Rethinking the health implications of society-environment relationships in built areas: An assessment of the access to healthy and hazards index in the context of COVID-19

An early warning precision public health approach for assessing COVID-19 vulnerability in the UK: the Moore-Hill Vulnerability Index (MHVI)

BACKGROUND

Most COVID-19 vulnerability indices rely on measures that are biased by rates of exposure or are retrospective like mortality rates that offer little opportunity for intervention. The Moore-Hill Vulnerability Index (MHVI) is a precision public health early warning alternative to traditional infection fatality rates that presents avenues for mortality prevention.

METHODS

We produced an infection-severity vulnerability index by calculating the proportion of all recorded positive cases that were severe and attended by ambulances at small area scale for the East Midlands of the UK between May 2020 and April 2022. We produced maps identifying regions with high and low vulnerability, investigated the accuracy of the index over shorter and longer time periods, and explored the utility of the MHVI compared to other common proxy measures and indices. Analysis included exploring the correlation between our novel index and the Index of Multiple Deprivation (IMD).

RESULTS

The MHVI captures geospatial dynamics that single metrics alone often overlook, including the compound health challenges associated with disadvantaged and declining coastal towns inhabited by communities with post-industrial health legacies. A moderate negative correlation between MHVI and IMD reflects spatial analysis which suggests that high vulnerability occurs in affluent rural as well as deprived coastal and urban communities. Further, the MHVI estimates of severity rates are comparable to infection fatality rates for COVID-19.

CONCLUSIONS

The MHVI identifies regions with known high rates of poor health outcomes prior to the pandemic that case rates or mortality rates alone fail to identify. Pre-hospital early warning measures could be utilised to prevent mortality during a novel pandemic.

From the Perspectives of Pollution Governance and Public Health: A Research of China's Fiscal Expenditure on Energy Conservation and Environmental Protection

Improving the scale and effectiveness of China's energy conservation and environmental protection fiscal expenditure is crucial to enhancing the capacity of ecological and environmental governance of China, considering the dual perspectives of pollution governance and public health. This article first explains the mechanism by which national energy conservation and environmental protection fiscal expenditure can improve pollution control and promote public health. Secondly, this article scrutinizes the current status and limitations of China's fiscal expenditure, highlighting the contribution of fiscal expenditure in the construction of ecological civilization from the standpoints of environmental governance and public health. Additionally, this study empirically uses DEA to measure the efficiency of the government's fiscal expenditure. Conclusions found that: First, environmental protection fiscal expenditure is mainly focused on technological transformation and pollution control, while relatively little is spent on public health protection. Second, the efficiency of environmental protection fiscal funds is relatively low. These suggestions aim to optimize the positive impact of energy conservation and environmental protection fiscal expenditure for improving pollution governance and promoting public health.

The Role of Greenery in Stress Reduction among City Residents during the COVID-19 Pandemic

Cities, as places of social interactions and human relationships, face new challenges, problems, and threats, which are sources of stress for residents. An additional cause of stress in recent years has been the COVID-19 pandemic; it was urban dwellers who were most exposed to the virus and most affected by it. Chronic stress has led to the serious erosion of physical health and psychophysical well-being among urban dwellers, and so there is a need to seek new solutions in terms of building the resilience of cities and their residents to stress. This study aims to verify the hypothesis that greenery reduced the level of stress among urban dwellers during the pandemic. The verification of this hypothesis was achieved based on a literature analysis and the results of geo-questionnaire studies conducted involving 651 residents of Poznan-among the largest of Polish cities, where the share of green areas in the spatial structure is more than 30%. According to the analysis, the interviewees experienced above-average stress levels that went up during the pandemic, and the source was not so much the virus but the restrictions imposed. Green areas and outdoor activities helped in reducing this stress (being surrounded by and looking at greenery, garden work, or plant cultivation). Residents perceive a post-pandemic city as one that is more green, in which priority is given to unmanaged green areas. It has also been pointed out that a response to the reported need for urban re-construction towards stress resilience may be a biophilic city.

The approaching pilot for One Health governance index

BACKGROUND

One Health approach advocates realizing the best health and harmonious symbiosis of human, animal and natural environment through cross-border, multi-sectoral and interdisciplinary cooperation. The good governance model is the leading factor for the performance of One Health governance. In order to tackle the complex problems in the One Health governance at the global level, the variation of One Health governance in different countries was analyzed by a set of indicators within the One Health system.

METHOD

The capacity of One Health governance was assessed after establishment of a set of indicators for the One Health governance index (OHGI) following the methodology of the global One Health index. The data to calculate OHGI was collected from various database sources, including the Food and Agriculture Organization, the World Health Organization, the World Organization for Animal Health, and official health-related institutions of various countries. Eight indicators (including 19 sub-indicators) were employed in the OHGI system to comprehensively evaluate the capacity of One Health governance in 146 countries of the world.

