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Lee LH, Haque A, Cui J, Smith A, Mancus G, Yi N, Yuen HK. Examining the indirect effect of park size on community health via crime risk in Alabama: A cross-sectional mediation model. Health Place 2025; 92:103423. [PMID: 39903991 DOI: 10.1016/j.healthplace.2025.103423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2024] [Revised: 01/17/2025] [Accepted: 01/26/2025] [Indexed: 02/06/2025]
Abstract
Across the United States and worldwide, communities face significant health challenges, including rising rates of chronic conditions such as obesity, heart disease, and diabetes. Addressing these issues requires comprehensive public health strategies that prioritize the development of infrastructure to support healthier lifestyles. One promising strategy is to expand and enhance public green spaces like urban parks. While numerous studies have examined the relationship between green spaces and physical health, inconsistent findings reveal gaps in current understanding. This study explores the complex relationship between urban park size, neighborhood crime risk, and community physical health in Alabama. Data were collected for 989 urban parks across Alabama using the Trust for Public Land's ParkServe database and city Parks and Recreation Department websites. Park size was measured with geographic information systems data, and crime risk data, including violent and property crimes, were provided by the Environmental Systems Research Institute. Community physical health data were obtained from the PLACES database to assess the prevalence of poor physical health. Our analysis revealed a significant negative total effect (p < .001) and a significant negative direct effect (p < .01), indicating that larger urban park sizes were consistently associated with a reduced prevalence of poor physical health. Additionally, larger urban parks were significantly associated with reduced neighborhood crime risk, which, in turn, was significantly related to a lower prevalence of poor physical health in communities (p < .05). These findings offer important policy insights for future urban planning and public health efforts.
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Affiliation(s)
- Lewis H Lee
- School of Social Work, University of Alabama, Tuscaloosa, AL 35487, USA.
| | - Akhlaque Haque
- Department of Political Science and Public Administration, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
| | - Jinhong Cui
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
| | - Adrian Smith
- Department of Occupational Therapy, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
| | - Gibran Mancus
- Department of Nursing, University of New Hampshire, Durham, NH 03824, USA.
| | - Nengjun Yi
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
| | - Hon K Yuen
- Department of Occupational Therapy, School of Health Professions, University of Alabama at Birmingham, 1720 2nd Ave S, Birmingham, AL 35294, USA.
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Su Y, Pan X, Li Y, Li G, Zhang G. Gender differences in the effects of urban environment on nighttime exercise behaviours: a qualitative study. Front Psychol 2024; 15:1465737. [PMID: 39606204 PMCID: PMC11598523 DOI: 10.3389/fpsyg.2024.1465737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2024] [Accepted: 10/30/2024] [Indexed: 11/29/2024] Open
Abstract
Objective With the acceleration of urbanization, nighttime exercise behaviours have rapidly emerged. Existing research indicates a correlation between urban environments and physical activity; however, studies focusing specifically on nighttime are still insufficient, particularly regarding gender differences. This study aims to identify the key factors in urban environments that influence residents' nighttime exercise behaviours and to explore the gender differences within these influences. Methods Purposeful sampling was employed to conduct semi-structured interviews with 30 residents who regularly engage in nighttime exercise. All transcribed interviews were analyzed using Colaizzi's phenomenological data analysis method. Results The findings revealed that physical environment and environmental perception are the two primary factors influencing nighttime exercise behaviour. These factors are further divided into 10 specific sub-themes: lighting, green spaces, site facilities and layout, traffic coherence, entertainment facilities, smart sports equipment, sense of safety, convenience, pleasure, and sense of belonging. Conclusion Females demonstrate a heightened sensitivity to the perception of the physical environment, placing greater emphasis on the feelings and experiences it provides. Males, on the other hand, focus more on the direct impact of the physical environment, such as its specific effects on exercise performance. Future urban planning and public policy should give greater consideration to gender differences in the use of urban exercise facilities, ensuring that nighttime exercise environments meet the needs of residents of different genders. This approach will contribute to enhancing overall community vitality and improving residents' health.
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Affiliation(s)
- Yuqin Su
- College of Physical Education, Institute of Sport Science, Southwest University, Chongqing, China
| | - Xiaoli Pan
- College of Physical Education, Institute of Sport Science, Southwest University, Chongqing, China
| | - Yike Li
- College of Physical Education, Institute of Sport Science, Southwest University, Chongqing, China
| | - Guanchong Li
- College of Physical Education, Institute of Sport Science, Southwest University, Chongqing, China
| | - Guodong Zhang
- College of Physical Education, Institute of Sport Science, Southwest University, Chongqing, China
- International College, Krirk University, Bangkok, Thailand
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Pan R, Wang W, Wei N, Liu L, Yi W, Song J, Cheng J, Su H, Fan Y. Does the morphology of residential greenspaces contribute to the development of a cardiovascular-healthy city? ENVIRONMENTAL RESEARCH 2024; 257:119280. [PMID: 38821460 DOI: 10.1016/j.envres.2024.119280] [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: 01/24/2024] [Revised: 05/04/2024] [Accepted: 05/29/2024] [Indexed: 06/02/2024]
Abstract
BACKGROUNDS Greenspaces are indispensable for the construction of a healthy city. Research has shown that greenspaces contribute to the reduction of cardiovascular risks. However, the role of greenspace morphology in the development of a healthy city is not well understood. METHODS Our study utilized data from a cardiovascular disease screening cohort comprising 106,238 residents in Anhui Province, China, aged between 35 and 75 years. We calculated landscape indices of each participant using high-resolution land cover data to measure the greenness, fragmentation, connectivity, aggregation, and shape of greenspaces. We used a multivariate linear regression model to assess the associations between these landscape indices and triglyceride risk, and employed a structural equation model to explore the potential contributions of heatwaves and fine particulate matter (PM2.5) to this association. RESULTS Overall, triglyceride was expected to increase by 0.046% (95% CI: 0.040%, 0.052%) with a 1% increase in the percentage of built-up area. Conversely, an increase in the percentage of greenspace was associated with a 0.270% (95% CI: 0.337%, -0.202%) decrease in triglyceride levels. Furthermore, when the total greenspace was held constant, the shape, connectedness, and aggregation of greenspace were inversely correlated with triglyceride levels, with effects of -0.605% (95% CI: 1.012%, -0.198%), -0.031% (95% CI: 0.039%, -0.022%), and -0.049% (95% CI: 0.058%, -0.039%), respectively. Likewise, the protective effect of the area-weighed mean shape index was higher than that of the total amount of greenspace. The stratification results showed that urban residents benefited more from greenspace exposure. Greenspace morphology can minimize triglyceride risk by reducing pollutant and heatwaves, with aggregation having the greatest effect on reducing pollutants whereas fragmentation is more efficient at reducing heatwaves. CONCLUSION Exposure to the greenspaces morphology is associated with a reduction in triglyceride risk. The study has important practical and policy implications for early health monitoring and the spatial layout of greenspace and will provide scientific information for healthy urban planning by reducing unfavorable health consequences.
