1
|
Mao Y, Xia T, Hu F, Chen D, He Y, Bi X, Zhang Y, Cao L, Yan J, Hu J, Ren Y, Xu H, Zhang J, Zhang L. The greener the living environment, the better the health? Examining the effects of multiple green exposure metrics on physical activity and health among young students. ENVIRONMENTAL RESEARCH 2024; 250:118520. [PMID: 38401683 DOI: 10.1016/j.envres.2024.118520] [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: 08/21/2023] [Revised: 01/29/2024] [Accepted: 02/17/2024] [Indexed: 02/26/2024]
Abstract
The sedentary and less active lifestyle of modern college students has a significant impact on the physical and mental well-being of the college community. Campus Green Spaces (GSs) are crucial in promoting physical activity and improving students' health. However, previous research has focused on evaluating campuses as a whole, without considering the diverse spatial scenarios within the campus environment. Accordingly, this study focused on the young people's residential scenario in university and constructed a framework including a comprehensive set of objective and subjective GSs exposure metrics. A systematic, objective exposure assessment framework ranging from 2D (GSs areas), and 2.5D (GSs visibility) to 3D (GSs volume) was innovatively developed using spatial analysis, deep learning technology, and unmanned aerial vehicle (UAV) measurement technology. Subjective exposure metrics incorporated GSs visiting frequency, GSs visiting duration, and GSs perceived quality. Our cross-sectional study was based on 820 university students in Nanjing, China. Subjective measures of GSs exposure, physical activity, and health status were obtained through self-reported questionnaires. The Generalized Linear Model (GLM) was used to evaluate the associations between GSs exposure, physical activity, and perceived health. Physical activity and social cohesion were considered as mediators, and path analysis based on Structural Equation Modeling (SEM) was used to disentangle the mechanisms linking GSs exposure to the health status of college students. We found that (1) 2D indicator suggested significant associations with health in the 100m buffer, and the potential underlying mechanisms were: GSs area → Physical activity → Social cohesion → Physical health → Mental health; GSs area → Physical activity → Social cohesion → Mental health. (2) Subjective GSs exposure indicators were more relevant in illustrating exposure-response relationships than objective ones. This study can clarify the complex nexus and mechanisms between campus GSs, physical activity, and health, and provide a practical reference for health-oriented campus GSs planning.
Collapse
Affiliation(s)
- Yuheng Mao
- Department of Landscape Architecture, School of Design, Shanghai Jiao Tong University, Shanghai, 200240, China.
| | - Tianyu Xia
- College of Landscape Architecture, Nanjing Forestry University, Nanjing, 210037, China.
| | - Fan Hu
- College of Civil Engineering, Nanjing Forestry University, Nanjing, 210037, China.
| | - Dan Chen
- Department of Landscape Architecture, School of Design, Shanghai Jiao Tong University, Shanghai, 200240, China.
| | - Yichen He
- Faculty of Science, National University of Singapore, Singapore, 119077, Singapore; Saw Swee Hock School of Public Health, National University of Singapore, Singapore, 119077, Singapore.
| | - Xing Bi
- Department of Landscape Architecture, School of Design, Shanghai Jiao Tong University, Shanghai, 200240, China.
| | - Yangcen Zhang
- Department of Landscape Architecture, School of Design, Shanghai Jiao Tong University, Shanghai, 200240, China.
| | - Lu Cao
- Department of Landscape Architecture, School of Design, Shanghai Jiao Tong University, Shanghai, 200240, China; School of Agriculture, Food and Ecosystem Sciences, Faculty of Science, The University of Melbourne, Burnley Campus, 500 Yarra Blvd, Richmond, Victoria, 3121, Australia.
| | - Jingheng Yan
- Department of Geography and Planning, Queen's University, Kingston, Ontario, K7L 3N6, Canada.
| | - Jinyu Hu
- College of Landscape Architecture, Nanjing Forestry University, Nanjing, 210037, China.
| | - Yanzi Ren
- School of Built Environment, Faculty of Arts, Design and Architecture, University of New South Wales, Sydney, NSW, 2052, Australia.
