A comparative analysis of the impacts of objective versus subjective neighborhood environment on physical, mental, and social health

Perceptions of anti-racism efforts and mental health among students in higher education in the United States

Background

Anti-racism efforts are imperative for campus communities, yet little is known about whether perceiving their presence on campuses relates to a range of mental health outcomes among students.

Methods

We analyzed data from the Healthy Minds Study 2020-2021 (N = 110,203). Using multivariable logistic regression, we examined the associations between perceptions of anti-racism efforts and several mental health outcomes.

Results

Individuals who disagreed that their schools combatted racism in their campus communities had significantly greater odds of mental health problems (depression, anxiety, psychotic experiences, suicidal ideation, suicide plan, suicide attempt, perceived need for help, and loneliness), and lower odds of flourishing when compared with those who strongly agreed with the statement. For most outcomes, we observed an apparent dose-response association.

Conclusion

Perceiving the presence of anti-racism efforts on campuses was inversely associated with mental health problems, calling for more research to test the effects of anti-racism efforts on mental health.

Institutional, neighborhood, and life stressors on loneliness among older adults

BACKGROUND

Loneliness is a public health epidemic in the United States (US), with older adults being vulnerable to experiencing loneliness. Predictors of loneliness are less understood among racial/ethnic groups of US older adults, and few studies have included perceived institutional discrimination (PID), stressful life events (SLE), and perceived neighborhood characteristics (PNC) as antecedent stressors of loneliness in diverse older adult samples. Our study assessed the relationship between these stressors and loneliness among specific racial/ethnic groups of older adults.

METHODS

We used the Health and Retirement Study data (n = 9,904) to examine whether PID, SLE, and PNC were associated with loneliness. Loneliness was measured using the 11-item UCLA Loneliness Scale. PID included unfairly not hired for a job, unfairly prevented from moving into a neighborhood, and unfairly treated by the police. SLE included moving to a worse neighborhood/residence, being robbed or burglarized, and unemployed/looking for a job. PNC were measured as discohesion and disorder. Lagged multivariate linear regression models regressed loneliness (2014/2016 HRS waves) on PID, SLE and PNC (2010/2012 HRS waves) measured as cumulative totals and individual items. Models were stratified by Black (BOAs), Hispanic/Latinx (HOAs), and White (WOAs) older adults.

RESULTS

Cumulative totals of PID, SLE, and neighborhood discohesion were associated with loneliness among BOAs while only discohesion was associated with loneliness among HOAs. Cumulative totals for PID, SLE, and PNC were associated with loneliness among WOAs. Individual stressors predicting loneliness for BOAs were moving to a worse residence and being robbed/burglarized. For HOAs, being prevented from moving to a neighborhood was associated with greater loneliness while being robbed/burglarized was associated with less loneliness. Individual stressors predicting greater loneliness for WOAs were being unfairly not hired for a job, receiving unfair treatment during police encounters, and moving to a worse residence.

CONCLUSIONS

Our study finds racial/ethnic variation in psychosocial stressors predicting loneliness four years later. Nevertheless, neighborhood discohesion was the most salient stressor and was associated with greater loneliness across all racial/ethnic groups. Future research and interventions should consider the differing stress appraisal processes across groups and to support the development of resources and policies to ameliorate loneliness among diverse older adults.

The Relationship Between the Neighbourhood Environment and Mental Health: Integrating Subjective and Objective Perspectives

AIMS

To explore the relationship between neighbourhood environments and mental health by integrating subjective and objective perspectives.

DESIGN

A cross-sectional study.

METHODS

From September 2023 to January 2024, adult residents at the physical examination centers of two public hospitals in China completed measurements of subjective neighbourhood environment, depressive and anxiety symptoms, psychological stress, and socio-demographic characteristics. Geographic information systems (GIS) were employed to extract objective environmental data including parks, bus stops, sports facilities, leisure facilities, residential housing, restaurants, food retail facilities, and street connectivity within a buffer zone of 500-m radius of the participants' residential areas. Data were analysed using univariate and multiple logistic regression analyses.

RESULTS

This study included 438 participants (mean age, 36.98 ± 11.05 years; 55.3% female). The mean scores for depression, anxiety, and psychological stress were 3.55 ± 2.99, 3.16 ± 2.91, and 13.11 ± 4.88, respectively. The total score of the subjective neighbourhood environment was 78.33 ± 10.63, with the mean scores of each dimension ranging from 5.14 to 23.76. After adjusting for potential confounders, higher scores on street environment and higher density of sports facility were statistically significantly associated with reduced risk of depressive symptoms and psychological stress. Additionally, higher scores on walking environment and social cohesion were significantly associated with reduced risk of anxiety symptoms.

CONCLUSIONS

This study found that street environments, walking environments, social cohesion, and density of sports facilities were independently associated with the mental health of adult residents in China.

IMPLICATIONS

The findings provide valuable insights for healthcare providers to consider specific health-related environmental factors and develop tailored interventions to promote the mental health of the residents.

IMPACT

Understanding the relationship between the subjective and objective environmental factors on mental health is crucial for developing effective intervention strategies, preventing psychological issues, enhancing the quality of care, and advancing public health policies and research.

REPORTING METHOD

The study was reported following the strengthening of the reporting of observational studies in epidemiology (STROBE) guidelines.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

How do neighborhood environments impact adolescent health: a comprehensive study from subjective and objective perspectives using machine learning method

Existing studies have established a linear relationship between urban environments and adolescent health, but the combined impacts of subjective and objective environments on multi-dimensional health status (including physical and mental health) have not been fully explored. Furthermore, while some studies have examined the non-linear relationship between urban environments and adult health, research specifically focusing on adolescents is sparse. Using Kunming, China, as a case study, we employ Random Forest model to examine the non-linear relationship between subjective/objective neighborhood environments and adolescent physical/mental health. The results indicate that the objective environment plays a more significant role in influencing physical and mental health in adolescents. There are generally non-linear correlations and threshold effects between neighborhood environment variables and adolescents' health status. Specifically, the effects of distance to subway station, ratio of traffic safety facilities, and greening view index on adolescent physical and mental health differ. Additionally, subjective environments characterized by community management, community image, and community capital tend to positively influence adolescents' health status. This study provides valuable insights for the planning of healthy communities, environmental interventions, and health promotion in specific dimensions among adolescents.

Beyond the Nest: The Role of Financial Independence in Young Adult Health

BACKGROUND

This study aimed to examine the impact of neighborhood conditions and household material hardship experiences on young adult health outcomes, while also considering financial autonomy as a critical determinant of health.

METHOD

We employed a cross-sectional observational design with a diverse sample of young adults from a large urban university. Structural equation modeling was used to analyze the relationships between neighborhood conditions and material hardship with health outcomes by financial autonomy.

RESULTS

Material hardship and neighborhood conditions were significantly related to various health outcomes among young adults. Food insecurity emerged as a significant mediator linking neighborhood conditions to health including global physical health, cognitive functioning, and depression. Financially independent young adults showed stronger direct and indirect effects of neighborhood conditions on health compared to financially dependent counterparts.

CONCLUSION

This study underscores the complex interplay of neighborhood conditions, household material hardship, and financial autonomy in shaping young adult health. Our findings also suggest how the impact of SDOH on young adult health may have long-term effects later in life. Future research should consider these factors comprehensively to address disparities in emerging adult health.

Neighborhood social environment and mental health of older adults in China: the mediating role of subjective well-being and the moderating role of green space

Introduction

With the continuous development of the global aging trend, the mental health of older adults has been a concern by the world. The living space of older adults is limited due to the decline of their activity function. Neighborhood environment, especially the neighborhood social environment, has become an important factor affecting the mental health of older adults. Therefore, this study explores the mechanism that influences the social environment of the neighborhood and the mental health of older adults, the mediating effect of subjective well-being (SWB), and the moderating effect of green space.

Methods

Based on the 2018 China Labor Dynamics Survey, this study used the structural equation model to explore the mediating effect of neighborhood social environment (neighborhood ties, social trust, community security) on the mental health of older adults through SWB and the moderating effect of green space.

