The environmental correlates of overall and neighborhood based recreational walking (a cross-sectional analysis of the RECORD Study)

Summer Heat, Historic Redlining, and Neighborhood Walking among Older Adults: 2017 National Household Travel Survey

No known studies have examined the relationships between urban heat islands, historic redlining, and neighborhood walking in older adults. We assessed whether (1) individual and neighborhood characteristics (including redlining score) differ by neighborhood summer land surface temperature (LST); (2) higher LST is associated with less neighborhood walking, and whether associations differ by historic redlining score; and (3) neighborhoods with discriminatory redlining scores have greater LSTs. We used data on 3982 ≥ 65 years old from the 2017 National Household Travel Survey. Multivariable negative binomial and linear regressions tested associations between LST z-score (comparing participant's neighborhood LST to surrounding region's LST) and self-reported neighborhood walking and the association between living in neighborhoods redlined as "definitely declining" or "hazardous" (versus "still desirable"/"best") and LST z-score. LSTs were higher for those in neighborhoods with higher area deprivation scores and more African American/Black residents. Older adults living in neighborhoods with higher summer LST z-scores had fewer minutes of neighborhood walking/day. This association seemed limited to individuals with neighborhood redlining scores of "still desirable"/"best." Neighborhood redlining scores of "definitely declining" or "hazardous" (versus "still desirable" and "best") were associated with greater neighborhood summer LSTs. Overall, these findings suggest that historically redlined neighborhoods may experience urban heat island effects more often. While older adults living in hotter neighborhoods with "still desirable" or "best" redlining scores may less often engage in neighborhood walking, those in neighborhoods with redlining scores of "definitely declining" and "hazardous" do not seem to decrease neighborhood walking with higher LSTs. Future work is needed to elucidate the impact of extreme heat on health-promoting behaviors such as walking and the types of interventions that can successfully counteract negative impacts on historically disadvantaged communities.

Joint associations of neighbourhood walkability and greenery with walking among middle-aged and older adults: Findings from diverse urban settings in Australia

There is evidence that neighbourhood walkability and greenery are associated with walking, but less is known about their joint associations. We investigated this using data from the AusDiab3 study (2011/12) with 3032 adults (mean age 60 years). Two-level logistic regression models were used with binary walking outcomes. There was an inverse relationship (r = -0.5) between walkability (a composite measure of residential, destinations and intersections densities) and greenery (the size of densely vegetated areas). However, both walkability and greenery were independently positively associated with odds of walking. Regarding joint associations, in low-walkability neighbourhoods, greenery was positively associated with walking. In high-walkability neighbourhoods, greenery was not associated with walking.

Association of residential greenness with incident pneumonia: A prospective cohort study

Residential greenness is considered beneficial to human health, and its association with respiratory function has been found in previous studies. However, its link with pneumonia remains unclear. To explore the association of residential greenness with incident pneumonia, we conducted a prospective cohort study based on participants of the UK Biobank, followed from 2006 to 2010 to the end of 2019. Residential greenness was measured by Normalized Difference Vegetation Index (NDVI) within 500 m and 1000 m buffer. Cox proportional hazard models were conducted to assess the association, and restricted cubic spline models were also constructed to estimate their exposure-response relationship. Results demonstrate that residential greenness was negatively related to the risk of incident pneumonia. An interquartile (IQR) increase in NDVI 500-m buffer was associated with 4 % [HR (95 % CI) =0.96 (0.94, 0.97), P < 0.001] lower risk of incident pneumonia. Compared to the lowest greenness quartile (Q1), the highest quartile (Q4) had a lower risk of incident pneumonia, with the HR (95 % CI) estimated to be 0.91 (0.87, 0.95) (P values <0.001). Analyses based on NDVI 1000-m buffer obtained similar results. Furthermore, a significant effect of modifications by age and income on the linkage between residential greenness and incident pneumonia was found. These findings propose a potential effective prevention of incident pneumonia and provide the scientific basis for promoting the construction of residential greenness.

Recreational walking and perceived environmental qualities: a national map-based survey in Denmark

BACKGROUND

The aim of the study is to explore the diversity in recreational walking motives across groups with different sociodemographic characteristics, and to use a dynamic and person-centered approach to geographically assess recreational walking behavior, and preferences for place quality related to recreational walking.

METHODS

A total of 1838 adult respondents (age 15-90 years), who engage in recreational walking, participated in the map-based survey. We used the online platform Maptionnaire to collect georeferenced information on the respondents' home location, other start locations for walking trips, and point of interest on their trips. Distance between home location and other start locations as well as point of interest were computed using a Geographic Information System (GIS). Additional information on recreational walking behavior and motives were collected using the traditional questionnaire function in Maptionnaire.

RESULTS

The most prevalent motives for walking were mental well-being and physical health, together with enjoyment and experiences related to walking. Having a tertiary education was positively associated with mental well-being motive, experiences, and taking the dog and the children outside. Income was also positively associated with experiences and walking the dog together with enjoyment of walking and spending time with others. Using the map-based approach, we found that recreational walking often starts at a location away from home and is not limited to the nearest neighborhood. A total of 4598 points of interest were mapped, and the most frequently reported place qualities were greenery, water, wildlife, good views, and tranquility.

CONCLUSION

We used a dynamic and person-centered approach and thereby giving the respondents the opportunity to point to relevant locations for their walking behavior independently of their residential neighborhood. Recreational walking often starts away from home or is not limit to the nearest neighborhod. The median distance from home to the mapped points of interests was between 1.0 and 1.6 km for home-based trips and between 9.4 and 30.6 km for trips with other start locations. The most popular place quality related to the mapped points were greenery, water, wildlife, good views, and tranquility.

The role of the perceived environment for recreational walking among adults in socioeconomically disadvantaged situations: A study using walk-along interviews

Background

Persons in socioeconomically disadvantaged situations (PSEDS) are generally less likely to engage in recreational walking (RW) compared to higher socioeconomic groups and are often more dependent on their local environment. Studies on RW have primarily focused on the role of the built environment for the general adult population and the older population in urban areas. The aim of this study is to qualitatively identify the perceived environmental factors affecting RW among PSEDS in peri-urban areas.