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Affiliation(s)
- Rubing Pan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Center for Big Data and Population Health of IHM, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - Weiqiang Wang
- Suzhou Hospital of Anhui Medical University, Suzhou, Anhui, China
| | - Ning Wei
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Center for Big Data and Population Health of IHM, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - Li Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Center for Big Data and Population Health of IHM, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - Weizhuo Yi
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Center for Big Data and Population Health of IHM, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - Jian Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Center for Big Data and Population Health of IHM, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - Jian Cheng
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Center for Big Data and Population Health of IHM, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - Hong Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Center for Big Data and Population Health of IHM, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China.
| | - Yinguang Fan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Center for Big Data and Population Health of IHM, Hefei, Anhui, China.
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Ccami-Bernal F, Soriano-Moreno DR, Fernandez-Guzman D, Tuco KG, Castro-Díaz SD, Esparza-Varas AL, Medina-Ramirez SA, Caira-Chuquineyra B, Cortez-Soto AG, Yovera-Aldana M, Rojas-Rueda D. Green space exposure and type 2 diabetes mellitus incidence: A systematic review. Health Place 2023; 82:103045. [PMID: 37159977 DOI: 10.1016/j.healthplace.2023.103045] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 04/04/2023] [Accepted: 05/03/2023] [Indexed: 05/11/2023]
Abstract
INTRODUCTION Epidemiological studies have suggested that exposure to green spaces is associated with a lower prevalence of diabetes. The aim of this systematic review was to summarize the evidence on green spaces and diabetes mellitus II (T2DM) in longitudinal studies. METHODS We searched PubMed, SCOPUS, Web of Science (WoS)/Core Collection, WoS/MEDLINE, and EMBASE until February 2023. We included cohort studies that assessed the incidence of T2DM according to the level of exposure to green spaces. Two authors independently performed study selection, data extraction, and analysis of risk of bias. No meta-analysis was performed due to clinical heterogeneity between studies. RESULTS We included 13 cohort studies with a sample size ranging from 1700 to 1 922 545 participants. Studies presented different ways of defining (quartiles, percentages) and measuring (tools, buffers) green spaces. Similarly, the definition of T2DM was heterogeneous (self-reports, medical records, clinical criteria). Twelve studies showed that individuals with higher exposure to green spaces had a decreased incidence of T2DM. Out of these 12 studies, 10 revealed statistically significant differences. All studies were of high methodological quality, except for one. CONCLUSION Our findings suggest that exposure to green space could be a protective factor for the development of T2DM. Promoting policies to preserve and increase green space could help to reduce T2DM at the community level. More standardization of green space exposure definition is needed in studies on green space and T2DM.
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Affiliation(s)
- Fabricio Ccami-Bernal
- Facultad de Medicina, Universidad Nacional de San Agustín de Arequipa, 04000, Arequipa, Peru.
| | - David R Soriano-Moreno
- Unidad de Investigación Clínica y Epidemiológica, Universidad Peruana Unión, 15464, Lima, Peru.
| | | | - Kimberly G Tuco
- Unidad de Investigación Clínica y Epidemiológica, Universidad Peruana Unión, 15464, Lima, Peru.
| | - Sharong D Castro-Díaz
- Unidad de Investigación Clínica y Epidemiológica, Universidad Peruana Unión, 15464, Lima, Peru.
| | - Analis L Esparza-Varas
- Sociedad Científica de Estudiantes de Medicina de la Universidad Nacional de Trujillo, 13011, Trujillo, Peru.
| | | | | | - Andrea G Cortez-Soto
- Sociedad Científica de Estudiantes de Medicina Humana de Ica (SOCEMI), 11004, Ica, Peru.
| | - Marlon Yovera-Aldana
- Grupo de Investigación Neurociencia, Efectividad Clínica y Salud Pública, Universidad Científica del Sur, 15067, Lima, Peru.
| | - David Rojas-Rueda
- Department of Environmental and Radiological Health Sciences, Colorado State University, 80523, Fort Collins, CO, USA; Colorado School of Public Health, Colorado State University, Fort Collins, CO, USA.