Results

Social trust and community security are both directly and positively associated with older adults' mental health. At the same time, neighborhood ties, social trust, and community security can promote the mental health of older adults by positively affecting SWB, while green space has an enhanced moderating effect between neighborhood ties and mental health.

Discussion

This study enriches the empirical research on neighborhood social environment and mental health. First of all, older adults living in communities with good safety conditions and high social trust are less affected by negative emotions and tend to have good mental health. Second, deeper neighborhood ties, higher social trust, and safer community environments help older adults to be less disturbed by negative situations, have a positive effect on their SWB, and indirectly promote mental health. At the same time, green space can provide a place for older adults to socialize, enhance the positive impact of neighborhood ties on SWB, and further promote the mental health of older adults. Finally, this study suggests that the government and community managers pay attention to the construction of neighborhood social environment and green space, and provide support for "healthy community" and "healthy aging" planning.

Effect of pre- and post-migration neighborhood environment on migrants' mental health: the case of Shenzhen, China

Existing mental health studies usually disregard people's neighborhood experiences in the past, which may have long-lasting mental health effects. This may particularly be true for migrants. To assess how the perceived pre- and post-migration neighborhood environment shapes migrants' mental health later on in life, a quasi-longitudinal survey (N = 591) among migrants was conducted in Shenzhen, China. The risk of poor mental health was screened with the General Health Questionnaire (GHQ). Perceptions of the pre- and post-migration neighborhood environment were measured retrospectively and assessed with structural equation models. The results show that the direct pathways linking the perceived post-migration neighborhood physical (NPE) and social environment (NSE) to migrants' mental health are significant. No direct association is found between the pre-migration neighborhood environments and mental health. The indirect path between the pre-migration NPE/NSE and mental health is significantly mediated by the post-migration NPE and NSE. Migrants' SES development and their neighborhood attainment interplay overtime which have long-term impacts on their mental health. Our findings suggest that the pre-migration neighborhood plays a crucial role in migrants' mental health. This confirms a path dependency of migrants' neighborhood environment throughout their migrations. Future mental health studies are advised to incorporate neighborhood characteristics along migrants' residential histories.

Objective and subjective accounts of urban exposures for epidemiological research on mental health. Measurement and analysis

The interest in the impact of urban environmental exposures (UrbEEs) on mental health has greatly increased in the last two decades. Researchers have tended to measure said exposures either via objective measurement procedures (eg, air pollution campaigns and geographic information systems computations) or by self-reported techniques such as the use of scales and questionnaires. It has been suggested that studying both the objective features of the environments and people's perceptions are key to understand environmental determinants of health and might be needed to tailor effective interventions. However, there is little guidance on how to approach this matter, the comparability between objective and subjective accounts of UrbEEs and, more importantly, suitable statistical procedures to deal with the practicalities of this kind of data. In this essay, we aim to build the case for the joint use of both sets of variables in epidemiological studies and propose socioecological models as a valid theoretical framework to accommodate these. In the methodological sphere, we will also review current literature to select examples of (un)appropriate subjective accounts of urban exposures and propose a series of statistical procedures to estimate the total, direct and indirect effects of UrbEEs on mental health and the potential associations between objective and subjective UrbEEs accounts.

Psychometric properties of the newly developed self-report environmental determinants of health questionnaire (EDH-Q): development and validation

BACKGROUND

The environmental determinants of health (EDH) have a significant impact on people's physical, mental, and social wellbeing. Everyone needs access to environmental resources of all types, including food, materials, and energy, to survive. Currently, no valid and reliable instrument exists for evaluating individuals' perceived levels of EDH. Hence, the purpose of this study was to develop and validate the environmental determinants of health questionnaire (EDH-Q) among undergraduate students in Nigeria.

METHOD

We conducted a cross-sectional survey among undergraduate students in Nigeria to assess the psychometric properties of the newly developed Environmental Determinants of Health Questionnaire (EDH-Q). Respondents were selected using a convenience sampling approach to evaluate their perceptions of environmental determinants of health. The Content Validity Index (CVI) and Face Validity Index (FVI) were calculated to ascertain the scale's content validity and response process validity, respectively. Additionally, exploratory factor analysis (EFA), confirmatory factor analysis (CFA), composite reliability (CR), average variance extracted (AVE), Cronbach's alpha, and intraclass correlation coefficient (ICC) were computed to assess the scale's construct validity.

RESULTS

The study involved 300 respondents in the EFA (males 55.7%, females 44.3%) and 430 respondents in the CFA (males 54.0%, females 46.0%). In the EFA, two constructs were identified (the natural environment and the built environment). The EFA model was able to explain 63.57% of the total cumulative variance, and the factor correlation was 0.671. The whole scale Cronbach's alpha value was 0.947, while the two constructs' Cronbach's alpha values were 0.918 (natural environment) and 0.935 (built environment). In the CFA, six pairs of error covariances were included between items within the same construct to improve the fit indices of the initial proposed measurement model. The final re-specified measurement model showed that the EDH-Q, which has two constructs and 18 items, has adequate construct validity (CFI = 0.948, TLI = 0.938, SRMR = 0.046, RMSEA = 0.052, and RMSEA p-value = 0.344). The CRs were 0.845 (natural environment) and 0.854 (built environment). The ICCs were 0.976 (natural environment) and 0.970 (built environment).

CONCLUSION

The results show that the newly created EDH-Q has sufficient construct validity and may be utilized to assess participants' perceptions of their level of EDH. Researchers should examine this instrument in populations with different age ranges and other demographic characteristics, as the present study only applied it to undergraduate students who may share similar characteristics.

Associations of occupational physical activity and active transport with depressive symptoms in a middle-income country

OBJECTIVE

This study investigated the associations of occupational physical activity and active transport with depressive symptoms, stratified by income range, among Brazilian working adults.

STUDY DESIGN

This cross-sectional study drew on data from the 2019 Brazilian National Health Survey.

METHODS

We used the Patient Health Questionnaire (PHQ-9) to assess depressive symptoms in working adults aged 18-65 years, with physical activities (occupational physical activity and active transport) self-reported through a specially developed questionnaire. Crude and adjusted logistic regression models were fitted.

RESULTS

Individuals at the highest level of occupational physical activity (odds ratio [OR] 1.35; 95% confidence interval [95% CI] 1.19-1.53) and at the moderate level of active transport to work (OR 1.66; 95% CI 1.24-2.22) returned increased odds of depressive symptoms as compared with those who were inactive in these domains. Stratified by income group, light active transport to work (OR 0.57; 95% CI 0.34-0.95) in the lower income group (Range 1) was associated with lower odds of depressive symptoms. On the other hand, individuals at the highest level of active transport to work returned higher odds of depressive symptoms in the low- and intermediate-income groups, Ranges 3 and 4 (OR 1.92; 95% CI 1.22-3.00 and OR 2.91; 95% CI 1.71-4.95, respectively).

CONCLUSION

Our results suggest that occupational physical activity and active transport may be a risk factor for depressive symptoms. They also point to differences in this relationship by income range. Further studies are needed to pursue the analysis of how specific domains of physical activity contribute to depressive symptoms.

Relationships between students' perceived campus walkability, mental health, and life satisfaction during COVID-19

Improving walkability in the campus environment and socio-psychological environments can promote students' mental health and subjective well-being. This study aimed to propose a theoretical model to investigate the link of perceived campus walkability (PCW) with mental health and life satisfaction (LS), and to disentangle the mediating impact of socio-psychological environments and academic performance on this relationship, while simultaneously considering the effect of the COVID-19 pandemic. We applied structural equation modeling to analyze the data collected through a questionnaire survey conducted at six universities and colleges in Yantai, China. PCW had both direct and indirect positive effects on mental health and LS. However, indirect effects are greater than direct effects. Walking attitudes, social capital, and academic performance were critical to the relationship between PCW, mental health, and LS. Academic performance had the strongest indirect effect on mental health, while social capital had the strongest indirect effect on LS. We also found that during the COVID-19 pandemic, body mass index and family income were significantly correlated with mental health and LS. The findings indicate that campus planners and policymakers should improve PCW and support the socio-psychological environment to promote students' mental and social health during situations like the COVID-19 pandemic.