Methods

In two peri-urban municipalities in Belgium, walk-along interviews were conducted until data saturation with a purposeful convenience sampling of 38 PSEDS (25-65y/o) to identify local environmental factors affecting RW. A subsample of 22 participants joined a focus group (n = 4) to categorize the identified factors into environmental types (physical, sociocultural, political, and economic) of the Analysis Grid for Environments Linked to Obesity (ANGELO) framework. The interviews were transcribed and analyzed thematically using Maxqda 2022.0.

Results

The information environment (dissemination, retrieving and understanding of information) was added to the ANGELO framework, highlighting the importance of digital literacy. Availability and accessibility of well-maintained walking surfaces, toilets, street lighting and seating options (physical environment), social support, dog-ownership, stigmatization, social isolation, and a sense of belonging (sociocultural environment) and indirect costs (economic environment) were identified as important environmental factors in RW among PSEDS. The identified political and economic factors are intertwined with the other environments.

Conclusions

Perceived environmental factors affect RW among PSEDS and peri-urban settings offer specific challenges. Local governments should incorporate citizen perception into decision-making processes to create supportive environments that have the potential to promote RW among PSEDS in a peri-urban setting.

Time in Nature: A Prescription for the Prevention or Management of Hypertension

Growing evidence suggests time in nature may positively influence a broad range of health outcomes including blood pressure. The mechanism(s) by which nature exerts this influence is not fully understood, but it has been proposed that nature or natural environments promote health due to opportunities for physical activity and stress reduction. Experimental and observational studies suggest that time in forests or other green spaces is associated with reduced blood pressure, lower prevalence of hypertension, and reduced odds of using antihypertensive medications. Therefore, prescribing time in nature for patients at risk or diagnosed with hypertension may have substantial benefits.

Exposure to Public Open Spaces and Leisure-Time Physical Activity: An Analysis of Adults in Primary Health Care in Brazil

Public open spaces (POS) enable many leisure activities. However, few studies have evaluated how different exposures to POS with structured physical activities (PA) could affect the leisure-time PA (LTPA) of adults with chronic diseases. This study aimed to analyze the associations between different exposures to POS and LTPA in adults in primary health care in Brazil. In 2019, a cross-sectional study was conducted with a representative sample of 615 users of 15 Basic Health Units in São José dos Pinhais. The POS exposure was measured by the presence and distance (GIS), and the usage and frequency of usage were self-reported. The IPAQ identified walking and moderate-to-vigorous PA (MVPA). Data were analyzed with multilevel Poisson regression adjusted for the possible confounders (sex, age, economic level, chronic diseases). The prevalence of walking and MVPA ≥150 min/week was 12% and 14%, respectively. The usage of POS increased by 52% the likelihood of walking ≥10 min/week (PR: 1.52; 95%CI: 1.02-2.21), while usage ≥2 times/week increased by 2 times the likelihood of this outcome (PR: 2.01; 95%CI: 1.28-3.05). The usage of POS increased by 2.7 times the likelihood of MVPA ≥10 min/week (PR: 2.73; 95%CI: 1.86-3.97), and usage ≥2 times/week increased by 3.5 times the likelihood of this outcome (PR: 3.45; 95%CI: 2.14-5.42). Finally, the usage of POS increased by 3 times the likelihood of MVPA ≥150 min/week (PR: 3.03; 95%CI: 1.92-4.74), while usage ≥2 times/week increased by 3.8 times the likelihood of this outcome (PR: 3.81; 95%CI: 2.19-6.38). In conclusion, only the usage of POS is positively associated with walking and MVPA in the leisure time of adult primary health care users.

The Land Use and Individual Correlates of Pedestrian Commuting: Who Walks to Their Work or Place of Study in the Large Cities of the MENA Region?

The body of research on the determinants of pedestrian commuting and the characteristics of on-foot commuters at the international level and especially in the Global South is inconsistent; hence, this study focuses on this topic with the case of megacities in the Middle East and North Africa. The study is based on 8284 face-to-face interviews with respondents in the three cities, 4543 of whom worked, and of those 4543, 658 individuals walked to their work or place of study. By using binary logistic regression, the determinants of walking to work were identified. Age, household car ownership, last relocation time, intersection density, number of accessed facilities from home, average walking accessibility to neighborhood amenities, and commuting distance are the significant determinants of on-foot commuting. The study identifies younger commuters with fewer cars or no driving license living in neighborhoods with connected street networks as the walkers. The results of the Mann–Whitney U Test show that there is a significant difference between the values of these determinants for walking commuters and those who commute by other modes. Based on these findings, this paper encourages urban planners and decision-makers of the MENA region to use urban land use, including street networks and access to local facilities, to motivate commuters to commute on foot, especially those who work within a walkable distance to their work or place of study.

A hierarchy of correlates impacting adults' sensor-based physical activity and sedentary time

Investigation into correlates across all levels of the socio-ecological model predictive of objectively measured physical activity has rarely been assessed in adults. While considering a diversity of correlates, we determined which correlates best predict sensor-based moderate-to-vigorous physical activity (MVPA) and sedentary-time (ST) in adults. A Chi-squared Automatic Interaction Detection algorithm was used to hierarchize the correlates associated with high ST (≥66.6^thpercentile) and sufficient MVPA (≥150 min/week) in 865 adults. The main correlate predictive of being active was currently partaking in sport/exercise. The following relevant correlates were being male for the exercisers and having trees in the neighbourhood for the non-exercisers. The final correlate to boost male exercisers' MVPA was having lots of shops in the neighbourhood and not having television in the bedroom for women. The primary correlate for high ST was job activity level, with individuals having highly active jobs being less likely to exhibit high levels of ST; being single, male, and a former athlete also increased the chances of being highly sedentary. To increase adults' MVPA, promotion of sport participation, neighbourhood landscape planning, shop availability, as well as limiting television in the bedroom must be prioritized. For counteracting ST, increasing workplace activity level is warranted.

Weather and climate in the assessment of tourism-related walkability

Walking is an important outdoor recreational and tourism activity, both in natural surroundings and in urban settings. Walkability is the extent to which the built environment promotes walking, and addresses issues such as comfort, connectivity, safety and aesthetic values. The paper explores a relatively overlooked domain of recreation- and tourism-related walkability: the extent to which weather and climatic conditions are incorporated into assessments of walkability and their influence on walking behaviour. Following a discussion of the assessment of walkability, the results of a scoping review of weather- and climate-related variables in walkability articles published up to June 2018 are presented. The review indicates there is little research on walkability from a tourist perspective, although there is substantial interest in walking for leisure and recreation. Four major themes were identified. The descriptive theme focuses on the general importance of weather and climate to walkability; the passive analyses the weather and climate conditions as barriers to, or as promoters of, walking; proactive studies refer to adapting to and managing weather, such as provision of shade or snow-clearing. The proactive perspective gains less attention than the passive analysis. Finally, statistical controlling was only employed by a minority of studies that adjusted their results to the impacts of weather conditions. The work concludes that the sub-field has been poorly served with respect to concept and variable definition and consistency of use mean that present knowledge is of limited scientific value. Strategies for future research are suggested.