RESULTS

Among the 146 countries scored in the OHGI system, the average score was 34.11, with a median score of 31.49, ranged from 8.50 to 70.28. Most countries with higher OHGI scores come from Europe and Central Asia, East Asia and the Pacific and North America, while countries with the lower OHGI scores are almost from sub-Saharan Africa. Six countries scored more than 65 points, including Australia, Sweden, Germany, Netherlands, the United States of America and Finland, indicating that these countries are relatively mature in most aspects of One Health governance. However, there were some developing countries with OHGI scored lower than 15. Therefore, the gap between countries with higher OHGI scores and those with lower OHGI scores is more than 60.

CONCLUSIONS

Good governance on One Health is an important indicator to measure One Health's governance capacity. The political stability, the level of rule of law and economic conditions in different regions are significantly correlated with the One Health governance capacity. Actions need to be taken urgently to close the gap of One Health governance between different regions.

Addressing External Shock in Urban Agglomeration: Implications From the Transmission Pattern of COVID-19 in the Beijing-Tianjin-Hebei Area

Properly addressing external shocks in urban agglomeration is critical to sustaining the complex regional system. The COVID-19 pandemic has been widely acknowledged as an unintended external shock, but the temporal and spatial transmission patterns are largely ignored. This study analyzed the temporal and spatial transmission patterns of COVID-19 at the macro, meso, and micro levels, and proposes a conceptual model for regional comprehensive risk calculation, taking the Beijing-Tianjin-Hebei (BTH) area as the focus region. Our results showed that 1) at the temporal scale, the epidemic in the BTH area experienced stages of rapid increase, gradual decrease, and stabilization, and the first wave of the epidemic was under control from 23 February 2020; 2) at the spatial scale, confirmed cases were largely distributed at the terminal of the migration network, with closely interconnected cities in the BTH area, including Beijing, Tianjin, Tangshan, and Langfang, holding the highest comprehensive epidemic risk, thus requiring special attention for epidemic prevention and control. Finally, a “two-wheels” conceptual framework was built to discuss implications for future policies for addressing external shocks. Our proposed framework consists of an isolation wheel, which involves information sharing from the holistic perspective, and a circulation wheel, which emphasizes stakeholder involvement from the individual perspective. The findings of this study provide a knowledge basis for epidemic prevention and control as well as useful implications for addressing external shocks in the future.

Characterizing Unusual Spatial Clusters of Male Mental Health Emergencies Occurring During the First National COVID-19 "Lockdown" in the East Midlands Region, UK: A Geospatial Analysis of Ambulance 999 Data

The widespread psychological effects of contagion mitigation measures associated with the novel coronavirus disease 2019 (COVID-19) are well known. Phases of “lockdown” have increased levels of anxiety and depression globally. Most research uses methods such as self-reporting that highlight the greater impact of the pandemic on the mental health of females. Emergency medical data from ambulance services may be a better reflection of male mental health. We use ambulance data to identify unusual clusters of high rates of male mental health emergencies occurring in the East Midlands of the United Kingdom during the first national “lockdown” and to explore factors that may explain clusters. Analysis of more than 5,000 cases of male mental health emergencies revealed 19 unusual spatial clusters. Binary logistic regression analysis (χ² = 787.22, df = 20, p ≤ .001) identified 16 factors that explained clusters, including proximity to “healthy” features of the physical landscape, urban and rural dynamics, and socioeconomic condition. Our findings suggest that the factors underlying vulnerability of males to severe mental health conditions during “lockdown” vary within and between rural and urban spaces, and that the wider “hinterland” surrounding clusters influences the social and physical access of males to services that facilitate mental health support. Limitations on social engagement to mitigate effects of the pandemic are likely to continue. Our approach could inform delivery of emergency services and the development of community-level services to support vulnerable males during periods of social isolation.

An exploration of factors characterising unusual spatial clusters of COVID-19 cases in the East Midlands region, UK: A geospatial analysis of ambulance 999 data

Complex interactions between physical landscapes and social factors increase vulnerability to emerging infections and their sequelae. Relative vulnerability to severe illness and/or death (VSID) depends on risk and extent of exposure to a virus and underlying health susceptibility. Identifying vulnerable communities and the regions they inhabit in real time is essential for effective rapid response to a new pandemic, such as COVID-19. In the period between first confirmed cases and the introduction of widespread community testing, ambulance records of suspected severe illness from COVID-19 could be used to identify vulnerable communities and regions and rapidly appraise factors that may explain VSID. We analyse the spatial distribution of more than 10,000 suspected severe COVID-19 cases using records of provisional diagnoses made by trained paramedics attending medical emergencies. We identify 13 clusters of severe illness likely related to COVID-19 occurring in the East Midlands of the UK and present an in-depth analysis of those clusters, including urban and rural dynamics, the physical characteristics of landscapes, and socio-economic conditions. Our findings suggest that the dynamics of VSID vary depending on wider geographic location. Vulnerable communities and regions occur in more deprived urban centres as well as more affluent peri-urban and rural areas. This methodology could contribute to the development of a rapid national response to support vulnerable communities during emerging pandemics in real time to save lives.