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Yu Y, Lin H, Liu Q, Ma Y, Zhao L, Li W, Zhou Y, Byun HM, Li P, Li C, Sun C, Chen X, Liu Z, Dong W, Chen L, Deng F, Wu S, Hou S, Guo L. Association of residential greenness, air pollution with adverse birth outcomes: Results from 61,762 mother‑neonatal pairs in project ELEFANT (2011-2021). THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 912:169549. [PMID: 38145684 DOI: 10.1016/j.scitotenv.2023.169549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 11/06/2023] [Accepted: 12/18/2023] [Indexed: 12/27/2023]
Abstract
BACKGROUND Emerging evidence has demonstrated the benefits of greenness exposure on human health, while conflicts remain unsolved in issue of adverse birth outcomes. METHODS Utilizing data from project ELEFANT spanning the years 2011 to 2021, we assessed residential greenness using the NDVI from MODIS data and residential PM2.5 exposure level from CHAP data. Our primary concerns were PTD, LBW, LGA, and SGA. Cox proportional hazard regression model was used to examine the association of residential greenness and air pollution exposure with risk of adverse birth outcomes. We performed mediation and modification effect analyses between greenness and air pollutant. RESULTS We identified 61,762 mother‑neonatal pairs in final analysis. For per 10 μg/m3 increase in PM2.5 concentration during entire pregnancy was associated with 19.8 % and 20.7 % increased risk of PTD and LGA. In contrast, we identified that an 0.1 unit increment in NDVI were associated with 24 %, 43 %, 26.5 %, and 39.5 % lower risk for PTD, LBW, LGA, and SGA, respectively. According to mediation analysis, NDVI mediated 7.70 % and 7.89 % of the associations between PM2.5 and PTD and LGA. Residential greenness could reduce the risk of PTD among mothers under 35 years old, living in rural areas, primigravidae and primiparity.. CONCLUSIONS In summary, our results highlighted the potential of residential greenness to mitigate the risk of adverse birth outcomes, while also pointing to the adverse impact of PM2.5 on increased risk of multiple adverse birth outcomes (PTD and LGA). The significant mediation effect of NDVI emphasizes its potential as an important protective factor of PM2.5 exposure. Additionally, the identification of susceptible subgroups can inform targeted interventions to reduce adverse birth outcomes related to air pollution and lack of green spaces. Further research and understanding of these associations can contribute to better public health strategies aimed at promoting healthier pregnancies and birth outcomes.
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Affiliation(s)
- Yuanyuan Yu
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin 300072, China; Wenzhou Safety (Emergency) Institute, Tianjin University, Wenzhou 325000, China; Tianjin Key Laboratory of Disaster Medicine Technology, Tianjin, China
| | - Huishu Lin
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin 300072, China; Wenzhou Safety (Emergency) Institute, Tianjin University, Wenzhou 325000, China; Tianjin Key Laboratory of Disaster Medicine Technology, Tianjin, China
| | - Qisijing Liu
- Research Institute of Public Health, School of Medicine, Nankai University, Tianjin, China
| | - Yuxuan Ma
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin 300072, China; Wenzhou Safety (Emergency) Institute, Tianjin University, Wenzhou 325000, China; Tianjin Key Laboratory of Disaster Medicine Technology, Tianjin, China
| | - Lei Zhao
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin 300072, China; Wenzhou Safety (Emergency) Institute, Tianjin University, Wenzhou 325000, China; Tianjin Key Laboratory of Disaster Medicine Technology, Tianjin, China
| | - Weixia Li
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin 300072, China; Wenzhou Safety (Emergency) Institute, Tianjin University, Wenzhou 325000, China; Tianjin Key Laboratory of Disaster Medicine Technology, Tianjin, China
| | - Yan Zhou
- School of Pharmaceutical Science and Technology, Tianjin University, Tianjin 300072, China
| | - Hyang-Min Byun
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Campus for Ageing and Vitality, Newcastle Upon Tyne NE4 5PL, UK
| | - Penghui Li
- Department of Environmental Science, School of Environmental Science and Safety Engineering, Tianjin University of Technology, Tianjin, China
| | - Chen Li
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Congcong Sun
- Department of Scientific Research Center, The Third Clinical Institute Affiliated of Wenzhou Medical University, The Third Affiliated of Shanghai University, Wenzhou People's Hospital, Wenzhou Maternal and Child Health Care Hospital, Wenzhou, China
| | - Xuemei Chen
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin 300072, China; Wenzhou Safety (Emergency) Institute, Tianjin University, Wenzhou 325000, China; Tianjin Key Laboratory of Disaster Medicine Technology, Tianjin, China
| | - Ziquan Liu
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin 300072, China; Wenzhou Safety (Emergency) Institute, Tianjin University, Wenzhou 325000, China; Tianjin Key Laboratory of Disaster Medicine Technology, Tianjin, China
| | - Wenlong Dong
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin 300072, China; Wenzhou Safety (Emergency) Institute, Tianjin University, Wenzhou 325000, China
| | - Liqun Chen
- Academy of Medical Engineering and Translational Medicine, Medical College, Tianjin University, Tianjin 300072, China
| | - Furong Deng
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Shaowei Wu
- Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Shike Hou
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin 300072, China; Wenzhou Safety (Emergency) Institute, Tianjin University, Wenzhou 325000, China; Tianjin Key Laboratory of Disaster Medicine Technology, Tianjin, China.
| | - Liqiong Guo
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin 300072, China; Wenzhou Safety (Emergency) Institute, Tianjin University, Wenzhou 325000, China; Tianjin Key Laboratory of Disaster Medicine Technology, Tianjin, China.
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Ye T, Xu R, Abramson MJ, Guo Y, Zhang Y, Saldiva PHN, Coelho MSZS, Li S. Maternal greenness exposure and preterm birth in Brazil: A nationwide birth cohort study. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 343:123156. [PMID: 38142032 DOI: 10.1016/j.envpol.2023.123156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 12/10/2023] [Accepted: 12/11/2023] [Indexed: 12/25/2023]
Abstract
In the dynamic landscape of maternal and child health, understanding the intricate interplay between environmental factors and pregnancy outcomes is of paramount importance. This study investigates the relationship between maternal greenness exposure and preterm births in Brazil using data spanning from 2010 to 2019. Satellite-derived indices, including the Normalized Difference Vegetation Index (NDVI) and Enhanced Vegetation Index (EVI), were employed to assess greenness exposure during whole pregnancy in maternal residential area. Employing Cox proportional hazard models, we calculated the hazard ratios (HRs) with 95% confidence intervals (CIs) for changes in NDVI, while adjusting for individual and area-level covariates. In total, 24,010,250 live births were included. Prevalence of preterm birth was 11.5%, with a modest but statistically significant decreasing trend (p = 0.013) observed across the nation over the study period. The findings reveal a significant association between greenness exposure and a reduced risk of preterm birth. Specifically, for every 0.1 increase in NDVI, there was a 2.0% decrease in the risk of preterm birth (95%CI: 1.9%-2.2%). Stratified analyses based on maternal education and ethnicity indicated potential effect modifications, with stronger protective effects observed among younger mothers and those with less years of education. Sensitivity analyses using EVI yielded consistent results. In conclusion, this study suggests that higher maternal greenness exposure is linked to a decreased risk of preterm birth in Brazil. These findings imply that enhancing residential greenspaces could be a valuable public health strategy to promote maternal and child health in Brazil.
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Affiliation(s)
- Tingting Ye
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Rongbin Xu
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Michael J Abramson
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Yuming Guo
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Yiwen Zhang
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Paulo H N Saldiva
- Urban Health Laboratory University of São Paulo, Faculty of Medicine/INSPER, São Paulo, 01246-903, Brazil
| | - Micheline S Z S Coelho
- Urban Health Laboratory University of São Paulo, Faculty of Medicine/INSPER, São Paulo, 01246-903, Brazil
| | - Shanshan Li
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia.
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Ahmer Z, Atif M, Zaheer S, Adil O, Shaikh S, Shafique K. Association between residential green spaces and pregnancy outcomes: a systematic review and meta-analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024:1-18. [PMID: 38185100 DOI: 10.1080/09603123.2023.2299242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 12/20/2023] [Indexed: 01/09/2024]
Abstract
Residential exposure to greenness has shown positive influences on pregnancy outcomes like birth weight, preterm births, and small to gestational age (SGA) deliveries. We aimed to comprehensively review and investigate these associations by conducting a systematic review with meta-analysis. Relevant studies were retrieved from PubMed, EMBASE, ScienceDirect, and Google Scholar databases before June 2023. Summary effect estimates included birth weight, low birth weight (LBW), preterm births, and SGA which were calculated for 0.1 unit increase in residential greenness exposure. Overall quality of the evidence was examined through Joanna Briggs Institute (JBI) critical appraisal tool. The review included 31 articles and found a statistically significant increase in birth weight measured at 250 m buffer distance (β = 8.95, 95% CI = 1.63-16.27). Green spaces were also associated with lower odds of LBW (OR = 0.97, 95% CI = 0.96-0.98). Residential greenness had positive impacts on pregnancy outcomes that calls for emphasis on urban planning, especially in developing countries.
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Affiliation(s)
- Zaeema Ahmer
- APPNA Institute of Public Health, Jinnah Sindh Medical University, Karachi, Sindh, Pakistan
- School of Public Health, Dow University of Health Sciences, Karachi, Sindh, Pakistan
| | - Maria Atif
- School of Public Health, Dow University of Health Sciences, Karachi, Sindh, Pakistan
| | - Sidra Zaheer
- School of Public Health, Dow University of Health Sciences, Karachi, Sindh, Pakistan
| | - Omair Adil
- School of Public Health, Dow University of Health Sciences, Karachi, Sindh, Pakistan
| | - Shiraz Shaikh
- APPNA Institute of Public Health, Jinnah Sindh Medical University, Karachi, Sindh, Pakistan
| | - Kashif Shafique
- School of Public Health, Dow University of Health Sciences, Karachi, Sindh, Pakistan
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Bravo MA, Zephyr D, Fiffer MR, Miranda ML. Weekly prenatal PM 2.5 and NO 2 exposures in preterm, early term, and full term infants: Decrements in birth weight and critical windows of susceptibility. ENVIRONMENTAL RESEARCH 2024; 240:117509. [PMID: 37890819 PMCID: PMC10842146 DOI: 10.1016/j.envres.2023.117509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/13/2023] [Accepted: 10/24/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Previous studies have observed associations between birth weight and prenatal air pollution exposure, but there is not consensus on timing of critical windows of susceptibility. OBJECTIVE We estimated the difference in birth weight among preterm, early term and full term births associated with weekly exposure to PM2.5 and NO2 throughout gestation. METHODS We included all singleton live births in the Lower Peninsula of Michigan (United States) between 2007 and 2012 occurring at or after 32 weeks gestational age (n = 497,897). Weekly ambient PM2.5 and NO2 concentrations were estimated at maternal residences using 1-km gridded data from ensemble-based models. We utilized a distributed lag nonlinear model to estimate the difference in birth weight associated with weekly exposures from the last menstrual period (week 0) through 31 weeks gestation for preterm births; through 36 weeks gestation for early term births; and through 38 weeks gestation for full term births. RESULTS In single-pollutant models, a 5 μg/m3 increase in PM2.5 exposure was associated with a reduction in birth weight among preterm births (-37.1 g [95% confidence interval [CI]: 60.8 g, -13.5 g]); early term births (-13.5 g [95% CI: 26.2 g, -0.67 g]); and full term births (-8.23 g [95% CI: 15.8 g, -0.68 g])]. In single-pollutant models, a 10 ppb increase in NO2 exposure was associated with a -11.7 g (95% CI: 14.46 g, -8.92 g) decrement in birth weight among full term births only. In models co-adjusted for PM2.5 and NO2, PM2.5 exposure was associated with reduced birth weight among preterm births (-36.9 g [95% CI: 61.9 g, -11.8 g]) and NO2 exposure was associated with reduced birth weight among full term births (-11.8 g [95% CI: 14.7 g, -8.94 g]). The largest decrements in birth weight were associated with PM2.5 exposure between approximately 10 and 26 weeks of pregnancy; for NO2 exposure, the largest decrements in birth weight in full term births were associated with exposure between weeks 6-18. CONCLUSION We observed the largest and most persistent adverse associations between PM2.5 exposure and birth weight in preterm infants, and between NO2 exposure and birth weight in full term infants. Exposure during the first half of pregnancy had a greater impact on birthweight.
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Affiliation(s)
- Mercedes A Bravo
- Global Health Institute, School of Medicine, Duke University, Durham, NC, USA; Children's Environmental Health Initiative, University of Illinois Chicago, Chicago, IL, USA.
| | - Dominique Zephyr
- Children's Environmental Health Initiative, University of Illinois Chicago, Chicago, IL, USA
| | - Melissa R Fiffer
- Children's Environmental Health Initiative, University of Illinois Chicago, Chicago, IL, USA
| | - Marie Lynn Miranda
- Children's Environmental Health Initiative, University of Illinois Chicago, Chicago, IL, USA; Department of Pediatrics, University of Illinois Chicago, Chicago, IL, USA
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Gailey S. Changes in Residential Greenspace and Birth Outcomes among Siblings: Differences by Maternal Race. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6790. [PMID: 37754649 PMCID: PMC10531468 DOI: 10.3390/ijerph20186790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/06/2023] [Accepted: 08/19/2023] [Indexed: 09/28/2023]
Abstract
Growing research investigates the perinatal health benefits of greenspace in a mother's prenatal environment. However, evidence of associations between residential greenspace and birth outcomes remains mixed, limiting the relevance this work holds for urban policy and greening interventions. Past research relies predominantly on cross-sectional designs that are vulnerable to residential selection bias, and rarely tests effect modification by maternal race/ethnicity, which may contribute to heterogeneous findings. This study uses a rigorous, longitudinal sibling comparison design and maternal fixed effect analyses to test whether increases in maternal exposure to residential greenspace between pregnancies precede improved birth outcomes among non-Hispanic (NH) white (n = 247,285) and Black (n = 54,995) mothers (mean age = 28 years) who had at least two consecutive live births in California between 2005 and 2015. Results show that increases in residential greenspace correspond with higher birthweight (coef. = 75.49, 95% CI: 23.48, 127.50) among Black, but not white (coef. = -0.51, 95% CI: -22.90, 21.90), infants. Additional analyses suggest that prior evidence of perinatal benefits associated with residential greenspace among white mothers may arise from residential selection; no such bias is observed for Black mothers. Taken together, these findings support urban greening initiatives in historically under-resourced neighborhoods. Efforts to evenly distribute residential greenspace may reduce persistent racial disparities in birth outcomes, an important step towards promoting health equity across the life course.
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Affiliation(s)
- Samantha Gailey
- Department of Forestry, Michigan State University, East Lansing, MI 48824, USA;
- Department of Public Health, Michigan State University, Flint, MI 48502, USA
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Li X, Jing MA, Cheng Y, Feng L, Wang S, Dong G. The relationship between extreme ambient temperature and small for gestational age: A cohort study of 1,436,480 singleton term births in China. ENVIRONMENTAL RESEARCH 2023:116412. [PMID: 37315757 DOI: 10.1016/j.envres.2023.116412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/29/2023] [Accepted: 06/11/2023] [Indexed: 06/16/2023]
Abstract
Studies have shown that exposure to extreme ambient temperature can contribute to adverse pregnancy outcomes, however, results across studies have been inconsistent. We aimed to evaluate the relationships between trimester-specific extreme temperature exposures and fetal growth restriction indicated by small for gestational age (SGA) in term pregnancies, and to assess whether and to what extent this relationship varies between different geographic regions. We linked 1,436,480 singleton term newborns (2014-2016) in Hubei Province, China, with a sub-district-level temperature exposures estimated by a generalized additive spatio-temporal model. Mixed-effects logistic regression models were employed to estimate the effects of extreme cold (temperature ≤5th percentile) and heat exposures (temperature >95th percentile) on term SGA in three different geographic regions, while adjusting for the effects of maternal age, infant sex, the frequency of health checks, parity, educational level, season of birth, area-level income, and PM2.5 exposure. We also stratified our analyses by infant sex, maternal age, urban‒rural type, income categories and PM2.5 exposure for robustness analyses. We found that both cold (OR:1.32, 95% CI: 1.25-1.39) and heat (OR:1.17, 95% CI: 1.13-1.22) exposures during the third trimester significantly increased the risk of SGA in the East region. Only extreme heat exposure (OR:1.29, 95% CI: 1.21-1.37) during the third trimester was significantly related to SGA in the Middle region. Our findings suggest that extreme ambient temperature exposure during pregnancy can lead to fetal growth restriction. Governments and public health institutions should pay more attention to environmental stresses during gestation, especially in the late stage of the pregnancy.