Workplace neighbourhood built environment and workers' physically-active and sedentary behaviour: a systematic review of observational studies

Background

Many desk-based workers can spend more than half of their working hours sitting, with low levels of physical activity. Workplace neighbourhood built environment may influence workers’ physical activities and sedentary behaviours on workdays. We reviewed and synthesised evidence from observational studies on associations of workplace neighbourhood attributes with domain-specific physical activity and sedentary behaviour and suggested research priorities for improving the quality of future relevant studies.

Methods

Published studies were obtained from nine databases (PubMed, Web of Science, PsycINFO, Scopus, Transport Research International Documentation, MEDLINE, Cochrane, Embase, and CINAHL) and crosschecked by Google Scholar. Observational studies with quantitative analyses estimating associations between workplace neighbourhood built environment attributes and workers’ physical activity or sedentary behaviour were included. Studies were restricted to those published in English language peer-reviewed journals from 2000 to 2019.

Results

A total of 55 studies and 455 instances of estimated associations were included. Most instances of potential associations of workplace neighbourhood built environment attributes with total or domain-specific (occupational, transport, and recreational) physical activity were non-significant. However, destination-related attributes (i.e., longer distances from workplace to home and access to car parking) were positively associated with transport-related sedentary behaviour (i.e., car driving).

Conclusions

The findings reinforce the case for urban design policies on designing mixed-use neighbourhoods where there are opportunities to live closer to workplaces and have access to a higher density of shops, services, and recreational facilities. Studies strengthening correspondence between the neighbourhood built environment attributes and behaviours are needed to identify and clarify potential relationships.

Protocol registration

The protocol of this systematic review was registered on the International Prospective Register of Systematic Reviews (PROSPERO) on 2 December 2019 (registration number: CRD42019137341).

Supplementary Information

The online version contains supplementary material available at 10.1186/s12966-020-01055-x.

Do Spatial Boundaries Matter for Exploring the Impact of Community Green Spaces on Health?

Green space exposure is thought to have a positive influence on physical activity behavior and overall health. However, the literature remains equivocal, and green space measurement methods remain complicated. Using data from the Illinois Behavioral Risk Factor Surveillance System, this study examines the influence of green space on health-related factors, such as exercise, physical health, and mental health. Moreover, we explore the methods for measuring community green space via various spatial boundaries and green space resources. The results show that combining two contextually designated census boundaries and a measure of green space with seasonality were the best spatial conceptualizations for capturing community green space. Moreover, the findings showed a positive influence of green space exposure on health outcomes. These findings highlight the importance of considering geographic contexts of daily human behaviors and green space seasonality in providing a better understanding of the influence of community activity space on environmental exposure measurement. Further, this work contributes to community planning for encouraging health-promoting behaviors.

Weekend and weekday associations between the residential built environment and physical activity: Findings from the ENABLE London study

Background

We assessed whether the residential built environment was associated with physical activity (PA) differently on weekdays and weekends, and contributed to socio-economic differences in PA.

Methods

Measures of PA and walkability, park proximity and public transport accessibility were derived for baseline participants (n = 1,064) of the Examining Neighbourhood Activities in Built Living Environments in London (ENABLE London) Study. Multilevel-linear-regressions examined associations between weekend and weekday steps and Moderate to Vigorous PA (MVPA), residential built environment factors, and housing tenure status as a proxy for socio-economic position.

Results

A one-unit decrease in walkability was associated with 135 (95% CI [28; 242]) fewer steps and 1.2 (95% CI [0.3; 2.1]) fewer minutes of MVPA on weekend days, compared with little difference in steps and minutes of MVPA observed on weekdays. A 1km-increase in distance to the nearest local park was associated with 597 (95% CI [161; 1032]) more steps and 4.7 (95% CI [1.2; 8.2]) more minutes of MVPA on weekend days; 84 fewer steps (95% CI [-253;420]) and 0.3 fewer minutes of MVPA (95%CI [-2.3, 3.0]) on weekdays. Lower public transport accessibility was associated with increased steps on a weekday (767 steps, 95%CI [–13,1546]) compared with fewer steps on weekend days (608 fewer steps, 95% CI [–44, 1658]). None of the associations between built environment factors and PA on either weekend or weekdays were modified by socio-economic status. However, socio-economic differences in PA related moderately to socio-economic disparities in PA-promoting features of the residential neighbourhood.

Conclusions

The residential built environment is associated with PA differently at weekends and on weekdays, and contributes moderately to socio-economic differences in PA.

Early life exposure to green space and insulin resistance: An assessment from infancy to early adolescence

BACKGROUND

Recent studies suggest that greater exposure to natural vegetation, or "green space" is associated with lower diabetes risk, possibly through increasing physical activity. However, there is limited research on green space and insulin resistance in youth. We hypothesized greater green space at early-life sensitive time periods would be associated with lower insulin resistance in youth.

METHODS

We used data from Project Viva (N = 460), a pre-birth cohort study that recruited pregnant women in eastern Massachusetts, 1999-2002, and followed offspring into adolescence. We defined residential green space exposure at infancy (median age - 1.1 years), early childhood (3.2 years), mid-childhood (7.7 years), and early adolescence (12.8 years), using 30 m resolution Landsat satellite imagery to estimate the Normalized Difference Vegetation Index [NDVI]. Our main outcome was early adolescence estimated insulin resistance (HOMA-IR). We used multiple imputation to account for missing data and multiple linear regression models adjusted for age, sex, race/ethnicity, parental education, household income, and neighborhood median household income.

