Heat-Resilient Schoolyards: Relations Between Temperature, Shade, and Physical Activity of Children During Recess

Association between ambient temperature and non-accidental mortality in Guiyang, China: A time-series analysis (2013-2023)

BACKGROUND

As climate change intensifies, ambient temperatures have become a global concern, leading to an increasing number of studies examining the impact of temperature on human health. Extreme weather events, including heatwaves and cold spells, are becoming more frequent and severe. Numerous studies have highlighted the positive correlation between non-optimal ambient temperatures and mortality. Understanding these impacts is crucial for developing targeted public health interventions and accurately predicting the future health burden associated with climate variability. This study aims to estimate the relative risks and mortality burden associated with temperature extremes over the past decade, focusing on the contributions of both heat and cold, as well as mild and extreme temperatures, and identifying vulnerable populations. By doing so, filling a regional research gap in Guiyang.

METHODS

We collected the daily weather and mortality data from 2013 to 2023. Descriptive analysis was conducted to characterize overall weather patterns and mortality trends during the study period. A quasi-Poisson regression with a distributed lag non-linear model (DLNM), incorporating a 21-day lag and controlling for trends, air pollutants, and the day of the week, was applied to estimate the cumulative relative risks of non-accidental mortality due to non-optimal and extreme temperatures. We calculated attributable fractions and attributable numbers for heat and cold (defined as temperatures above and below the daily mean temperature), mild temperatures (defined using cutoffs at the minimum mortality temperature, with mild heat ranging from the minimum mortality temperature to the 97.5th temperature percentile and mild cold ranging from the 2.5th temperature percentile to the minimum mortality temperature) and extreme temperatures (defined as temperatures below the 2.5th temperature percentile for extreme cold and above the 97.5th temperature percentile for extreme heat).

RESULTS

A total of 140,099 non-accidental deaths were included in the study.Temperature and mortality showed U-shaped associations, except for 0-64 years age group. For extreme low temperatures, the effects appeared in lag 2 to 4 days and lasted for approximately 18 days, peaking on lag day 5, yielding a cumulative relative risks (RRs) of 1.24% (95% CI 1.14% to 1.36%) for non-accidental mortality. For extreme high temperatures, the strongest effect was observed on the same day, with an RR of 1.18%(95% CI 1.03% to 1.35%). The attributable fraction of non-accidental mortality associated with non-optimal temperatures was 9.21% (95% eCI: 5.32% to 12.15%). The mortality burden from heat and cold was 5.55% (95% eCI: 2.04% to 8.59%) and 3.67% (95% eCI: 1.45% to 5.80%), respectively. Mild heat was responsible for the majority of the mortality burden.

CONCLUSION

Extreme low temperatures had higher cumulative relative risk and a prolonged effect compared to extreme high temperatures. The attributable fraction associated with non-optimal temperatures was highest for respiratory-related deaths. Mild heat was responsible for the majority of the mortality burden. Additionally, males and the individuals aged 65 years and above were particularly vulnerable populations.

Microclimate Performance Analysis of Urban Vegetation: Evidence from Hot Humid Middle Eastern Cities

Urban heat islands (UHIs) pose a growing challenge in rapidly urbanizing areas, necessitating effective mitigation strategies to enhance environmental sustainability and human well-being. This study examined the role of vegetation in regulating urban microclimates, focusing on its ability to mitigate the effects of UHIs, promote thermal comfort, and enhance urban esthetics. The study drew on existing research that employed spatial analysis and Geographic Information Systems (GIS) to explore the relationship between vegetation metrics and reductions in surface temperature. Municipal initiatives in Khobar, Saudi Arabia, including tree-planting programs and street humanization projects, aimed to improve urban esthetics and pedestrian experiences. Although these efforts enhanced urban livability, they lacked a comprehensive ecological perspective, emphasizing the need for strategies that integrate thermal comfort, environmental resilience, and broader sustainability goals. The analysis demonstrated the societal and environmental benefits of tree-planting activities and linked urban vegetation plans to the achievement of Sustainable Development Goals (SDGs). The results highlighted the importance of incorporating green infrastructure in urban development to mitigate the effects of UHIs, improve air quality, and enhance overall urban livability. This paper proposed a framework for sustainable urban design, offering practical insights for policymakers and urban planners working to create resilient, environmentally conscious communities in extreme climates.

Community Use and Perceptions of Climate Shelters in Schoolyards in Barcelona

Objectives

This study explores the use and perceptions of thermal comfort and wellbeing among the local community in the schoolyards in Barcelona that had been transformed into accessible climate shelters.