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Affiliation(s)
- Xiang Li
- Beijing Key Laboratory for Remote Sensing of Environment and Digital Cities, Faculty of Geographical Science, Beijing Normal University, 19 Xinjiekouwai Street, Beijing. 100875, China.
| | - M A Jing
- Beijing Key Laboratory for Remote Sensing of Environment and Digital Cities, Faculty of Geographical Science, Beijing Normal University, 19 Xinjiekouwai Street, Beijing. 100875, China.
| | - Yang Cheng
- Beijing Key Laboratory for Remote Sensing of Environment and Digital Cities, Faculty of Geographical Science, Beijing Normal University, 19 Xinjiekouwai Street, Beijing. 100875, China
| | - Ling Feng
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095, Jiefang Road, Wuhan, 430030, China
| | - Shaoshuai Wang
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095, Jiefang Road, Wuhan, 430030, China
| | - Guanpeng Dong
- Key Research Institute of Yellow River Civilization and Sustainable Development, Henan University, 85, Minglun Street, Kaifeng, 475001, China; Key Laboratory of Geospatial Technology for the Middle and Lower Yellow River Regions, Henan University, 85, Minglun Street, Kaifeng, 475001, China.
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Kim B, Spoer BR, Titus AR, Chen A, Thurston GD, Gourevitch MN, Thorpe LE. Life Expectancy and Built Environments in the U.S.: A Multilevel Analysis. Am J Prev Med 2023; 64:468-476. [PMID: 36935164 PMCID: PMC10621668 DOI: 10.1016/j.amepre.2022.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 10/14/2022] [Accepted: 10/18/2022] [Indexed: 03/21/2023]
Abstract
INTRODUCTION The purpose of this study is to examine the associations between built environments and life expectancy across a gradient of urbanicity in the U.S. METHODS Census tract‒level estimates of life expectancy between 2010 and 2015, except for Maine and Wisconsin, from the U.S. Small-Area Life Expectancy Estimates Project were analyzed in 2022. Tract-level measures of the built environment included: food, alcohol, and tobacco outlets; walkability; park and green space; housing characteristics; and air pollution. Multilevel linear models for each of the 4 urbanicity types were fitted to evaluate the associations, adjusting for population and social characteristics. RESULTS Old housing (built before 1979) and air pollution were important built environment predictors of life expectancy disparities across all gradients of urbanicity. Convenience stores were negatively associated with life expectancy in all urbanicity types. Healthy food options were a positive predictor of life expectancy only in high-density urban areas. Park accessibility was associated with increased life expectancy in all areas, except rural areas. Green space in neighborhoods was positively associated with life expectancy in urban areas but showed an opposite association in rural areas. CONCLUSIONS After adjusting for key social characteristics, several built environment characteristics were salient risk factors for decreased life expectancy in the U.S., with some measures showing differential effects by urbanicity. Planning and policy efforts should be tailored to local contexts.
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Affiliation(s)
- Byoungjun Kim
- Department of Population Health, New York University Grossman School of Medicine, New York, New York.
| | - Ben R Spoer
- Department of Population Health, New York University Grossman School of Medicine, New York, New York
| | - Andrea R Titus
- Department of Population Health, New York University Grossman School of Medicine, New York, New York
| | - Alexander Chen
- Department of Population Health, New York University Grossman School of Medicine, New York, New York
| | - George D Thurston
- Department of Environmental Medicine, New York University Grossman School of Medicine, New York, New York
| | - Marc N Gourevitch
- Department of Population Health, New York University Grossman School of Medicine, New York, New York
| | - Lorna E Thorpe
- Department of Population Health, New York University Grossman School of Medicine, New York, New York
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Wang K, Sun Z, Cai M, Liu L, Wu H, Peng Z. Impacts of Urban Blue-Green Space on Residents' Health: A Bibliometric Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16192. [PMID: 36498264 PMCID: PMC9737146 DOI: 10.3390/ijerph192316192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/24/2022] [Accepted: 11/30/2022] [Indexed: 06/17/2023]
Abstract
Urban blue-green space (UBGS), as an important component of the urban environment, is found to closely relate to human health. An extensive understanding of the effects of UBGS on human health is necessary for urban planning and intervention schemes towards healthy city development. However, a comprehensive review and discussion of relevant studies using bibliometric methods is still lacking. This paper adopted the bibliometric method and knowledge graph visualization technology to analyze the research on the impact of UBGS on residents' health, including the number of published papers, international influence, and network characteristics of keyword hotspots. The key findings include: (1) The number of articles published between 2001 and 2021 shows an increasing trend. Among the articles collected from WoS and CNKI, 38.74% and 32.65% of the articles focus on physical health, 38.32% and 30.61% on mental health, and 17.06% and 30.61% on public health, respectively. (2) From the analysis of international partnerships, countries with high levels of economic development and urbanization have closer cooperation than other countries. (3) UBGS has proven positive effects on residents' physical, mental, and public health. However, the mediating effects of UBGS on health and the differences in the health effects of UBGS on different ages and social classes are less studied. Therefore, this study proposes several future research directions. First, the mediating effect of UBGS on health impacts should be further examined. Furthermore, the interactive effects of residents' behaviors and the UBGS environment should be emphasized. Moreover, multidisciplinary integration should be strengthened. The coupling mechanism between human behavior and the environment should also be studied in depth with the help of social perception big data, wearable devices, and human-computer interactive simulation. Finally, this study calls for developing health risk monitoring and early warning systems, and integrating health impact assessment into urban planning, so as to improve residents' health and urban sustainability.
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Affiliation(s)
- Kun Wang
- School of Urban Design, Wuhan University, Wuhan 430072, China
| | - Zhihao Sun
- School of Urban Design, Wuhan University, Wuhan 430072, China
- Wuhan Natural Resources Conservation and Utilization Center, Wuhan 430014, China
| | - Meng Cai
- School of Urban Design, Wuhan University, Wuhan 430072, China
| | - Lingbo Liu
- School of Urban Design, Wuhan University, Wuhan 430072, China
- Center for Digital City Research, Wuhan University, Wuhan 430072, China
- Center for Geographic Analysis, Harvard University, Cambridge, MA 02138, USA
| | - Hao Wu
- School of Urban Design, Wuhan University, Wuhan 430072, China
- Center for Digital City Research, Wuhan University, Wuhan 430072, China
| | - Zhenghong Peng
- School of Urban Design, Wuhan University, Wuhan 430072, China
- Center for Digital City Research, Wuhan University, Wuhan 430072, China
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Villeneuve PJ, Lam S, Tjepkema M, Pinault L, Crouse DL, Osornio-Vargas AR, Hystad P, Jerrett M, Lavigne E, Stieb DM. Residential proximity to greenness and adverse birth outcomes in urban areas: Findings from a national Canadian population-based study. ENVIRONMENTAL RESEARCH 2022; 204:112344. [PMID: 34742713 DOI: 10.1016/j.envres.2021.112344] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 10/07/2021] [Accepted: 11/02/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Over the last decade, several studies have reported that residential proximity to vegetation, or 'greenness', is associated with improved birth outcomes, including for term birth weight (TBW), preterm birth (PTB), and small for gestational age (SGA). However, there remain several uncertainties about these possible benefits including the role of air pollution, and the extent to they are influenced socioeconomic status. METHODS We addressed these gaps using a national population-based study of 2.2 million singleton live births in Canadian metropolitan areas between 1999 and 2008. Exposures to greenness, fine particulate matter (PM2.5), and nitrogen dioxide (NO2) were assigned to infants using the postal code of their mother's residence at the time of birth. The Normalized Difference Vegetation Index (NDVI) was used to characterize greenness, while estimates of ambient PM2.5 and NO2 were estimated using remote sensing, and a national land-use regression surface, respectively. Multivariable regression analysis was performed to describe associations between residential greenness and the birth outcomes. Stratified analyses explored whether these associations were modified by neighbourhood measures of socioeconomic status. RESULTS Mothers who lived in greener areas had a lower risk of low TBW, PTB, and SGA babies. These associations persisted after adjustment for ambient NO2 and PM2.5. Specifically, in fully adjusted models, an interquartile range (IQR = 0.16) increase in the NDVI within a residential buffer of 250 m yielded odds ratios of 0.93 (95% confidence interval (CI): 0.92, 0.94), 0.94 (95% CI: 0.92, 0.95), and 0.94 (95% CI: 0.93, 0.95) for the outcomes of PTB, low TBW, and SGA, respectively. Similarly, an IQR increase in greenness was associated with a 16.3 g (95% CI: 15.3, 17.4) increase in TBW. We found inverse associations between greenness and the occurrence of adverse birth outcomes regardless of the socioeconomic status of the neighbourhood. INTERPRETATION Our findings support the hypothesis that residential greenness contributes to healthier pregnancies, that these associations are independent from exposure to air pollution. , and that proximity to greenness benefits all mothers regardless of socioeconomic status.
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Affiliation(s)
- Paul J Villeneuve
- CHAIM Research Center, Carleton University, Herzberg Building, Room 5413, Ottawa, ON, K1S 5B6, Canada; Department of Neuroscience, Carleton University, Ottawa, ON, Canada.
| | - Sandy Lam
- Department of Health Sciences, Carleton University, Ottawa, ON, Canada
| | | | - Lauren Pinault
- Health Analysis Division, Statistics Canada, Ottawa, ON, Canada
| | | | - Alvaro R Osornio-Vargas
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Perry Hystad
- School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
| | - Michael Jerrett
- Department of Environmental Health Sciences, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Eric Lavigne
- Air Health Science Division, Health Canada, Ottawa, Canada
| | - David M Stieb
- School of Epidemiology and Public Health, University of Ottawa, Canada; Environmental Health Science and Research Bureau, Health Canada, Vancouver, Canada
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10
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Yitshak-Sade M, Kloog I, Schwartz JD, Novack V, Erez O, Just AC. The effect of prenatal temperature and PM 2.5 exposure on birthweight: Weekly windows of exposure throughout the pregnancy. ENVIRONMENT INTERNATIONAL 2021; 155:106588. [PMID: 33940393 PMCID: PMC8292186 DOI: 10.1016/j.envint.2021.106588] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 03/22/2021] [Accepted: 04/15/2021] [Indexed: 05/13/2023]
Abstract
BACKGROUND Birthweight is a strong predictor of normal growth, healthy development, and survival. Several studies have found associations between temperature, fine particulate matter (PM2.5), and birth weight. However, the relevant timing of exposures varies between studies and is yet unclear. Therefore, we assessed the difference in term birthweight (TBW) associated with weekly exposure to temperature and PM2.5 throughout 37 weeks of gestation. METHODS We included all singleton live term births in Massachusetts, U.S between 2004 and 2015 (n = 712,438). Weekly PM2.5 and temperature predictions were estimated on a 1 km grid from satellite-based models. We utilized a distributed lag nonlinear model (DLNM) to estimate the difference in TBW associated with weekly exposures from the last menstrual period to 37 weeks of gestation. RESULTS We found a nonlinear association with prenatal temperature exposure. Larger effects were observed in warmer temperatures, where higher temperatures were negatively associated with TBW. Temperature effects were larger in the first and final weeks of gestation. We observed a negative difference in TBW associated with PM2.5 exposure. Overall, a 1 µg/m3 increase in prenatal exposure was associated with 3.9 g lower TBW (95% CI -5.0 g; -2.9 g). PM2.5 effects were larger in the final weeks of gestation. CONCLUSION We found heat and PM2.5 exposure to be related to lower TBW. Our findings suggest that women are more susceptible to both exposures towards the end of pregnancy. Susceptibility to heat was higher in the initial weeks of pregnancy as well. These critical windows of susceptibility can be communicated to pregnant women during routine prenatal visits to increase awareness and target interventions to reduce exposures.
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Affiliation(s)
- Maayan Yitshak-Sade
- Icahn School of Medicine at Mount Sinai, Department of Environmental Medicine and Public Health, New York, NY, USA.
| | - Itai Kloog
- Icahn School of Medicine at Mount Sinai, Department of Environmental Medicine and Public Health, New York, NY, USA; Department of Geography and Environmental Development, Faculty of Humanities and Social Sciences, Ben-Gurion University, Beer-Sheva, Israel
| | - Joel D Schwartz
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Victor Novack
- Negev Environmental Health Research Institute, Beer Sheva, Israel; Department of Medicine, Faculty of Health Sciences, Ben-Gurion University, Beer-Sheva, Israel; Soroka University Medical Center, Beer Sheva, Israel
| | - Offer Erez
- Soroka University Medical Center, Beer Sheva, Israel
| | - Allan C Just
- Icahn School of Medicine at Mount Sinai, Department of Environmental Medicine and Public Health, New York, NY, USA
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11
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Xiao X, Gao M, Zhou Y, Xu SL, Knibbs LD, Heinrich J, Dharmage SC, Morawska L, Lin S, Jalaludin B, Shen X, Zhou Y, Dong GH. Is greener better? Associations between greenness and birth outcomes in both urban and non-urban settings. Int J Epidemiol 2021; 51:88-98. [PMID: 34406380 DOI: 10.1093/ije/dyab164] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 07/23/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Beneficial effects of greenness on birth outcomes have been reported, but few studies have investigated the associations in both urban and non-urban settings. We aimed to evaluate and compare linear and nonlinear associations between greenness and birth outcomes in urban and non-urban settings. METHODS From October 2015 to December 2018, participants were recruited into the Maoming Birth Cohort Study. A total of 11 258 live birth records were obtained. Greenness exposure was assessed using the normalized difference vegetation index (NDVI) and enhanced vegetation index (EVI). Linear regression and nonlinear restricted cubic spline models were implemented to investigate the associations between greenness and birthweight, birth length, gestational age, preterm birth, low birthweight, small for gestational age and the potential for effect variation under urban or non-urban settings, after adjusting for covariates. RESULTS A 0.1-unit increase in NDVI-500m was significantly associated with an increase of 35.4 g in birthweight [95% confidence interval (CI): 13.2, 57.7], 0.15 cm in birth length (95% CI: 0.03, 0.26), 0.88 days in gestational age (95% CI: 0.05, 1.71) and lower odds of low birthweight [odds ratio (OR) = 0.69, 95% CI: 0.56, 0.85] and preterm birth (OR = 0.70, 95% CI: 0.58, 0.85). No association with head circumference was observed. For all outcomes, no significant linear associations were observed among non-urban dwellers. Inversed 'U-shaped' associations between greenness exposure and birth outcomes were observed in the total study population. CONCLUSIONS Greenness exposure was associated with increased gestational age, birthweight and birth length in urban dwellers. Nonlinear associations assessed by restricted cubic splines suggested that health benefits could be larger when increasing greenness levels from low to medium compared with increasing greenness from medium to high levels. Further studies adopting nonlinear methods are warranted to verify our findings.
