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Dong J, Browning MHEM, Reuben A, McAnirlin O, Yuan S, Stephens C, Maisonet M, Zhang K, Hart JE, James P, Yeager R. The paradox of high greenness and poor health in rural Central Appalachia. ENVIRONMENTAL RESEARCH 2024; 248:118400. [PMID: 38309568 DOI: 10.1016/j.envres.2024.118400] [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: 06/12/2023] [Revised: 01/29/2024] [Accepted: 01/31/2024] [Indexed: 02/05/2024]
Abstract
While many studies have found positive correlations between greenness and human health, rural Central Appalachia is an exception. The region has high greenness levels but poor health. The purpose of this commentary is to provide a possible explanation for this paradox: three sets of factors overwhelming or attenuating the health benefits of greenness. These include environmental (e.g., steep typography and limited access to green space used for outdoor recreation), social (e.g., chronic poverty, declining coal industry, and limited access to healthcare), and psychological and behavioral factors (e.g., perceptions about health behaviors, healthcare, and greenness). The influence of these factors on the expected health benefits of greenness should be considered as working hypotheses for future research. Policymakers and public health officials need to ensure that greenness-based interventions account for contextual factors and other determinants of health to ensure these interventions have the expected health benefits.
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Affiliation(s)
- Jiaying Dong
- School of Architecture, Huaqiao University, Xiamen, China; Virtual Reality and Nature Lab, Department of Parks, Recreation & Tourism Management, Clemson University, Clemson, SC, USA
| | - Matthew H E M Browning
- Virtual Reality and Nature Lab, Department of Parks, Recreation & Tourism Management, Clemson University, Clemson, SC, USA.
| | - Aaron Reuben
- Department of Psychology & Neuroscience, Duke University, Durham, NC, USA
| | - Olivia McAnirlin
- Virtual Reality and Nature Lab, Department of Parks, Recreation & Tourism Management, Clemson University, Clemson, SC, USA
| | - Shuai Yuan
- Virtual Reality and Nature Lab, Department of Parks, Recreation & Tourism Management, Clemson University, Clemson, SC, USA
| | | | - Mildred Maisonet
- Biostatistics and Epidemiology Department, College of Public Health, East Tennessee State University, Johnson City, TN, USA
| | - Kuiran Zhang
- Virtual Reality and Nature Lab, Department of Parks, Recreation & Tourism Management, Clemson University, Clemson, SC, USA
| | - Jaime E Hart
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Peter James
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Ray Yeager
- Division of Environmental Medicine, Department of Medicine, University of Louisville, Louisville, KY, USA
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Slanzi CM, MacDonald GA, Nemoianu AT, Salzer MS. Community Participation of Individuals with Mental Illnesses in Rural Areas: Stakeholder Perspectives on Barriers and Facilitators. Community Ment Health J 2024; 60:832-838. [PMID: 38133720 DOI: 10.1007/s10597-023-01217-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 12/09/2023] [Indexed: 12/23/2023]
Abstract
Community inclusion and participation are social determinants of physical and mental health. This study examines activity preferences, barriers to engagement, and potential strategies for facilitating community participation for individuals with serious mental illness living in rural communities. Data for this qualitative study were collected in a series of focus groups with a stakeholders in rural Pennsylvania. Written responses to questions on activities, barriers, facilitators, and solutions were analyzed by members of the research team. The activities that are important to our participants included both those readily accessible in rural areas and those only accessible in more urban areas. Many of the barriers identified aligned with prior research (e.g., poverty, community mobility issues). A number of novel and feasible solutions to overcome barriers were provided at the policy, program, and practice levels, some of which that can be implemented immediately, to increase participation, and improve overall health of people with mental illnesses.
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Affiliation(s)
- Crystal M Slanzi
- Department of Social and Behavioral Sciences, Temple University, 1700 N Broad St., Philadelphia, 19121, USA
| | - Gillian A MacDonald
- Department of Social and Behavioral Sciences, Temple University, 1700 N Broad St., Philadelphia, 19121, USA
| | | | - Mark S Salzer
- Department of Social and Behavioral Sciences, Temple University, 1700 N Broad St., Philadelphia, 19121, USA.
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Schwartz AJ, Richman AR, Scott M, Liu H, White W, Doherty C. Increasing Access to Care for the Underserved: Voices of Riders, Drivers, & Staff of a Rural Transportation Program. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13539. [PMID: 36294124 PMCID: PMC9603744 DOI: 10.3390/ijerph192013539] [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: 09/03/2022] [Revised: 10/12/2022] [Accepted: 10/13/2022] [Indexed: 06/16/2023]
Abstract
The qualitative data presented in this paper was part of a larger concurrent mixed methods study evaluating the effectiveness of a transportation program (Project TRIP) for low-income residents in rural eastern North Carolina. Twenty stakeholders involved in TRIP were interviewed, including riders (n = 12) of which 83% were over 50 years old, program staff including the program coordinator and 5 case managers (n = 6), and transportation providers (n = 2). Due to the COVID-19 pandemic, interviews were completed by phone with each participant. Themes from the qualitative data included the: (1) Emotional, health, & financial impacts of TRIP, (2) Changes that should be implemented into TRIP when replicating the program, and (3) Unique aspects of how TRIP operates that could inform other rural transportation programs. Thematic analysis was used to analyze the transcript data. The findings are couched in the context of how TRIP potentially defrays the impacts of cumulative disadvantage that residents experience over the life course by increasing access to healthcare.