| | - Hongmei Xu
- Department of Physical Education, Nanjing Forestry University, Nanjing, 210037, China.
| | - Jinguang Zhang
- College of Landscape Architecture, Nanjing Forestry University, Nanjing, 210037, China.
| | - Liqing Zhang
- Department of Landscape Architecture, School of Design, Shanghai Jiao Tong University, Shanghai, 200240, China.
| |
Collapse
|
2
|
Bereziartua A, Cabrera-León A, Subiza-Pérez M, García-Baquero G, Delís Gomez S, Ballester F, Estarlich M, Merelles A, Esplugues A, Irles MA, Barona C, Mas R, Font-Ribera L, Bartoll X, Pérez K, Oliveras L, Binter AC, Daponte A, García Mochon L, García Cortés H, Sánchez-Cantalejo Garrido MDC, Lacasaña M, Cáceres R, Rueda M, Saez M, Lertxundi A. Urban environment and health: a cross-sectional multiregional project based on population health surveys in Spain (DAS-EP project) - study protocol. BMJ Open 2024; 14:e074252. [PMID: 38553060 PMCID: PMC10982794 DOI: 10.1136/bmjopen-2023-074252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 02/26/2024] [Indexed: 04/02/2024] Open
Abstract
INTRODUCTION The European Environment Agency estimates that 75% of the European population lives in cities. Despite the many advantages of city life, the risks and challenges to health arising from urbanisation need to be addressed in order to tackle the growing burden of disease and health inequalities in cities. This study, Urban environment and health: a cross-sectional multiregional project based on population health surveys in Spain (DAS-EP project), aims to investigate the complex association between the urban environmental exposures (UrbEEs) and health. METHODS AND ANALYSIS DAS-EP is a Spanish multiregional cross-sectional project that combines population health surveys (PHS) and geographical information systems (GIS) allowing to collect rich individual-level data from 17 000 adult citizens participating in the PHS conducted in the autonomous regions of the Basque Country, Andalusia, and the Valencian Community, and the city of Barcelona in the years 2021-2023. This study focuses on the population living in cities or metropolitan areas with more than 100 000 inhabitants. UrbEEs are described by objective estimates at participants' home addresses by GIS, and subjective indicators present in PHS. The health outcomes included in the PHS and selected for this study are self-perceived health (general and mental), prevalence of chronic mental disorders, health-related quality of life, consumption of medication for common mental disorders and sleep quality. We aim to further understand the direct and indirect effects between UrbEEs and health, as well as to estimate the impact at the population level, taking respondents' sociodemographic and socioeconomic characteristics, and lifestyle into consideration. ETHICS AND DISSEMINATION The study was approved by the regional Research Ethics Committee of the Basque Country (Ethics Committee for Research Involving Medicinal Products in the Basque Country; PI2022138), Andalusia (Biomedical Research Ethics Committee of the Province of Granada; 2078-N-22), Barcelona (CEIC-PSMar; 2022/10667) and the Valencian Community (Ethics Committee for Clinical Research of the Directorate General of Public Health and Center for Advanced Research in Public Health; 20221125/04). The results will be communicated to the general population, health professionals, and institutions through conferences, reports and scientific articles.