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Affiliation(s)
- Xiang Xiao
- Department of Geography, Hong Kong Baptist University, Hong Kong SAR, China.,Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Meng Gao
- Department of Geography, Hong Kong Baptist University, Hong Kong SAR, China
| | - Yang Zhou
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou, China
| | - Shu-Li Xu
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Luke D Knibbs
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia.,School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
| | - Joachim Heinrich
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany.,Comprehensive Pneumology Center Munich, German Center for Lung Research, Munich, Germany
| | - Shyamali C Dharmage
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Lidia Morawska
- International Laboratory for Air Quality and Health, Queensland University of Technology, Brisbane, Australia
| | - Shao Lin
- Department of Environmental Health Sciences and Epidemiology and Biostatistics, University at Albany, State University of New York, Rensselaer, NY, USA
| | - Bin Jalaludin
- School of Public Health and Community Medicine, Faculty of Medicine, The University of New South Wales, Kensington, Australia
| | - Xubo Shen
- Department of Epidemiology & Biostatistics, School of Public Health, Zunyi Medical University, Zunyi, China
| | - Yuanzhong Zhou
- Department of Epidemiology & Biostatistics, School of Public Health, Zunyi Medical University, Zunyi, China
| | - Guang-Hui Dong
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
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12
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Margerison CE, Pearson AL, Lin Z, Sanciangco J. Changes in residential greenness between pregnancies and birth outcomes: longitudinal evidence from Michigan births 1990--2012. Int J Epidemiol 2021; 50:190-198. [PMID: 33130859 DOI: 10.1093/ije/dyaa158] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Residential exposure to greenness is associated with better birth outcomes, but it remains unknown whether this is explained by maternal characteristics associated with both place of residence and birth outcomes. We examined whether changes in residential greenness are associated with preterm birth (PTB) and birthweight. METHODS We examined cross-sectional associations between maternal exposure to residential greenness [normalized difference vegetation index (NDVI)] and PTB (<37 weeks of gestation) and birthweight in grams, using all births in Michigan (1990-2012) linked by mother (n = 1 730 424). We used maternal fixed effects analysis to estimate associations within mothers across multiple pregnancies and associations for mothers who did not move, but for whom greenness changed between pregnancies, to mimic an intervention. RESULTS Each 0.1-unit change in NDVI was associated with 0.98 [95% confidence interval (CI): 0.97, 0.99] times lower odds of PTB and a 9.0 (95% CI: 8.1, 9.9)-gram increase in birthweight after adjusting for individual and neighbourhood covariates. When we controlled for time-invariant maternal unmeasured confounders; these associations were close to null [odds ratio (OR): 1.00 (95% CI: 0.98, 1.01); β: -0.3 (95% CI: -2.0, 3.6)]. We did not find a relationship between greenness and birth outcomes among women who did not move between pregnancies, but for whom greenness changed within their residential location (as in an intervention). CONCLUSIONS Residential greenness does not predict birth outcomes, after controlling for time-invariant maternal characteristics, using longitudinal evidence. Future research should explore residential selection factors, spatial and individual heterogeneity and experimental study designs.
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Affiliation(s)
- Claire E Margerison
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA
| | - Amber L Pearson
- Department of Public Health, University of Otago, Wellington, New Zealand.,Department of Geography, Environment and Spatial Sciences, Michigan State University, East Lansing, MI, USA
| | - Zihan Lin
- Department of Geography, Environment and Spatial Sciences, Michigan State University, East Lansing, MI, USA.,Center for Global Change and Earth Observations, Michigan State University, East Lansing, MI, USA
| | - Jonnell Sanciangco
- Department of Geography, Environment and Spatial Sciences, Michigan State University, East Lansing, MI, USA
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13
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Akaraci S, Feng X, Suesse T, Jalaludin B, Astell-Burt T. Greener neighbourhoods, healthier birth outcomes? Evidence from Australia. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 278:116814. [PMID: 33677222 DOI: 10.1016/j.envpol.2021.116814] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 01/23/2021] [Accepted: 02/19/2021] [Indexed: 06/12/2023]
Abstract
Growing body of research recognizes the importance of green spaces on the perinatal outcomes however, further evidence from different geographies are warranted. We aimed to investigate association between, and differential responses to, maternal exposure to green space and birthweight. Birth records (n = 82,221) were extracted from the Perinatal Data Collection (PDC) in Sydney's metropolitan area between January 2016 and December 2017. Association between green space quantity and birthweight, term birthweight, low birthweight, term low birthweight and preterm were assessed using linear and logistic regressions. Potential modification by area-level socioeconomic status and maternal country of birth were tested using interaction terms. Difference in birth weight for the ≥40% versus <20% green space within SA2s was 59.0 g (95%CI: 42.9, 75.3) in unadjusted models which dropped to 25.6 g (95%CI: 13.0, 38.2) in adjusted models. Stratified analysis suggested stronger associations for babies of mothers from affluent neighbourhoods, while statistically significant association was not observed in deprived areas. Furthermore, the association was more pronounced among babies to mothers who were born overseas. Associations were consistent for term births. Higher levels of green space were associated with lower odds of preterm birth in adjusted models. However, we did not identify statistically significant association between green space quantity and the risk of low birthweight (LBW). Our study suggests that green space may support healthier birth outcomes and help to reduce the birthweight gap between newborns of mothers born in Australia and overseas. However, disproportionate benefits among women in affluent neighbourhoods may widen socioeconomic inequities in birthweight.
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Affiliation(s)
- Selin Akaraci
- Population Wellbeing and Environment Research Lab (PowerLab), School of Health and Society, Faculty of Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia.
| | - Xiaoqi Feng
- Population Wellbeing and Environment Research Lab (PowerLab), School of Health and Society, Faculty of Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia; School of Population Health, Faculty of Medicine and Health, University of New South Wales, NSW 2052, Australia; Menzies Centre for Health Policy, University of Sydney, Sydney, Australia; National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Thomas Suesse
- NIASRA, National Institute for Applied Statistics Research Australia School of Mathematics and Applied Statistics, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, NSW, 2522, Australia.
| | - Bin Jalaludin
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, NSW 2052, Australia; Ingham Institute for Applied Medical Research, University of New South Wales, Sydney, NSW, 2170, Australia.
| | - Thomas Astell-Burt
- Population Wellbeing and Environment Research Lab (PowerLab), School of Health and Society, Faculty of Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia; Menzies Centre for Health Policy, University of Sydney, Sydney, Australia; National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; School of Population Medicine and Public Health, Peking Union Medical College and The Chinese Academy of Medical Sciences, Beijing, China.
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14
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Greenspace, Air Pollution, Neighborhood Factors, and Preeclampsia in a Population-Based Case-Control Study in California. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105127. [PMID: 34066190 PMCID: PMC8151979 DOI: 10.3390/ijerph18105127] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/05/2021] [Accepted: 05/06/2021] [Indexed: 12/26/2022]
Abstract
To investigate preeclampsia etiologies, we examined relationships between greenspace, air pollution, and neighborhood factors. Data were from hospital records and geocoded residences of 77,406 women in San Joaquin Valley, California from 2000 to 2006. Preeclampsia was divided into mild, severe, or superimposed onto pre-existing hypertension. Greenspace within 100 and 500 m residential buffers was estimated from satellite data using normalized difference vegetation index (NDVI). Air quality data were averaged over pregnancy from daily 24-h averages of nitrogen dioxide, particulate matter <10 µm (PM10) and <2.5 µm (PM2.5), and carbon monoxide. Neighborhood socioeconomic (SES) factors included living below the federal poverty level and median annual income using 2000 US Census data. Odds of preeclampsia were estimated using logistic regression. Effect modification was assessed using Wald tests. More greenspace (500 m) was inversely associated with superimposed preeclampsia (OR = 0.57). High PM2.5 and low SES were associated with mild and severe preeclampsia. We observed differences in associations between greenspace (500 m) and superimposed preeclampsia by neighborhood income and between greenspace (500 m) and severe preeclampsia by PM10, overall and among those living in higher SES neighborhoods. Less greenspace, high particulate matter, and high-poverty/low-income neighborhoods were associated with preeclampsia, and effect modification was observed between these exposures. Further research into exposure combinations and preeclampsia is warranted.
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15
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Milando CW, Yitshak-Sade M, Zanobetti A, Levy JI, Laden F, Fabian MP. Modeling the impact of exposure reductions using multi-stressor epidemiology, exposure models, and synthetic microdata: an application to birthweight in two environmental justice communities. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2021; 31:442-453. [PMID: 33824415 PMCID: PMC8141037 DOI: 10.1038/s41370-021-00318-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 02/25/2021] [Accepted: 03/12/2021] [Indexed: 05/07/2023]
Abstract
BACKGROUND Many vulnerable populations experience elevated exposures to environmental and social stressors, with deleterious effects on health. Multi-stressor epidemiological models can be used to assess benefits of exposure reductions. However, requisite individual-level risk factor data are often unavailable at adequate spatial resolution. OBJECTIVE To leverage public data and novel simulation methods to estimate birthweight changes following simulated environmental interventions in two environmental justice communities in Massachusetts, USA. METHODS We gathered risk factor data from public sources (US Census, Behavioral Risk Factor Surveillance System, and Massachusetts Department of Health). We then created synthetic individual-level data sets using combinatorial optimization, and probabilistic and logistic modeling. Finally, we used coefficients from a multi-stressor epidemiological model to estimate birthweight and birthweight improvement associated with simulated environmental interventions. RESULTS We created geographically resolved synthetic microdata. Mothers with the lowest predicted birthweight were those identifying as Black or Hispanic, with parity > 1, utilization of government prenatal support, and lower educational attainment. Birthweight improvements following greenness and temperature improvements were similar for all high-risk groups and were larger than benefits from smoking cessation. SIGNIFICANCE Absent private health data, this methodology allows for assessment of cumulative risk and health inequities, and comparison of individual-level impacts of localized health interventions.
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Affiliation(s)
- Chad W Milando
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA.
| | - Maayan Yitshak-Sade
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Antonella Zanobetti
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jonathan I Levy
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Francine Laden
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - M Patricia Fabian
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
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16
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Krabbendam L, van Vugt M, Conus P, Söderström O, Abrahamyan Empson L, van Os J, Fett AKJ. Understanding urbanicity: how interdisciplinary methods help to unravel the effects of the city on mental health. Psychol Med 2021; 51:1099-1110. [PMID: 32156322 DOI: 10.1017/s0033291720000355] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Twenty-first century urbanization poses increasing challenges for mental health. Epidemiological studies have shown that mental health problems often accumulate in urban areas, compared to rural areas, and suggested possible underlying causes associated with the social and physical urban environments. Emerging work indicates complex urban effects that depend on many individual and contextual factors at the neighbourhood and country level and novel experimental work is starting to dissect potential underlying mechanisms. This review summarizes findings from epidemiology and population-based studies, neuroscience, experimental and experience-based research and illustrates how a combined approach can move the field towards an increased understanding of the urbanicity-mental health nexus.
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Affiliation(s)
- Lydia Krabbendam
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Institute for Brain and Behavior Amsterdam, Vrije Universiteit Amsterdam, Van der Boechorststraat 1, 1081 BTAmsterdam, The Netherlands
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, 16 De Crespigny Park, LondonSE5 8AF, UK
| | - Mark van Vugt
- Department of Experimental and Applied Psychology, Faculty of Behavioral and Movement Sciences, Institute for Brain and Behavior Amsterdam, Vrije Universiteit Amsterdam, Van der Boechorststraat 1, 1081 BTAmsterdam, The Netherlands
| | - Philippe Conus
- Treatment and Early Intervention in Psychosis Program (TIPP), Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), Clinique de Cery, Prilly, Switzerland
| | - Ola Söderström
- Institut de Géographie, Université de Neuchâtel, Espace Louis-Agassiz, 2000, Neuchâtel, Switzerland
| | - Lilith Abrahamyan Empson
- Treatment and Early Intervention in Psychosis Program (TIPP), Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), Clinique de Cery, Prilly, Switzerland
| | - Jim van Os
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, 16 De Crespigny Park, LondonSE5 8AF, UK
- Department of Psychiatry, UMC Utrecht Brain Center, Utrecht, The Netherlands
- Department of Psychiatry and Psychology, School for Mental Health and Neuroscience (MHeNS), Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Anne-Kathrin J Fett
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Institute for Brain and Behavior Amsterdam, Vrije Universiteit Amsterdam, Van der Boechorststraat 1, 1081 BTAmsterdam, The Netherlands
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, 16 De Crespigny Park, LondonSE5 8AF, UK
- Department of Psychology, City, University of London, Northampton Square, LondonEC1V 0HB, UK
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17
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Green Space and Health Equity: A Systematic Review on the Potential of Green Space to Reduce Health Disparities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052563. [PMID: 33806546 PMCID: PMC7967323 DOI: 10.3390/ijerph18052563] [Citation(s) in RCA: 123] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 02/25/2021] [Accepted: 02/26/2021] [Indexed: 02/07/2023]
Abstract
Disadvantaged groups worldwide, such as low-income and racially/ethnically minoritized people, experience worse health outcomes than more privileged groups, including wealthier and white people. Such health disparities are a major public health issue in several countries around the world. In this systematic review, we examine whether green space shows stronger associations with physical health for disadvantaged groups than for privileged groups. We hypothesize that disadvantaged groups have stronger protective effects from green space because of their greater dependency on proximate green space, as they tend to lack access to other health-promoting resources. We use the preferred reporting items for systematic reviews and meta-analyses (PRISMA) method and search five databases (CINAHL, Cochrane, PubMed, Scopus, and Web of Science) to look for articles that examine whether socioeconomic status (SES) or race/ethnicity modify the green space-health associations. Based on this search, we identify 90 articles meeting our inclusion criteria. We find lower-SES people show more beneficial effects than affluent people, particularly when concerning public green spaces/parks rather than green land covers/greenness. Studies in Europe show stronger protective effects for lower-SES people versus higher-SES people than do studies in North America. We find no notable differences in the protective effects of green space between racial/ethnic groups. Collectively, these results suggest green space might be a tool to advance health equity and provide ways forward for urban planners, parks managers, and public health professionals to address health disparities.
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18
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Verheyen VJ, Remy S, Lambrechts N, Govarts E, Colles A, Poelmans L, Verachtert E, Lefebvre W, Monsieurs P, Vanpoucke C, Nielsen F, Van den Eeden L, Jacquemyn Y, Schoeters G. Residential exposure to air pollution and access to neighborhood greenspace in relation to hair cortisol concentrations during the second and third trimester of pregnancy. Environ Health 2021; 20:11. [PMID: 33573648 PMCID: PMC7879652 DOI: 10.1186/s12940-021-00697-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 02/01/2021] [Indexed: 05/14/2023]
Abstract
BACKGROUND Exposure to air pollution during pregnancy has been associated with adverse pregnancy outcomes in studies worldwide, other studies have described beneficial effects of residential greenspace on pregnancy outcomes. The biological mechanisms that underlie these associations are incompletely understood. A biological stress response, which implies release of cortisol, may underlie associations of air pollution exposure and access to neighborhood greenspaces with health. METHODS We explored residential exposure to air pollution and residential access to neighborhood greenspaces in relation to hair cortisol concentrations of participants in a prospective pregnancy cohort study in Flanders, Belgium. Hair samples were collected at the end of the second pregnancy trimester (n = 133) and shortly after delivery (n = 81). Cortisol concentrations were measured in 3-cm scalp-near hair sections, to reflect second and third pregnancy trimester cortisol secretion. We estimated long-term (3 months before sampling) residential exposure to fine particulate matter (PM2.5), nitrogen dioxide (NO2) and black carbon (BC), assessed residential distance to major roads and residential access to neighborhood greenspaces (NHGS). Associations between residential exposures and hair cortisol concentrations were studied using linear regression models while adjusting for season of sampling. RESULTS Three-month mean residential NO2 and BC concentrations were positively associated with third pregnancy trimester hair cortisol concentrations (p = 0.008 and p = 0.017). Access to a large NHGS (10 ha or more within 800 m from residence) was negatively associated with third trimester hair cortisol concentrations (p = 0.019). Access to a large NHGS significantly moderated the association between residential proximity to major roads and second trimester hair cortisol concentrations (p = 0.021). Residential distance to major roads was negatively associated with second trimester hair cortisol concentrations of participants without access to a large NHGS (p = 0.003). The association was not significant for participants with access to a large NHGS. The moderation tended towards significance in the third pregnancy trimester (p < 0.10). CONCLUSIONS Our findings suggest a positive association between long-term residential exposure to air pollution and biological stress during pregnancy, residential access to neighborhood greenspaces may moderate the association. Further research is needed to confirm our results. TRIAL REGISTRATION The IPANEMA study is registered under number NCT02592005 at clinicaltrials.gov .