Deconstructing Social Work Exam Bias: Advocacy Practice Guidelines to Close the Gap

INTRODUCTION

The social work profession is in a precarious situation regarding licensure. Test takers of color are struggling to pass social work licensure exams at rates comparable to their White counterparts, per data released by the Association of Social Work Boards (ASWB). As a nation, we are required to meet the needs of our increasingly diverse population. Yet the recruitment and retention of a diverse body of social workers is unlikely to be actualized if disparities persist in these exams. Given ASWB's monopoly on social work exams and the likelihood that many states will continue to require the exams for licensure, we sought to explore public responses to the data released, using the National Association of Social Work (NASW) as our starting point. As the nation's largest association of social workers, having local chapters within each state, NASW serves as an area of connection between social workers nationwide.

METHODS

We utilized content analysis to explore emerging themes and conduct a review of the state chapter's public responses to exam pass rate data.

RESULTS

A variety of state chapter's responses, with few states engaging in advocacy efforts or taking action to facilitate change.

DISCUSSION

Advocacy efforts play a pivotal role in the restructuring of fragmented systems. This study revisits seemingly ignored disparities diverse test takers may face, while also serving as a call-to-action in advocacy engagement. We conclude with a set of advocacy practice guidelines for use in the promotion of equitable licensing opportunities for all test takers.

Perceived urban green spaces and youth mental health in the post-COVID-19 era

Introduction

The urban green space (UGS) is one of the most significant urban spaces with unique visual and social features, including pleasant air, low noise, and vitality, making it a recreational place for citizens, especially the youth. According to previous studies, perceived green space and the interaction with it is associated with mental health and lower symptoms of anxiety and depression. Although the presence of urban and blue-green spaces in Isfahan has a long history, the UGSs have been out of reach, causing a significant impact on youth mental health due to the spread of COVID-19 and the forcing of the Iranian government to severe and long-term lockdown. This study investigates the relationship between the long-term isolation of youth and being away from UGSs on their mental health in Isfahan city.

Methods

In September 2022, the youth (n = 273) in 12 neighborhoods with similar socio-economic status were asked to answer the online questionnaire. To investigate the correlation between perceived UGS and the mental health of the youth, Structural Equation Modeling (SEM) is done.

Results

The results show that the perceived UGSs negatively relate to the youth's fear of the reoccurrence of COVID-19 infection, anxiety, and depression. Moreover, the model shows that perceived UGS has an inverse correlation with anxiety (β = -0.24, p = 0.00), and no meaningful correlation exists with depression.

Discussion

These results point to a practical solution for designing UDGs in residential areas for youth according to their benefits for mental health during the epidemic era.

The built environment, purpose-specific walking behaviour and overweight: evidence from Wuhan metropolis in central China

The impact of objective and subjective environmental factors on health outcomes has been a topic of significant debate, with a growing body of research acknowledging the role of a physically active lifestyle in promoting health. However, consensus regarding their precise influence remains elusive. This study contributes to these discussions by exploring how individual health outcomes correlate with transport and leisure walking behaviours, set against both the objective and subjective aspects of environmental influences in the context of Wuhan, an inland Chinese megacity. Street view images, multi-source geospatial data and a questionnaire survey were employed to characterise the "5D + Greenery" objective and perceived characteristics of the neighbourhood environment. Multi-group structural equation modelling was utilised to unravel the complex relationship and gender heterogeneity among environmental factors, purpose-specific walking, and overweight. Our results suggest that both objective land use diversity and perceived convenience are significantly associated with overweight. The accessibility of local service facilities and visible greenery promote both transport and leisure walking. While perceived neighbourhood safety encourages transport walking, perceived walkability is positively correlated with leisure walking. Notably, leisure walking, usually considered beneficial, presents a positive association with overweight conditions, acting as a mediation. Gender disparities exist in pathways between the environment and purpose-specific walking, as well as weight. The findings lend support to the planning of an activity-supporting built environment as a crucial strategy for obesity prevention.

Loneliness and sense of community are not two sides of the same coin: Identifying different determinants using the 2019 Nova Scotia Quality of Life data

The purpose of this study was to explore the relative importance of lifestyle factors and living conditions when predicting loneliness and sense of community (SOC) in a representative sample of 12,871 participants from Nova Scotia collected in 2019. Using multiple regression and measures of relative importance based on the Lindeman, Merenda and Gold (lmg) method, we identified which variables are most important to predicting measures of loneliness and SOC. Twenty-two predictors accounted for 46% of the variance in SOC and the top 10 predictors accounted for 36% of the variance: satisfaction with quality of the natural environment in the neighborhood (ri = 0.09), life satisfaction (ri = 0.05), number of neighbors one can rely on (ri = 0.05), confidence in institutions (ri = 0.05), feeling better off due to government policy or programming (ri = 0.04), feeling safe walking in neighborhood after dark (ri = 0.03), mental health (ri = 0.02), number of friends one can rely on (ri = 0.02), volunteering (ri = 0.02), and perceptions of time adequacy (ri = 0.02). Only six of these variables were also the top predictors of loneliness. These results show that both community- and individual-level variables are substantial predictors of social well-being. The effect sizes differ between models, which suggests that there may be important predictors of loneliness that we have not accounted for. This study may inform community-level programming and policy that seeks to promote social well-being for individuals and their communities.

Perceived neighborhood disorder, social cohesion, and depressive symptoms in spousal caregivers

OBJECTIVES

Prior research into the factors linked to mental health of caregivers of older adults have largely focused on individual- or household-level characteristics, but neighborhood supports and stressors may also matter for caregiver mental health. The current study fills this knowledge gap by examining the association of neighborhood social cohesion and disorder and depressive symptoms among spousal caregivers.

METHOD

We used data from the 2006 to 2016 waves of the Health and Retirement Study, which include 2,322 spousal caregivers. Negative binomial regression models were estimated to examine the association of perceived neighborhood social cohesion and disorder with depressive symptoms.

RESULTS

A higher level of perceived neighborhood social cohesion was associated with fewer depressive symptoms (b = -0.06, 95% CI: -0.10, -0.02). On the other hand, greater perceived neighborhood disorder was associated with more symptoms (b = 0.04, 95% CI: 0.01, 0.08). The association of perceived social cohesion with depressive symptoms remained even after controlling for perceived disorder, but neighborhood disorder was no longer associated with depressive symptoms after accounting for reported neighborhood social cohesion.

CONCLUSIONS

This study suggests neighborhood supports and stressors matter for caregiver well-being. Neighborhood-based social support may be particularly important for caregivers as they navigate the challenges caregiving for an aging spouse can bring. Future studies should determine if enhancing positive characteristics of the neighborhood promotes well-being of spousal caregivers.

Current methods for evaluating people's exposure to green space: A scoping review

People's exposure to green space is a critical link between urban green space and urban residents' health. Since green space may affect human health through multiple pathways regarding diverse human health outcomes, the measurement of people's exposure to green space must be tailored to concrete study contexts and research questions. In this scoping review, we systematically categorized the available green space representations and metrics in the last two decades that can be used to derive people's exposure to green space regarding different research topics. A three-phase systematic review was conducted after a generalized search of relevant research articles from the three most-used publication databases, namely Scopus, the Web of Science, and PubMed. We identified 260 research articles that particularly discuss green space representations and metrics. We further developed a multi-pathway framework to articulate the complicated context issues in green space studies. We categorized the most relevant green space representations and metrics into five groups, including green space indices, the delineation, inventory, and usage of green space, the spatiotemporal evolution of green space, the attributes and components of green space, and the green space landscape and fragmentation. Finally, we discussed the inter-conversion between different green space representations and metrics, the "mobility-turn" in green space studies and how it may affect the derivation of people's exposure to green space, and other potential methodological issues in measuring people's exposure to green space. Our scoping review provides the most comprehensive framework and categories for deriving people's exposure to green space to date, which may strongly support a broad range of studies that concern green space's health effects.