RESULTS

The highest green space tertile had the highest percentage of white participants (85%), college-educated mothers (87%) and fathers (85%), and households with income higher than US$70,000 (86%). Unadjusted models showed that participants living in the highest green space tertile at infancy had a 0.15 unit lower HOMA-IR (95% CI: -0.23, -0.06) in early adolescence, than those living in the lowest tertile. However, in adjusted models, we did not observe evidence of associations between green space from infancy to early adolescence and HOMA-IR in early adolescence, although some point estimates were in the hypothesized direction. For example, participants in the highest green space tertile in infancy had 0.03 units lower HOMA-IR (95%CI: -0.14, 0.08) than those living in the lowest tertile.

CONCLUSIONS

Exposure to green space at early life sensitive time periods was not associated with HOMA-IR in youth. Early-life longitudinal studies across diverse populations are needed to confirm or refute our results.

Active design of built environments for increasing levels of physical activity in adults: the ENABLE London natural experiment study

Background

Low physical activity is widespread and poses a serious public health challenge both globally and in the UK. The need to increase population levels of physical activity is recognised in current health policy recommendations. There is considerable interest in whether or not the built environment influences health behaviours, particularly physical activity levels, but longitudinal evidence is limited.

Objectives

The effect of moving into East Village (the former London 2012 Olympic and Paralympic Games Athletes’ Village, repurposed on active design principles) on the levels of physical activity and adiposity, as well as other health-related and well-being outcomes among adults, was examined.

Design

The Examining Neighbourhood Activities in Built Environments in London (ENABLE London) study was a longitudinal cohort study based on a natural experiment.

Setting

East Village, London, UK.

Participants

A cohort of 1278 adults (aged ≥ 16 years) and 219 children seeking to move into social, intermediate and market-rent East Village accommodation were recruited in 2013–15 and followed up after 2 years.

Intervention

The East Village neighbourhood, the former London 2012 Olympic and Paralympic Games Athletes’ Village, is a purpose-built, mixed-use residential development specifically designed to encourage healthy active living by improving walkability and access to public transport.

Main outcome measure

Change in objectively measured daily steps from baseline to follow-up.

Methods

Change in environmental exposures associated with physical activity was assessed using Geographic Information System-derived measures. Individual objective measures of physical activity using accelerometry, body mass index and bioelectrical impedance (per cent of fat mass) were obtained, as were perceptions of change in crime and quality of the built environment. We examined changes in levels of physical activity and adiposity using multilevel models adjusting for sex, age group, ethnic group, housing sector (fixed effects) and baseline household (random effect), comparing the change in those who moved to East Village (intervention group) with the change in those who did not move to East Village (control group). Effects of housing sector (i.e. social, intermediate/affordable, market-rent) as an effect modifier were also examined. Qualitative work was carried out to provide contextual information about the perceived effects of moving to East Village.

Results

A total of 877 adults (69%) were followed up after 2 years (mean 24 months, range 19–34 months, postponed from 1 year owing to the delayed opening of East Village), of whom 50% had moved to East Village; insufficient numbers of children moved to East Village to be considered further. In adults, moving to East Village was associated with only a small, non-significant, increase in mean daily steps (154 steps, 95% confidence interval –231 to 539 steps), more so in the intermediate sector (433 steps, 95% confidence interval –175 to 1042 steps) than in the social and market-rent sectors (although differences between housing sectors were not statistically significant), despite sizeable improvements in walkability, access to public transport and neighbourhood perceptions of crime and quality of the built environment. There were no appreciable effects on time spent in moderate to vigorous physical activity or sedentary time, body mass index or percentage fat mass, either overall or by housing sector. Qualitative findings indicated that, although participants enjoyed their new homes, certain design features might actually serve to reduce levels of activity.

Conclusions

Despite strong evidence of large positive changes in neighbourhood perceptions and walkability, there was only weak evidence that moving to East Village was associated with increased physical activity. There was no evidence of an effect on markers of adiposity. Hence, improving the physical activity environment on its own may not be sufficient to increase population physical activity or other health behaviours.

Funding

This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 8, No. 12. See the NIHR Journals Library website for further project information. This research was also supported by project grants from the Medical Research Council National Prevention Research Initiative (MR/J000345/1).

Development of a national childhood obesogenic environment index in the United States: differences by region and rurality

Background

Diverse environmental factors are associated with physical activity (PA) and healthy eating (HE) among youth. However, no study has created a comprehensive obesogenic environment index for children that can be applied at a large geographic scale. The purpose of this study was to describe the development of a childhood obesogenic environment index (COEI) at the county level across the United States.

Methods

A comprehensive search of review articles (n = 20) and input from experts (n = 12) were used to identify community-level variables associated with youth PA, HE, or overweight/obesity for potential inclusion in the index. Based on strength of associations in the literature, expert ratings, expertise of team members, and data source availability, 10 key variables were identified – six related to HE (# per 1000 residents for grocery/superstores, farmers markets, fast food restaurants, full-service restaurants, and convenience stores; as well as percentage of births at baby (breastfeeding)-friendly facilities) and four related to PA (percentage of population living close to exercise opportunities, percentage of population < 1 mile from a school, a composite walkability index, and number of violent crimes per 1000 residents). Data for each variable for all counties in the U.S. (n = 3142) were collected from publicly available sources. For each variable, all counties were ranked and assigned percentiles ranging from 0 to 100. Positive environmental variables (e.g., grocery stores, exercise opportunities) were reverse scored such that higher values for all variables indicated a more obesogenic environment. Finally, for each county, a total obesogenic environment index score was generated by calculating the average percentile for all 10 variables.

Results

The average COEI percentile ranged from 24.5–81.0 (M = 50.02,s.d. = 9.01) across US counties and was depicted spatially on a choropleth map. Obesogenic counties were more prevalent (F = 130.43,p < .0001) in the South region of the U.S. (M = 53.0,s.d. = 8.3) compared to the Northeast (M = 43.2,s.d. = 6.9), Midwest (M = 48.1,s.d. = 8.5), and West (M = 48.4,s.d. = 9.8). When examined by rurality, there were also significant differences (F = 175.86,p < .0001) between metropolitan (M = 46.5,s.d. = 8.4), micropolitan (M = 50.3,s.d. = 8.1), and rural counties (M = 52.9,s.d. = 8.8) across the U.S.

Conclusion

The COEI can be applied to benchmark obesogenic environments and identify geographic disparities and intervention targets. Future research can examine associations with obesity and other health outcomes.