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Affiliation(s)
- Veerle Josefa Verheyen
- Flemish Institute for Technological Research (VITO), Mol, Belgium
- Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | - Sylvie Remy
- Flemish Institute for Technological Research (VITO), Mol, Belgium
| | | | - Eva Govarts
- Flemish Institute for Technological Research (VITO), Mol, Belgium
| | - Ann Colles
- Flemish Institute for Technological Research (VITO), Mol, Belgium
| | - Lien Poelmans
- Flemish Institute for Technological Research (VITO), Mol, Belgium
| | - Els Verachtert
- Flemish Institute for Technological Research (VITO), Mol, Belgium
| | - Wouter Lefebvre
- Flemish Institute for Technological Research (VITO), Mol, Belgium
| | - Pieter Monsieurs
- Flemish Institute for Technological Research (VITO), Mol, Belgium
| | | | - Flemming Nielsen
- The Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Lena Van den Eeden
- Department of Obstetrics and Gynecology, Antwerp University Hospital, Antwerp, Belgium
- People and Health, Thomas More University College, Lier, Belgium
| | - Yves Jacquemyn
- Department of Obstetrics and Gynecology, Antwerp University Hospital, Antwerp, Belgium
- Global Health Institute, Faculty of Medicine, University of Antwerp, Antwerp, Belgium
- Antwerp Surgical Training, Anatomy and Research Centre, University of Antwerp, Antwerp, Belgium
| | - Greet Schoeters
- Flemish Institute for Technological Research (VITO), Mol, Belgium
- Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
- The Department of Public Health, University of Southern Denmark, Odense, Denmark
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19
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Hu CY, Yang XJ, Gui SY, Ding K, Huang K, Fang Y, Jiang ZX, Zhang XJ. Residential greenness and birth outcomes: A systematic review and meta-analysis of observational studies. ENVIRONMENTAL RESEARCH 2021; 193:110599. [PMID: 33307084 DOI: 10.1016/j.envres.2020.110599] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 12/04/2020] [Accepted: 12/04/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND The amount of natural vegetation surrounding homes (residential greenness) has been proposed as a mitigation measure to buffer the adverse health effects of urban living, associated with promoting health and wellbeing including birth outcomes. This study aimed to systematically review the epidemiological evidence on the association of residential greenness with birth outcomes and quantitatively provide summary effect estimates of the current literature. METHODS We extensively searched epidemiological studies related to residential greenness and birth outcomes in three electronic databases (EMBASE, Web of Science, and PubMed) using terms related to residential greenness and birth outcomes before July 10, 2020. Summary effect estimates of residential greenness on birth outcomes including SGA (small for gestational age), PTB (preterm birth), LBW (low birth weight), and birth weight were calculated for each 0.1 unit increase in residential greenness exposure, as well as comparing the highest to the lowest categories using random-effects meta-analyses. We assessed the risk of bias of each individual study, and the overall quality of the body of evidence and level of evidence for each exposure-outcome were also evaluated. RESULTS The initial search identified 161 studies, of which 29 studies were finally included. Meta-analysis for continuous exposure suggested that an increase in residential greenness, measured by NDVI (normalized difference vegetation index) with different buffer sizes, was generally associated with higher birth weights ranging from 7.99 g [95% confidence interval (CI) = 4.29-11.70] to 15.35 g (95% CI = 11.41-19.29) and lower odds of LBW ranging from 0.79 (95% CI = 0.65-0.96) to 0.93 (95% CI = 0.86-1.00), but associations between residential greenness and PTB or SGA were not significant. When introducing the exposure as high versus low categories, similar results were found. The overall evidence for each exposure-outcome combination was considered to be of "moderate" certainty. CONCLUSIONS This study indicated a potential positive association between residential greenness and several birth outcomes. However, because of the moderate to high between-study heterogeneity, further studies with better adjustment of covariates, improved residential greenness assessment in a longitudinal approach throughout pregnancy rather than a cross-sectional approach at time of delivery, and accounting thoroughly for socioeconomic status, are warranted to replicate these findings as well as to explore in greater detail in their implications.
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Affiliation(s)
- Cheng-Yang Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China; Department of Humanistic Medicine, School of Humanistic Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Xiao-Jing Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Si-Yu Gui
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, China
| | - Kun Ding
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Kai Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Yuan Fang
- Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, 3000, CA Rotterdam, the Netherlands
| | - Zheng-Xuan Jiang
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, China.
| | - Xiu-Jun Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China; Center for Evidence-Based Practice, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China.
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Santri IN, Jiang CB, Chen YH, Wu CD, Zou ML, Chien LC, Lo YC, Chao HJ. Associations of birth outcomes with air pollution and land use characteristics in the Greater Taipei Area. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 750:141579. [PMID: 32853937 DOI: 10.1016/j.scitotenv.2020.141579] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 07/20/2020] [Accepted: 08/07/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Understanding the effects of environmental factors on birth outcomes is crucial for public health because newborns' birth size affects their likelihood of childhood survival, risk of perinatal morbidity, and subsequent health and growth. Therefore, we investigated the associations of birth outcomes with prenatal air pollutant exposure and residential land use characteristics in the Greater Taipei Area. METHODS Participants were selected from the Longitudinal Examination across Prenatal and Postpartum Health in Taiwan study, which is an ongoing prospective study launched in July 2011. Parental sociodemographic data and medical histories were collected using standardized questionnaires. Mean air pollutant levels during each trimester were estimated using the spatial interpolation technique (Ordinary Kriging). Land use types surrounding participants' homes were evaluated within a designated radius of their residential addresses. We used multiple regressions to examine relationships between birth outcomes (i.e., birth weight, height, and head circumference) and environmental factors after adjustment for parental characteristics. RESULTS A total of 436 pregnant women-infant pairs were included. Birth weight was negatively associated with commercial land and greenhouse areas near the residence. Living near greenhouse areas negatively affected birth height, but higher greenness level within 100 m of the residence had a positive effect. Birth head circumference was only associated with sociodemographic factors in the multivariate model. CONCLUSION Land use types near the homes of pregnant women, but not exposure to air pollutants, were significantly associated with birth weight and height in the Greater Taipei Area. Increased greenness level was positively associated with birth height, and living near commercial or greenhouse areas had adverse effects on birth outcomes. Living in a healthy neighborhood is critical for the birth outcomes of infants and presumably their health in early childhood.
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Affiliation(s)
| | - Chuen-Bin Jiang
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, MacKay Children's Hospital, Taipei, Taiwan; Department of Medicine, MacKay Medical College, New Taipei City, Taiwan
| | - Yi-Hua Chen
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan; Neuroscience Research Center, Taipei Medical University, Taipei, Taiwan
| | - Chih-Da Wu
- Department of Geomatics, National Cheng Kung University, Tainan, Taiwan; National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Ming-Lun Zou
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Ling-Chu Chien
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan; Neuroscience Research Center, Taipei Medical University, Taipei, Taiwan
| | - Yu-Chun Lo
- Neuroscience Research Center, Taipei Medical University, Taipei, Taiwan; Ph.D. Program for Neural Regenerative Medicine, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
| | - Hsing Jasmine Chao
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan; Neuroscience Research Center, Taipei Medical University, Taipei, Taiwan.
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Possibilities for Harmonisation between Recreation Services and Their Production within the Forest Sector—A Case Study of Municipal Forest Enterprise Hradec Králové (CZ). FORESTS 2020. [DOI: 10.3390/f12010013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This paper deals with the possibility of harmonising the needs of society and the possibilities of the forest property manager. The Municipal forest enterprise of the city of Hradec Králové (MLHK) in the Czech Republic (CZ) is an example of this principle, which proves that the intensive development of a recreational service is possible without limiting this principle. The forest enterprise manages 3707 ha of forest in the immediate vicinity of the city with 92,000 inhabitants. The forest enterprise pays the city rent and makes a profit. The data were obtained by analysing the economic data of the surveyed company, the annual observation of the forest attendance, the surveys of the characteristics of the forest visitors and the surveys of selected 16 companies (from seven countries) managing the forests of some European cities. The main results concerning MLHK are as follows: the share of recreational service costs in the total costs of the forestry activities is 19.7%. The recreational services of the forest are financed from 71.5% from revenues from the sale of raw wood, 17.5% from revenues from the sale of sand from its own quarry, 3.9% from revenues from the recreational services and 7.1% from subsidies. The operation of the gravel quarry contributes to the economic result of the forest enterprise roughly by an amount corresponding to the costs of the recreational services. An average annual forest attendance is 243 people/ha. The inhabitants of the city account for 61.5% of the visitors, 20.4% of the visitors live within a distance of up to 30 km, and 18.1% of the visitors live at a distance of more than 30 km. The main results of the survey among the forest enterprises managing the forests of the selected European cities are as follows: the share of costs for the recreational services in the total costs of the forestry activities is 21–72% for cities with a population of over 100,000, and 3–14% for cities with less than 100,000 inhabitants. As a source of financing recreational services, the forest enterprises from mentioned cities with over 100,000 inhabitants, the money especially came from the city budget (70–100%). Forest enterprises from cities under 100,000 inhabitants stated that they fund a recreational service with 95–100% of the revenues from the sale of raw wood. Data on the MLHK show that it is possible to finance a recreational forest service from its own resources if this is the owner’s priority. However, this only applies under certain conditions, such as that, in addition to the income from forest management, there are other sources of income (in this case, sand mining or subsidies from public programmes). If the forest owner did not have these resources, they would have to pay for the recreational service from their own other resources (e.g., from the city budget).
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Yitshak-Sade M, Fabian MP, Lane KJ, Hart JE, Schwartz JD, Laden F, James P, Fong KC, Kloog I, Zanobetti A. Estimating the Combined Effects of Natural and Built Environmental Exposures on Birthweight among Urban Residents in Massachusetts. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8805. [PMID: 33260804 PMCID: PMC7731163 DOI: 10.3390/ijerph17238805] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/13/2020] [Accepted: 11/21/2020] [Indexed: 12/18/2022]
Abstract
Intrauterine growth has health implications both in childhood and adulthood. Birthweight is partially determined by prenatal environmental exposures. We aim to identify important predictors of birthweight out of a set of environmental, built environment exposures, and socioeconomic environment variables during pregnancy (i.e., fine particulate matter (PM2.5), temperature, greenness, walkability, noise, and economic indices). We included all singleton live births of mothers who resided in urban census block-groups and delivered in Massachusetts between 2001 and 2011 (n = 640,659). We used an elastic-net model to select important predictors of birthweight and constructed a multivariate model including the selected predictors, with adjustment for confounders. We additionally used a weighted quantile sum regression to assess the contribution of each exposure to differences in birthweight. All exposures were selected as important predictors of birthweight. In the multivariate model, lower birthweight was significantly associated with lower greenness and with higher temperature, walkability, noise, and segregation of the "high income" group. Treating the exposures individually, nighttime noise had the highest weight in its contribution to lower birthweight. In conclusion, after accounting for individual confounders, maternal environmental exposures, built environment exposures, and socioeconomic environment during pregnancy were important predictors of birthweight, emphasizing the role of these exposures in fetal growth and development.
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Affiliation(s)
- Maayan Yitshak-Sade
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - M. Patricia Fabian
- Department of Environmental Health, Boston University School of Public Health, Boston, MA 02118, USA; (M.P.F.); (K.J.L.)
| | - Kevin J. Lane
- Department of Environmental Health, Boston University School of Public Health, Boston, MA 02118, USA; (M.P.F.); (K.J.L.)
| | - Jaime E. Hart
- Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; (J.E.H.); (J.D.S.); (F.L.); (P.J.); (K.C.F.); (A.Z.)
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Joel D. Schwartz
- Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; (J.E.H.); (J.D.S.); (F.L.); (P.J.); (K.C.F.); (A.Z.)
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Francine Laden
- Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; (J.E.H.); (J.D.S.); (F.L.); (P.J.); (K.C.F.); (A.Z.)
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Peter James
- Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; (J.E.H.); (J.D.S.); (F.L.); (P.J.); (K.C.F.); (A.Z.)
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA 02215, USA
| | - Kelvin C. Fong
- Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; (J.E.H.); (J.D.S.); (F.L.); (P.J.); (K.C.F.); (A.Z.)
- School of the Environment, Yale University, New Haven, MA 06511, USA
| | - Itai Kloog
- Department of Geography and Environmental Development, Faculty of Humanities and Social Sciences, Ben-Gurion University, Beer-Sheva 84105, Israel;
| | - Antonella Zanobetti
- Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; (J.E.H.); (J.D.S.); (F.L.); (P.J.); (K.C.F.); (A.Z.)
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Weber KA, Lyons E, Yang W, Stevenson C, Stevenson DK, Shaw GM. Residential proximity to green space and preeclampsia in California. ACTA ACUST UNITED AC 2020; 4:e120. [PMID: 33336135 PMCID: PMC7727466 DOI: 10.1097/ee9.0000000000000120] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 09/15/2020] [Indexed: 11/25/2022]
Abstract
Background We investigated whether residing near more green space might reduce the risk of preeclampsia. Methods Participants were women who delivered a live, singleton birth between 1998 and 2011 in eight counties of the San Joaquin Valley in California. There were 7276 cases of preeclampsia divided into mild, severe, or superimposed on preexisting hypertension. Controls were 197,345 women who did not have a hypertensive disorder and delivered between 37 and 41 weeks. Green space was estimated from satellite data using Normalized Difference Vegetation Index (NDVI), an index calculated from surface reflectance at the visible and near-infrared wavelengths. Values closer to 1 denote a higher density of green vegetation. Average NDVI was calculated within a 50 m, 100 m, and 500 m buffer around each woman's residence. Odds ratios and 95% confidence intervals were estimated comparing the lowest and highest quartiles of mean NDVI to the interquartile range comparing each preeclampsia phenotype, divided into early (20-31 weeks) and late (32-36 weeks) preterm birth, to full-term controls. Results We observed an inverse association in the 500 m buffer for women in the top quartile of NDVI and a positive association for women in the lowest quartile of NDVI for women with superimposed preeclampsia. There were no associations in the 50 and 100 m buffers. Conclusion Within a 500 m buffer, more green space was inversely associated with superimposed preeclampsia. Future work should explore the mechanism by which green space may protect against preeclampsia.