Traveling Together: A Road Map for Researching Neighborhood Effects on Population Health and Health Inequities

As evidence of the relationship between place and health mounts, more epidemiologists and clinical science researchers are becoming interested in incorporating place-based measures and analyses into their examination of population health and health inequities. Given the extensive literature on place and health, it can be challenging for researchers new to this area to develop neighborhood-effects research questions and apply the appropriate measures and methods. This paper provides a road map for guiding health researchers through the conceptual and methodological stages of incorporating various dimensions of place into their quantitative health research. Synthesizing across reviews, commentaries, and empirical investigations, the road map consists of 4 broad stages for considering place and health: 1) why?: articulating the motivation for assessing place and health and grounding the motivation in theory; 2) what?: identifying the relevant place-based characteristics and specifying their link to health to build a conceptual framework; 3) how?: determining how to operationalize the conceptual framework by defining, measuring, and assessing place-based characteristics and quantifying their effect on health; and 4) now what?: discussing the implications of neighborhood research findings for future research, policy, and practice. This road map supports efforts to develop conceptually and analytically rigorous neighborhood research projects.

Revealing the practical strategies for promoting Chinese migrant workers' health and well-being: Organizational empowerment perspective

The health and well-being of migrant workers struggling to make ends meet are being compromised, especially with the uncertainty of the COVID-19 pandemic. The aim is to analyze how organizational empowerment promotes health and well-being from an applied psychological perspective, taking into account the shaping role of individual vulnerability. Links between theory and practice will be established to achieve equitable health and well-being. The underlying mechanism by which organizational empowerment mitigated workplace-induced adverse outcomes was validated in the analysis of construction workers (n = 966). In addition, individual characteristics, namely, excitability, low perceptual threshold, control, and knowledge, attitude, and practice, were identified as critical factors, as well-being consequences vary from person to person. Moderating effect analysis showed that high excitability enhanced the association between work environment exposure and health and well-being. Control and knowledge, attitude, and practice have opposite effects. Moreover, the dual effects of the low perception threshold are verified, that is, facing the work environment produces more negative consequences, whereas perceiving more resources stimulates more positive consequences. Overall, the research provides a clearer dialectical view of vulnerability, contributing wisdom toward accurate management based on empowerment theory, which lays a solid foundation for bridging gaps in health and well-being.

Gentrification, perceptions of neighborhood change, and mental health in Montréal, Québec

While census-defined measures of gentrification are often used in research on gentrification and health, surveys can be used to better understand how residents perceive neighborhood change, and the implications for mental health. Whether or not gentrification affects mental health may depend on the extent to which an individual perceives changes in their neighborhood. Using health and map-based survey data, collected from 2020 to 2021, from the Interventions, Research, and Action in Cities Team, we examined links between perceptions of neighborhood change, census-defined neighborhood gentrification at participant residential addresses, and mental health among 505 adults living in Montréal. After adjusting for age, gender, race, education, and duration at current residence, greater perceived affordability and more positive feelings about neighborhood changes were associated with better mental health, as measured by the mental health component of the short-form health survey. Residents who perceived more change to the social environment had lower mental health scores, after adjusting individual covariates. Census-defined gentrification was not significantly associated with mental health, and perceptions of neighborhood change did not significantly modify the effect of gentrification on mental health. Utilizing survey tools can help researchers understand the role that perceptions of neighborhood change play in the understanding how neighborhood change impacts mental health.

Housing and psychosocial well-being during the COVID-19 pandemic

The loss of psychosocial well-being is an overlooked but monumental consequence of the COVID-19 pandemic. These effects result not only from the pandemic itself but, in a secondary way, from the Non-Pharmaceutical Interventions (NPIs) made to curb the spread of disease. The unprecedented physical distancing and stay-at-home requirements and recommendations provide a unique window for housing researchers to better understand the mechanisms by which housing affects psychosocial well-being. This study draws on a survey conducted with over 2,000 residents of the neighbouring Canadian provinces of British Columbia and Alberta in 2021. We propose a new multi-dimensional model to examine the relationships between the Material, Economic, Affordances, Neighbourhood, and Stability (MEANS) aspects of housing and psychosocial well-being. Our analysis reveals the direct and indirect pathways by which deficiencies in each of these areas had negative effects on psychosocial well-being. Residential stability, housing affordances, and neighbourhood accessibility exert stronger direct impacts on psychosocial well-being than material and economic housing indicators (e.g. size of living space and tenure). Notably, we find no significant well-being differences between different homeowners and renters when we account for other housing MEANS. These findings have important implications for housing policy across pandemic and post-pandemic contexts, suggesting a need for research and policy focus on understanding housing and well-being in terms of non-material aspects, such as residential stability and affordances that housing provides.

Are actual and perceived environmental conditions associated with variation in mental health?

OBJECTIVE

Empirical evidence on the relationship between environmental factors and mental health remains inconclusive. One reason is that there is only scant evidence on the association between mental health and subjective exposure to environmental stressors, relative to objective pollution. We thus focus on how the perceived and actual presence of noise, air pollution, and green spaces relates to mental health.

METHODS AND RESULTS

Our cross-sectional study is based on a large representative sample of the adult population in Switzerland (n = 5729). Using individual-level geocodes of subjects' residence, we combined data from a survey of these individuals with data on objectively measured longer-term environmental conditions (noise, air pollution, green spaces). Subclinical mental health was assessed with the 12-item General Health Questionnaire (GHQ-12). When fitting multiple regressions and mediation models, we find that perceptions of environmental stressors are a better predictor of mental distress than objectively measured stressors. In addition, the predictive power of actual nature visits is stronger than the predictive power of mere proximity to green spaces at the place of residence. We found no direct link between actual environmental stressors and mental health, but mediation via perceived environmental stressors. Further, the association between the frequency of nature visits and mental health is mediated by perceived, but not actual pollution.

CONCLUSION

Since actual environmental stressors are not perceived as equally burdensome by all people, their subjective perception is crucial when evaluating policy interventions aimed at improving mental health. Even a relatively low level of environmental stressors, classified as non-harmful to human health in a physical or biological sense, may thus contribute to negative mental health outcomes. The main policy implication is that attractive and accessible green spaces may provide individuals with an enhanced sense of control over their exposure to environmental stressors and thereby reduce negative impacts.

Neighbourhood transportation, elapsed years, and well-being after surrendering the driver's licence in older Japanese adults: The JAGES longitudinal study

This study aimed to examine how the associations between surrendering driving licence and changes in self-rated health and social interactions among older adults differ by the years elapsed since surrendering and the number of public transportation systems (PTS) in the neighbourhood. We used the 2013 and 2016 survey data from the Japan Gerontological Evaluation Study targeting residents aged ≥65 years in 30 municipalities in Japan. Two-waves longitudinal data from 4894 older adults were evaluated. Based on the difference-in-differences method, the interaction terms of respondents' driving status, which was the categorical exposure variable representing respondents' driving status for three years during the study period, and a dummy variable of year (2016) were used as explanatory variables in logistic regression analyses to examine changes in outcomes (poor self-rated health and infrequent meeting with friends) between 2013 and 2016 by driving status during this period. Analyses were stratified based on neighbourhood PTS ('more PTS' and 'fewer PTS' groups). We found that, while surrendering licence within three years was associated with increased probability of poor self-rated health in more PTS group, the confidence interval was large. Although surrendering licence within three years was associated with decreased social interactions, this association weakened if licence was surrendered more than three years ago. These associations were not markedly affected by neighbourhood PTS. Our findings suggested that, regardless of neighbourhood PTS, support and care to promote social interactions at or shortly after surrendering licence may be beneficial to the well-being of older adults who lost their driving licence.