Collapse
Affiliation(s)
- Ainhoa Bereziartua
- Department of Preventive Medicine and Public Health, University of the Basque Country (UPV/EHU), Leioa, Bizkaia, Spain
- Group of Environmental Epidemiology and Child Development, IIS Biogipuzkoa, Donostia-San Sebastian, Guipuzcoa, Spain
| | - Andrés Cabrera-León
- Andalusian School of Public Health, Granada, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Comunidad de Madrid, Spain
| | - Mikel Subiza-Pérez
- Group of Environmental Epidemiology and Child Development, IIS Biogipuzkoa, Donostia-San Sebastian, Guipuzcoa, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Comunidad de Madrid, Spain
- Department of Clinical and Health Psychology and Research Methods, University of the Basque Country UPV/EHU, Bilbao, País Vasco, Spain
- Bradford Institute for Health Research, Bradford, UK
| | - Gonzalo García-Baquero
- Group of Environmental Epidemiology and Child Development, IIS Biogipuzkoa, Donostia-San Sebastian, Guipuzcoa, Spain
- Faculty of Pharmacy, University of Salamanca, Salamanca, Spain
| | | | - Ferran Ballester
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Comunidad de Madrid, Spain
- Faculty of Nursing and Chiropody, University of Valencia, Valencia, Comunitat Valenciana, Spain
- Epidemiology and Environmental Health Joint Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valèncian Region, FISABIO-Public Health, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain
| | - Marisa Estarlich
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Comunidad de Madrid, Spain
- Epidemiology and Environmental Health Joint Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valèncian Region, FISABIO-Public Health, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain
- Faculty of Nursing and Chiropody, Universitat de Valencia, Valencia, Comunitat Valenciana, Spain
| | - Antonio Merelles
- Epidemiology and Environmental Health Joint Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valèncian Region, FISABIO-Public Health, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain
- Faculty of Nursing and Chiropody, Universitat de Valencia, Valencia, Comunitat Valenciana, Spain
| | - Ana Esplugues
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Comunidad de Madrid, Spain
- Epidemiology and Environmental Health Joint Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valèncian Region, FISABIO-Public Health, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain
- Faculty of Nursing and Chiropody, Universitat de Valencia, Valencia, Comunitat Valenciana, Spain
| | | | - Carmen Barona
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Comunidad de Madrid, Spain
- General Directorate of Public Health, Valencia, Valencian Community, Spain
- Research group "Local Action on Health and Equity (ALES)", Foundation for the Promotion of Health and Biomedical Research in the Valèncian Region, FISABIO-Public Health, Valencia, Spain
| | - Rosa Mas
- General Directorate of Public Health, Valencia, Valencian Community, Spain
- Research group "Local Action on Health and Equity (ALES)", Foundation for the Promotion of Health and Biomedical Research in the Valèncian Region, FISABIO-Public Health, Valencia, Spain
| | - Laia Font-Ribera
- Agencia de Salut Publica de Barcelona, Barcelona, Catalunya, Spain
- Institut d'Investigacio Biomedica Sant Pau (IIB SANT PAU), Barcelona, Spain
| | - X Bartoll
- Agencia de Salut Publica de Barcelona, Barcelona, Catalunya, Spain
- Institut d'Investigacio Biomedica Sant Pau (IIB SANT PAU), Barcelona, Spain
| | - Katherine Pérez
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Comunidad de Madrid, Spain
- Agencia de Salut Publica de Barcelona, Barcelona, Catalunya, Spain
- Institut d'Investigacio Biomedica Sant Pau (IIB SANT PAU), Barcelona, Spain
| | - Laura Oliveras
- Agencia de Salut Publica de Barcelona, Barcelona, Catalunya, Spain
- Institut d'Investigacio Biomedica Sant Pau (IIB SANT PAU), Barcelona, Spain
| | - Anne-Claire Binter
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Comunidad de Madrid, Spain
- Barcelona Institute for Global Health, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Antonio Daponte