Methods

We conducted a qualitative evaluation through a spontaneous ethnographic approach, combining 22 non-participant observations in the 11 transformed schoolyards with brief spontaneous interviews with 76 users and 18 caretakers who supervised the schoolyards during non-school days (June-July 2022). We conducted a thematic content analysis. We analyzed user characteristics, thermal comfort and wellbeing, activities and differences by age and gender, social behavior, additional benefits, and areas for improvement.

Results

Adapted schoolyards were mostly visited by families and groups of adolescents with a higher proportion of boys. Participants reported that shade provided coolness and comfort, vegetation offered pleasant and naturalized environments, and water features were enjoyed for their cooling capacity and play opportunities. Schoolyards were mainly used as places for outdoor recreation and socialization.

Conclusion

This study provides policymakers with evidence to support the transformation of schoolyards into climate shelters, creating comfortable outdoor recreational areas for the surrounding urban community.

Physical Activity in Natural Settings: An Opportunity for Lifestyle Medicine

Physical activity is a well-known behavior for promoting health and preventing a variety of chronic diseases. Despite widespread knowledge of the benefits of physical activity, most Americans do not engage in sufficient physical activity. Over the past decade, there has been increasing recognition of the health benefits of spending time in nature, mediated in part through physical activity. This has led to new partnerships across health, parks and recreation, public lands, and environmental organizations to increase time spent, and physical activity, in natural settings. This review assesses the current evidence around physical activity in natural settings (PANS), strategies for promoting PANS including health professional engagement, and current gaps in the research literature.

SchoolHEAT: Racial and Ethnic Inequity in School Temperature

Exposure to high environmental temperature is detrimental to health through multiple pathways. This paper describes disparities in school-based high-temperature exposure at metropolitan schools in the United States. Using school location and sociodemographic data from the National Center for Education Statistics, neighborhood data from the US Census Bureau, and land surface temperature (LST) data from the Aqua Earth-observing satellite mission, we find that for every 10% more Black or Hispanic residents in the neighborhood, schools have LST 0.25 °C and 0.38 °C hotter, respectively. When the Black or Hispanic student population is greater than the neighborhood population, LST is an additional 0.20 °C and 0.40 °C for each 10% increase in students over neighborhood population, respectively. Black and Hispanic students are overrepresented in the hottest schools, making up 58.7% of students in the hottest 20% of schools, compared to only 30.0% of students in the coolest 20% of schools.

Urban heatwave, green spaces, and mental health: A review based on environmental health risk assessment framework

Utilizing the framework of environmental health risk assessment and healing, the article reviews the effectiveness and potential of green space systems in mitigating the impact of high temperatures, promoting mental health, and improving the risk characteristics of high-temperature heat waves. We utilized CiteSpace software to conduct a time-zone analysis of the relationship between heatwaves, green spaces, and health using clustered data from 2001 to 2023. This study evaluates the role of green space systems in mitigating high temperatures and enhancing mental health within the environmental health risk assessment framework. Using CiteSpace software, we analyzed literature from 2001 to 2023, focusing on the interactions among heatwaves, green spaces, and health. Our results indicate that most existing research concentrates on hazard identification, with insufficient exploration of the dose-response relationships between green spaces and temperature reduction. Quantitative studies on green space design and spatial optimization are scarce, and guidance on effective configurations remains limited. Additionally, the health impacts of heatwaves vary by region, with a noticeable imbalance in research focus; Asia and Africa, in particular, are underrepresented in studies addressing heatwave effects. We conclude that effective mitigation strategies require: (1) a comprehensive environmental health risk assessment framework that integrates advanced methods like big data analysis and geospatial simulations to improve green space planning and design; (2) further theoretical exploration into the mechanisms by which green spaces regulate temperature and mental health, including detailed analysis of spatiotemporal patterns and the functional optimization of green space structures; and (3) the development of robust parameterized design guidance based on specific therapeutic dosages (green space stimulus) to optimize configurations and enhance the effectiveness of green spaces in mitigating adverse mental health impacts from deteriorating thermal environments. Future research should prioritize underrepresented regions, focusing on exposure levels, dose-response relationships, and high-temperature warning systems while fostering multidisciplinary collaboration to develop effective urban planning and climate adaptation strategies.

Where the children play: Gender gaps in recess physical activity by age and playground area

Objective

Recess contributes meaningfully to physical activity (PA), but recess time has declined. The study's purpose was to report PA by age, gender, and playground feature to inform potential playground configurations more conducive to PA during recess.

Methods

Using the System for Observing Play and Leisure Activity in the Youth, kindergarten through 5th grade recesses were observed on at least four days at four schools in Little Rock, Arkansas, United States during May 2023. Target playground features were ball courts, grass, pavement, play structures, and swings. To provide inferential analysis, a comparison of conditional means across playground features, age, and gender was conducted using linear regression with robust standard errors clustered by school.