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Sillman D, Rigolon A, Browning MHEM, Yoon HV, McAnirlin O. Do sex and gender modify the association between green space and physical health? A systematic review. ENVIRONMENTAL RESEARCH 2022; 209:112869. [PMID: 35123971 DOI: 10.1016/j.envres.2022.112869] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 01/19/2022] [Accepted: 01/28/2022] [Indexed: 06/14/2023]
Abstract
A growing literature shows that green space can have protective effects on human health. As a marginalized group, women often have worse life outcomes than men, including disparities in some health outcomes. Given their marginalization, women might have "more to gain" than men from living near green spaces. Yet, limited research has deliberately studied whether green space-health associations are stronger for women or men. We conducted a systematic review to synthesize empirical evidence on whether sex or gender modifies the protective associations between green space and seven physical health outcomes (cardiovascular disease, cancer, diabetes, general physical health, non-malignant respiratory disease, mortality, and obesity-related health outcomes). After searching five databases, we identified 62 articles (including 81 relevant analyses) examining whether such effect modification existed. We classified analyses based on whether green space-health were stronger for women, no sex/gender differences were detected, or such associations were stronger for men. Most analyses found that green space-physical health associations were stronger for women than for men when considering study results across all selected health outcomes. Also, women showed stronger protective associations with green space than men for obesity-related outcomes and mortality. Additionally, the protective green space-health associations were slightly stronger among women for green land cover (greenness, NDVI) than for public green space (parks), and women were also favored over men when green space was measured very close to one's home (0-500 m). Further, the green space-health associations were stronger for women than for men in Europe and North America, but not in other continents. As many government agencies and nongovernmental organizations worldwide work to advance gender equity, our review shows that green space could help reduce some gender-based health disparities. More robust empirical studies (e.g., experimental) are needed to contribute to this body of evidence.
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Affiliation(s)
- Delaney Sillman
- Department of City & Metropolitan Planning, The University of Utah, Salt Lake City, UT, 84112, USA.
| | - Alessandro Rigolon
- Department of City & Metropolitan Planning, The University of Utah, Salt Lake City, UT, 84112, USA.
| | - Matthew H E M Browning
- Department of Parks, Recreation and Tourism Management, Clemson University, Clemson, SC, 29634, USA.
| | - Hyunseo Violet Yoon
- Department of Recreation, Sport, and Tourism, University of Illinois at Urbana-Champaign, Champaign, IL, 61820, USA.
| | - Olivia McAnirlin
- Department of Parks, Recreation and Tourism Management, Clemson University, Clemson, SC, 29634, USA.
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Nassary EK, Msomba BH, Masele WE, Ndaki PM, Kahangwa CA. Exploring urban green packages as part of Nature-based Solutions for climate change adaptation measures in rapidly growing cities of the Global South. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2022; 310:114786. [PMID: 35240569 DOI: 10.1016/j.jenvman.2022.114786] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 01/16/2022] [Accepted: 02/20/2022] [Indexed: 06/14/2023]
Abstract
Given a lot of elusive information on the use and implementation of Nature-based Solutions (NbS) in the Global South, this review provides a synthesis of the evidence on the: - (1) distribution of urban green technologies in form of arboriculture and urban agriculture as a part of NbS packages for the sustainability of cities against population growth and impact of climate change; and (2) options of integrating and mainstreaming various NbS packages into city development policies, planning processes, and decision-making agendas. The sustainability of urban green as part of NbS packages and the usefulness for improvement of livelihoods is determined by the spatial (geographical location) and temporal (time of action) scales, and socio-ecological and institutional factors. Various NbS packages have shown the ability for use as climate change adaptation measures throughout the world. These functions include protection from soil erosion, protection from inland flooding, buffering natural resources against drier and more variable climates, protection from coastal hazards and sea-level rise, moderation of urban heatwaves and effects of heat island, and managing storm-water and flooding in urban areas. Furthermore, the benefits of urban agriculture and arboriculture include use as sources of food and generation of income; improve recreation and social interactions, and the sustainability of biodiversity. They also mitigate the impact of environmental pollution and climate change through reduction of gas emissions and act as carbon sinks. While the starting capital and lack of policy on urban agriculture and arboriculture in many countries, the importance of the industry is inevitably a useful agenda especially in the Global South due to vulnerability to the impact of climate change. This review also suggests the inclusion of all institutions, governments, and relevant stakeholders to emphasize gender sensitization at all levels of planning and decision-making in food production and adaptation measures to climate change.
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Affiliation(s)
- Eliakira Kisetu Nassary
- Department of Soil and Geological Sciences, College of Agriculture, Sokoine University of Agriculture, P. O. Box 3008, Chuo-Kikuu, Morogoro, Tanzania.
| | | | - Wilson Elias Masele
- Institute of Resource Assessment, Centre for Climate Change Studies, University of Dar Es Salaam, P. O. Box 35097, Dar Es Salaam, Tanzania.
| | - Patrick Madulu Ndaki
- Institute of Resource Assessment, Centre for Climate Change Studies, University of Dar Es Salaam, P. O. Box 35097, Dar Es Salaam, Tanzania.
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Zhou R, Zheng YJ, Yun JY, Wang HM. The Effects of Urban Green Space on Depressive Symptoms of Mid-Aged and Elderly Urban Residents in China: Evidence from the China Health and Retirement Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020717. [PMID: 35055539 PMCID: PMC8775628 DOI: 10.3390/ijerph19020717] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/29/2021] [Accepted: 01/06/2022] [Indexed: 02/04/2023]
Abstract
The aim of this study is to assess the impacts of urban green space on depressive symptoms among Chinese urban residents aged 45 and older. In total, 7397 urban respondents were included in this study. Each respondent participated in the China Health and Retirement Longitudinal Study Wave 3 (2015). Environmental-level variables were retrieved from the National Bureau of Statistics database. Both unadjusted and adjusted methods were used in the multilevel regression analysis. Almost one-third of the sample population suffered from depressive symptoms (31.20%). The multilevel logistic regression model showed that green coverage ratio of city-built districts is negatively associated with the prevalence of depressive symptoms among urban mid-aged (OR = 0.79, p < 0.05) and elderly (OR = 0.75, p < 0.05) residents, and the public recreational green space helps to reduce elderly people’s depressive symptoms (OR = 0.77, p < 0.05). This study adds insights about the impact of green space and other environmental factors on depressive symptoms among mid-aged and elderly urban dwellers. It is important to provide enough and accessible overall urban green spaces; additionally, attention should also be paid to specific green space forms such as public recreational green space.