- Andalusian School of Public Health, Granada, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Comunidad de Madrid, Spain
| | - Leticia García Mochon
- Andalusian School of Public Health, Granada, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Comunidad de Madrid, Spain
- Instituto de Investigación Biosanitaria de Granada, Granada, Spain
| | - Helena García Cortés
- Andalusian School of Public Health, Granada, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Comunidad de Madrid, Spain
| | - María Del Carmen Sánchez-Cantalejo Garrido
- Andalusian School of Public Health, Granada, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Comunidad de Madrid, Spain
| | - Marina Lacasaña
- Andalusian School of Public Health, Granada, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Comunidad de Madrid, Spain
- Instituto de Investigación Biosanitaria de Granada, Granada, Spain
| | - Rocío Cáceres
- Nursing Department, University of Seville, Sevilla, Spain
- Research group PAIDI CTS-1050: "Complex Care, Chronicity and Health Outcomes", University of Seville, Seville, Spain
| | - María Rueda
- Department of Statistics and Operational Research, University of Granada, Granada, Spain
- Institute of Mathematics, University of Granada, Granada, Spain
| | - Marc Saez
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Comunidad de Madrid, Spain
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Catalunya, Spain
| | - Aitana Lertxundi
- Department of Preventive Medicine and Public Health, University of the Basque Country (UPV/EHU), Leioa, Bizkaia, Spain
- Group of Environmental Epidemiology and Child Development, IIS Biogipuzkoa, Donostia-San Sebastian, Guipuzcoa, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Comunidad de Madrid, Spain
| |
Collapse
|
3
|
Yang Z, Liao J, Zhang Y, Lin Y, Ge Y, Chen W, Qiu C, Berhane K, Bai Z, Han B, Xu J, Jiang YH, Gilliland F, Yan W, Chen Z, Huang G, Zhang J(J. Critical windows of greenness exposure during preconception and gestational periods in association with birthweight outcomes. ENVIRONMENTAL RESEARCH, HEALTH : ERH 2024; 2:015001. [PMID: 38022394 PMCID: PMC10647935 DOI: 10.1088/2752-5309/ad0aa6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 10/26/2023] [Accepted: 11/07/2023] [Indexed: 12/01/2023]
Abstract
Few studies have examined the association between greenness exposure and birth outcomes. This study aims to identify critical exposure time windows during preconception and pregnancy for the association between greenness exposure and birth weight. A cohort of 13 890 pregnant women and newborns in Shanghai, China from 2016-2019 were included in the study. We assessed greenness exposure using Normalized Difference Vegetation Index (NDVI) during the preconception and gestational periods, and evaluated the association with term birthweight, birthweight z-score, small-for-gestational age, and large-for-gestational age using linear and logistic regressions adjusting for key maternal and newborn covariates. Ambient temperature, relative humidity, ambient levels of fine particles (PM2.5) and nitrogen dioxide (NO2) assessed during the same period were adjusted for as sensitivity analyses. Furthermore, we explored the potential different effects by urbanicity and park accessibility through stratified analysis. We found that higher greenness exposure at the second trimester of pregnancy and averaged exposure during the entire pregnancy were associated with higher birthweight and birthweight Z-score. Specifically, a 0.1 unit increase in second trimester averaged NDVI value was associated with an increase in birthweight of 10.2 g (95% CI: 1.8-18.5 g) and in birthweight Z-score of 0.024 (0.003-0.045). A 0.1 unit increase in an averaged NDVI during the entire pregnancy was associated with 10.1 g (95% CI: 1.0-19.2 g) increase in birthweight and 0.025 (0.001-0.048) increase in birthweight Z-score. Moreover, the associations were larger in effect size among urban residents than suburban residents and among residents without park accessibility within 500 m compared to those with park accessibility within 500 m. Our findings suggest that increased greenness exposure, particularly during the second trimester, may be beneficial to birth weight in a metropolitan area.