Objective and Perceived Neighborhood Greenness of Students Differ in their Agreement in Home and Study Environments

Research has reported the associations between objective or subjective neighborhood greenness and health, with low agreement between the greenness scores. College students are prone to poor health, and data are lacking on home and university environments. We studied the agreement between greenness parameters and the associations of objective greenness with health in different locations. Three hundred and seventy-seven college students were recruited, with a mean age of 24 years, in the city of Graz, Austria. Objective and perceived greenness was assessed at home and at university. Health measures included the WHO-5 questionnaire for mental health, the IPAQ questionnaire (short) for physical activity and sedentariness, and body mass index. Per location, quintile pairs of objective and perceived greenness were classified into underestimates, correct estimates or overestimates. Interrater reliability and correlation analyses revealed agreement between greenness scores at home but not at university. ANOVA models only showed poorer mental health for students underestimating greenness at university (M = 51.38, SD = 2.84) compared to those with correct estimates (M = 61.03, SD = 1.85). Agreement between greenness scores at home but not at university was obtained, and mental health was related to the perception of greenness at university. We conclude that reliable and corresponding methods for greenness scores need to be developed.

Determinants of Residential Preferences Related to Built and Social Environments and Concordance between Neighborhood Characteristics and Preferences

We explored associations between residential preferences and sociodemographic characteristics, the concordance between current neighborhood characteristics and residential preferences, and heterogeneity in concordance by income and race/ethnicity. Data came from a cross-sectional phone and mail survey of 3668 residents of New York City, Baltimore, Chicago, Los Angeles, St. Paul, and Winston Salem in 2011-12. Scales characterized residential preferences and neighborhood characteristics. Stronger preferences were associated with being older, female, non-White/non-Hispanic, and lower education. There was significant positive but weak concordance between current neighborhood characteristics and residential preferences (after controlling sociodemographic characteristics). Concordance was stronger for persons with higher income and for Whites, suggesting that residential self-selection effects are strongest for populations that are more advantaged.

Sedentariness of College Students Is Negatively Associated with Perceived Neighborhood Greenness at Home, but Not at University

Previous studies reported contradictory evidence for associations between perceived greenness and obesity mediated by physical activity, focusing on people’s homes or general greenness. Data are lacking in other environments. We studied the association of perceived greenness at home and at university with BMI and physical activity. An online survey collected data from 601 participants, living and studying in and around the city of Graz, Austria; mean age of 24 years. Greenness was assessed using questions on quality of and access to green space; Body mass index (BMI) was derived from self-reported measures; physical activity and sedentariness were measured using the IPAQ questionnaire (short version). On average, BMI was 22.6 (SD = 3.7), physical activity was 63.3 (SD = 51.7) METh/week, and participants spent 5.8 (SD = 4.0) h/day sitting. Regression analyses revealed no associations between perceived greenness and BMI and physical activity for all environments, but a negative association for sedentariness and perceived greenness at home, but not at university. The results indicate a relation between perceived greenness and sedentariness, which differs for the home-and study environment.

Translating Urban Walkability Initiatives for Older Adults in Rural and Under-Resourced Communities

The built environment can promote physical activity in older adults by increasing neighborhood walkability. While efforts to increase walkability are common in urban communities, there is limited data related to effective implementation in rural communities. This is problematic, as older adults make up a significant portion of rural inhabitants and exhibit lower levels of physical activity. Translating lessons from urban strategies may be necessary to address this disparity. This review examines best practices from urban initiatives that can be implemented in rural, resource-limited communities. The review of the literature revealed that simple, built environment approaches to increase walkability include microscale and pop-up infrastructure, municipal parks, and community gardens, which can also increase physical activity in neighborhoods for urban older adults. These simple and cost-effective strategies suggest great potential for rural communities.

Effect of Residential Greenness and Nearby Parks on Respiratory and Allergic Diseases among Middle School Adolescents in a Chinese City

Research on the health impacts of green environments has mainly been conducted in developed countries. Differences in the urban forms between China and Western countries make it essential to understand the role of greenspace in Chinese settings. From 2014 to 2015, middle school students (n = 5643) in Suzhou, China were enrolled in a study on the health effect of residential greenness. The normalized difference vegetation index (NDVI) and distance to the nearest park were calculated for each home address. Logistic regression was performed to test associations between exposure and self-reported doctor diagnoses of asthma, pneumonia, rhinitis, and eczema, adjusting for important confounders. No statistically significant associations were observed for any seasonal NDVI-based measures. However, the proximity of the participants’ residences to the closest park showed an inverse relationship to reported symptoms. The odds ratios for the furthest quartile compared to the closest quartile based on the distance to the nearest park were 0.58 (95% CI: 0.35, 0.99), 0.70 (95% CI: 0.50, 0.96), 0.92 (95% CI: 0.74, 1.15), 0.97 (95% CI: 0.76, 1.24), 0.86 (95% CI: 0.68, 1.10) for current asthma, ever asthma, ever pneumonia, ever rhinitis, and ever eczema, respectively. These findings focused on a single Chinese city and suggest that exposure to natural vegetation in urban areas may affect health through various pathways.

Physical Activity, Residential Environment, and Nature Relatedness in Young Men-A Population-Based MOPO Study

Background: In general, nature relatedness is positively associated with physical activity, health, and subjective well-being. However, increased residence in urban areas, and the decrease in natural spaces, may affect the younger generation most adversely. The associated environmental changes can increase youths’ risk of spending most of their time indoors, and weaken their nature relatedness, making them less likely to enjoy nature’s health benefits. This is a serious public health issue, since inadequate physical activity, combined with minimum time spent in green space, can affect health across the whole lifespan. Thus, to develop effective interventions for physical activation and promote health and well-being among young men, further knowledge of the determinants of their nature relatedness is necessary. Aims: To explore factors related to nature relatedness, including physical activity, physical activity with parents, and residential environment. Methods: The study population consisted of all 914 young men (mean—17.8 years; SD—0.5) who participated in mandatory call-ups for military service and completed the study questionnaire in 2013. The questionnaire inquired about their nature relatedness, demographic characteristics, socioeconomic status, physical activity, health, and subjective well-being. A geographic information system (GIS) was used to assess the features of their residential environments. Multivariable linear regression was used to analyze the data. Results: Physical activity (p = 0.021) and physical activity with parents at primary school age (p = 0.007), and currently (p = 0.001) as well as good self-rated health (p = 0.001), and father’s higher socioeconomic status (p = 0.041), were positively connected to nature relatedness. Conclusions: Physical activity in general, physical activity with parents, and nature relatedness were positively related. This knowledge can be utilized in promoting physical activity and health among young men.