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Affiliation(s)
- Kari A Weber
- Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, Stanford, California
| | - Evan Lyons
- Department of Earth System Science, Stanford University, Stanford, California; and
| | - Wei Yang
- Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, Stanford, California
| | | | - David K Stevenson
- Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, Stanford, California
| | - Gary M Shaw
- Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, Stanford, California
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Lee KJ, Moon H, Yun HR, Park EL, Park AR, Choi H, Hong K, Lee J. Greenness, civil environment, and pregnancy outcomes: perspectives with a systematic review and meta-analysis. Environ Health 2020; 19:91. [PMID: 32854706 PMCID: PMC7457282 DOI: 10.1186/s12940-020-00649-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 08/21/2020] [Indexed: 05/19/2023]
Abstract
BACKGROUND Various maternal conditions, especially in utero conditions and prenatal exposure to environments with air pollution and greenness, have been reviewed to address the enhancement and prevention of susceptibility to health risks, including low birthweight, preterm delivery, and preeclampsia. This study aimed to qualitatively and quantitatively investigate the associations between pregnancy outcomes and the characteristics of surrounding living environment, including greenness, air pollution, and civilization. METHODS A secondary search of the MEDLINE, EMBASE, Cochrane Library, K-eArticles, and CINAHL databases was conducted without language restrictions to identify the relevant publications from the time of inception of the databases to April 2019. RESULTS A total of 89 studies were identified, and 10 were included in the quantitative synthesis. The greenness of the environment within 100-, 250- and 500-m buffers, after adjusting for the air quality and civilization factors, was weakly but positively associated with birthweight. The pooled regression slope was 0.00134 (95% confidence interval [CI], 0.000, 0.0020). The greenness of the environment was also associated with a significant decrease in the incidence of poor pregnancy outcomes, namely, low birthweight, small for gestational age (odds ratio [OR] 0.94; 95% CI, 0.92, 0.97), and preterm delivery (OR 0.98; 95% CI, 0.97, 0.99). CONCLUSIONS The greenness of the environment had a positive effect on the pregnancy outcomes, despite poor air quality and civilization. Following urbanization, planning for greenness management, environmental medicine, and public health is important and thus should be proposed as preventive methods as way of increasing birthweight and life expectancy.
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Affiliation(s)
- Kyung Ju Lee
- Department of Obstetrics and Gynecology, Korea University Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841, South Korea.
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, South Korea.
- Department of Public Health, Korea University Graduate School, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841, South Korea.
| | - Hyemi Moon
- Department of Biostatistics, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, South Korea
| | - Hyo Ri Yun
- Department of Biostatistics, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, South Korea
| | - Eun Lyeong Park
- Department of Biostatistics, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, South Korea
| | - Ae Ran Park
- Department of Biostatistics, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, South Korea
| | - Hijeong Choi
- Graduate School of Integrative Medicine, Cha University, Pocheon-si, Gyeonggi-do, South Korea
| | - Kwan Hong
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, South Korea
- Department of Public Health, Korea University Graduate School, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841, South Korea
| | - Juneyoung Lee
- Department of Biostatistics, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, South Korea.
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Lin L, Li Q, Yang J, Han N, Chen G, Jin C, Xu X, Liu Z, Liu J, Luo S, Raat H, Guo Y, Wang H. The associations of residential greenness with fetal growth in utero and birth weight: A birth cohort study in Beijing, China. ENVIRONMENT INTERNATIONAL 2020; 141:105793. [PMID: 32417616 DOI: 10.1016/j.envint.2020.105793] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 04/17/2020] [Accepted: 05/02/2020] [Indexed: 05/11/2023]
Abstract
BACKGROUND Although studies have examined the association between residential greenness and birth weight, there is no evidence regarding the association between residential greenness and fetal growth in utero. We aimed to investigate the associations of residential greenness with both fetal growth in utero and birth weight. METHODS A birth cohort (2014-2017) with 18,665 singleton pregnancies was established in Tongzhou Maternal and Child hospital of Beijing, China. Residential greenness was matched with maternal residential address and estimated from remote satellite data using normalized difference vegetation index with 200 m and 500 m buffers (NDVI-200 and NDVI-500). Fetal parameters including estimated fetal weight (EFW), abdominal circumference (AC), head circumference (HC) and femur length (FL) were assessed by ultrasound measurements during pregnancy. Fetal parameters were standardized as gestational-age- and gender-adjusted Z-score and undergrowth was defined as Z-score < -1.88. Birth weight Z-score, low birth weight (LBW) and small for gestational age (SGA) were assessed as birth outcomes. Generalized estimating equations with the autoregressive working correlation structure and generalized linear regression were used to examine the associations of residential greenness with quantitative and categorized outcomes. RESULTS We found an increase Z-score of EFW [0.054, 95% confidence interval (CI): 0.020-0.087], AC (0.045, 95%CI: 0.011-0.080) and HC (0.054, 95%CI: 0.020-0.089) associated with residential greenness above NDVI-500 median compared to less than and equal to NDVI-500 median. Stratified analyses indicated that the associations might be stronger in women exposed to lower levels of particles with aerodynamic diameters ≤2.5 µm. No associations were found in the analyses of NDVI-250 with fetal growth in utero. We didn't observe significant associations of NDVI with birth weight Z-score, LBW and SGA. CONCLUSIONS This study identified a positive association of NDVI-500 and fetal growth in utero, but we didn't observe its association with birth weight measures. Our results suggest that building sufficient green infrastructure might potentially promote early life health.
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Affiliation(s)
- Lizi Lin
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, People's Republic of China; National Health Commission Key Laboratory of Reproductive Health, Beijing, People's Republic of China
| | - Qin Li
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, People's Republic of China; Reproductive Medical Centre, Department of Obstetrics and Gynaecology, Peking University Third Hospital, Beijing 100191, People's Republic of China
| | - Jie Yang
- Tongzhou Maternal and Child Health Hospital, Beijing 101101, People's Republic of China
| | - Na Han
- Tongzhou Maternal and Child Health Hospital, Beijing 101101, People's Republic of China
| | - Gongbo Chen
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan 430071, People's Republic of China
| | - Chuyao Jin
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, People's Republic of China
| | - Xiangrong Xu
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, People's Republic of China
| | - Zheng Liu
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, People's Republic of China
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, People's Republic of China
| | - Shusheng Luo
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, People's Republic of China
| | - Hein Raat
- Department of Public Health, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Haijun Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, People's Republic of China; National Health Commission Key Laboratory of Reproductive Health, Beijing, People's Republic of China.
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Dzhambov AM, Browning MHEM, Markevych I, Hartig T, Lercher P. Analytical approaches to testing pathways linking greenspace to health: A scoping review of the empirical literature. ENVIRONMENTAL RESEARCH 2020; 186:109613. [PMID: 32668553 DOI: 10.1016/j.envres.2020.109613] [Citation(s) in RCA: 93] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 04/26/2020] [Accepted: 04/26/2020] [Indexed: 05/04/2023]
Abstract
BACKGROUND Inadequate translation from theoretical to statistical models of the greenspace - health relationship may lead to incorrect conclusions about the importance of some pathways, which in turn may reduce the effectiveness of public health interventions involving urban greening. In this scoping review we aimed to: (1) summarize the general characteristics of approaches to intervening variable inference (mediation analysis) employed in epidemiological research in the field; (2) identify potential threats to the validity of findings; and (3) propose recommendations for planning, conducting, and reporting mediation analyses. METHODS We conducted a scoping review, searching PubMed, Scopus, and Web of Science for peer-reviewed epidemiological studies published by December 31, 2019. The list of potential studies was continuously updated through other sources until March 2020. Narrative presentation of the results was coupled with descriptive summary of study characteristics. RESULTS We found 106 studies, most of which were cross-sectional in design. Most studies only had a spatial measure of greenspace. Mental health/well-being was the most commonly studied outcome, and physical activity and air pollution were the most commonly tested intervening variables. Most studies only conducted single mediation analysis, even when multiple potentially intertwined mediators were measured. The analytical approaches used were causal steps, difference-of-coefficients, product-of-coefficients, counterfactual framework, and structural equation modelling (SEM). Bootstrapping was the most commonly used method to construct the 95% CI of the indirect effect. The product-of-coefficients method and SEM as used to investigate serial mediation components were more likely to yield findings of indirect effect. In some cases, the causal steps approach thwarted tests of indirect effect, even though both links in an indirect effect were supported. In most studies, sensitivity analyses and proper methodological discussion of the modelling approach were missing. CONCLUSIONS We found a persistent pattern of suboptimal conduct and reporting of mediation analysis in epidemiological studies investigating pathways linking greenspace to health; however, recent years have seen improvements in these respects. Better planning, conduct, and reporting of mediation analyses are warranted.
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Affiliation(s)
- Angel M Dzhambov
- Department of Hygiene and Ecomedicine, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria.
| | - Matthew H E M Browning
- Department of Park, Recreation, and Tourism Management, Clemson University, Clemson, USA
| | - Iana Markevych
- Institute of Psychology, Jagiellonian University, Krakow, Poland
| | - Terry Hartig
- Institute for Housing and Urban Research, Uppsala University, Uppsala, Sweden
| | - Peter Lercher
- Institute for Highway Engineering and Transport Planning, Graz University of Technology, Graz, Austria
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Zhan Y, Liu J, Lu Z, Yue H, Zhang J, Jiang Y. Influence of residential greenness on adverse pregnancy outcomes: A systematic review and dose-response meta-analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 718:137420. [PMID: 32325616 DOI: 10.1016/j.scitotenv.2020.137420] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 02/16/2020] [Accepted: 02/17/2020] [Indexed: 05/04/2023]
Abstract
BACKGROUND With the development of urbanization, there is a decreasing tendency for people contact with natural greenness. Whether maternal exposure to greenness has an impact on pregnancy complications and pregnancy outcomes remains to be confirmed. OBJECTIVES To estimate the association and dose-response relationship between residential greenness and pregnancy outcomes. DATA SOURCES PubMed, Embase, Ovid, Scopus and Web of Science from inception to 1st December 2019 were searched. SYNTHESIS METHODS The summary regression coefficient (β) and odds ratio (OR) with corresponding 95% confidence interval (95%CI) were calculated. The linear dose-response relationship between greenness and adverse pregnancy outcomes was also investigated. RESULTS Overall, 36 studies with a total of 11,983,089 participants were included. Birth weight was significantly higher in highest level of greenness exposure group compared to lowest level group (e.g. β:20.22, 95%CI:13.50-26.93 at 100 m buffer). The odds of low birth weight (LBW) decreased in the highest level of group compared to lowest level group (e.g. OR:0.86, 95%CI:0.75-0.99 at 100 m buffer). The odds of small for gestational age (SGA) also decreased in the highest group (OR:0.93, 95%CI:0.88-1.00 at 100 m buffer). In addition, maternal exposure to greenness was associated with increased head circumference and decreased mental disorders. The dose-response models showed a 2% decrease risk of LBW per 0.1 normalized difference vegetation index (NDVI) increase within 300 m buffer (OR:0.98, 95%CI:0.97-0.99, P < 0.001) and a 1% decrease risk of SGA per 0.1 NDVI increase within 300 m buffer (OR:0.99, 95%CI:0.98-1.00, P = 0.037). No significant associations were found on preterm birth, gestational age, gestational diabetes mellitus, gestational hypertension or preeclampsia. CONCLUSIONS This review confirms an inverse association between residential greenness and adverse pregnancy outcomes. Findings of our study provide evidences for pregnant women to increase greenness exposure.
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Affiliation(s)
- Yongle Zhan
- School of Public Health, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100730, China.
| | - Jintao Liu
- Department of Urban Planning, School of Architecture & Fine Art, Dalian University of Technology, Dalian 116024, China
| | - Zhiming Lu
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Hexin Yue
- School of Public Health, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100730, China
| | - Jingwen Zhang
- School of Public Health, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100730, China
| | - Yu Jiang
- School of Public Health, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100730, China.
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Akaraci S, Feng X, Suesse T, Jalaludin B, Astell-Burt T. A Systematic Review and Meta-Analysis of Associations between Green and Blue Spaces and Birth Outcomes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082949. [PMID: 32344732 PMCID: PMC7215926 DOI: 10.3390/ijerph17082949] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 04/13/2020] [Accepted: 04/21/2020] [Indexed: 12/13/2022]
Abstract
Previous studies suggest that green and blue spaces may promote several health outcomes including birth outcomes. However, no synthesis of previous work has specifically asked policy-relevant questions of how much and what type is needed in every neighborhood to elicit these benefits at the population level. A systematic review and meta-analyses were conducted to synthesize thirty-seven studies on the association between residential green and blue spaces and pregnancy outcomes. Meta-analyses were performed for birth weight (BW), small for gestational age (SGA), low birth weight (LBW) and preterm birth (PTB). Increase in residential greenness was statistically significantly associated with higher BW [β = 0.001, 95%CI: (<0.001, 0.002)] and lower odds of SGA [OR = 0.95, 95%CI: (0.92, 0.97)]. Associations between green space and LBW and PTB were as hypothesized but not statistically significant. Associations between blue spaces and pregnancy outcomes were not evident. No study explicitly examined questions of threshold, though some evidence of nonlinearity indicated that moderate amounts of green space may support more favorable pregnancy outcomes. Policy-relevant green and blue space exposures involving theory-driven thresholds warrant testing to ensure future investments in urban greening promote healthier pregnancy outcomes.
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Affiliation(s)
- Selin Akaraci
- Population Wellbeing and Environment Research Lab (PowerLab), School of Health and Society, Faculty of Social Sciences, University of Wollongong, Wollongong, NSW 2522, Australia; (S.A.); (X.F.)
| | - Xiaoqi Feng
- Population Wellbeing and Environment Research Lab (PowerLab), School of Health and Society, Faculty of Social Sciences, University of Wollongong, Wollongong, NSW 2522, Australia; (S.A.); (X.F.)
- School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
- Menzies Centre for Health Policy, University of Sydney, Sydney, NSW 2006, Australia
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention (China CDC), Beijing 102206, China
| | - Thomas Suesse
- NIASRA, National Institute for Applied Statistics Research Australia School of Mathematics and Applied Statistics, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, NSW 2522, Australia;
| | - Bin Jalaludin
- Ingham Institute for Applied Medical Research, University of New South Wales, Sydney, NSW 2170, Australia;
| | - Thomas Astell-Burt
- Population Wellbeing and Environment Research Lab (PowerLab), School of Health and Society, Faculty of Social Sciences, University of Wollongong, Wollongong, NSW 2522, Australia; (S.A.); (X.F.)
- Menzies Centre for Health Policy, University of Sydney, Sydney, NSW 2006, Australia
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention (China CDC), Beijing 102206, China
- School of Public Health, Peking Union Medical College and The Chinese Academy of Medical Sciences, Beijing 100730, China
- Correspondence:
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Prescott SL, Bland JS. Spaceship Earth Revisited: The Co-Benefits of Overcoming Biological Extinction of Experience at the Level of Person, Place and Planet. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17041407. [PMID: 32098222 PMCID: PMC7068540 DOI: 10.3390/ijerph17041407] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 02/16/2020] [Accepted: 02/18/2020] [Indexed: 12/27/2022]
Abstract
Extensive research underscores that we interpret the world through metaphors; moreover, common metaphors are a useful means to enhance the pursuit of personal and collective goals. In the context of planetary health—defined as the interdependent vitality of all natural and anthropogenic ecosystems (social, political and otherwise)—one enduring metaphor can be found in the concept of “Spaceship Earth”. Although not without criticism, the term “Spaceship Earth” has been useful to highlight both resource limitations and the beauty and fragility of delicate ecosystems that sustain life. Rene Dubos, who helped popularize the term, underscored the need for an exposome perspective, one that examines the total accumulated environmental exposures (both detrimental and beneficial) that predict the biological responses of the “total organism to the total environment” over time. In other words, how large-scale environmental changes affect us all personally, albeit in individualized ways. This commentary focuses the ways in which microbes, as an essential part of all ecosystems, provide a vital link between personal and planetary systems, and mediate the biopsychosocial aspects of our individualized experience—and thus health—over our life course journey. A more fine-grained understanding of these dynamics and our power to change them, personally and collectively, lies at the core of restoring “ecosystems balance” for person, place and planet. In particular, restoring human connectedness to the natural world, sense of community and shared purpose must occur in tandem with technological solutions, and will enhance individual empowerment for personal well-being, as well as our collective potential to overcome our grand challenges. Such knowledge can help shape the use of metaphor and re-imagine solutions and novel ways for restoration or rewilding of ecosystems, and the values, behaviors and attitudes to light the path toward exiting the Anthropocene.