Building a City with Low Noise Pollution: Exploring the Mental Health Effect Thresholds of Spatiotemporal Environmental Noise Exposure and Urban Planning Solution

Urban noise pollution and health hazards have become serious social problems and challenges. Noise prevention and control is the most cost-effective health strategy. However, in urban planning and noise control, reliable evidence is still lacking on individual spatiotemporal environmental noise exposure and its mental health effects. This study used real-time noise exposure data and GPS trackers from 142 volunteers aged 18 to 60 years in Guangzhou, and further analyzed the differences in environmental noise exposure and its mental health impact thresholds under individual spatiotemporal behavior. The results showed that the noise exposure of residents under daily activities has obvious differences in time, space and place. Regarding the threshold relationship between noise exposure and mental health, noise exposure at night, work, personal affairs, travel and sleep activities, as well as at home and work had a threshold effect on residents' mental health. Noise thresholds were 60 dB, 60 dB, and about 34 dB at night, during work or at a workplace, and while sleeping, respectively. The optimal sound environment for personal affairs, traveling, and at home was around 50 dB, 55-70 dB, and 45 dB, respectively. The environmental noise exposure assessment and mental health impact threshold analysis based on the spatial and temporal activities of individuals will provide important reference for government management departments in planning and policy formulation.

An Iterative, Participatory Approach to Developing a Neighborhood-Level Indicator System of Health and Wellbeing

Despite increased awareness of the essential role of neighborhood characteristics for residents' health and wellbeing, the development of neighborhood-level indicator systems has received relatively little attention to date. To address this gap, we describe the participatory development process of a small-area indicator system that includes information on local health needs in a pilot neighborhood in the German city of Mannheim. To identify relevant indicators, we partnered with representatives of the city's public health department and used an iterative approach that included multiple Plan-Do-Check-Act cycles with ongoing feedback from local key stakeholders. The described process resulted in a web-based indicator system with a total of 86 indicators. Additionally, 123 indicators were perceived as relevant by stakeholders but could not be included due to data unavailability. Overall, stakeholders evaluated the participatory approach as useful. Even though the onset of the COVID-19 pandemic and the lack of some data elements hindered instrument development, close collaboration with public health partners facilitated the process. To identify and target sub-national health inequalities, we encourage local public health stakeholders to develop meaningful and useful neighborhood-level indicator systems, building on our experiences from the applied development process and considering identified barriers and facilitators.

Nonlinear Effects of the Neighborhood Environments on Residents' Mental Health

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.

Trends and inequalities in distance to and use of nearest natural space in the context of the 20-min neighbourhood: A 4-wave national repeat cross-sectional study, 2013 to 2019

The 20-min neighbourhood is a policy priority for governments worldwide; a key feature of this policy is providing access to natural space (NS) within 800 m of home. The study aims were to (1) examine the association between distance to nearest NS and frequent use over time and (2) examine whether frequent use and changes in use were patterned by income and housing tenure over time. Bi-annual Scottish Household Survey data were obtained for 2013 to 2019 (n:42128 aged 16+). Adults were asked the walking distance to their nearest NS, the frequency of visits to this space and their housing tenure, as well as age, sex and income. We examined the association between distance from home of nearest NS, housing tenure, and the likelihood of frequent NS use (visited once a week or more). Two-way interaction terms were further applied to explore variation in the association between tenure and frequent NS use over time. We found that 87% of respondents lived within 10 min walk of a NS, meeting the policy specification for a 20-min neighbourhood. Greater proximity to NS was associated with increased use; individuals living a 6-10 min walk and over 10 min walk were respectively 53% and 78% less likely to report frequent NS use than those living within a 5 min walk. Housing tenure was an important predictor of frequent NS use; private renters and homeowners were more likely to report frequent NS use than social renters. Our findings provide evidence that proximity to NS is a strong predictor of frequent use. Our study provides important evidence that time-based access measures alone do not consider deep-rooted socioeconomic variation in use of NS. Policy makers should ensure a nuanced lens is applied to operationalising and monitoring the 20-min neighbourhood to safeguard against exacerbating existing inequalities.

Can leisure and entertainment lifestyle promote health among older people living alone in China?-A simultaneous equation approach

Objectives

With the surging number of older people living alone, their lifestyles and health status have aroused increasing concern. This study aims to investigate whether a leisure and entertainment lifestyle (LEL) can improve the multidimensional health among older people living alone and try to identify the latent mechanisms among them.

Method

For this purpose, we extracted data from the Chinese General Social Survey (CGSS) and established a simultaneous equations model, comprising ordinary least square regression (OLS), two-stage least squares (2SLS), and the mediating effect model.

Results

Older people living alone in China reported relatively better mental health status (3.64 ± 1.07), followed by physical health (3.41 ± 1.26) and social health (2.75 ± 1.18). In the OLS model, LEL significantly improved the social health of older people living alone (β = 0.054, P < 0.01), followed by physical health (β = 0.042, P < 0.01) and mental health (β = 0.027, P < 0.01). After endogenous tests from 2SLS model and robustness tests, we found that more active LEL was associated with higher levels of physical health and mental health. However, LEL had no significant effect on the improvement of the social health of the older people living alone. Using the mediation analysis, exercise efficacy partially mediated the relationship of LEL with physical health and mental health, and the ratios were 19.75 and 24.85%, respectively. Similarly, positive life attitudes partially mediated the relationship between LEL and physical health, and LEL and mental health, with ratios of 10.65 and 26.83%, respectively.

Conclusion

Our findings suggested that LEL is significantly associated with better physical and mental health for older people living alone in China, and the association is mediated by exercise efficacy and positive attitudes toward life. Promoting more leisure and recreational activities, upgrading exercise efficacy, and encouraging positive life attitudes are necessary health promotion measures in active aging policies for the wellbeing of older people living alone.

Impact of urban green space on self-rated health: Evidence from Beijing

As a crucial component of urban green space (UGS), urban parks have been found to be closely associated with the health of urban residents. Drawing on a large-scale survey, "International First-class Harmonious and Livable Capital", in Beijing conducted in 2018, this paper examines the impact of subjective and objective characteristics of UGS on residents' self-rated health (SRH) by using a binary logistic regression model. The results indicate that the overall SRH status of urban residents in Beijing is relatively good, with 73.8% of the respondents reporting good SRH. The perceived quality of UGS and objectively measured accessibility to UGS are positively associated with residents' SRH, but the subjective indicator of UGS has a greater impact on SRH than the objective indicator of UGS. In terms of influencing mechanisms, social interaction and air quality perception were the two major mediators of UGS that affected residents' SRH. The heterogeneity analysis suggests that objective accessibility to different types of urban parks has mixed effects on residents' SRH. Access to high-quality parks is positively associated with residents' SRH, whereas access to common parks has a negative impact on residents' SRH. Our findings provide important policy implications for optimizing urban park design and improving the quality of urban park provision according to human needs in the Beijing Metropolitan Area.

Residential open space and the perception of health benefits: How much is the public willing to pay?

Emerging evidence suggests that residential open space (ROS) is beneficial for multiple health outcomes for urban residents. However, the general public's understanding of and demand for the health benefits related to ROS have not been widely explored. This study aims to examine the impact of residents' socioeconomic status and perceptions of landscape health benefits on their willingness to pay (WTP) for ROS and to evaluate the perceived monetary value of different residential landscape elements. An online survey with 1348 respondents was conducted between August 2020 and October 2021 in China using a contingent valuation (CV) method. Respondents perceived the landscape benefits related to mental health to be higher than those related to physical and social health. The perception of landscape health benefits positively affected WTP and the WTP value of ROS. Residents' monthly income was a significant influencing factor for WTP and the latter's value. For individuals with positive WTP, the average annual WTP for ROS was CNY 68.98 (USD 10.81), while for all the respondents, the estimated mean annual WTP for ROS was CNY 91.75 (USD 14.38). Moreover, the estimated WTP for plants was the highest, whereas the WTP for activity spaces was estimated as the lowest. These findings may improve city planners' and community managers' understanding of the perceived value of residential landscapes among the public and help them make effective decisions to build healthy communities.