The "Residential" Effect Fallacy in Neighborhood and Health Studies: Formal Definition, Empirical Identification, and Correction

BACKGROUND

Because of confounding from the urban/rural and socioeconomic organizations of territories and resulting correlation between residential and nonresidential exposures, classically estimated residential neighborhood-outcome associations capture nonresidential environment effects, overestimating residential intervention effects. Our study diagnosed and corrected this "residential" effect fallacy bias applicable to a large fraction of neighborhood and health studies.

METHODS

Our empirical application investigated the effect that hypothetical interventions raising the residential number of services would have on the probability that a trip is walked. Using global positioning systems tracking and mobility surveys over 7 days (227 participants and 7440 trips), we employed a multilevel linear probability model to estimate the trip-level association between residential number of services and walking to derive a naïve intervention effect estimate and a corrected model accounting for numbers of services at the residence, trip origin, and trip destination to determine a corrected intervention effect estimate (true effect conditional on assumptions).

RESULTS

There was a strong correlation in service densities between the residential neighborhood and nonresidential places. From the naïve model, hypothetical interventions raising the residential number of services to 200, 500, and 1000 were associated with an increase by 0.020, 0.055, and 0.109 of the probability of walking in the intervention groups. Corrected estimates were of 0.007, 0.019, and 0.039. Thus, naïve estimates were overestimated by multiplicative factors of 3.0, 2.9, and 2.8.

CONCLUSIONS

Commonly estimated residential intervention-outcome associations substantially overestimate true effects. Our somewhat paradoxical conclusion is that to estimate residential effects, investigators critically need information on nonresidential places visited.

Neighborhood educational disparities in active commuting among women: the effect of distance between the place of residence and the place of work/study (an ACTI-Cités study)

Background

Active transportation has been associated with favorable health outcomes. Previous research highlighted the influence of neighborhood educational level on active transportation. However, little is known regarding the effect of commuting distance on social disparities in active commuting. In this regard, women have been poorly studied. The objective of this paper was to evaluate the relationship between neighborhood educational level and active commuting, and to assess whether the commuting distance modifies this relationship in adult women.

Methods

This cross-sectional study is based on a subsample of women from the Nutrinet-Santé web-cohort (N = 1169). Binomial, log-binomial and negative binomial regressions were used to assess the associations between neighborhood education level and (i) the likelihood of reporting any active commuting time, and (ii) the share of commuting time made by active transportation modes. Potential effect measure modification of distance to work on the previous associations was assessed both on the additive and the multiplicative scales.

Results

Neighborhood education level was positively associated with the probability of reporting any active commuting time (relative risk = 1.774; p < 0.05) and the share of commuting time spent active (relative risk = 1.423; p < 0.05). The impact of neighborhood education was greater at long distances to work for both outcomes.

Conclusions

Our results suggest that neighborhood educational disparities in active commuting tend to increase with commuting distance among women. Further research is needed to provide geographically driven guidance for health promotion intervention aiming at reducing disparities in active transportation among socioeconomic groups.

Electronic supplementary material

The online version of this article (doi:10.1186/s12889-017-4464-8) contains supplementary material, which is available to authorized users.

Residential greenness and risk of prostate cancer: A case-control study in Montreal, Canada

BACKGROUND

Recent studies suggest that exposure to greenness favors several health outcomes. We assessed whether living in the proximity of greener areas was related to prostate cancer incidence in a population-based case-control study in Montreal, Canada.

MATERIALS AND METHODS

Interviews eliciting lifetime addresses were conducted with 1933 prostate cancer cases diagnosed in 2005-2009 and 1994 population controls. Odds ratios (OR) and 95% confidence intervals (CI) estimated the association between residential greenness, both at recruitment (2005-2009) and about ten years prior (1996), defined by the normalized difference vegetation index (NDVI) around the home, and prostate cancer risk. Three models were developed adjusting for age, individual characteristics, and individual and ecological characteristics, estimating relative risk in relation to an interquartile range (IQR) increase of the NDVI.

RESULTS

We observed inverse associations between greenness measured within home buffers of 150m, 300m, 500m and 1000m, at both time points, and risk of prostate cancer, independently of individual and ecological characteristics. For instance, using a buffer of 300m, the OR for an IQR increase of 0.11 in NDVI at the time of recruitment was 0.82 (95%CI 0.74-0.92). The corresponding OR for an IQR increase of 0.15 in NDVI in 1996 was 0.86 (95%CI 0.74-1.00). There were little differences in risks according to buffer size, the time point of exposure, when considering prostate cancer aggressiveness, or when restricting controls to men recently screened for prostate cancer to reduce the likelihood of undiagnosed cancer among them.

CONCLUSION

Men living in greener areas, either recently or about a decade earlier, had lower risks of prostate cancer, independently of socio-demographic and lifestyle factors. These observations are novel and require confirmation.

Pneumonia Hospitalization Risk in the Elderly Attributable to Cold and Hot Temperatures in Hong Kong, China

The growth of pathogens potentially relevant to respiratory tract infection may be triggered by changes in ambient temperature. Few studies have examined the association between ambient temperature and pneumonia incidence, and no studies have focused on the susceptible elderly population. We aimed to examine the short-term association between ambient temperature and geriatric pneumonia and to assess the disease burden attributable to cold and hot temperatures in Hong Kong, China. Daily time-series data on emergency hospital admissions for geriatric pneumonia, mean temperature, relative humidity, and air pollution concentrations between January 2005 and December 2012 were collected. Distributed-lag nonlinear modeling integrated in quasi-Poisson regression was used to examine the exposure-lag-response relationship between temperature and pneumonia hospitalization. Measures of the risk attributable to nonoptimal temperature were calculated to summarize the disease burden. Subgroup analyses were conducted to examine the sex difference. We observed significant nonlinear and delayed associations of both cold and hot temperatures with pneumonia in the elderly, with cold temperatures having stronger effect estimates. Among the 10.7% of temperature-related pneumonia hospitalizations, 8.7% and 2.0% were attributed to cold and hot temperatures, respectively. Most of the temperature-related burden for pneumonia hospitalizations in Hong Kong was attributable to cold temperatures, and elderly men had greater susceptibility.