Collapse
Affiliation(s)
- Zhenchun Yang
- Duke Global Health Institute, Duke University, Durham, NC, United States of America
| | - Jiawen Liao
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America
| | - Yi Zhang
- Children’s Hospital of Fudan University, Shanghai Key Laboratory of Birth Defect, Shanghai, People’s Republic of China
| | - Yan Lin
- Duke Global Health Institute, Duke University, Durham, NC, United States of America
| | - Yihui Ge
- Duke Global Health Institute, Duke University, Durham, NC, United States of America
| | - Wu Chen
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America
| | - Chenyu Qiu
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America
| | - Kiros Berhane
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, United States of America
| | - Zhipeng Bai
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, People’s Republic of China
| | - Bin Han
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, People’s Republic of China
| | - Jia Xu
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, People’s Republic of China
| | - Yong Hui Jiang
- Department of Genetics, Neuroscience, and Pediatrics, Yale University School of Medicine, New Haven, CT, United States of America
| | - Frank Gilliland
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America
| | - Weili Yan
- Children’s Hospital of Fudan University, Shanghai Key Laboratory of Birth Defect, Shanghai, People’s Republic of China
| | - Zhanghua Chen
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America
| | - Guoying Huang
- Children’s Hospital of Fudan University, Shanghai Key Laboratory of Birth Defect, Shanghai, People’s Republic of China
| | - Junfeng (Jim) Zhang
- Duke Global Health Institute, Duke University, Durham, NC, United States of America
- Division of Environmental Science and Policy, Nicholas School of the Environment, Duke University, Durham, NC, United States of America
| |
Collapse
|
4
|
Chua KJ, Knorr DA, Jimenez J, Francia A, Rojas V, Garcia JI, Fox M. What Do Your Neighbors Think About You? How Perceived Neighbor Attitudes Toward Latinos Influence Mental Health Among a Pregnant Latina Cohort. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01684-5. [PMID: 37391606 PMCID: PMC10756922 DOI: 10.1007/s40615-023-01684-5] [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: 04/14/2023] [Revised: 06/10/2023] [Accepted: 06/12/2023] [Indexed: 07/02/2023]
Abstract
Latina women living in the USA experience disproportionately higher rates of psychological distress compared to their non-Latina White counterparts. Poor maternal mental health during pregnancy can contribute to intergenerational mental health disparities. Through this pathway, mothers' experiences, environments, and exposures (henceforth "exposures") during pregnancy become biologically embodied and can negatively affect the fetus and life-long developmental trajectories of her child. One of the exposures that can affect mother-offspring dyads is the neighborhood. With the goal of integrating anthropological and sociological theories to explain mental health disparities among pregnant Latina women, we explored how perceptions of neighbor attitudes may influence mental health during pregnancy. We analyzed self-reported responses from 239 pregnant Latina women in Southern California (131 foreign-born, 108 US-born) on their mental health and perceived attitudes of their neighbors using multiple linear regression models. Among foreign-born Latina women, living in neighborhoods with more favorable views of Latinos was associated with lower depression scores (pooled β = - .70, SE = .29, p = .019) and lower pregnancy-related anxiety scores (pooled β = - .11, SE = .05, p = .021), but greater state anxiety scores (pooled β = .09, SE = .04, p = .021). Among US-born women, there were no associations between neighbor attitudes and mental health. Overall, results suggest that social environments are correlated with mental health and that foreign-born and US-born Latinas have varied mental health experiences in the USA. Our findings highlight the importance of improving aspects of neighborhood cohesion as part of maternal-fetal care management.
Collapse
Affiliation(s)
- Kristine J Chua
- Department of Anthropology, University of California Los Angeles, 341 Haines Hall, 375 Portola Plaza, Los Angeles, CA, 90095, USA
- California Center for Population Research, University of California Los Angeles, Los Angeles, CA, 90095, USA
| | - Delaney A Knorr
- Department of Anthropology, University of California Los Angeles, 341 Haines Hall, 375 Portola Plaza, Los Angeles, CA, 90095, USA
- California Center for Population Research, University of California Los Angeles, Los Angeles, CA, 90095, USA
| | - Janelly Jimenez
- Department of Anthropology, University of California Los Angeles, 341 Haines Hall, 375 Portola Plaza, Los Angeles, CA, 90095, USA
| | - Arlene Francia
- Department of Anthropology, University of California Los Angeles, 341 Haines Hall, 375 Portola Plaza, Los Angeles, CA, 90095, USA
| | - Valeria Rojas
- Department of Anthropology, University of California Los Angeles, 341 Haines Hall, 375 Portola Plaza, Los Angeles, CA, 90095, USA
| | - Jhoana Infante Garcia
- Department of Anthropology, University of California Los Angeles, 341 Haines Hall, 375 Portola Plaza, Los Angeles, CA, 90095, USA
| | - Molly Fox
- Department of Anthropology, University of California Los Angeles, 341 Haines Hall, 375 Portola Plaza, Los Angeles, CA, 90095, USA.
- California Center for Population Research, University of California Los Angeles, Los Angeles, CA, 90095, USA.