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Affiliation(s)
- Susan L. Prescott
- The ORIGINS Project, Telethon Kids Institute, University of Western Australia, Perth Children’s Hospital, Nedlands, WA 6009, Australia
- inVIVO Planetary Health of the Worldwide Universities Network (WUN), West New York, NJ 10704, USA;
- Correspondence:
| | - Jeffrey S. Bland
- inVIVO Planetary Health of the Worldwide Universities Network (WUN), West New York, NJ 10704, USA;
- Personalized Lifestyle Medicine Institute, Tacoma, WA 98443, USA
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Guo P, Chen Y, Wu H, Zeng J, Zeng Z, Li W, Zhang Q, Huo X, Feng W, Lin J, Miao H, Zhu Y. Ambient air pollution and markers of fetal growth: A retrospective population-based cohort study of 2.57 million term singleton births in China. ENVIRONMENT INTERNATIONAL 2020; 135:105410. [PMID: 31884132 DOI: 10.1016/j.envint.2019.105410] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Revised: 12/07/2019] [Accepted: 12/10/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUNDS Evidence is scarce on the relation between maternal exposure to ambient air pollution during pregnancy and fetal growth in developing countries. Moreover, the current evidence is inconsistent. We aimed to investigate the association of trimester-specific exposure to air pollution with risk of being born small for gestational age (SGA) and birth weight-markers of fetal growth-among Chinese term births. METHODS This retrospective population-based cohort study consisted of 2,567,457 singleton term live-births from January 1, 2014 to December 31, 2017 across 123 Chinese districts and counties. Personal exposure to ambient air pollutants including carbon monoxide (CO), sulfur dioxide (SO2), nitrogen dioxide (NO2), ozone (O3), particulate matter with aerodynamic diameter < 2.5 μm (PM2.5), and PM10 was assigned using the inverse distance weighting spatial interpolation algorithm. Generalized estimating equations (GEE) logistic regression models were performed to estimate the associations between trimester-specific exposure to air pollution and risk of SGA or low birth weight (LBW), and GEE linear regression to examine the associations between the exposure and term birth weight, adjusting for maternal demographics, maternal cigarette smoking status during pregnancy, mode of delivery, gravidity, gestational age, year and month of conception, neonate's sex, and meteorological factors. Stratified and sensitivity analyses were also performed. RESULTS When mother exposed to ambient air pollutants over the entire pregnancy, per IQR increment (0.122 mg/m3) in ambient CO concentrations was associated with higher risk of SGA (odds ratio (OR) = 1.04, 95% confidence interval (CI): 1.02, 1.05) and reduced birth weight among term births (-5.95 g, 95% CI: -8.01, -3.89). This association was also pronounced in the second and third trimesters. Term birth weight was negatively associated with per IQR increase of O3 (-3.52 g, 95% CI: -6.23, -0.81), PM2.5 (-5.93 g, 95% CI: -8.36, -3.49) and PM10 (-7.78 g, 95% CI: -10.41, -5.16) during the entire pregnancy, respectively. No significant association was detected between maternal exposure to air pollutants and term LBW. Effect estimates of heterogeneity suggested that maternal age and infant sex modified the impact of air pollution on birth weight. CONCLUSIONS The findings suggest that maternal exposure to air pollution during pregnancy is adversely affecting fetal growth. Further studies are warranted to integrate these findings and take clinical or public health interventions in pregnancy.
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Affiliation(s)
- Pi Guo
- Department of Preventive Medicine, Shantou University Medical College, Shantou 515041, China
| | - Yuliang Chen
- Department of Preventive Medicine, Shantou University Medical College, Shantou 515041, China
| | - Haisheng Wu
- Department of Preventive Medicine, Shantou University Medical College, Shantou 515041, China
| | - Jing Zeng
- Guangdong Women and Children Hospital, Guangzhou 511442, China
| | - Zhisheng Zeng
- Guangdong Women and Children Hospital, Guangzhou 511442, China
| | - Weiping Li
- Clinical Cohort Research Center, First Affiliated Hospital of Shantou University Medical College, Shantou 515041, China
| | - Qingying Zhang
- Department of Preventive Medicine, Shantou University Medical College, Shantou 515041, China
| | - Xia Huo
- Laboratory of Environmental Medicine and Developmental Toxicology, Guangzhou and Guangdong Key Laboratory of Environmental Pollution and Health, School of Environment, Jinan University, Guangzhou 510632, China
| | - Wenru Feng
- Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China
| | - Jiumin Lin
- Department of Hepatology and Infectious Diseases, the Second Affiliated Hospital, Shantou University Medical College, Shantou 515041, China
| | - Huazhang Miao
- Guangdong Women and Children Hospital, Guangzhou 511442, China.
| | - Yingxian Zhu
- Guangdong Women and Children Hospital, Guangzhou 511442, China.
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31
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Devarajan R, Prabhakaran D, Goenka S. Built environment for physical activity-An urban barometer, surveillance, and monitoring. Obes Rev 2020; 21:e12938. [PMID: 31701653 PMCID: PMC6916279 DOI: 10.1111/obr.12938] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 08/14/2019] [Accepted: 08/14/2019] [Indexed: 12/19/2022]
Abstract
The Lancet Commission on Obesity (LCO), also known as the "syndemic commission," states that radical changes are required to harness the common drivers of "obesity, undernutrition, and climate change." Urban design, land use, and the built environment are few such drivers. Holding individuals responsible for obesity detracts from the obesogenic built environments. Pedestrian priority and dignity, wide pavements with tree canopies, water fountains with potable water, benches for the elderly at regular intervals, access to open-green spaces within 0.5-km radius and playgrounds in schools are required. Facilities for physical activity at worksite, prioritization of staircases and ramps in building construction, redistribution of land use, and access to quality, adequate capacity, comfortable, and well-networked public transport, which are elderly and differently abled sensitive with universal design are some of the interventions that require urgent implementation and monitoring. An urban barometer consisting of valid relevant indicators aligned to the sustainable development goals (SDGs), UN-Habitat-3 and healthy cities, should be considered a basic human right and ought to be mounted for purposes of surveillance and monitoring. A "Framework Convention on Built Environment and Physical Activity" needs to be taken up by WHO and the UN for uptake and implementation by member countries.
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Affiliation(s)
- Raji Devarajan
- Department of Physical Activity and Obesity Prevention, Centre for Chronic Disease Control, New Delhi, India
| | - Dorairaj Prabhakaran
- Executive Director, Centre for Chronic Disease Control, New Delhi, India.,Centre for Chronic Conditions & Injuries, Public Health Foundation of India, Gurugram, India.,Faculty of Epidemiology and Population Health, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Shifalika Goenka
- Department of Physical Activity and Obesity Prevention, Centre for Chronic Disease Control, New Delhi, India.,Centre for Chronic Conditions & Injuries, Public Health Foundation of India, Gurugram, India.,Department of Social and Behavioral Sciences, Indian Institute of Public Health-Delhi, Gurugram, India
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Dzhambov AM, Markevych I, Lercher P. Associations of residential greenness, traffic noise, and air pollution with birth outcomes across Alpine areas. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 678:399-408. [PMID: 31077918 DOI: 10.1016/j.scitotenv.2019.05.019] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Revised: 04/29/2019] [Accepted: 05/02/2019] [Indexed: 05/25/2023]
Abstract
UNLABELLED Aim This explorative study aimed to investigate the association of residential greenness, traffic noise, and air pollution with birth outcomes in several Alpine areas with unique topography. METHODS We used data from two cross-sectional studies (UIT, n = 573 and BBT, n = 518) in the Tyrol Region (Austria/Italy). Only mothers who had lived in their current residence during the whole pregnancy were included. They completed a questionnaire, and medical records were used to draw data on birth weight, low birth weight (LBW), preterm birth, and small for gestational age (SGA). Normalized Difference Vegetation Index (NDVI) in the year of birth was assigned at the residential address as a measure of greenness. Road/railway traffic noise (Ldn) and air pollution (NO2) were calculated about 10 years after birth and used as surrogates for exposure levels during pregnancy. RESULTS In the UIT survey, higher NDVI500-m was consistently associated with lower odds for LBW and SGA, while an increase of Ldn was associated with higher odds for LBW. Other effect estimates were in the expected direction albeit non-significant. In the BBT survey, most findings were inconclusive (for NDVI) or present only in subgroups (for Ldn and NO2). CONCLUSION This study provides inconclusive evidence that the surrounding environment might be associated with birth outcomes in mountainous areas. Given the disparate associations across the study areas, further research in larger representative samples is warranted.
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Affiliation(s)
- Angel M Dzhambov
- Department of Hygiene and Ecomedicine, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria.
| | - Iana Markevych
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany; Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children's Hospital, Munich, Ludwig Maximilian University of Munich, Munich, Germany
| | - Peter Lercher
- Institute for Highway Engineering and Transport Planning, Graz University of Technology, Graz, Austria
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Laurent O, Benmarhnia T, Milesi C, Hu J, Kleeman MJ, Cockburn M, Wu J. Relationships between greenness and low birth weight: Investigating the interaction and mediation effects of air pollution. ENVIRONMENTAL RESEARCH 2019; 175:124-132. [PMID: 31112849 DOI: 10.1016/j.envres.2019.05.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Revised: 04/22/2019] [Accepted: 05/01/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Associations between residential greenness and improved birth weight have been increasingly reported, but underlying mechanisms and interactions with other environmental exposures are still unclear. OBJECTIVES To study the relationships between low birth weight (LBW, <2500 g), residential greenness, and the potential influence of air pollution in these relationships (interaction and mediation) in California, over the period 2001-2008. METHODS Residential greenness around maternal homes was characterized using the Normalized Difference Vegetation Index (NDVI). Complementary indicators of air pollution exposure reflected its main components. Birth weight and maternal characteristics were obtained from birth certificate records. In this case-cohort study, associations between greenness and LBW were investigated using multi-level Poisson regression with random effect at the hospital level. We investigated potential interaction of greenness and air pollutants on both additive and multiplicative scales. Mediation analyses were conducted to estimate the potential contribution of local variations in air pollutant concentrations associated with greenness on LBW risk. RESULTS In total 72,632 LBW cases were included. A reduction of LBW risk was associated with an increase in NDVI (adjusted risk ratio per inter-quartile range in NDVI: 0.963; 95% confidence interval: 0.947; 0.978). We observed no interaction between NDVI and air pollution on LBW risk. The estimated mediating effect of fine particulate matter in the impact of greenness on LBW was 12%. CONCLUSION This large study confirms that residential greenness is associated with a reduced risk of LBW and suggests that greenness might benefit to LBW partly through a local reduction in air pollution.
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Affiliation(s)
- Olivier Laurent
- Program in Public Health, 653 East Peltason Drive, University of California, Irvine, CA, 92697-3957, USA
| | - Tarik Benmarhnia
- Family Medicine and Public Health Department, University of California, San Diego, 9500 Gilman Drive #0725, CA, La Jolla, 92093, USA
| | | | - Jianlin Hu
- Department of Civil and Environmental Engineering. 1 Shields Avenue. University of California, Davis, CA, 95616, USA; Jiangsu Key Laboratory of Atmospheric Environment Monitoring and Pollution Control, Jiangsu Engineering Technology Research Center of Environmental Cleaning Materials, Collaborative Innovation Center of Atmospheric Environment and Equipment Technology, School of Environmental Science and Engineering, Nanjing University of Information Science & Technology, 219 Ningliu Road, Nanjing, 210044, China
| | - Michael J Kleeman
- Department of Civil and Environmental Engineering. 1 Shields Avenue. University of California, Davis, CA, 95616, USA
| | - Myles Cockburn
- Keck School of Medicine, University of Southern California, 1441 Eastlake Avenue, Los Angeles, CA, 90089-9175, USA
| | - Jun Wu
- Program in Public Health, 653 East Peltason Drive, University of California, Irvine, CA, 92697-3957, USA.
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Heo S, Bell ML. The influence of green space on the short-term effects of particulate matter on hospitalization in the U.S. for 2000-2013. ENVIRONMENTAL RESEARCH 2019; 174:61-68. [PMID: 31039514 PMCID: PMC6550459 DOI: 10.1016/j.envres.2019.04.019] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 04/16/2019] [Accepted: 04/18/2019] [Indexed: 05/20/2023]
Abstract
Although a few studies have identified positive association between green space and reduced mortality rate, the effect modification of green space for the impact of air pollution on health outcomes is under studied. We quantified whether green space modifies associations between short-term exposure to particulate matter (PM10, PM2.5) and hospitalization across 364 urban U.S. counties for 2000-2013. Green space was measured by normalized difference vegetation index (NDVI). Daily number of hospital admissions for cardiovascular or respiratory diseases from Medicare enrollees (≥65yrs) and air quality monitoring data for each county were used to assess risks, as percent change in hospitalization related to 10μg/m3 increase in particulate matter. We computed an absolute change in county-specific relative risks explained by difference in county-level NDVI. The study results found that the association between air pollution and health was less in areas with more green space. We estimated that an interquartile range increase in NDVI corresponds to a 1.68% (95% CI: 0.43, 2.91) decrease in the association between PM10 and cardiovascular hospitalization and 10.40% (95% CI: 7.34, 13.34) decrease in the PM10-hospitalization association of acute myocardial infarction. For hospitalization associated with PM2.5, a 0.18% (95% CI: -0.39, 0.73) absolute decrease in relative risk was found for cardiovascular hospitalizations. In results stratified by age, younger age groups (65-74, 75-84yrs) had larger reductions for the PM10-hospitalization association with increase in NDVI than older populations (≥85yrs) but not for the PM2.5-hospitalization association. These findings add evidence for health benefits of green space in diminishing the health impacts of particulate matters on hospitalizations for older populations in the U.S.
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Affiliation(s)
- Seulkee Heo
- School of Forestry and Environmental Studies, Yale University, New Haven, United States.
| | - Michelle L Bell
- School of Forestry and Environmental Studies, Yale University, New Haven, United States
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Sun S, Spangler KR, Weinberger KR, Yanosky JD, Braun JM, Wellenius GA. Ambient Temperature and Markers of Fetal Growth: A Retrospective Observational Study of 29 Million U.S. Singleton Births. ENVIRONMENTAL HEALTH PERSPECTIVES 2019; 127:67005. [PMID: 31162981 PMCID: PMC6792370 DOI: 10.1289/ehp4648] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
BACKGROUND Emerging studies suggest that ambient temperature during pregnancy may be associated with fetal growth, but the existing evidence is limited and inconsistent. OBJECTIVES We aimed to evaluate the association of trimester-specific temperature with risk of being born small for gestational age (SGA) and birth weight-markers of fetal growth-among term births in the contiguous United States. METHODS We included data on 29,597,735 live singleton births between 1989 and 2002 across 403 U.S. counties. We estimated daily county-level population-weighted mean temperature using a spatially refined gridded climate data set. We used logistic regression to estimate the association between trimester-specific temperature and risk of SGA and linear regression to evaluate the association between trimester-specific temperature and term birth weight z-score, adjusting for parity, maternal demographics, smoking or drinking during pregnancy, chronic hypertension, and year and month of conception. We then pooled results overall and by geographic regions and climate zones. RESULTS High ambient temperatures ([Formula: see text] percentile) during the entire pregnancy were associated with higher risk of term SGA {odds ratio [OR] [Formula: see text] 1.041 [95% confidence interval (CI): 1.029, 1.054]} and lower term birth weight [standardized to [Formula: see text] (95% CI: [Formula: see text], [Formula: see text]) reduction in birth weight for infants born at 40 weeks of gestation]. Low temperatures ([Formula: see text] percentile) during the entire pregnancy were not associated with SGA [OR [Formula: see text] 1.003 (95% CI: 0.991, 1.015)] but were associated with a small decrement in term birth weight [standardized to [Formula: see text] (95% CI: [Formula: see text], [Formula: see text])]. Risks of term SGA and birth weight were more strongly associated with temperature averaged across the second and third trimesters, in areas the Northeast, and in areas with cold or very cold climates. CONCLUSIONS Above-average temperatures during pregnancy were associated with lower fetal growth. Our findings provide evidence that temperature may be a novel risk factor for reduced fetal growth. https://doi.org/10.1289/EHP4648.