Using GPS, GIS, and Accelerometer Data to Predict Transportation Modes

INTRODUCTION

Active transportation is a substantial source of physical activity, which has a positive influence on many health outcomes. A survey of transportation modes for each trip is challenging, time-consuming, and requires substantial financial investments. This study proposes a passive collection method and the prediction of modes at the trip level using random forests.

METHODS

The RECORD GPS study collected real-life trip data from 236 participants over 7 d, including the transportation mode, global positioning system, geographical information systems, and accelerometer data. A prediction model of transportation modes was constructed using the random forests method. Finally, we investigated the performance of models on the basis of a limited number of participants/trips to predict transportation modes for a large number of trips.

RESULTS

The full model had a correct prediction rate of 90%. A simpler model of global positioning system explanatory variables combined with geographical information systems variables performed nearly as well. Relatively good predictions could be made using a model based on the 991 trips of the first 30 participants.

CONCLUSIONS

This study uses real-life data from a large sample set to test a method for predicting transportation modes at the trip level, thereby providing a useful complement to time unit-level prediction methods. By enabling predictions on the basis of a limited number of observations, this method may decrease the workload for participants/researchers and provide relevant trip-level data to investigate relations between transportation and health.

The contribution of travel-related urban zones, cycling and pedestrian networks and green space to commuting physical activity among adults - a cross-sectional population-based study using geographical information systems

BACKGROUND

The current political agenda aims to promote active environments and physical activity while commuting to work, but research on it has provided mixed results. This study examines whether the proximity of green space and people's residence in different travel-related urban zones contributes to commuting physical activity.

METHODS

Population-based cross-sectional health examination survey, Health 2011 study, and geographical information system (GIS) data were utilized. The GIS data on green space and travel-related urban zones were linked to the individuals of the Health 2011 study, based on their home geocoordinates. Commuting physical activity was self-reported. Logistic regression models were applied, and age, gender, education, leisure-time and occupational physical activity were adjusted. Analyses were limited to those of working age, living in the core-urban areas of Finland and having completed information on commuting physical activity (n = 2 098).

RESULTS

Home location in a pedestrian zone of a main centre (odds ratio = 1.63; 95 % confidence interval = 1.06-2.51) or a pedestrian zone of a sub-centre (2.03; 1.09-3.80) and higher proportion of cycling and pedestrian networks (3.28; 1.71-6.31) contributed to higher levels of commuting physical activity. The contribution remained after adjusting for all the environmental attributes and individuals. Based on interaction analyses, women living in a public transport zone were almost two times more likely to be physically active while commuting compared to men. A high proportion of recreational green space contributed negatively to the levels of commuting physical activity (0.73; 0.57-0.94) after adjusting for several background factors. Based on interaction analyses, individuals aged from 44 to 54 years and living in sub-centres, men living in pedestrian zones of sub-centres, and those individuals who are physically inactive during leisure-time were less likely to be physically active while commuting.

CONCLUSIONS

Good pedestrian and cycling infrastructure may play an important role in promoting commuting physical activity among the employed population, regardless of educational background, leisure-time and occupational physical activity. Close proximity to green space and a high proportion of green space near the home may not be sufficient to initiate commuting physical activity in Finland, where homes surrounded by green areas are often situated in car-oriented zones far from work places.

Destinations That Older Adults Experience Within Their GPS Activity Spaces Relation to Objectively Measured Physical Activity

Identifying the relevant geography is an ongoing obstacle to effectively evaluate the influence of neighborhood built environment on physical activity. We characterized density and diversity of destinations that 77 older adults experienced within individually representative GPS activity spaces and traditional residential buffers and assessed their associations with accelerometry-measured physical activity. Traditional residential buffers had lower destination density and diversity than activity spaces. Activity spaces based only on pedestrian and bicycling trips had higher destination densities than all-mode activity spaces. Regardless of neighborhood definition, adjusted associations between destinations and physical activity generally failed to reach statistical significance. However, within pedestrian and bicycling-based activity spaces each additional destination type was associated with 243.3 more steps/day (95% confidence interval (CI) 36.0, 450.7). Traditional buffers may not accurately portray the geographic space or neighborhood resources experienced by older adults. Pedestrian and bicycling activity spaces elucidate the importance of destinations for facilitating active transportation.

Do Neighborhood Physical Activity Resources and Land Use Influence Physical Activity among African American Public Housing Residents?

Few studies have examined neighborhood influences on physical activity (PA) among low-income African Americans living in public housing. This study measured the associations of PA resources and land use with PA among 216 African Americans living in 12 low-income housing developments in Houston, Texas. Neighborhood measures included both detailed information from in-person audits and geographic information systems (GIS) data. Hierarchical linear regression models tested the associations of neighborhood PA resource availability and quality and land use density and diversity with individual-level, self-reported PA. Land use diversity was positively associated with walking among men after controlling for other neighborhood characteristics. Policies that promote land use diversity or improve the pedestrian environment in areas with diverse destinations may encourage PA among public housing residents.

Accounting for the daily locations visited in the study of the built environment correlates of recreational walking (the RECORD Cohort Study)

BACKGROUND

Understanding how built environment characteristics influence recreational walking is of the utmost importance to develop population-level strategies to increase levels of physical activity in a sustainable manner.

PURPOSE

This study analyzes the residential and non-residential environmental correlates of recreational walking, using precisely geocoded activity space data.

METHODS

The point-based locations regularly visited by 4365 participants of the RECORD Cohort Study (Residential Environment and CORonary heart Disease) were collected between 2011 and 2013 in the Paris region using the VERITAS software (Visualization and Evaluation of Regular Individual Travel destinations and Activity Spaces). Zero-inflated negative binomial regressions were used to investigate associations between both residential and non-residential environmental exposure and overall self-reported recreational walking over 7 days.

RESULTS

Density of destinations, presence of a lake or waterway, and neighborhood education were associated with an increase in the odds of reporting any recreational walking time. Only the density of destinations was associated with an increase in time spent walking for recreational purpose. Considering the recreational locations visited (i.e., sports and cultural destinations) in addition to the residential neighborhood in the calculation of exposure improved the model fit and increased the environment-walking associations, compared to a model accounting only for the residential space (Akaike Information Criterion equal to 52797 compared to 52815).

CONCLUSIONS

Creating an environment supportive to walking around recreational locations may particularly stimulate recreational walking among people willing to use these facilities.

