuo
- Natural Resources and Environmental Sciences, University of Illinois, Urbana-Champaign, IL, USA
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50
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Effect of Urban Green Space in the Hilly Environment on Physical Activity and Health Outcomes: Mediation Analysis on Multiple Greenery Measures. LAND 2022. [DOI: 10.3390/land11050612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
Background: Green spaces reduce the risk of multiple adverse health outcomes by encouraging physical activity. This study examined correlations between urban green space and residents’ health outcomes in hilly neighborhoods: if they are mediated by social cohesion, visual aesthetics, and safety. Methods: We used multiple green space indicators, including normalized difference vegetation index (NDVI) extracted from satellite imagery, green view index (GVI) obtained from street view data using deep learning methods, park availability, and perceived level of greenery. Hilly terrain was assessed by the standard deviation of the elevation to represent variations in slope. Resident health outcomes were quantified by their psychological and physiological health as well as physical activity. Communities were grouped by quartiles of slopes. Then a mediation model was applied, controlling for socio-demographic factors. Results: Residents who perceived higher quality greenery experienced stronger social cohesion, spent more time on physical activity and had better mental health outcomes. The objective greenery indicators were not always associated with physical activity and might have a negative influence with certain terrain. Conclusions: Perceived green space offers an alternative explanation of the effects on physical activity and mental health in hilly neighborhoods. In some circumstances, geographical environment features should be accounted for to determine the association of green space and resident health outcomes.
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