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Affiliation(s)
- Shengzhi Sun
- Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island
| | - Keith R. Spangler
- Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island
- Department of Earth, Environmental and Planetary Sciences, Brown University, Providence, Rhode Island
| | - Kate R. Weinberger
- Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island
| | - Jeff D. Yanosky
- Division of Epidemiology, Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, Pennsylvania
| | - Joseph M. Braun
- Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island
| | - Gregory A. Wellenius
- Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island
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Larkin A, Hystad P. Evaluating street view exposure measures of visible green space for health research. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2019; 29:447-456. [PMID: 29352209 DOI: 10.1038/s41370-018-0017-1] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 09/25/2017] [Accepted: 11/21/2017] [Indexed: 05/04/2023]
Abstract
Urban green space, or natural environments, are associated with multiple physical and mental health outcomes. Several proposed pathways of action for these benefits (e.g., stress reduction and attention restoration) require visual perception of green space; however, existing green space exposure measures commonly used in epidemiological studies do not capture street-scale exposures. We downloaded 254 Google Street View (GSV) panorama images from Portland, Oregon and calculated percent of green in each image, called Green View Index (GVI). For these locations we also calculated satellite-based normalized difference vegetation index (NDVI), % tree cover, % green space, % street tree buffering, distance to parks, and several neighborhood socio-economic variables. Correlations between the GVI and other green space measures were low (-0.02 to 0.50), suggesting GSV-based measures captured unique information about green space exposures. We further developed a GVI:NDVI ratio, which was associated with the amount of vertical green space in an image. The GVI and GVI:NDVI ratio were weakly related to neighborhood socioeconomic status and are therefore less susceptible to confounding in health studies compared to other green space measures. GSV measures captured unique characteristics of the green space environment and offer a new approach to examine green space and health associations in epidemiological research.
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Affiliation(s)
- Andrew Larkin
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA.
| | - Perry Hystad
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
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Abstract
Despite mounting evidence that urban greenspace protects against mortality in adults, few studies have explored the relationship between greenspace and death among infants. Here, we describe results from an analysis of associations between greenness and infant mortality in Philadelphia, PA. We used images of the normalized difference vegetation index (NDVI), derived from processed satellite data, to estimate greenness density in each census tract. We linked these data with census tract level counts of total infant mortality cases (n = 963) and births (n = 113,610) in years 2010-2014, and used Bayesian spatial areal unit, conditional autoregressive models to estimate associations between greenness and infant mortality. The models included a set of random effects to account for spatial autocorrelation between neighboring census tracts. Infant mortality counts were modeled using a Poisson distribution, and the logarithm of total births in each census tract was specified as the offset term. The following variables were included as potential confounders and effect modifiers: percentage non-Hispanic black, percentage living below the poverty line, an indicator of housing quality, and population density. In adjusted models, the rate of infant mortality was 27% higher in less green compared to more green tracts (95% CI 1.02-1.59). These results contribute further evidence that greenspace may be a health promoting environmental asset.
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Affiliation(s)
- Leah H Schinasi
- Dornsife School of Public Health, Urban Health Collaborative, Drexel University, Philadelphia, PA, USA.
- Dornsife School of Public Health, Department of Environmental and Occupational Health, Drexel University, Philadelphia, PA, USA.
| | - Harrison Quick
- Dornsife School of Public Health, Urban Health Collaborative, Drexel University, Philadelphia, PA, USA
- Dornsife School of Public Health, Department of Biostatistics and Epidemiology, Drexel University, Philadelphia, PA, USA
| | - Jane E Clougherty
- Dornsife School of Public Health, Urban Health Collaborative, Drexel University, Philadelphia, PA, USA
- Dornsife School of Public Health, Department of Environmental and Occupational Health, Drexel University, Philadelphia, PA, USA
| | - Anneclaire J De Roos
- Dornsife School of Public Health, Urban Health Collaborative, Drexel University, Philadelphia, PA, USA
- Dornsife School of Public Health, Department of Environmental and Occupational Health, Drexel University, Philadelphia, PA, USA
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38
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Sanchez-Badini O, Innes JL. [Forests and trees: A public health perspective]. SANTE PUBLIQUE 2019; S1:241-248. [PMID: 31210483 DOI: 10.3917/spub.190.0241] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Forests have historically supplied humans with timber, fuel, and forage. They have also provided goods and services associated with human physical, mental, social, and spiritual health. Given competing priorities for funding in healthcare, research on forests and health is important from a health economics perspective. Engagement with forests (including wilderness areas, managed production forests, and urban forests) for enhanced human health and wellbeing, and perhaps for illness prevention at a fraction of the cost of medical interventions, is a major opportunity for forest management in the 21st century. Despite this general recognition, there is a lack of information regarding public health policies and approaches that exist in relation to forests and trees. The available literature suggests that the majority in the field of public health view the natural environment with ambivalence. However, a paradigm shift is underway and there is an emerging field working with the positive impacts that trees and forests have on human health and wellbeing. While the value of forests has been noted by many health practitioners in Europe and Japan, health practitioners and the associated health industry in North America remain largely focused on treatment rather than preventative approaches. Largely as a result of advocacy from forestry and recreational organizations, this view is beginning to change, but the focus in the healthcare industry on treatment rather than prevention remains deeply entrenched.
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Donovan GH, Gatziolis D, Jakstis K, Comess S. The natural environment and birth outcomes: Comparting 3D exposure metrics derived from LiDAR to 2D metrics based on the normalized difference vegetation index. Health Place 2019; 57:305-312. [DOI: 10.1016/j.healthplace.2019.05.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 05/05/2019] [Accepted: 05/13/2019] [Indexed: 10/26/2022]
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40
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Servadio JL, Lawal AS, Davis T, Bates J, Russell AG, Ramaswami A, Convertino M, Botchwey N. Demographic Inequities in Health Outcomes and Air Pollution Exposure in the Atlanta Area and its Relationship to Urban Infrastructure. J Urban Health 2019; 96:219-234. [PMID: 30478764 PMCID: PMC6458195 DOI: 10.1007/s11524-018-0318-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Environmental burdens such as air pollution are inequitably distributed with groups of lower socioeconomic statuses, which tend to comprise of large proportions of racial minorities, typically bearing greater exposure. Such groups have also been shown to present more severe health outcomes which can be related to adverse pollution exposure. Air pollution exposure, especially in urban areas, is usually impacted by the built environment, such as major roadways, which can be a significant source of air pollution. This study aims to examine inequities in prevalence of cardiovascular and respiratory diseases in the Atlanta metropolitan region as they relate to exposure to air pollution and characteristics of the built environment. Census tract level data were obtained from multiple sources to model health outcomes (asthma, chronic obstructive pulmonary disease, coronary heart disease, and stroke), pollution exposure (particulate matter and nitrogen oxides), demographics (ethnicity and proportion of elderly residents), and infrastructure characteristics (tree canopy cover, access to green space, and road intersection density). Conditional autoregressive models were fit to the data to account for spatial autocorrelation among census tracts. The statistical model showed areas with majority African-American populations had significantly higher exposure to both air pollutants and higher prevalence of each disease. When considering univariate associations between pollution and health outcomes, the only significant association existed between nitrogen oxides and COPD being negatively correlated. Greater percent tree canopy cover and green space access were associated with higher prevalence of COPD, CHD, and stroke. Overall, in considering health outcomes in connection with pollution exposure infrastructure and ethnic demographics, demographics remained the most significant explanatory variable.
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Affiliation(s)
- Joseph L Servadio
- Division of Environmental Health Sciences, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Abiola S Lawal
- Schools of Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Tate Davis
- School of City and Regional Planning, Georgia Institute of Technology, Atlanta, GA, USA
| | - Josephine Bates
- Schools of Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | | | - Anu Ramaswami
- Humphrey School of Public Affairs, University of Minnesota, Minneapolis, MN, USA
| | - Matteo Convertino
- Graduate School of Information Science and Technology, Hokkaido University, Sapporo, Japan
| | - Nisha Botchwey
- School of City and Regional Planning, Georgia Institute of Technology, Atlanta, GA, USA.
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41
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Spatiotemporal Contextual Uncertainties in Green Space Exposure Measures: Exploring a Time Series of the Normalized Difference Vegetation Indices. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16050852. [PMID: 30857201 PMCID: PMC6427170 DOI: 10.3390/ijerph16050852] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Revised: 03/04/2019] [Accepted: 03/05/2019] [Indexed: 11/16/2022]
Abstract
Environmental health studies on green space may be affected by contextual uncertainties originating from the temporality of environmental exposures and by how the spatial context is delimitated. The Normalized Difference Vegetation Index (NDVI) is frequently used as an outdoor green space metric capturing the chlorophyll content in the vegetation canopy. This study assessed (1) whether residential NDVI exposures vary over time, and (2) how these time series of NDVI scores vary across spatial context delimitations. Multi-temporal NDVI data for the period 2006–2017 for the Netherlands were obtained from the Moderate Resolution Imaging Spectroradiometer (MODIS) satellite platform. Annual NDVI exposures were determined across multiple buffer sizes (i.e., 300, 600, and 1000 m) centered on a random sample of 10,000 Dutch residential addresses. Besides the descriptive statistics, pairwise Wilcoxon tests and Fligner–Killeen tests were used to determine mean and variance differences in annual NDVI scores across buffer widths. Heat maps visualized the correlation matrices. Significance levels were adjusted for multiple hypotheses testing. The results indicated that annual NDVI metrics were significantly correlated but their magnitude varied notably between 0.60 to 0.97. Numerous mean and variance differences in annual NDVI exposures were significant. It seems that the disparate buffers (i.e., 300 and 1000 m) were less strongly correlated, possibly because variance heterogeneity is reduced in larger buffers. These results have been largely consistent over the years and have passed Monte Carlo-based sensitivity tests. In conclusion, besides assessing green space exposures along different buffer sizes, our findings suggest that green space–health studies should employ NDVI data that are well-aligned with epidemiological data. Even an annual temporal incompatibility may obscure or distort green space–health associations. Both strategies may diminish contextual uncertainties in environmental exposure assessments.
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42
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Richardson EA, Shortt NK, Mitchell R, Pearce J. A sibling study of whether maternal exposure to different types of natural space is related to birthweight. Int J Epidemiol 2019; 47:146-155. [PMID: 29253203 PMCID: PMC5837571 DOI: 10.1093/ije/dyx258] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 11/25/2017] [Indexed: 11/13/2022] Open
Abstract
Background Birthweight is an important determinant of health across the life course. Maternal exposure to natural space has been linked to higher birthweight, but stronger evidence of a causal link is needed. We use a quasi-experimental sibling study design to investigate if change in the mother’s exposure to natural space between births was related to birthweight, in urban Scotland. Methods Amount (% area) of total natural space, total accessible (public) natural space, parks, woodlands and open water within 100 m of the mother’s postcode was calculated for eligible births (n = 40 194; 1991–2010) in the Scottish Longitudinal Study (a semi-random 5.3% sample of the Scottish population). Associations between natural space and birthweight were estimated, using ordinary least squares and fixed effects models. Results Birthweight was associated with the total amount of natural space around the mother’s home (+8.2 g for interquartile range increase), but was unrelated to specific types of natural space. This whole-sample relationship disappeared in the sibling analysis, indicating residual confounding. The sibling models showed effects for total natural space with births to women who already had children (+20.1 g), and to those with an intermediate level of education (+14.1 g). Conclusions The importance of total natural space for birthweight suggests that benefits can be experienced near to as well as within natural space. Ensuring expectant mothers have good access to high quality neighbourhood natural space has the potential to improve the infant’s start in life, and consequently their health trajectory over the life course.
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Affiliation(s)
- Elizabeth A Richardson
- National Health Service Health Scotland, Edinburgh, UK.,Centre for Research on Environment, Society and Health (CRESH), University of Edinburgh, Edinburgh, UK and
| | - Niamh K Shortt
- Centre for Research on Environment, Society and Health (CRESH), University of Edinburgh, Edinburgh, UK and
| | - Richard Mitchell
- Centre for Research on Environment, Society and Health (CRESH), University of Glasgow, Glasgow, UK
| | - Jamie Pearce
- Centre for Research on Environment, Society and Health (CRESH), University of Edinburgh, Edinburgh, UK and
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43
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Nielsen CC, Amrhein CG, Shah PS, Aziz K, Osornio-Vargas AR. Spatiotemporal Patterns of Small for Gestational Age and Low Birth Weight Births and Associations With Land Use and Socioeconomic Status. ENVIRONMENTAL HEALTH INSIGHTS 2019; 13:1178630219869922. [PMID: 31488949 PMCID: PMC6709433 DOI: 10.1177/1178630219869922] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 07/23/2019] [Indexed: 05/22/2023]
Abstract
In addition to small for gestational age (SGA) and low birth weight at term (LBWT), critically ill cases of SGA/LBWT are significant events from outcomes and economic perspectives that require further understanding of risk factors. We aimed to assess the spatiotemporal distribution of locations where there were consistently higher numbers of critically ill SGA/LBWT (hot spots) in comparison with all SGA/LBWT and all births. We focused on Edmonton (2008-2010) and Calgary (2006-2010), Alberta, and used a geographical information system to apply emerging hot spot analysis, as a new approach for understanding SGA, LBWT, and the critically ill counterparts (ciSGA or ciLBWT). We also compared the resulting aggregated categorical patterns with proportions of land use and socioeconomic status (SES) using Spearman correlation and logistic regression. There was an overall increasing trend in all space-time clusters. Whole period emerging hot spot patterns among births and SGA generally coincided, but SGA with ciSGA and LBWT with ciLBWT did not. Regression coefficients were highest for low SES with SGA and LBWT, but not with ciSGA and ciLBWT. Open areas and industrial land use were most associated with ciLBWT but not with ciSGA, SGA, or LBWT. Differences in the space-time hot spot patterns and the associations with ciSGA and ciLBWT indicate further need to research the interplay of maternal and environmental influences. We demonstrated the novel application of emerging hot spot analysis for small newborns and spatially related them to the surrounding environment.
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Affiliation(s)
- Charlene C Nielsen
- Department of Pediatrics, University of
Alberta, Edmonton, AB, Canada
- Department of Earth and Atmospheric
Sciences, University of Alberta, Edmonton, AB, Canada
| | - Carl G Amrhein
- Department of Earth and Atmospheric
Sciences, University of Alberta, Edmonton, AB, Canada
- Faculty of Arts and Sciences, The Aga
Khan University, Nairobi, Kenya
- Faculty of Arts and Sciences, The Aga
Khan University, Karachi, Pakistan
| | - Prakesh S Shah
- Department of Pediatrics and Institute
of Health Policy, Management, and Evaluation, University of Toronto, Mount Sinai
Hospital, The Canadian Neonatal Network, Toronto, ON, Canada
| | - Khalid Aziz
- Department of Pediatrics, University of
Alberta, Edmonton, AB, Canada
| | - Alvaro R Osornio-Vargas
- Department of Pediatrics, University of
Alberta, Edmonton, AB, Canada
- Alvaro R. Osornio-Vargas, Department of
Pediatrics, University of Alberta, 3-591 ECHA, 11405 87th Avenue, Edmonton, AB
T6G 1C9, Canada.