- Department of Psychiatry & Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, 90095, USA.
| |
Collapse
|
5
|
Foster SF, Vazquez C, Cubbin C, Nichols AR, Rickman RR, Widen EM. Breastfeeding, socioeconomic status, and long-term postpartum weight retention. Int Breastfeed J 2023; 18:1. [PMID: 36600252 PMCID: PMC9814482 DOI: 10.1186/s13006-022-00534-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 12/18/2022] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Almost half of all pregnant women in the United States gain weight above Institute of Medicine gestational weight gain guidelines. Breastfeeding has been shown to reduce weight retention in the first year postpartum; however, women with lower socioeconomic status (SES) tend to initiate breastfeeding less often than women with higher SES. We investigated associations between duration of breastfeeding with mother's long-term postpartum weight status at 4-10 years and evaluated whether the associations varied by SES. METHODS Maternal and infant dyads (N = 2144 dyads) are from the Geographic Research on Wellbeing survey (GROW), 2012-2013, a long-term, cross-sectional follow-up of the Maternal and Infant Health Assessment (MIHA) based in California, USA. Pre-pregnancy body mass index (BMI) was obtained from self-report of height and weight during MIHA, while breastfeeding history and self-report of current body weight was collected at the 4-10 year GROW postpartum visit. SES score was derived from a composite score of percent federal poverty level and education and was dichotomized into High and Low SES groups at a score of three. Multivariable linear regression was used to examine association between breastfeeding and maternal weight status, and to examine for effect modification by SES. RESULTS Average long-term weight retention 4-10 years postpartum was 4.0 kg. Fewer lower SES vs. higher SES women breast fed at least six months (51% versus 70%, p < .001) or ever breastfed (74% versus 89%, P < .001). Women who breastfed at least six months had lower long-term postpartum weight retention compared to those who did not (b = -1.06 kg, (-1.93, 0.25); p = 0.01); however, these association did not vary by SES. CONCLUSION Six months of breastfeeding is associated with lower BMI at 4-10 years and lower body weight, and effects do not vary by SES. Future policies and guidelines should consider building an infrastructure that is supportive of longer breastfeeding duration. Moreover, further research is needed to identify the impact of additional behavioral and environmental factors on long-term maternal weight status. Understanding the drivers of excessive weight retention pospartum can help us not only improve the pregnant person's health but the health of their children.
Collapse
Affiliation(s)
- Saralyn F. Foster
- grid.89336.370000 0004 1936 9924Department of Nutritional Sciences, The University of Texas at Austin, 200 W. 24th Street, A2703, Austin, United States
| | - Christian Vazquez
- grid.89336.370000 0004 1936 9924Steve Hicks School of Social Work, The University of Texas at Austin, 1925 San Jacinto Blvd, Austin, United States ,grid.267315.40000 0001 2181 9515School of Social Work, The University of Texas at Arlington, 211 S Cooper St Arlington, Arlington, United States
| | - Catherine Cubbin
- grid.89336.370000 0004 1936 9924Steve Hicks School of Social Work, The University of Texas at Austin, 1925 San Jacinto Blvd, Austin, United States ,grid.89336.370000 0004 1936 9924Departments of Population Health and Health Social Work, Dell Medical School, The University of Texas at Austin, 1601 Trinity Street, Austin, United States
| | - Amy R. Nichols
- grid.89336.370000 0004 1936 9924Department of Nutritional Sciences, The University of Texas at Austin, 200 W. 24th Street, A2703, Austin, United States
| | - Rachel R. Rickman
- grid.89336.370000 0004 1936 9924Department of Nutritional Sciences, The University of Texas at Austin, 200 W. 24th Street, A2703, Austin, United States
| | - Elizabeth M. Widen
- grid.89336.370000 0004 1936 9924Department of Nutritional Sciences, The University of Texas at Austin, 200 W. 24th Street, A2703, Austin, United States ,grid.89336.370000 0004 1936 9924Departments of Women’s Health & Pediatrics, Dell Pediatric Research Institute, The University of Texas at Austin, 1400 Barbara Jordan Blvd, Austin, United States
| |
Collapse
|
6
|
Zhang L, Zhou S, Qi L, Deng Y. Nonlinear Effects of the Neighborhood Environments on Residents' Mental Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16602. [PMID: 36554482 PMCID: PMC9778789 DOI: 10.3390/ijerph192416602] [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: 11/01/2022] [Revised: 12/04/2022] [Accepted: 12/05/2022] [Indexed: 06/17/2023]
Abstract