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Pou SA, Diaz MDP, Velázquez GA, Aballay LR. Sociodemographic disparities and contextual factors in obesity: updated evidence from a National Survey of Risk Factors for Chronic Diseases. Public Health Nutr 2021; 25:1-13. [PMID: 34924081 PMCID: PMC9991557 DOI: 10.1017/s1368980021004924] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 12/14/2021] [Accepted: 12/16/2021] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To assess the association of sociodemographic and environmental factors with the obesity occurrence in Argentina from a sex- and age-comparative perspective and a multilevel approach. DESIGN Cross-sectional study based on secondary data from the National Survey of Chronic Diseases Risk Factors (CDRF) 2018, Argentina. Two-level logistic regression models stratified by sex and age were used. SETTING The nationwide probabilistic sample of the CDRF survey and twenty-four geographical units. PARTICIPANTS 16 410 adult people, living in Argentine towns of at least 5000 people, nested into 24 geographical units. Sex and age groups were defined as young (aged 18-44 years), middle-aged (45-64 years) and older (65 years and older) men and women. RESULTS Single men (all age groups) and divorced/widowed men (aged 45 years or older) had a lower obesity risk compared to married ones. In the middle-aged group, men with higher education showed a lower risk than men with incomplete primary education. In young women, a marked social gradient by educational level was observed. A low-income level coupled with highly urbanised contexts represents an unfavourable scenario for young and middle-aged women. Having a multi-person household was a risk factor for obesity (OR = 1·26, P = 0·038) in middle-aged women. Contextual factors linked to the availability of socially constructed recreational resources and green spaces were associated with obesity among young adults. CONCLUSIONS Socio-environmental determinants of obesity seem to operate differently according to sex and age in Argentina. This entails the need to address the obesity epidemic considering gender inequalities and the socio-environmental context at each stage of life.
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Affiliation(s)
- Sonia Alejandra Pou
- Instituto de Investigaciones en Ciencias de la Salud (INICSA), Universidad Nacional de Córdoba, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Facultad de Ciencias Médicas, Córdoba, Argentina
- Estadística y Bioestadística, Escuela de Nutrición, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba5016, Argentina
| | - Maria Del Pilar Diaz
- Instituto de Investigaciones en Ciencias de la Salud (INICSA), Universidad Nacional de Córdoba, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Facultad de Ciencias Médicas, Córdoba, Argentina
- Estadística y Bioestadística, Escuela de Nutrición, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba5016, Argentina
| | - Guillermo Angel Velázquez
- Instituto de Geografía, Historia y Ciencias Sociales (IGEHCS), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Universidad Nacional del Centro de la Provincia de Buenos Aires, Tandil, Buenos Aires, Argentina
| | - Laura Rosana Aballay
- Estadística y Bioestadística, Escuela de Nutrición, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba5016, Argentina
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Nguyen PY, Astell-Burt T, Rahimi-Ardabili H, Feng X. Green Space Quality and Health: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11028. [PMID: 34769549 PMCID: PMC8582763 DOI: 10.3390/ijerph182111028] [Citation(s) in RCA: 85] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 09/28/2021] [Accepted: 10/08/2021] [Indexed: 12/18/2022]
Abstract
(1) Background: As cities densify, researcher and policy focus is intensifying on which green space types and qualities are important for health. We conducted a systematic review to examine whether particular green space types and qualities have been shown to provide health benefits and if so, which specific types and qualities, and which health outcomes. (2) Methods: We searched five databases from inception up to June 30, 2021. We included all studies examining a wide range of green space characteristics on various health outcomes. (3) Results: 68 articles from 59 studies were found, with a high degree of heterogeneity in study designs, definitions of quality and outcomes. Most studies were cross-sectional, ecological or cohort studies. Environment types, vegetation types, and the size and connectivity of green spaces were associated with improved health outcomes, though with contingencies by age and gender. Health benefits were more consistently observed in areas with greater tree canopy, but not grassland. The main outcomes with evidence of health benefits included allergic respiratory conditions, cardiovascular conditions and psychological wellbeing. Both objectively and subjectively measured qualities demonstrated associations with health outcomes. (4) Conclusion: Experimental studies and longitudinal cohort studies will strengthen current evidence. Evidence was lacking for needs-specific or culturally-appropriate amenities and soundscape characteristics. Qualities that need more in-depth investigation include indices that account for forms, patterns, and networks of objectively and subjectively measured green space qualities.
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Affiliation(s)
- Phi-Yen Nguyen
- School of Population Health, University of New South Wales, Sydney, NSW 2033, Australia; (P.-Y.N.); (H.R.-A.)
- Population Wellbeing and Environment Research Lab (PowerLab), Wollongong, NSW 2522, Australia;
| | - Thomas Astell-Burt
- Population Wellbeing and Environment Research Lab (PowerLab), Wollongong, NSW 2522, Australia;
- School of Health and Society, Faculty of Arts, Social Sciences, and Humanities, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Hania Rahimi-Ardabili
- School of Population Health, University of New South Wales, Sydney, NSW 2033, Australia; (P.-Y.N.); (H.R.-A.)
- Population Wellbeing and Environment Research Lab (PowerLab), Wollongong, NSW 2522, Australia;
| | - Xiaoqi Feng
- School of Population Health, University of New South Wales, Sydney, NSW 2033, Australia; (P.-Y.N.); (H.R.-A.)