Quality of Public Open Spaces and Recreational Walking

OBJECTIVES

We examined associations between specific public open space (POS) attributes and recreational walking to local POS.

METHODS

Between October 2004 and December 2006, 1465 adults of the RESIDential Environments Project, conducted in Perth, Australia, reported whether they walk to a POS for recreation. For each participant, we identified all open spaces larger than 0.8 hectares within 1.6 kilometers from home. On the basis of field audit data, we created 3 scores (presence, count, size-weighted presence) for 19 specific open space attributes.

RESULTS

With logistic regression analyses, we found that walking to a POS was associated with the presence of gardens, grassed areas, walking paths, water features, wildlife, amenities, dog-related facilities, and off-leash areas for dogs. It was also associated with the highest number of these attributes in a single open space, but not with the total number of attributes in all POSs within 1.6 kilometers of home.

CONCLUSIONS

Building 1 high-quality local park may be more effective in promoting recreational walking than is providing many average-quality parks.

A Review of the Health Benefits of Greenness

Researchers are increasingly exploring how neighborhood greenness, or vegetation, may affect health behaviors and outcomes. Greenness may influence health by promoting physical activity and social contact; decreasing stress; and mitigating air pollution, noise, and heat exposure. Greenness is generally measured using satellite-based vegetation indices or land-use databases linked to participants' addresses. In this review, we found fairly strong evidence for a positive association between greenness and physical activity, and a less consistent negative association between greenness and body weight. Research suggests greenness is protective against adverse mental health outcomes, cardiovascular disease, and mortality, though most studies were limited by cross-sectional or ecological design. There is consistent evidence that greenness exposure during pregnancy is positively associated with birth weight, though findings for other birth outcomes are less conclusive. Future research should follow subjects prospectively, differentiate between greenness quantity and quality, and identify mediators and effect modifiers of greenness-health associations.

Public open space, physical activity, urban design and public health: Concepts, methods and research agenda

Public open spaces such as parks and green spaces are key built environment elements within neighbourhoods for encouraging a variety of physical activity behaviours. Over the past decade, there has been a burgeoning number of active living research studies examining the influence of public open space on physical activity. However, the evidence shows mixed associations between different aspects of public open space (e.g., proximity, size, quality) and physical activity. These inconsistencies hinder the development of specific evidence-based guidelines for urban designers and policy-makers for (re)designing public open space to encourage physical activity. This paper aims to move this research agenda forward, by identifying key conceptual and methodological issues that may contribute to inconsistencies in research examining relations between public open space and physical activity.

Adolescents' use of the built environment for physical activity

Background

Physical activity is a health-enhancing behavior, but few adolescents achieve the recommended levels of moderate-to-vigorous physical activity. Understanding how adolescents use different built environment spaces for physical activity and activity varies by location could help in designing effective interventions to promote moderate-to-vigorous physical activity. The objective of this study was to describe the locations where adolescents engage in physical activity and compare traditional intensity-based measures with continuous activity when describing built environment use patterns among adolescents.

Methods

Eighty adolescents aged 11–14 years recruited from community health and recreation centers. Adolescents wore accelerometers (Actigraph GT3X) and global positioning system receivers (QStarz BT-Q1000XT) for two separate weeks to record their physical activity levels and locations. Accelerometer data provided a continuous measure of physical activity and intensity-based measures (sedentary time, moderate-to-vigorous physical activity). Physical activity was mapped by land-use classification (home, school, park, playground, streets & sidewalks, other) using geographic information systems and this location-based activity was assessed for both continuous and intensity-based physical activity derived from mixed-effects models which accounted for repeated measures and clustering effects within person, date, school, and town.

Results

Mean daily moderate-to-vigorous physical activity was 22 minutes, mean sedentary time was 134 minutes. Moderate-to-vigorous physical activity occurred in bouts lasting up to 15 minutes. Compared to being at home, being at school, on the streets and sidewalks, in parks, and playgrounds were all associated with greater odds of being in moderate-to-vigorous physical activity and achieving higher overall activity levels. Playground use was associated with the highest physical activity level (β = 172 activity counts per minute, SE = 4, p < 0.0001) and greatest odds of being in moderate-to-vigorous physical activity (odds ratio 8.3, 95% confidence interval 4.8-14.2).

Conclusion

Adolescents were more likely to engage in physical activity, and achieved their highest physical activity levels, when using built environments located outdoors. Novel objective methods for determining physical activity can provide insight into adolescents’ spatial physical activity patterns, which could help guide physical activity interventions. Promoting zoning and health policies that encourage the design and regular use of outdoor spaces may offer another promising opportunity for increasing adolescent physical activity.

Work economic sectors and cardiovascular risk factors: cross-sectional analysis based on the RECORD Study

Background

Little is known on the comparative effect of work economic sectors on multiple cardiovascular risk factors. Such information may be useful to target Public health interventions, e.g., through the occupational medicine. We investigated whether and how a large panel of cardiovascular risk factors varied between 11 work economic sectors.

Methods

Data on 4360 participants from the French RECORD Study geolocated at their residence were analyzed. Ten outcomes were assessed: body mass index (BMI), waist circumference, systolic and diastolic blood pressure (BP), pulse pressure, total cholesterol, glycaemia, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and resting heart rate. Multilevel linear regression models stratified by sex and adjusted for individual and neighborhood sociodemographic characteristics were estimated.

Results

Among men, the Health and social work sector was found to be the most protective sector for BMI, waist circumference, and glycaemia (while the Construction sector and the Transport and communications sector tended to be unfavorable for these outcomes). The Health and social work sector was also associated with higher HDL cholesterol among men. However, men working in the Health and social work sector showed the highest systolic BP and pulse pressure. Women working in the Health and social work sector had the highest BMI, the largest waist circumference, and the most elevated systolic and diastolic BP. The Commercial and repair of vehicles sector, the Transport and communication sector, and the Collective, social, and personal services sector were associated with a more favorable profile for these risk factors among women.

Conclusion

Work economic sectors contribute to shape metabolic and cardiovascular parameters after adjustment for individual/neighborhood sociodemographic characteristics. However, patterns of associations varied strikingly according to the risk factor examined and between men and women. Such findings may be useful to target interventions for reducing cardiovascular risk, e.g., through the occupational medicine.

Electronic supplementary material

The online version of this article (doi:10.1186/1471-2458-14-750) contains supplementary material, which is available to authorized users.