Subjective Well-Being of Professional Females: A Case Study of Dalian High-Tech Industrial Zone

The education level and social participation of contemporary Chinese women have reached their historical peak; work is fast becoming the dominant theme of their lives. However, influenced by traditional attitudes, women are still expected to undertake the main family care tasks, thus, facing dual constraints of family and work, which seriously affect their life happiness. Based on the theory of subjective well-being and feminist geography, this study used the questionnaire survey and in-depth interview results of professional females in Dalian High-tech Industrial Zone as basic data to explore the life satisfaction and emotional cognition in intra- and extra-household life of professional females (Professional females: In this study, they are the women who have received formal education and currently have full-time and steady job (including regular employees in the national systems and those who have signed labor contracts with labor units).). The following results were obtained: (1) Most professional females reported higher life satisfaction in intra- rather than extra-household life, and it varied with individual attributes, reflecting the internal differences among them. (2) The positive emotions of professional females came from the company of family and friends in intra-household life, and satisfaction with the working environment and treatment in extra-household life. (3) The negative emotions came from the pressure of "marriage," "birth," and other traditional concepts in intra-household life. In extra-household life, it came from the health problems caused by working stress, interpersonal problems and gender inequality in the workplace, and the anxiety of age and future career development. Therefore, this study committed to revealing the living status and subjective feelings of contemporary professional females in China, hoping to improve women's life quality and enhance their life happiness from a theoretical and realistic perspective.

The Relationship Between Built Environment and Mental Health of Older Adults: Mediating Effects of Perceptions of Community Cohesion and Community Safety and the Moderating Effect of Income

Many studies revealed a significant correlation between low-density built environment and the mental health of older adults in developed countries. However, scholars and decision-makers recently began to pay close attention to the effect of this relationship in high-density built environments and in developing countries. Using point-of-interest (POI) data from Baidu and data on 20 communities in Guangzhou, China, which were collected through a questionnaire survey, this study aimed to examine the relationship between built environment and the mental health of older adults as well as the physiological–psychological mediating paths between the two, so as to enrich the research on population aging in the high-density urban context in developing countries. The findings indicated that facility accessibility and distance to parks significantly positively correlated with the mental health of older adults and the number of public transit stations, and the distance to these stations significantly negatively correlated with the mental health of older adults. Also, the perceptions of community cohesion and community safety had a significant mediating effect between the built environment and the mental health of older adults. Furthermore, the moderating effect analysis results verified the moderating effect of income: with an increase in income, the perception of community cohesion enhanced the protection of the mental health of older adults and reduced the mediating effect of the perception of community safety. The results provided a reference for policy-makers and urban planners in their efforts to plan and build health-supporting communities and a healthy aging society.

Assisting Personalized Healthcare of Elderly People: Developing a Rule-Based Virtual Caregiver System Using Mobile Chatbot

To assist personalized healthcare of elderly people, our interest is to develop a virtual caregiver system that retrieves the expression of mental and physical health states through human-computer interaction in the form of dialogue. The purpose of this paper is to implement and evaluate a virtual caregiver system using mobile chatbot. Unlike the conventional health monitoring approach, our key idea is to integrate a rule-based virtual caregiver system (called "Mind Monitoring" service) with the physical, mental, and social questionnaires into the mobile chat application. The elderly person receives one question from the mobile chatbot per day, and answers it by pushing the optional button or using a speech recognition technique. Furthermore, a novel method is implemented to quantify the answers, generate visual graphs, and send the corresponding summaries or advice to the specific elder. In the experimental evaluation, we applied it to eight elderly subjects and 19 younger subjects within 14 months. As main results, its effects were significantly improved by the proposed method, including the above 80% in the response rate, the accurate reflection of their real lives from the responses, and high usefulness of the feedback messages with software quality requirements and evaluation. We also conducted interviews with subjects for health analysis and improvement.

Predicting the effect of street environment on residents' mood states in large urban areas using machine learning and street view images

BACKGROUND

Researchers have demonstrated that the built environment is associated with mental health outcomes. However, evidence concerning the effects of street environments on mood in fast-growing Asian cities is scarce. Traditional questionnaires and interview methods are labor intensive and time consuming and pose challenges for accurately and efficiently evaluating the impact of urban-scale street environments on mood.

OBJECTIVE

This study aims to use street view images and machine learning methods to model the impact of street environments on mood states in a large urban area in Guangzhou, China, and to assess the effect of different street view elements on mood.

METHODS

A total of 199,754 street view images of Guangzhou were captured from Tencent Street View, and street elements were extracted by pyramid scene parsing network. Data on six mood state indicators (motivated, happy, positive-social emotion, focused, relaxed, and depressed) were collected from 1590 participants via an online platform called Assessing the Effects of Street Views on Mood. A machine learning approach was proposed to predict the effects of street environment on mood in large urban areas in Guangzhou. A series of statistical analyses including stepwise regression, ridge regression, and lasso regression were conducted to assess the effects of street view elements on mood.

RESULTS

Streets in urban fringe areas were more likely to produce motivated, happy, relaxed, and focused feelings in residents than those in city center areas. Conversely, areas in the city center, a high-density built environment, were more likely to produce depressive feelings. Street view elements have different effects on the six mood states. "Road" is a robust indicator positively correlated with the "motivated" indicator and negatively correlated with the "depressed" indicator. "Sky" is negatively associated with "positive-social emotion" and "depressed" but positively associated with "motivated". "Building" is a negative predictor for the "focused" and "happy" indicator but is positively related to the "depressed" indicator, while "vegetation" and "terrain" are the variables most robustly and positively correlated with all positive moods.

CONCLUSION

Our findings can help urban designers identify crucial areas of the city for optimization, and they have practical implications for urban planners seeking to build urban environments that foster better mental health.

Perceived Neighborhood Environment Impacts on Health Behavior, Multi-Dimensional Health, and Life Satisfaction

The impacts of perceived neighborhood environment on adults' health and life satisfaction have drawn increasing academic attention. However, previous studies usually examine multi-dimensional (physical, mental, and perceived) health and life satisfaction separately, and few studies dealt with them simultaneously. Moreover, limited research revealed the mechanisms behind the effects of perceived neighborhood environment on health and life satisfaction, as well as how such effects are moderated by socio-demographics. Therefore, employing the 2016 China Family Panel Study Dataset and using structural equation modeling, this study delves into the complicated relationships among perceived neighborhood environment, health behavior, health outcomes (i.e., body mass index, self-rated health status, and depression), and life satisfaction. Notably, it considers mediation and moderation simultaneously. It finds: (1) Better perceived neighborhood environment significantly promotes physical activity and reduces sedentary behavior, smoking, and drinking; (2) Health behavior fully mediates the effects of perceived neighborhood environment on health; (3) Perceived neighborhood environment significantly affects life satisfaction both directly and indirectly (through health behavior and health outcomes); (4) Socio-demographics moderate the above relationships. This study disentangles the complicated impacts of perceived neighborhood environment on adults' multi-dimensional health and life satisfaction, thus providing policy makers and practitioners with nuanced knowledge for intervention.

Profiling the variability and inequity in the residential environment in Cyprus according to citizens' ratings: a cross-sectional internet-based "Place Standard" survey

Background

The “Place Standard Tool” (PST) offers a practical framework for structuring conversations about physical and social dimensions of Place which impact on health and well-being. The aim of this study was to survey citizens’ perceptions of Place across diverse settings in Cyprus. While the PST has been extensively used in the context of community engagement, its properties as a measurement tool haven’t been explored.

Methods

An open call was addressed to citizens to rate their neighbourhood environment across the 14 PST items (1: large to 7: little room for improvement). Exploratory factor, cluster and regression analyses were used to explore the dimensionality of the scale, depict neighbourhood profiles and explore differences in ratings according to socio-demographic characteristics, area-level census indicators and residents’ assessment of neighbourhood social position (10-step ladder).