- Population Wellbeing and Environment Research Lab (PowerLab), Wollongong, NSW 2522, Australia;
- School of Health and Society, Faculty of Arts, Social Sciences, and Humanities, University of Wollongong, Wollongong, NSW 2522, Australia
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Zhang L, Chen C, Liu C, Zhang Y, Fang J, Han J, Zhao F, Du P, Wang Q, Wang J, Shi W, Wang W, Shi S, Chen R, Kan H, Meng X, Li T, Shi X. Associations of residential greenness with peripheral and central obesity in China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 791:148084. [PMID: 34139501 DOI: 10.1016/j.scitotenv.2021.148084] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 05/21/2021] [Accepted: 05/24/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Obesity is a well-known risk factor for public health. Recent studies found that greenness exposure may protect against obesity. However, the accumulated evidence on associations of greenness-obesity is inconsistent and most of them are from developed countries. OBJECTIVES This study aimed to evaluate the associations of greenness exposure with indicators of peripheral and central obesity. METHODS This cross-sectional study was based on a Chinese national Sub-Clinical Outcomes of Polluted Air (SCOPA) prospective cohort across 15 provinces, and 5849 participants with average age of 64.7 were included. Surrounding greenness was estimated with the Enhanced Vegetation Index (EVI), which was calculated at each participant's residential addresses within a 250 m buffer. Weight, height and waist circumference (WC) were measured, and body mass index (BMI) and the waist-to-height ratio% (WHtR%) were calculated based on those measurements. The relationships between EVI and obese outcomes were explored using multiple linear regression and logistic regression models. RESULTS Non-linear associations were observed between EVI and obese indicators. Participants living in Quartile 3 benefited more than in Quartile 4 compared to the lowest quartile (Quartile 1) of greenness. For peripheral obesity, participants living in Quartile 3 of EVI250m had 0.86 kg/m2 (β -0.86, 95% CI: -1.10, -0.61) lower BMI, and 46% (OR 0.54, 95% CI: 0.44-0.66) lower odds of peripheral obesity than in Quartile 1. For central obesity, participants living in Quartile 3 of EVI250m had 1.85 cm (β -1.85, 95% CI: -2.54, -1.15) lower waist circumference, 1.12% (β -1.12, 95% CI: -1.56, -0.67) lower waist-to-height ratio% (WHtR%), and 33% (OR 0.67, 95% CI: 0.57-0.78) lower odds of central obesity than in Quartile 1 of EVI250m. CONCLUSIONS Higher levels of greenness were statistically significant associated with lower obesity risk.
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Affiliation(s)
- Lina Zhang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai 200032, China
| | - Chen Chen
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Cong Liu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai 200032, China
| | - Yi Zhang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Jianlong Fang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Jingxiu Han
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Feng Zhao
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Peng Du
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Qiong Wang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Jiaonan Wang
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China
| | - Wanying Shi
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Weidong Wang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai 200032, China
| | - Su Shi
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai 200032, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai 200032, China
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai 200032, China
| | - Xia Meng
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai 200032, China.
| | - Tiantian Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China.
| | - Xiaoming Shi
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
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11
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Do Neighborhoods with Highly Diverse Built Environment Exhibit Different Socio-Economic Profiles as Well? Evidence from Shanghai. SUSTAINABILITY 2021. [DOI: 10.3390/su13147544] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The link between the built environment and residential segregation has long been of interest to the discussion for sustainable and socially resilient cities. However, direct assessments on how extensively diverse built environments affect the social landscapes of cities at the neighborhood level are rare. Here, we investigate whether neighborhoods with a diverse built environment also exhibit different socio-economic profiles. Through a geodemographic approach, we scrutinize the socio-economic composition of Shanghai’s neighborhoods. We statistically compare the top 10% (very high values) to the bottom 10% (very low values) of the following built environment variables: density, land use mix, land use balance, and greenness. We show that high-density areas have three times the percentage of divorced residents than low-density areas. Neighborhoods with a high level of greenness have median values of 30% more residents aged between 25–44 years old and five times the percentage of houses between 60 to 119 m2 than low-greenness areas. In high land-use mix areas, the share of people that live on a pension is 30% more than the low land-use mix areas. The findings of this study can be used to improve the designs of modern, sustainable cities at the neighborhood level, significantly improving quality of life.
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12
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Zhou Y, von Lengerke T, Dreier M. Comparing different data sources by examining the associations between surrounding greenspace and children's weight status. Int J Health Geogr 2021; 20:24. [PMID: 34049563 PMCID: PMC8164277 DOI: 10.1186/s12942-021-00278-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 05/13/2021] [Indexed: 01/26/2023] Open
Abstract
Background Studies on the association between surrounding greenspace and being overweight in childhood show inconsistent results, possibly because they differ widely in their definition and measurement of surrounding greenspace. Our aim was to evaluate whether the association of greenspace with being overweight depends on the measurement of greenspace in different data sources. Methods Based on data from the school entry examinations of 22,678 children in the city of Hannover, Germany, from 2010 to 14, the association between greenspace availability and overweight was examined. Three different sources of greenspace availability were derived for a set of 51 areas of the city: The Normalized Difference Vegetation Index (NDVI), the OpenStreetMap (OSM) dataset, and the European Urban Atlas (UA) dataset. Agreement between the indicators on the quantity of greenspace coverage was compared. The association with children's BMI z-score, including potential interaction terms, was assessed using multilevel regression analysis. Results Greenspace availability per district area derived by NDVI was on average 42%, by OSM 29% and UA 22%, with OSM and UA being strongly correlated. Only the greenspace availability derived by NDVI showed an association with children's BMI z-score: The higher the greenspace availability was, the lower the BMI. The trend of association was higher for boys and migrant children than for girls and non-migrants and was restricted to the highest levels of greenspace availability. Conclusions Associations of greenspace with children's weight status depend on the greenspace measurement chosen. Surrounding greenspace was measured more comprehensively by NDVI. Data sources based on land use categories such as UA and OSM may be less suitable to reflect surrounding greenspace relevant for health outcomes. Potential mechanisms warrant further analysis and investigation.