Results

3,356 playground scans (intercoder correlation = 0.93) were collected and aggregated by school, day, gender, age (grade), and target feature for a sample size of 292 observations. The gender gap was widest among 4-5th graders, 79 % (95 % CI: 72, 86) for males and 64 % (95 % CI: 58, 70) for females. Among females, PA was highest on swings [82 % (95 % CI: 77, 86)] and lowest on paved areas [56 % (95 % CI: 43, 69)]. Among males, it was highest on both swings [81 % (95 % CI: 75, 86)] and ball courts [83 % (95 % CI: 77, 89)] and lowest on grassy areas [64 % (95 % CI: 60, 67)].

Conclusion

Swings, courts, and play structures were associated with a higher proportion of children being engaged in PA. Research is needed to identify whether physical improvements to facilitate access to these features increase PA.

Adapting Schools to Climate Change with Green, Blue, and Grey Measures in Barcelona: Study Protocol of a Mixed-Method Evaluation

Under the framework of the Urban Innovative Actions program of the European Commission, in 2020, 11 primary schools in Barcelona were transformed into climate shelters by implementing green, blue, and grey measures. Schoolyards were also opened to the local community to be used during non-school periods. Here we present the study protocol of a mixed-method approach to evaluate the effectiveness of the interventions in terms of improving environmental quality and health for users. We evaluated school level through the following: (1) quantitative pre-post quasi-experimental study, and (2) qualitative evaluation. The quantitative study included measures of (a) environmental variables (collected via low-cost and non-low-cost sensors), (b) students' health and well-being (collected via health questionnaires, attention levels test, and systematic observations), and (c) teachers' health and well-being (collected via thermal comfort measurements and health questionnaires). The qualitative methods evaluated the perceptions about the effects of the interventions among students (using Photovoice) and teachers (through focus groups). The impact of the interventions was assessed at community level during summer non-school periods through a spontaneous ethnographic approach. Data collection started in August 2019 and ended in July 2022. The evaluation provides the opportunity to identify those solutions that worked and those that need to be improved for future experiences, as well as improve the evaluation methodology and replication for these kinds of interventions.

How Societal Forces of Change Are Transforming Youth Physical Activity Promotion in North America

BACKGROUND

Climate change, increasing recognition of institutionalized discrimination, and the COVID-19 pandemic are large-scale, societal events (ie, forces of change) that affect the timing, settings, and modes of youth physical activity. Despite the impact that forces of change have on youth physical activity and physical activity environments, few studies consider how they affect physical activity promotion.

METHODS

The authors use 2 established frameworks, the ecological model of physical activity and the youth physical activity timing, how, and setting framework, to highlight changes in physical activity patterns of youth in North America that have resulted from contemporary forces of change.

RESULTS

North American countries-Canada, Mexico, and the United States-have faced similar but contextually different challenges for promoting physical activity in response to climate change, increasing recognition of institutionalized discrimination, and the COVID-19 pandemic. Innovative applications of implementation science, digital health technologies, and community-based participatory research methodologies may be practical for increasing and sustaining youth physical activity in response to these forces of change.

CONCLUSIONS

Thoughtful synthesis of existing physical activity frameworks can help to guide the design and evaluation of new and existing physical activity initiatives. Researchers, practitioners, and policymakers are encouraged to carefully consider the intended and unintended consequences of actions designed to respond to forces of change.

Impact of Playground Shade Structures on Ultraviolet Radiation Exposure and Physical Activity among Children at a Childcare Facility

Skin cancer is the most common cancer in Canada, and rates continue to rise. While sunscreen and protective clothing remain critical strategies to reduce skin cancer risk, shade is generally the most effective way to control exposure. There remains a lack of data, particularly in British Columbia (BC), demonstrating the extent to which shade availability reduces ultraviolet radiation (UVR) exposure in a real-world setting and the potential impacts of shade provision on physical activity. We evaluated the impact of shade structures on UVR exposure and physical activity at a Vancouver-area childcare center with an outdoor play area with limited existing shade. 22 children, aged 3-5 years, participated in the study. Three removable shade sails were installed in the outdoor play space, and UVR and physical activity measurements were collected during the spring, summer, and fall months. Ultraviolet B (UVB) radiation data was measured using UVB dosimeters, and physical activity data was measured using accelerometers. Data were collected during each season over a total of four days-two days with shade sails installed and two days with shade sails removed. Overall, with shade installation, UVR exposures and physical activity levels among children were reduced by 50% and 20%, respectively. This study supports the use of shade sails to significantly reduce UVR exposures among preschool-aged children in BC; however, the potential for decreased physical activity from shade sails should be further explored in future research.