Results

With the exception of safety (M = 4.4, SD = 1.7), 492 participants (mean age 42, 50% residents for > 10 years) from 254 postcodes (21.7% islandwide) did not rate other features favourably, with lowest scores for “influence and sense of control” and “public transport”. A stepwise pattern of dissatisfaction was observed along the social position continuum both for features rated less as well as more favourably (e.g. social contact). For instance, among participants who placed their neighbourhood at the three top steps of the ladder, 48.8% gave a low rating for “influence and sense of control”, while the equivalent figure was 81.0% at the bottom three steps (OR = 4.5, 95% CI 2.3, 8.6). A clear dimensionality of Built (6 items, Cronbach’s α = 0.798), Physical (3 items, α = 0.765), Social (2 items, α = 0.749) and Service (3 items, α = 0.58) environment was identified. A social gradient was evident according to census measures of socio-economic disadvantage (e.g. pre-1980 housing, single-parent households) with larger differences in terms of the built than the social environment.

Conclusions

The study profiled the variability and documented the inequity in the health-related neighbourhood environment across Cypriot communities. The readily interpretable dimensionality of the scale supports its construct validity, allowing calculation of composite scores. The PST can be used as measurement tool in research as well as public health practice to advocate for neighbourhood initiatives which support and enhance citizens’ participation.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-12706-y.

The impact of neighborhood context on telomere length: A systematic review

A growing body of research demonstrates the association between neighborhood context and health. The underlying biological mechanisms of this association are not fully understood. We conducted a systematic review of studies that investigated the association between neighborhood context and telomere length (TL), a DNA-protein complex that shortens after cell division. Short TL is linked to age-related diseases and may be impacted by chronic stress. Nineteen eligible articles identified through PubMed and Scopus met inclusion criteria. Results demonstrated inconsistent support for the relationship between neighborhood disadvantage and short TL. However, findings across several studies provide evidence for an inverse association between perceived neighborhood problems and TL, suggesting that TL may be an important factor in understanding health vulnerabilities associated specifically with negative perceptions of the neighborhood context.

The short- and long-term effects of the Great Recession on late-life depression in Europe: The role of area deprivation

INTRODUCTION

The prevalence of depression increases in times of economic crises. Less is known about whether people living in advantaged or disadvantaged areas suffer equally from negative effects of crisis.

OBJECTIVE

To explore the role of area deprivation on the short- and long-term effects of the Great Recession in Europe on late-life depression.

METHODS

Individual panel data from Austria, Belgium, Denmark, France, Germany, Italy, Spain, Sweden, Switzerland of the SHARE (age 50+, n = 6866) between 2004 and 2017 were used. Late-life depression (LLD) was measured by the EURO-D scale (4+ symptoms). Area deprivation was assessed by a country-specific z-standardized scale measuring perceived access to various services and quality of the social and built environment. Quarterly country-level GDP and yearly unemployment data were explored to define country-specific durations of the Great Recession. Individual fixed effects panel regressions were estimated controlling for time-varying socioeconomic and health-related confounders.

RESULTS

Prevalence and incidence of late-life depression was generally higher in deprived than in non-deprived areas, and these differences in prevalence and incidence increased during the Great Recession. Regressions showed that the Great Recession was related to a 23% higher long-term risk of late-life depression (OR: 1.23, CI: 1.05-1.44) for all study participants. In the short-term of the Great Recession, people from deprived areas had a 22% higher risk of late-life depression (OR: 1.22, CI: 1.02-1.46) than people from non-deprived areas.

CONCLUSION

The findings suggest that older adults exposed to adverse area determinants suffer more from the negative short-term effects of a severe economic crisis on depression and mental health inequalities may have increased between people living in deprived versus non-deprived areas. This potential increase in mental health inequalities warrants particular attention for those people living in deprived areas.

Delineating the geographic context of physical activities: A systematic search and scoping review of the methodological approaches used in social ecological research over two decades

BACKGROUND

The social ecological approach suggests that the spatial context among other factors influence physical activity behavior. Ample research documents physical environmental effects on physical activity. Yet, to date inconsistent associations remain, which might be explained by conceptual and methodological challenges in measuring the spatial dimensions of health behavior. We review methods applied to measure the spatial contexts in the social ecological physical activity literature.

METHODS

Online databases and selected reviews were used to identify papers published between 1990 and 2020. A total of 2167 records were retrieved, from which 412 studies that used physical activity as a primary outcome variable, included measures of the physical environment and applied the main principles of the social ecological approach, were included.

RESULTS

Subjective approaches were the dominant method to capture the spatial context of physical activities. These approaches were applied in 67% (n=279) of the studies. From the objective approaches an administrative unit was most prevalent and was applied in 29% (n=118) of the studies. The most comprehensive objective spatial methods that capture the true environmental exposure, were used only in 2% (n=10) of the studies.

CONCLUSIONS

Current social ecological physical activity research applies simple conceptualizations and methods of the spatial context. While conceptual and methodological concerns have been repeatedly expressed, no substantive progress has been made in the use of spatial approaches. To further our understanding on place effects on health, future studies should carefully consider the choice of spatial approaches, and their effect on study results.

Multiple environmental exposures along daily mobility paths and depressive symptoms: A smartphone-based tracking study

Few studies go beyond the residential environment in assessments of the environment-mental health association, despite multiple environments being encountered in daily life. This study investigated 1) the associations between multiple environmental exposures and depressive symptoms, both in the residential environment and along the daily mobility path, 2) examined differences in the strength of associations between residential- and mobility-based models, and 3) explored sex as a moderator. Depressive symptoms of 393 randomly sampled adults aged 18-65 were assessed using the Patient Health Questionnaire (PHQ-9). Respondents were tracked via global positioning systems- (GPS) enabled smartphones for up to 7 days. Exposure to green space (normalized difference vegetation index (NDVI)), blue space, noise (Lden) and air pollution (particulate matter (PM_2.5)) within 50 m and 100 m of each residential address and GPS point was computed. Multiple linear regression analyses were conducted separately for the residential- and mobility-based exposures. Wald tests were used to assess if the coefficients differed across models. Interaction terms were entered in fully adjusted models to determine if associations varied by sex. A significant negative relationship between green space and depressive symptoms was found in the fully adjusted residential- and mobility-based models using the 50 m buffer. No significant differences were observed in coefficients across models. None of the interaction terms were significant. Our results suggest that exposure to green space in the immediate environment, both at home and along the daily mobility path, is associated with a reduction in depressive symptoms. Further research is required to establish the utility of dynamic approaches to exposure assessment in studies on the environment and mental health.

The Effect of High-Density Built Environments on Elderly Individuals' Physical Health: A Cross-Sectional Study in Guangzhou, China

The built environment refers to the objective material environment built by humans in cities for living and production activities. Existing studies have proven that the built environment plays a significant role in human health, but little attention is paid to the elderly in this regard. At the same time, existing studies are mainly concentrated in Western developed countries, and there are few empirical studies in developing countries such as China. Based on POI (point of interest) data and 882 questionnaires collected from 20 neighborhoods in Guangzhou, we employ multilevel linear regression modeling, mediating effect modeling, to explore the path and mechanism of the impact of the built environment on elderly individuals' physical health, especially the mediating effects of physical and social interaction activity. The results show that the number of POIs, the distance to the nearest park and square, and the number of parks and squares are significantly positively correlated with the physical health of the elderly, while the number of bus and subway stations and the distance to the nearest station are significantly negatively correlated. Secondly, physical activity and social networks play a separate role in mediating the effect of the built environment on elderly individuals' physical health. The results enrich the research on the built environment and elderly individuals' health in the context of high-density cities in China and provide some reference basis for actively promoting spatial intervention and cultivating a healthy aging society.

How does perceived residential environment quality influence life satisfaction? Evidence from urban China

Against the background of fast-paced aging and urbanization in China, the current study proposed a "Residential environment-Emotional health-Life satisfaction" framework to investigate the associations among perceived residential environment quality (PREQ), positive affect (PA), social trust (ST), and life satisfaction (LS) of old adults. Data used were from a nationwide survey and covered 3825 people aged 60 years or older living in urban communities. The partial least squares-structural equation modeling approach was adopted to verify hypotheses. The results found that (1) PREQ, PA, and ST were positively correlated with LS; (2) ST mediated the relationship between PREQ and LS; and (3) people who are men, living without children, high environmental perception, and with a workout habit were more sensitively to PREQ. These findings indicate that improving the residential environment helps to promote the mental health of the Chinese urban elderly, which may have some implications for establishing an age-friendly community.