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Affiliation(s)
- Yusheng Zhou
- Hannover Medical School, Institute for Epidemiology, Social Medicine and Health Systems Research, Carl-Neuberg Str. 1, 30625, Hannover, Germany.
| | - Thomas von Lengerke
- Department of Medical Psychology, Hannover Medical School, Centre for Public Health and Healthcare, Carl-Neuberg Str. 1, 30625, Hannover, Germany
| | - Maren Dreier
- Hannover Medical School, Institute for Epidemiology, Social Medicine and Health Systems Research, Carl-Neuberg Str. 1, 30625, Hannover, Germany
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13
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Obesity and Natural Spaces in Adults and Older People: A Systematic Review. J Phys Act Health 2021; 18:714-727. [PMID: 33883287 DOI: 10.1123/jpah.2020-0589] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 02/11/2021] [Accepted: 02/12/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Obesity is an important public health issue that has increased globally in the last decade and continues to be one of the main causes of morbidity and premature mortality. An accumulating body of evidence suggests that contact with nature is a valuable resource for the promotion of a more active lifestyle and seems to have a central role in maintaining a healthy weight. The authors conducted a systematic review to summarize the findings of studies that investigated the relationship between natural spaces and obesity. METHODS Following Primary Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a literature search was conducted using 11 databases for studies fully available in English and published between 2010 and 2020, with adults (18-64 y) and/or older people (≥65 y). RESULTS Fifty studies were found that met all the inclusion criteria. The majority (68%) of papers found that higher availability and less distance to green and blue spaces are associated with lower levels of adiposity. These associations were positive, even after adjusting for the demographic and socioeconomic factors. CONCLUSIONS Exploring the characteristics of green and blue spaces seems to be a promising tool for urban planning and health policies. The authors suggest the implementation of exercise programs in contact with nature for future interventions.
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14
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Gender Disparity in Perceived Urban Green Space and Subjective Health and Well-Being in China: Implications for Sustainable Urban Greening. SUSTAINABILITY 2020. [DOI: 10.3390/su122410538] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
It is generally agreed that green space has a positive effect on the health and well-being of urban residents. A number of papers have studied the relationship between green space and various sociodemographic characteristics; however, little is known about how perceptions of green space affect health and well-being differently between men and women. Such knowledge is significant for informing policy makers in designing urban green space to benefit the health and well-being of all people. In addition, urban greening has rarely been studied in the context of the UN 2030 Agenda and the UN New Urban Agenda. This study examines gender disparities in perceived green space and health and well-being, the effect of perceived green space, personal, and family variables on subjective health and well-being, and the interactive effects of perceived green space, personal, and family variables on health and well-being. The analyses were based on a survey of 9325 participants in 40 Chinese cities, using the Geographical Detector method. The results suggest that men tend to have a higher perception of green space but lower subjective health and well-being than women. Compared to health, well-being is more affected by perception of urban green space and personal and family factors. Perception of urban green space has a higher effect on men’s health and well-being than women’s. Women’s health and well-being tends to be more affected by personal and family factors than men’s. There are clear interactive effects of perceived green space, personal, and family variables on health and well-being. The combined effect is greater than the sum of individual effects on health and well-being, suggesting complexity in sustainable urban green space development with attention to gender equality in the context of the UN Agendas for sustainable development.
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15
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Luo YN, Huang WZ, Liu XX, Markevych I, Bloom MS, Zhao T, Heinrich J, Yang BY, Dong GH. Greenspace with overweight and obesity: A systematic review and meta-analysis of epidemiological studies up to 2020. Obes Rev 2020; 21:e13078. [PMID: 32677149 DOI: 10.1111/obr.13078] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 05/25/2020] [Accepted: 05/26/2020] [Indexed: 12/23/2022]
Abstract
Several reviews have been conducted to assess the association between greenspace and overweight or obesity, but the conclusions were inconsistent. However, an updated comprehensive review and meta-analysis is warranted, because several high-quality papers have been published more recently. The objectives of this study are to systematically and quantitatively assess the evidence for a link between greenspace with overweight/obesity and to make specific recommendations for further research. We searched three English language databases, four Chinese language databases and the reference lists of previously published reviews for epidemiological studies on greenspace and overweight/obesity published before January 2020. We developed inclusion criteria, screened the literature and extracted key data from selected papers. We assessed methodological quality and risk of bias, and we graded the credibility of the pooled evidence. We also performed sensitivity analyses. Fifty-seven records met our inclusion criteria and were included in the study. Most studies were cross-sectional designs (81%) and were from developed nations (88%). More than half (55%) of the included studies found beneficial associations between greenspace and overweight/obesity in overall or subpopulations. Our meta-analytical results showed that greater normalized difference vegetation index was associated with lower odds of overweight/obesity in a statistically significant fashion (odds ratio [OR]: 0.88; 95% CI: 0.84, 0.91) but not residential proximity to greenspace (OR: 0.99; 95% CI: 0.99, 1.00), proportion of greenspace (OR: 0.96; 95% CI: 0.85, 1.08) or number of parks in an area (OR: 0.99; 95% CI: 0.97, 1.01). However, we detected high between-study heterogeneity in two of the four meta-analyses, which reduced the credibility of the pooled evidence. Current evidence indicates that there might be an association between greater access to greenspace and lower odds of overweight/obesity. However, additional high-quality studies are needed to more definitively assess the evidence for a causal association.
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Affiliation(s)
- Ya-Na Luo
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Wen-Zhong Huang
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xiao-Xuan Liu
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Iana Markevych
- Institute of Psychology, Jagiellonian University, Krakow, Poland
| | - Michael S Bloom
- Departments of Environmental Health Sciences and Epidemiology and Biostatics, University at Albany, State University of New York, Rensselaer, New York, USA
| | - Tianyu Zhao
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, Ludwig Maximilian University of Munich, Comprehensive Pneumology Center (CPC) Munich, German Center for Lung Research, Munich, Germany.,Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany
| | - Joachim Heinrich
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, Ludwig Maximilian University of Munich, Comprehensive Pneumology Center (CPC) Munich, German Center for Lung Research, Munich, Germany.,Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Bo-Yi Yang
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Guang-Hui Dong
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
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16
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Xiao Y, Zhang Y, Sun Y, Tao P, Kuang X. Does Green Space Really Matter for Residents' Obesity? A New Perspective From Baidu Street View. Front Public Health 2020; 8:332. [PMID: 32850579 PMCID: PMC7426459 DOI: 10.3389/fpubh.2020.00332] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Accepted: 06/15/2020] [Indexed: 11/25/2022] Open
Abstract
Despite a growing literature on the topic, the association between neighborhood greenness and body weight is inconsistent. The objective of this research is to examine the association between neighborhood greenness and residents' obesity levels in a high population density area. We accounted for three greenness features: green access, green exposure, and view-based green index. We used the novel technique of deep convolutional neural network architecture to extract eye-level information from Baidu Street View images to capture the urban vertical greenness level. The research involved a survey with 9,524 respondents from 40 communities in Shanghai. Generally, we found all aspects of horizontal greenery, vertical greenery, and proximity of green levels to be impactful on body weight; however, only the view-based green index consistently had an adverse effect on weight and obesity.