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44
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Agay-Shay K, Michael Y, Basagaña X, Martínez-Solanas È, Broday D, Lensky IM, Rudolf M, Rubin L, Kent R, Levy N, Haklai Z, Grotto I. Mean and variance of greenness and pregnancy outcomes in Tel Aviv during 2000–14: longitudinal and cross-sectional approaches. Int J Epidemiol 2018; 48:1054-1072. [DOI: 10.1093/ije/dyy249] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2018] [Indexed: 01/02/2023] Open
Abstract
Abstract
Background
Natural environments may have beneficial impacts on pregnancy outcomes. However, longitudinal evidence is limited and the associations with variance in surrounding greenness is unknown. Our objective was to evaluate these associations among 73 221 live births in Tel Aviv, Israel.
Methods
Longitudinal exposure to mean of greenness during pregnancy and trimesters were calculated using satellite-based Moderate Resolution Imaging Spectroradiometer (MODIS) Normalised Difference Vegetation Index (NDVI) data. In addition, exposure to mean and variation of NDVI from high-resolution satellite and percentage of tree cover [Vegetation Continuous Fields (VCF)] at 300-m buffer were evaluated in a cross-sectional approach. Generalized linear models were used to estimate the crude and adjusted associations. We explore the possible mediating role of ambient exposures and distance to ‘outdoor gyms’ located in parks.
Results
Crude beneficial associations between exposure to higher mean NDVI during pregnancy and pregnancy outcomes were observed [for birthweight, 3rd/1st tertile exposure increased the mean by 25.5 g, 95% confidence intervals (CIs): 15.4, 35.5] and decreased the odds of low birthweight, small for gestational age, preterm deliveries (PTD) and very PTD. Adjustment for individual and neighbourhood-level markers of socio-economic status (SES) attenuated all the associations. Strongest associations were observed during the first and second trimesters. Cross-sectional associations for mean greenness were similar with narrower CIs, and associations with NDVI were stronger than with tree cover and stronger for mean compared with variance of greenness. Associations were consistent for term births, different buffer sizes and for further adjustment to maternal education. Stronger associations were observed for lowest SES. Distance to ‘outdoor gyms’ and variance of greenness had the largest estimates of mediation.
Conclusion
This study adds to the limited information on when exposure to greenness is most beneficial, on the association with variance of greenness and the possible pathways. These observations require confirmation in other populations.
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Affiliation(s)
- Keren Agay-Shay
- Department of Population Health, Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel
| | - Yaron Michael
- Department of Geography and Environment, Bar Ilan University, Ramat-Gan, Israel
| | - Xavier Basagaña
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Èrica Martínez-Solanas
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - David Broday
- Department of Environmental, Water, and Agricultural Engineering, Faculty of Civil and Environmental Engineering, Technion—Israel Institute of Technology, Haifa, Israel
| | - Itamar M Lensky
- Department of Geography and Environment, Bar Ilan University, Ramat-Gan, Israel
| | - Mary Rudolf
- Department of Population Health, Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel
| | - Lisa Rubin
- Department of Maternal and Child Health, Public Health Services, Ministry of Health, Jerusalem, Israel
- School of Public Health, University of Haifa, Haifa, Israel
| | - Rafi Kent
- Department of Geography and Environment, Bar Ilan University, Ramat-Gan, Israel
| | - Nadav Levy
- Public Transport Unit, Tel Aviv Municipality, Tel Aviv, Israel
| | - Ziona Haklai
- Health Information Division, Ministry of Health, Jerusalem, Israel
| | - Itamar Grotto
- Ministry of Health, Jerusalem, Israel
- School of Public Health, Faculty of Health Science, Ben-Gurion University of the Negev, Beer Sheva, Israel
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45
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Cusack L, Sbihi H, Larkin A, Chow A, Brook JR, Moraes T, Mandhane PJ, Becker AB, Azad MB, Subbarao P, Kozyrskyj A, Takaro TK, Sears MR, Turvey SE, Hystad P. Residential green space and pathways to term birth weight in the Canadian Healthy Infant Longitudinal Development (CHILD) Study. Int J Health Geogr 2018; 17:43. [PMID: 30514315 PMCID: PMC6280529 DOI: 10.1186/s12942-018-0160-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Accepted: 11/22/2018] [Indexed: 01/30/2023] Open
Abstract
Background A growing number of studies observe associations between the amount of green space around a mother’s home and positive birth outcomes; however, the robustness of this association and potential pathways of action remain unclear.
Objectives To examine associations between mother’s residential green space and term birth weight within the Canadian Healthy Infant Longitudinal Development (CHILD) study and examine specific hypothesized pathways. Methods We examined 2510 births located in Vancouver, Edmonton, Winnipeg, and Toronto Canada. Green space was estimated around mother’s residences during pregnancy using Landsat 30 m normalized difference vegetation index (NDVI). We examined hypothesized pathways of: (1) reduction of environmental exposure; (2) built environment features promoting physical activity; (3) psychosocial conditions; and (4) psychological influences. Linear regression was used to assess associations between green space and term birth weight adjusting first for a comprehensive set of confounding factors and then incrementally for pathway variables. Results Fully adjusted models showed non-statistically significant increases in term birth weight with increasing green space. For example, a 0.1 increase in NDVI within 500 m was associated with a 21.5 g (95% CI − 4.6, 47.7) increase in term birth weight. Associations varied by city and were most robust for high-density locations. For the two largest cities (Vancouver and Toronto), we observed an increase in birth weight of 41.2 g (95% CI 7.8, 74.6) for a 0.1 increase in NDVI within 500 m. We did not observe substantial reductions in the green space effect on birth weight when adjusting for pathway variables. Conclusion Our results highlight the need to further characterize the interactions between green space, urban density and climate related factors as well as the pathways linking residential green space to birth outcomes.
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Affiliation(s)
| | - Hind Sbihi
- University of British Columbia, Vancouver, BC, Canada.,BC Children's Hospital, Vancouver, BC, Canada
| | | | | | | | - Theo Moraes
- Hospital for Sick Children, Toronto, ON, Canada
| | | | | | | | | | | | | | | | - Stuart E Turvey
- University of British Columbia, Vancouver, BC, Canada.,BC Children's Hospital, Vancouver, BC, Canada
| | - Perry Hystad
- College of Public Health and Human Sciences, Oregon State University, 2520 SW Campus Way, Corvallis, OR, 97331, USA.
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46
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Franchini M, Mannucci PM. Mitigation of air pollution by greenness: A narrative review. Eur J Intern Med 2018; 55:1-5. [PMID: 30180945 DOI: 10.1016/j.ejim.2018.06.021] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 06/19/2018] [Accepted: 06/25/2018] [Indexed: 12/14/2022]
Abstract
Air pollution represents one of the world's most important environmental health risks, being associated with an increased rate of multiple diseases (mainly cardiopulmonary) and of premature deaths. A number of actions have been suggested and implemented to mitigate the deleterious health effects of air pollution. Accordingly, recent research has attempted to estimate the beneficial effect of exposure to greenness on human health. In this narrative review, we summarize and review the current literature on the favourable association between greenness and human health in both the outdoor and indoor environments. The potential mechanisms underlying this benefit will be also addressed.
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Affiliation(s)
- Massimo Franchini
- Department of Transfusion Medicine and Hematology, Carlo Poma Hospital, Mantova, Italy
| | - Pier Mannuccio Mannucci
- Scientific Direction, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico and University of Milan, Italy.
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47
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Fong KC, Kloog I, Coull BA, Koutrakis P, Laden F, Schwartz JD, James P. Residential Greenness and Birthweight in the State of Massachusetts, USA. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15061248. [PMID: 29895795 PMCID: PMC6025231 DOI: 10.3390/ijerph15061248] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 06/04/2018] [Accepted: 06/07/2018] [Indexed: 11/16/2022]
Abstract
Natural vegetation, or greenness, may benefit maternal health and consequently, fetal growth, by providing opportunities for physical activity and psychological restoration, and decreasing detrimental environmental exposures. We retrieved Massachusetts Birth Registry data from 2001⁻2013 and investigated the association between residential greenness and birthweight in full-term births (≥37 weeks gestation). We calculated average residential greenness during pregnancy using 250 m normalized difference vegetation index (NDVI) from satellites. We estimated associations between greenness and continuous birthweight, term low birthweight (TLBW: <2500 g), and small for gestational age (SGA: <10th percentile of birthweight stratified by sex and gestational age) adjusted for individual and neighborhood covariates and considered nonlinearity and effect modification. Higher greenness exposure was associated with higher birthweight with stronger associations in the lower than higher range of greenness. Greenness was associated with lower odds of TLBW (OR 0.98; 95% CI 0.97, 0.99 per 0.1 increase in NDVI) and SGA (OR 0.98; 95% 0.97, 0.99) and associations varied by population density (TLBW) and socioeconomic status (TLBW, SGA). Our results suggest that greenness is beneficial to fetal growth exhibited by higher birthweight and lower odds of TLBW and SGA. Unlike prior studies, associations with TLBW and SGA appeared stronger among those with higher socioeconomic status.
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Affiliation(s)
- Kelvin C Fong
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA.
| | - Itai Kloog
- Department of Geography and Environmental Development, Ben-Gurion University of the Negev, Beer Sheva 653, Israel.
| | - Brent A Coull
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA.
| | - Petros Koutrakis
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA.
| | - Francine Laden
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA.
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA.
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.
| | - Joel D Schwartz
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA.
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA.
| | - Peter James
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA 02115, USA.
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48
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Glazer KB, Eliot MN, Danilack VA, Carlson L, Phipps MG, Dadvand P, Savitz DA, Wellenius GA. Residential green space and birth outcomes in a coastal setting. ENVIRONMENTAL RESEARCH 2018; 163:97-107. [PMID: 29433021 PMCID: PMC5878729 DOI: 10.1016/j.envres.2018.01.006] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 01/05/2018] [Accepted: 01/09/2018] [Indexed: 05/18/2023]
Abstract
BACKGROUND Residential green space may improve birth outcomes, with prior studies reporting higher birthweight among infants of women living in greener areas. However, results from studies evaluating associations between green space and preterm birth have been mixed. Further, the potential influence of residential proximity to water, or 'blue space', on health has not previously been evaluated. OBJECTIVES To evaluate associations between green and blue space and birth outcomes in a coastal area of the northeastern United States. METHODS Using residential surrounding greenness (measured by Normalized Difference Vegetation Index [NDVI]) and proximity to recreational facilities, coastline, and freshwater as measures of green and blue space, we examined associations with preterm birth (PTB), term birthweight, and term small for gestational age (SGA) among 61,640 births in Rhode Island. We evaluated incremental adjustment for socioeconomic and environmental metrics. RESULTS In models adjusted for individual - and neighborhood-level markers of socioeconomic status (SES), an interquartile range (IQR) increase in NDVI was associated with a 12% higher (95% CI: 4, 20%) odds of PTB and, conversely, living within 500 m of a recreational facility was associated with a 7% lower (95% CI: 1, 13%) odds of PTB. These associations were eliminated after further adjustment for town of residence. NDVI was associated with higher birthweight (7.4 g, 95% CI: 0.4-14.4 g) and lower odds of SGA (OR = 0.92, 95% CI: 0.87-0.98) when adjusted for individual-level markers of SES, but not when further adjusted for neighborhood SES or town. Living within 500 m of a freshwater body was associated with a higher birthweight of 10.1 g (95% CI: 2.0, 18.2) in fully adjusted models. CONCLUSIONS Findings from this study do not support the hypothesis that residential green space is associated with reduced risk of preterm birth or higher birthweight after adjustment for individual and contextual socioeconomic factors, but variation in results with incremental adjustment raises questions about the optimal degree of control for confounding by markers of SES. We found that living near a freshwater body was associated with higher birthweight. This result is novel and bears further investigation in other settings and populations.
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Affiliation(s)
- Kimberly B Glazer
- Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Box G-S121, Floor 2, Providence, RI 02903, USA.
| | - Melissa N Eliot
- Division of Research, Women & Infants Hospital, 101 Dudley Street, Providence, RI, USA
| | - Valery A Danilack
- Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Box G-S121, Floor 2, Providence, RI 02903, USA; Division of Research, Women & Infants Hospital, 101 Dudley Street, Providence, RI, USA
| | - Lynn Carlson
- Department of Earth, Environmental, and Planetary Sciences, Brown University, 85 Waterman Street, IBES 143, Providence, RI, USA
| | - Maureen G Phipps
- Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Box G-S121, Floor 2, Providence, RI 02903, USA; Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University, Providence, RI, USA; Department of Obstetrics and Gynecology, Women & Infants Hospital, Providence, RI, USA
| | - Payam Dadvand
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona Biomedical Research Park, Dr. Aiguader, 88, 08003 Barcelona, Spain; Pompeu Fabra University, Barcelona, Catalonia, Spain; Ciber on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - David A Savitz
- Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Box G-S121, Floor 2, Providence, RI 02903, USA; Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Gregory A Wellenius
- Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Box G-S121, Floor 2, Providence, RI 02903, USA
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Abstract
OBJECTIVE The purpose of this systematic review is to report findings of published studies of the relationships between poor-quality built environments and negative birth outcomes. METHOD Quantitative studies measuring various aspects of the built environment including property damage, housing damage, physical disorder, physical incivilities, nuisance, vacancy, tenure, occupancy, and structural deterioration and their effects on birth outcomes such as preterm birth, low birthweight, and small for gestational age were identified using Scopus, PubMed, Medline, and PsycINFO databases. RESULTS A total of 2,059 abstracts were reviewed based on the search criteria. After excluding 2,051 studies that did not measure the relationship between the physical built environment and negative birth outcomes, eight studies were reviewed. Seven of the eight studies identified reported significant positive relationships between poor-quality built environment and negative birth outcomes. CLINICAL IMPLICATIONS A poor-quality built environment is related to negative birth outcomes, particularly for African American women. Nurses should assess conditions of the built environment of pregnant women. Women who experience psychological stress and/or depressive symptoms due to their built environment should be referred for mental health evaluation and treatment with the goal of improving maternal mental health and birth outcomes.
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Fong KC, Hart JE, James P. A Review of Epidemiologic Studies on Greenness and Health: Updated Literature Through 2017. Curr Environ Health Rep 2018; 5:77-87. [PMID: 29392643 PMCID: PMC5878143 DOI: 10.1007/s40572-018-0179-y] [Citation(s) in RCA: 271] [Impact Index Per Article: 45.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE OF REVIEW Many studies suggest that exposure to natural vegetation, or greenness, may be beneficial for a variety of health outcomes. We summarize the recent research in this area. RECENT FINDINGS We observed consistent and strong evidence of associations for higher greenness with improvements in birth weights and physical activity, as well as lower mortality rates. Recent studies also suggested that exposure to greenness may lower levels of depression and depressive symptoms. The evidence on greenness and cardiovascular health remains mixed. Findings are also inconsistent for greenness measures and asthma and allergies. Our knowledge of the impacts of greenness on a wide variety of health outcomes continues to evolve. Future research should incorporate information on specific species and some qualities of natural greenness that might drive health outcomes, integrate exposure assessments that incorporate personal mobility into analyses, and include prospective designs to add to the growing evidence that nature exposure positively affects health.
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Affiliation(s)
- Kelvin C Fong
- Department of Environmental Health, Harvard TH Chan School of Public Health, 401 Park Dr, Boston, MA, 02215, USA.
| | - Jaime E Hart
- Department of Environmental Health, Harvard TH Chan School of Public Health, 401 Park Dr, Boston, MA, 02215, USA
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Peter James
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
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