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Affiliation(s)
- Abby J. Schwartz
- School of Social Work, East Carolina University, Greenville, NC 27858, USA
| | - Alice R. Richman
- Department of Health Education and Promotion, East Carolina University, Greenville, NC 27858, USA
| | - Mallary Scott
- Department of Health Education and Promotion, East Carolina University, Greenville, NC 27858, USA
| | - Haiyong Liu
- Department of Finance and Economics, Texas State University, San Marcos, TX 78666, USA
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Pope CN, Stavrinos D, Fazeli PL, Vance DE. Transportation Barriers and Health-Related Quality of Life in a Sample of Middle-Aged and Older Adults Living with HIV in the Deep South. AIDS Behav 2022; 26:2148-2158. [PMID: 35066731 PMCID: PMC8783768 DOI: 10.1007/s10461-021-03560-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2021] [Indexed: 12/01/2022]
Abstract
Access to reliable transportation is a social determinant of health imperative for disease management for those aging with HIV/AIDS. To what degree transportation barriers are associated with health-related quality of life (HRQOL) in middle-aged and older people living with HIV (PWH) in the Deep South region of the United States is presently unknown. PWH (n = 261, age range = 39 to 73 years old, 80.1% African American, 64.4% male) were recruited from an academic medical center in the Deep South. Variables included sociodemographics, HIV characteristics, depressive symptoms, HRQOL, and perceived transportation barriers. Spearman rho correlations and linear regressions accounting for covariates were conducted. After accounting for covariates, greater perceived transportation barriers were associated with worse health perceptions, pain, social functioning, health distress, and health transitions. Access to reliable transportation is a key factor in improving health for PWH. Considerations for healthcare and traffic safety are discussed.
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Affiliation(s)
- Caitlin N Pope
- Department of Health, Behavior & Society, University of Kentucky, Lexington, KY, USA.
- Graduate Center for Gerontology, 725 Rose St. Suite 401 Multidisciplinary Sciences Building, Lexington, KY, 40536, USA.
| | - Despina Stavrinos
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Pariya L Fazeli
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - David E Vance
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
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Dabelko-Schoeny H, Fields NL, White K, Sheldon M, Ravi K, Robinson SR, Murphy IE, Jennings C. Using Community-Based Participatory Research Strategies in Age-Friendly Communities to Solve Mobility Challenges. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2020; 63:447-463. [PMID: 32458771 DOI: 10.1080/01634372.2020.1769787] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 05/12/2020] [Accepted: 05/12/2020] [Indexed: 06/11/2023]
Abstract
The number of older adults is steadily increasing in the United States and across the globe. Aging is linked to an increased risk of disability. Disabilities that limit one or more major life activities such as seeing, hearing, walking, and motor skills impact a person's ability to drive a car. Low utilization of alternative transportation by older adults and people with disabilities may put them at risk for social isolation. Social isolation is associated with a variety of negative health outcomes. While communities are challenged to create available, acceptable, accessible, adaptable and affordable mobility options, there are widely held, inaccurate biases around older adults' abilities to contribute to the development and improvement of alternative transportation options. Gerontological social workers are well-positioned to address this bias. This paper presents a case study of a large metropolitan county in the Midwest where community-based participatory research (CBPR) strategies were used to engage older residents to support the development of alternative transportation options supporting the tenets of environmental justice.
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Affiliation(s)
| | - Noelle L Fields
- School of Social Work, The University of Texas at Arlington , Arlington, Texas, USA
| | - Katie White
- Age-Friendly Communities, Columbus and Franklin County, College of Social Work, The Ohio State University , Columbus, Ohio, USA
| | - Marisa Sheldon
- Age-Friendly Communities, Columbus and Franklin County, College of Social Work, The Ohio State University , Columbus, Ohio, USA
| | - Kristen Ravi
- College of Social Work, the University of Tennessee-Knoxville , Knoxville, Tennessee, USA
| | - Sarah R Robinson
- School of Social Work, The University of Texas at Arlington , Arlington, Texas, USA
| | - Ian E Murphy
- College of Social Work, The Ohio State University , Columbus, Ohio, USA
| | - Claire Jennings
- Age-Friendly Communities, Columbus and Franklin County, College of Social Work, The Ohio State University , Columbus, Ohio, USA
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