Neighborhood social integration as a predictor of neighborhood perceptions

A growing body of literature has established a relationship between neighborhood perceptions and both physical and mental health outcomes, yet there remains a need to further explicate possible psychosocial factors that are predictive of neighborhood perceptions. This study hypothesized that an increase in social integration would result in more positive neighborhood perceptions. Propensity score matching on social integration was employed to strengthen the ability to draw a causal inference about the effect on neighborhood perceptions. When controlling for a range of sociodemographic covariates-including area deprivation index as a measure of objective neighborhood conditions-high social integration accounted for more than a 7% increase in neighborhood perceptions. The findings indicate the role of social integration as a predictor of neighborhood perceptions, revealing the potential importance of interventions and mechanisms aimed at improving neighborhood perceptions via social integration for the purposes of improving physical health and mental wellbeing.

Assessing the perceived changes in neighborhood physical and social environments and how they are associated with Chinese internal migrants' mental health

BACKGROUND

Migrants experience substantial changes in their neighborhood physical and social environments along their migration journeys, but little is known about how perceived changes in their neighborhood environment pre- and post-migration correlate with their mental health. Our aim was to examine the associations between recalled changes in the perceived neighborhood physical and social environments and migrants' mental health in the host city.

METHODS

We used cross-sectional data on 591 migrants in Shenzhen, China. We assessed their risk of mental illness using the General Health Questionnaire (GHQ). Neighborhood perceptions were collected retrospectively pre- and post-migration. We used random forests to analyze possibly non-linear associations between GHQ scores and changes in the neighborhood environment, variable importance, and for exploratory analysis of variable interactions.

RESULTS

Perceived changes in neighborhood aesthetics, safety, and green space were non-linearly associated with migrants' mental health: A decline in these characteristics was associated with poor mental health, while improvements in them were unrelated to mental health benefits. Variable importance showed that change in safety was the most influential neighborhood characteristic, although individual-level characteristics-such as self-reported physical health, personal income, and hukou (i.e., the Chinese household registration system)-appeared to be more important to explain GHQ scores and also strongly interacted with other variables. For physical health, we found different associations between changes in the neighborhood provoked by migration and mental health.

CONCLUSION

Our findings suggest that perceived degradations in the physical environment are related to poorer post-migration mental health. In addition, it seems that perceived changes in the neighborhood environment play a minor role compared to individual-level characteristics, in particular migrants' physical health condition. Replication of our findings in longitudinal settings is needed to exclude reverse causality.

Does the perceived neighborhood environment promote mental health during pregnancy? Confirmation of a pathway through social cohesion in two Spanish samples

Physical neighborhood attributes such as greenness, walkability and environmental pollution may have an influence on people's behavior and health. It has been claimed that part of such effects may come from the promotion of physical activity and the strengthening of social cohesion. In this study, we recruited samples of pregnant women in two Spanish cities (Donostia-San Sebastián, 440 participants and Barcelona, 360 participants) who filled in a questionnaire and wore an accelerometer for 1 week during the first trimester of pregnancy. The influence of perceived residential greenness, walkability and environmental pollution on mental health (GHQ-12) was tested in two structural equation models that included light physical activity, moderate-to-vigorous physical activity and social cohesion as mediators. Two solutions showing excellent and good fits (Donostia-San Sebastián: X²(3) = 2.56, p = .465, CFI = 1, RMSEA < 0.001; Barcelona: X²(6) = 4.86, p = .566, CFI = 1, RMSEA = 0.048) consistently showed that neighborhood attributes promote mental health through social cohesion in the two cities. Stratified analyses revealed that the social cohesion-mental health effect was only statistically significant for low and medium socioeconomic status groups in the Donostia-San Sebastián sample. Pathways through physical activity were not confirmed.

Perceived urban green and residents' health in Beijing

Green space serves urban residents in various functions including promoting health, but the roles of different types of green space are unclear. A survey titled "Healthy Neighborhood" was conducted in Beijing from May to July 2019 to examine and compare the associations between three types of perceived green space (park green, public-square green and utility green) and three aspects of residents' health (physical health, mental health and social health). Results from the multilevel modeling (MLM) analysis show that the perceived park green has a positive correlation with mental health, and all three types of perceived green space correlate with social health positively. No significant correlation of any type of green space is detected on participants' physical health, nor any relation of public-square green or utility green to their mental health. Overall the role of urban green space is stronger on social health than physical and mental health. The findings support the complementary roles of different types of green space, and suggest that expansion in utility greens could be as effective as investing in more costly park and public-square greens, especially in their benefit in promoting social health.

Environmental stressors and well-being on middle-aged and elderly people: the mediating role of outdoor leisure behaviour and place attachment

This study develops a relational model of how environmental stressors, place attachment and outdoor leisure are related to urban green zones and, accordingly, Fujian Province in China is studied as our case problem. The research is participated by primarily middle-aged and elderly residents. In total, 871 valid questionnaires are retrieved. Structural equation modelling and path analysis are used to verify the model's fitness. The results indicate that environmental stressors and outdoor leisure are significantly negatively correlated. In addition, the outdoor leisure and place attachment are significantly positively correlated. As such, the place attachment and well-being are significantly positively correlated. However, the place attachment and outdoor leisure mediated the relationship between environmental stressors and well-being. The mediating path indicated that middle-aged and elderly residents face severe environmental stressors and will engage in a few outdoor leisure activities, resulting in low well-being. Furthermore, when middle-aged and elderly residents face severe environmental stressors, they have increased place attachment, thereby increasing their well-being. The findings can serve as a reference for environmental management agencies and future researchers.

Neighborhood built environment and late-life depression: A multilevel path analysis in a Chinese society

OBJECTIVE

Neighborhood built environments (BEs) are increasingly recognized as being associated with late-life depression. However, their pathways are still understudied. This study investigates the mediating effects of physical, social activities (PA & SA) and functional ability (FA) in the relationships between BEs and late-life depression.

METHOD

We conducted a cross-sectional analysis with data from 2,081 community-dwellers aged 65 years and above in Hong Kong in 2014. Two road-network-based service area buffers (200- and 500-meter buffers) adjusted by terrain and slope from participants' residences were created to define the scope of neighborhoods. BEs comprised population density in District Council Constituency Areas (DCCAs), urban greenness, land use diversity, and neighborhood facilities within 200- and 500-meter buffers. Multilevel path analysis models were used.

RESULTS

More urban greenness within both buffers and more commercial facilities within a 500-meter buffer were directly associated with fewer depressive symptoms. SA mediated the relationship between the number of community facilities and depressive symptoms within a 200-meter buffer. Neighborhood urban greenness and the number of commercial facilities had indirect associations on depressive symptoms within a 500-meter buffer, which were mediated by FA.

CONCLUSION

Our findings have implications for the ecological model of aging. The mediating effects of SA and FA underscore the importance of promoting active social lifestyles and maintaining FA for older adults' mental health in high-density cities. Policy implications on how to build age-friendly communities are discussed.

Planning Walkable Neighborhoods for “Aging in Place”: Lessons from Five Aging-Friendly Districts in Singapore

Today, “walkability” is considered a critical component of an aging-friendly neighborhood. This study examined the relationships between the neighborhood physical environment, walkability, and physical activity levels of older residents in Singapore. Five neighborhoods notable for their “aging in place” strategies were selected for a site survey. A questionnaire focusing on the evaluation of neighborhood walkability was administered to older adults in these neighborhoods. The questionnaire included three sections: neighborhood satisfaction, walkability, and the daily physical activity of older adults. The results indicated that adequate physical facilities and connectivity to the city were critical to older adults’ satisfaction with their neighborhoods. The mean walking time significantly dropped as the number of nearby facilities increased, and the number of facilities was negatively correlated with the daily activity levels of older adults. Thus, planners should attempt to calibrate the provision of neighborhood facilities to maintain the physical activity levels of older adults.