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Affiliation(s)
- Yang Xiao
- College of Architecture and Urban Planning, Tongji University, Shanghai, China
| | - Yuhang Zhang
- College of Architecture and Urban Planning, Tongji University, Shanghai, China
| | - Yangyang Sun
- Shanghai Tongji Urban Planning and Design Institute, Shanghai, China
| | - Peihong Tao
- College of Architecture and Urban Planning, Tongji University, Shanghai, China
| | - Xiaoming Kuang
- College of Architecture and Urban Planning, Tongji University, Shanghai, China
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17
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Xiao X, Yang BY, Hu LW, Markevych I, Bloom MS, Dharmage SC, Jalaludin B, Knibbs LD, Heinrich J, Morawska L, Lin S, Roponen M, Guo Y, Lam Yim SH, Leskinen A, Komppula M, Jalava P, Yu HY, Zeeshan M, Zeng XW, Dong GH. Greenness around schools associated with lower risk of hypertension among children: Findings from the Seven Northeastern Cities Study in China. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2020; 256:113422. [PMID: 31672364 DOI: 10.1016/j.envpol.2019.113422] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 10/12/2019] [Accepted: 10/15/2019] [Indexed: 05/12/2023]
Abstract
Evidence suggests that residential greenness may be protective of high blood pressure, but there is scarcity of evidence on the associations between greenness around schools and blood pressure among children. We aimed to investigate this association in China. Our study included 9354 children from 62 schools in the Seven Northeastern Cities Study. Greenness around each child's school was measured by NDVI (Normalized Difference Vegetation Index) and SAVI (Soil-Adjusted Vegetation Index). Particulate matter ≤ 1 μm (PM1) concentrations were estimated by spatiotemporal models and nitrogen dioxide (NO2) concentrations were collected from air monitoring stations. Associations between greenness and blood pressure were determined by generalized linear and logistic mixed-effect models. Mediation by air pollution was assessed using mediation analysis. Higher greenness was consistently associated with lower blood pressure. An increase of 0.1 in NDVI corresponded to a reduction in SBP of 1.39 mmHg (95% CI: 1.86, -0.93) and lower odds of hypertension (OR = 0.76, 95% CI: 0.69, 0.82). Stronger associations were observed in children with higher BMI. Ambient PM1 and NO2 mediated 33.0% and 10.9% of the association between greenness and SBP, respectively. In summary, greater greenness near schools had a beneficial effect on blood pressure, particularly in overweight or obese children in China. The associations might be partially mediated by air pollution. These results might have implications for policy makers to incorporate more green space for both aesthetic and health benefits.
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Affiliation(s)
- Xiang Xiao
- 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, 510080, China
| | - Bo-Yi Yang
- 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, 510080, China
| | - Li-Wen Hu
- 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, 510080, China
| | - Iana Markevych
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstraße 1, 80336, Munich, Germany; Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Ingolstädter Landstraße 1, 85764, Neuherberg, Germany
| | - Michael S Bloom
- 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, 510080, China; Departments of Environmental Health Sciences & Epidemiology and Biostatistics, University at Albany, State University of New York, Rensselaer, NY, 12144, USA
| | - Shyamali C Dharmage
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Melbourne, VIC, 3004, Australia; Murdoch Children Research Institute, Melbourne, VIC, 3010, Australia
| | - Bin Jalaludin
- Centre for Air Quality and Health Research and Evaluation, Glebe, NSW, 2037, Australia; IIngham Institute for Applied Medial Research, University of New South Wales, Sydney, 2170, Australia
| | - Luke D Knibbs
- School of Public Health, The University of Queensland, Herston, Queensland, 4006, Australia
| | - Joachim Heinrich
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstraße 1, 80336, Munich, Germany; Comprehensive Pneumology Center Munich, German Center for Lung Research, Ziemssenstraße 1, 80336, Munich, Germany
| | - Lidia Morawska
- International Laboratory for Air Quality and Health, Queensland University of Technology (QUT), GPO Box 2434, Brisbane, Queensland, 4001, Australia
| | - Shao Lin
- Departments of Environmental Health Sciences & Epidemiology and Biostatistics, University at Albany, State University of New York, Rensselaer, NY, 12144, USA
| | - Marjut Roponen
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, FI, 70211, Finland
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Steve Hung Lam Yim
- Department of Geography and Resource Management, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong, China; Stanley Ho Big Data Decision Analytics Research Centre, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong, China
| | - Ari Leskinen
- Finnish Meteorological Institute, Kuopio, 70211, Finland; Department of Applied Physics, University of Eastern Finland, Kuopio, 70211, Finland
| | - Mika Komppula
- Finnish Meteorological Institute, Kuopio, 70211, Finland
| | - Pasi Jalava
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, FI, 70211, Finland
| | - Hong-Yao Yu
- 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, 510080, China
| | - Mohammed Zeeshan
- 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, 510080, China
| | - Xiao-Wen Zeng
- 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, 510080, 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, 510080, China.