In the context of rapid urbanization and the "Healthy China" strategy, neighborhood environments play an important role in improving mental health among urban residents. While an increasing number of studies have explored the linear relationships between neighborhood environments and mental health, much remains to be revealed about the nonlinear health effects of neighborhood environments, the thresholds of various environmental factors, and the optimal environmental exposure levels for residents. To fill these gaps, this paper collected survey data from 1003 adult residents in Guangzhou, China, and measured the built and social environments within the neighborhoods. The random forest model was then employed to examine the nonlinear effects of neighborhood environments on mental health, evaluate the importance of each environmental variable, as well as identify the thresholds and optimal levels of various environmental factors. The results indicated that there are differences in the importance of diverse neighborhood environmental factors affecting mental health, and the more critical environmental factors included greenness, neighborhood communication, and fitness facility density. The nonlinear effects were shown to be universal and varied among neighborhood environmental factors, which could be classified into two categories: (i) higher exposure levels of some environmental factors (e.g., greenness, neighborhood communication, and neighborhood safety) were associated with better mental health; (ii) appropriate exposure levels of some environmental factors (e.g., medical, fitness, and entertainment facilities, and public transport stations) had positive effects on mental health, whereas a much higher or lower exposure level exerted a negative impact. Additionally, this study identified the exact thresholds and optimal exposure levels of neighborhood environmental factors, such as the threshold (22.00%) and optimal exposure level (>22.00%) of greenness and the threshold (3.80 number/km2) and optimal exposure level (3.80 number/km2) of fitness facility density.
Collapse
Affiliation(s)
- Lin Zhang
- Institute of Studies for the Greater Bay Area (Guangdong, Hong Kong, Macau), Guangdong University of Foreign Studies, Guangzhou 510006, China
| | - Suhong Zhou
- School of Geography and Planning, Sun Yat-sen University, Guangzhou 510006, China
- Guangdong Provincial Engineering Research Center for Public Security and Disaster, Guangzhou 510275, China
| | - Lanlan Qi
- School of Management, Guangdong Industry Polytechnic, Guangzhou 510300, China
| | - Yue Deng
- School of Architecture and Civil Engineering, Chengdu University, Chengdu 610106, China
| |
Collapse
|
7
|
Green Space for Mental Health in the COVID-19 Era: A Pathway Analysis in Residential Green Space Users. LAND 2022. [DOI: 10.3390/land11081128] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Residential green space is among the most accessible types of urban green spaces and may help maintain mental health during the COVID-19 pandemic. However, it is insufficiently understood how residents use residential green space for exercise during the epidemic. The pathways between residential green space and mental health also merit further exploration. Therefore, we conducted an online study among Chinese residents in December 2021 to capture data on engagement with urban green space for green exercise, the frequency of green exercise, perceived pollution in green space, perceptions of residential green space, social cohesion, depression, and anxiety. Among the 1208 respondents who engaged in green exercise last month, 967 (80%) reported that green exercise primarily occurred in residential neighborhoods. The rest (20%) reported that green exercise occurred in more distant urban green spaces. The most common reasons that respondents sought green exercise in urban green spaces were better air and environmental qualities. Structural equation modeling (SEM) was then employed to explore the pathways between the perceived greenness of residential neighborhoods and mental health among respondents who used residential green space for exercise. The final model suggested that residential green space was negatively associated with anxiety (β = −0.30, p = 0.001) and depression (β = −0.33, p < 0.001), mainly through indirect pathways. Perceived pollution and social cohesion were the two mediators that contributed to most of the indirect effects. Perceived pollution was also indirectly associated with green exercise through less social cohesion (β = −0.04, p = 0.010). These findings suggest a potential framework to understand the mental health benefits of residential green space and its accompanying pathways during the COVID-19 era.
Collapse
|