Human health outcomes at the neighbourhood scale implications: Elderly's heat-related cardiorespiratory mortality and its influencing factors

The Interplay Between the Built Environment, Health, and Well-Being—A Scoping Review

Objective: This scoping review aims to investigate the complex interplay between the built environment, health, and well-being and to provide a comprehensive overview of the knowledge needed for crucial health and well-being enhancement in cities. Method: A scoping review method has been chosen using four databases. The first sample was reduced from 2819 papers to 71 papers by implementing exclusion criteria, snowballing, and direct searches to find a relevant final sample. Results: Built environmental elements such as the neighborhood, urban architecture, activities, public spaces, greenery, lights, safety, aesthetics, and amenities were identified to be impactful on health and well-being outcomes. The two-way association of each environmental factor and its criteria with specific types of health and well-being issues such as cancer, cardiovascular diseases, stress, etc. was determined to identify solutions and ways for improvement. Conclusions: This scoping review provides a comprehensive overview of the intricate interplay between the built environment, health, and well-being. By synthesizing existing knowledge of the built environmental factors, it explores the basis for evidence-based strategies to enhance health and well-being. By illuminating theoretical knowledge of the built environment on health and well-being, our findings will provide a deeper foundation of sources and practical insights for related fields.

Estimating changes in inequality of ecosystem services provided by green exposure: From a human health perspective

Ecosystem services provided by green spaces are closely related to human health, strongly supporting sustainable urban and territorial development. Urbanization has not only resulted in the reduction of green spaces but has also created inequalities in exposure. Inequitable green exposure creates disparities in residents' access to the ecosystem services provided by green spaces and can lead to significant health inequities. In this context, we first categorized green exposures into active and passive types based on their characteristics. Second, utilizing the benefit transfer method and Gini coefficient, we estimated the value and equity of ecosystem services offered by these green exposures around residences at the municipality level in Japan from 2000 to 2020, with a focus on human health implications. Finally, we explored the potential relationship between socioeconomics and ecosystem service inequity. Our findings reveal that: 1) ecosystem service value per capita and equity provided by green exposure are significantly different across municipalities; 2) although most municipalities show an upward trend in per capita ecosystem service value around residences, ecosystem service inequity increases significantly; and 3) ecosystem service inequity is related to the socioeconomic factors of municipalities and could be non-linear. The results of this study suggest that the government should adopt indicators related to the ecosystem services provided by green exposure during urban planning. While focusing on per-capita ecosystem services, they should also consider the equitable distribution of ecosystem services to promote sustainable urban health development.

Urban heat island impacts on heat-related cardiovascular morbidity: A time series analysis of older adults in US metropolitan areas

Many United States (US) cities are experiencing urban heat islands (UHIs) and climate change-driven temperature increases. Extreme heat increases cardiovascular disease (CVD) risk, yet little is known about how this association varies with UHI intensity (UHII) within and between cities. We aimed to identify the urban populations most at-risk of and burdened by heat-related CVD morbidity in UHI-affected areas compared to unaffected areas. ZIP code-level daily counts of CVD hospitalizations among Medicare enrollees, aged 65-114, were obtained for 120 US metropolitan statistical areas (MSAs) between 2000 and 2017. Mean ambient temperature exposure was estimated by interpolating daily weather station observations. ZIP codes were classified as low and high UHII using the first and fourth quartiles of an existing surface UHII metric, weighted to each have 25% of all CVD hospitalizations. MSA-specific associations between ambient temperature and CVD hospitalization were estimated using quasi-Poisson regression with distributed lag non-linear models and pooled via multivariate meta-analyses. Across the US, extreme heat (MSA-specific 99th percentile, on average 28.6 °C) increased the risk of CVD hospitalization by 1.5% (95% CI: 0.4%, 2.6%), with considerable variation among MSAs. Extreme heat-related CVD hospitalization risk in high UHII areas (2.4% [95% CI: 0.4%, 4.3%]) exceeded that in low UHII areas (1.0% [95% CI: -0.8%, 2.8%]), with upwards of a 10% difference in some MSAs. During the 18-year study period, there were an estimated 37,028 (95% CI: 35,741, 37,988) heat-attributable CVD admissions. High UHII areas accounted for 35% of the total heat-related CVD burden, while low UHII areas accounted for 4%. High UHII disproportionately impacted already heat-vulnerable populations; females, individuals aged 75-114, and those with chronic conditions living in high UHII areas experienced the largest heat-related CVD impacts. Overall, extreme heat increased cardiovascular morbidity risk and burden in older urban populations, with UHIs exacerbating these impacts among those with existing vulnerabilities.

Effective interventions on health effects of Chinese rural elderly under heat exposure

Due to climate change, the heatwave has become a more serious public health threat with aging as an aggravating factor in recent years. There is a pressing need to detect the most effective prevention and response measures. However, the specific health effects of interventions have not been characterized on an individual scale. In this study, an intervention experiment was designed to explore the health effects of heat exposure at the individual level and assess the effects of different interventions based on a comprehensive health sensitivity index (CHSI) in Xinyi, China. Forty-one subjects were recruited randomly, and divided into one control group and three intervention groups. Interventions included education (Educate by lecturing, offering relative materials, and communication), subsidy support (offer subsidy to offset the cost of running air conditioning), and cooling-spray (install a piece of cooling-spray equipment in the yard). Results showed that systolic blood pressure (SBP) and deep sleep duration (DSD) were significantly affected by short-term heat exposure, and the effects could be alleviated by three types of interventions. The estimated CHSI indicated that the effective days of the education group were longer than other groups, while the lower CHSI of the subsidy group showed lower sensitivity than the control group. These findings provide feasible implementation strategies to optimize Heat-health action plans and evaluate the intervention performance.

ELECTRONIC SUPPLEMENTARY MATERIAL

Supplementary material is available in the online version of this article at 10.1007/s11783-022-1545-4 and is accessible for authorized users.

Assessing the Spatial Mapping of Heat Vulnerability under Urban Heat Island (UHI) Effect in the Dhaka Metropolitan Area

The urban heat island (UHI) phenomenon gets intensified in the process of urbanization, which increases the vulnerability of urban dwellers to heatwaves. The UHI-induced vulnerability to heatwaves has increased in Bangladesh during past decades. Thus, this study aims to examine the UHI and vulnerability to heatwaves in the city of Dhaka using a heat vulnerability index (HVI). The HVI is constructed using various demographic, socioeconomic, and environmental risk variables at thana level. Principal component analysis (PCA) was applied to the 26 normalized variables for each of the 41 thanas of Dhaka to prepare the HVI. Result shows that more than 60% of the city is under built-up areas, while vegetation cover and water bodies are in low proportion. Analysis of HVI shows that the very high- and high-risk zones comprise 6 and 11 thanas, while low- and very low-risk zones comprise only 5 and 8 thanas. The correlation of HVI with variables such as exposure (0.62) and sensitivity (0.80) was found to be highly positive, while adaptive capacity had a negative correlation (−0.26) with the HVI. Findings of this study can be utilized in the mitigation of UHI phenomenon and maintaining the thermal comfort of Dhaka.