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18
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Benjamin-Neelon SE, Platt A, Bacardi-Gascon M, Armstrong S, Neelon B, Jimenez-Cruz A. Greenspace, physical activity, and BMI in children from two cities in northern Mexico. Prev Med Rep 2019; 14:100870. [PMID: 31016122 PMCID: PMC6468144 DOI: 10.1016/j.pmedr.2019.100870] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 03/31/2019] [Accepted: 04/03/2019] [Indexed: 12/26/2022] Open
Abstract
Numerous previous studies have reported positive associations between exposure to greenspace and children's physical activity, but in high-income countries only. Prior studies have also examined greenspace and obesity in children, but these have yielded inconsistent results and focused mostly on older children. The purpose of this study was to assess associations between time children spent in greenspace as the primary exposure and our outcomes of interest, including 1) minutes of physical activity, and 2) body mass index (BMI) z-score. Our sample was 102 children ages 3 to 5 years living in Ensenada and Tijuana, Mexico. We fit linear mixed models to estimate associations between greenspace and children's physical activity and BMI z-score. After adjustment for potential confounders, greater time in greenspace was associated with decreased sedentary time (−0.08 min per hour for each additional 30 min in greenspace; 95% CI −0.13, −0.04; p = 0.002) and increased moderate-to-vigorous physical activity (MVPA) (0.06; 95% CI 0.03, 0.10; p < 0.001). Results were driven primarily by children in Tijuana (−0.22; 95% CI −0.38, −0.06; p = 0.008 for sedentary time and 0.15; 95% CI 0.06, 0.38; p = 0.007 for MVPA). Time in greenspace was not associated with BMI z-score in children in Ensenada (0.001; 95% CI −0.008, 0.01; p = 0.83) or Tijuana (−0.009; 95% CI −0.02, 0.004; p = 0.17). Greater time in greenspace was associated with physical activity but not BMI in our sample of children—more so in Tijuana compared to Ensenada. Given high rates of obesity, interventions should aim to increase physical activity in young children in Northern Mexico. Greater time in greenspace was associated with decreased sedentary time. Greater time in greenspace was associated with increased physical activity. Associations were mainly driven by children in Tijuana compared to Ensenada. Time spent in greenspace was not associated with body mass index z-score.
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Affiliation(s)
- Sara E Benjamin-Neelon
- Department of Health, Behavior and Society, 615 North Wolfe Street, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Alyssa Platt
- Duke Global Health Institute, Department of Biostatistics and Bioinformatics, 310 Trent Drive, Durham, NC 27710, USA
| | - Montserrat Bacardi-Gascon
- Schools of Medicine and Psychology, Universidad Autónoma de Baja California, Calzada Universidad 14418, Mesa de Otay, CP 22390 Tijuana, Mexico
| | - Sarah Armstrong
- Department of Pediatrics, 4020 Roxboro Road, Duke University Medical Center, Durham, NC 27704, USA
| | - Brian Neelon
- Department of Public Health Sciences, Medical University of South Carolina, 135 Cannon Street, Charleston, SC 29415, USA
| | - Arturo Jimenez-Cruz
- Schools of Medicine and Psychology, Universidad Autónoma de Baja California, Calzada Universidad 14418, Mesa de Otay, CP 22390 Tijuana, Mexico
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Associations between Body Mass Index and Urban "Green" Streetscape in Cleveland, Ohio, USA. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15102186. [PMID: 30301237 PMCID: PMC6210302 DOI: 10.3390/ijerph15102186] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Revised: 09/30/2018] [Accepted: 10/03/2018] [Indexed: 11/23/2022]
Abstract
Public health researchers are increasingly interested in assessing the impact of neighborhood environment on physical activities and chronic health issues among humans. Walkable streets and proximity to green space have long been believed to promote active lifestyles in cities, which contribute to positive health outcomes among residents. Traditionally, urban environmental metrics were calculated at the area level to describe the physical environment of neighborhoods. However, considering the fact that streets are the basic unit for human activities in cities, it is important to understand how the streetscape environment can influence human health conditions. In this study, we investigated the influence of street greenery and walkability on body mass index in Cleveland, Ohio, USA. Different from the area level and overhead view greenery metrics, we used the green view index calculated from the Google Street View to represent the amount of street greenery. The Walk Score was used to indicate the walkability of neighborhoods also at the street level. Statistical analysis results show that the Walk Score has a more significant association with decreased BMI for males than females and the street greenery has a more significant association with decreased BMI for females than males in Cleveland, Ohio. The results of this study would provide a reference for designing gender-specific healthy cities.
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Dempsey S, Lyons S, Nolan A. Urban green space and obesity in older adults: Evidence from Ireland. SSM Popul Health 2018; 4:206-215. [PMID: 29552630 PMCID: PMC5852306 DOI: 10.1016/j.ssmph.2018.01.002] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 01/26/2018] [Accepted: 01/29/2018] [Indexed: 12/30/2022] Open
Abstract
We examine the association between living in an urban area with more or less green space and the probability of being obese. This work involves the creation of a new dataset which combines geo-coded data at the individual level from the Irish Longitudinal Study on Ageing with green space data from the European Urban Atlas 2012. We find evidence suggestive of a u-shaped relationship between green space in urban areas and obesity; those living in areas with the lowest and highest shares of green space within a 1.6 km buffer zone have a higher probability of being classified as obese (BMI [Formula: see text]). The unexpected result that persons in areas with both the lowest and highest shares of green space have a higher probability of being obese than those in areas with intermediate shares, suggests that other characteristics of urban areas may be mediating this relationship.
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Affiliation(s)
- Seraphim Dempsey
- Economic and Social Research Institute, Sir John Rogerson's Quay, Dublin, Ireland
| | - Seán Lyons
- Economic and Social Research Institute, Sir John Rogerson's Quay, Dublin, Ireland
- Department of Economics, Trinity College Dublin, Ireland
| | - Anne Nolan
- Economic and Social Research Institute, Sir John Rogerson's Quay, Dublin, Ireland
- Department of Economics, Trinity College Dublin, Ireland
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Ireland
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