Association of changes in commute mode with body mass index and visceral adiposity: a longitudinal study

Towards optimization of community vulnerability indices for COVID-19 prevalence

BACKGROUND

The Centers for Disease Control and Prevention (CDC)'s social vulnerability index (SVI) for exploring social and health disparities in the United States may not be suitable for assessing COVID-19 risk in specific communities and subpopulations. This study aims to develop the community vulnerability index (CVI) optimized for demographic-specific COVID-19 prevalence at the census tract level and apply it to Clark County, Nevada, which includes the vibrant Las Vegas metropolitan area.

METHODS

We constructed the CVI using fifteen social condition variables from the CDC's SVI along with eight additional community variables measuring inactive commuting, park deprivation, retail density, low-income homeowner or renter severe housing cost burden, housing inadequacy, segregation, and population density. Deploying weighted quantile sum (WQS) regression through a bootstrapping technique, the CVI was optimized by linking the 23 community variables to cumulative confirmed cases of COVID-19 from January 2020 to November 2021, excluding reinfections. This study resulted in whole-population and 13 demographic-specific CVIs representative of various age (0-4, 5-17, 18-24, 25-49, 50-64, and 65 +), race (White, Black, Hispanic, Asian/Pacific Islander, and others), and sex (male and female) groups.

RESULTS

All WQS regressions revealed significant associations between the CVIs and corresponding COVID-19 prevalence. The most influential variables to the whole-population CVI included minority status, park deprivation, aged 17 and younger, inactive commuting, and housing inadequacy, which also contributed significantly to several CVIs corresponding to COVID-19 prevalence in subpopulations. Other influential community variables to the CVIs in general varied by subpopulation. The distributions of the subpopulation CVIs showed different levels of spatial disparities, with the largest disparities observed in female, White, and age 50-64 groups.

CONCLUSIONS

This study established a practical approach to optimize CVI for assessing COVID-19 risk. The incorporation of additional variables, specificity for subpopulations, and adaptability through the WQS regression collectively contribute to its value in informing evidence-based policy decisions and guiding targeted interventions to mitigate the impact of COVID-19 on vulnerable communities.

Development of a multifactorial prediction model for commute mode choice in 10 983 Finnish public sector employees: a cross-sectional study

OBJECTIVE

The objective of this study is to examine the feasibility of using survey data to identify factors that predict commute mode choice.

DESIGN

The study design is cross-sectional.

SETTING

Survey data from the Finnish Public Sector study (2020) were used.

PARTICIPANTS

42 574 public sector employees, of whom 10 983 were selected for the final sample. These included employees with 5 km or less commuting distances and those working full-time onsite or partly remotely. The mean age was 46 (SD 11) years, and 84% were women.

PRIMARY OUTCOMES

Commute by (1) bike or foot (an active mode) during summer and winter weather and (2) by car (a passive mode) during summer and winter weather.

METHODS

Using logistic Lasso (least-absolute-shrinkage-and-selection-operator) regression, we developed and tested a prediction model for short commutes of 5 km or less to identify the characteristics of employees most likely to commute actively during summer and winter weather and passively during summer and winter weather.

RESULTS

All models had a good predictive ability with a C-index of 0.82, 0.77, 0.72 and 0.71. Cycling and walking during summer weather were predicted by shorter commutes, higher physical activity, lower body mass index (BMI), female sex and higher team psychological safety. Predictors of cycling and walking during winter weather were shorter commute length, higher physical activity, lower BMI and higher age. Commuting by car during summer weather was predicted by longer journey length, higher BMI, lower physical activity, male sex and having children 7-18 years old living at home. Predictors of driving during winter weather were almost identical, but the male sex was replaced by having a spouse.

CONCLUSIONS

We identified the correlates of active and passive commute choice in different weather conditions with eight variables. This information can be used to develop and target interventions to promote sustainable and healthy commuting modes.

Blood pressure classification using the Japanese Society of Hypertension Guidelines for the Management of Hypertension and cardiovascular events among young to middle-aged working adults

The Japanese Society of Hypertension updated guidelines for hypertension management (JSH2019), changing the blood pressure (BP) classification. However, evidence is sparse regarding the association of the classification with cardiovascular disease (CVD) events among young to middle-aged workers in Japan. We examined this issue using longitudinal data from Japan Epidemiology Collaboration on Occupational Health Study with a prospective cohort design. Participants were 81,876 workers (aged 20-64 years) without taking antihypertensive medication at baseline. BP in 2011 or 2010 was used as exposure. CVD events that occurred from 2012 to 2021 were retrieved from a within-study registry. Cox regression was used to calculate multivariable-adjusted hazard ratios of CVD events. During 0.5 million person-years of follow-up, 334 cardiovascular events, 75 cardiovascular deaths, and 322 all-cause deaths were documented. Compared with normal BP (systolic BP [SBP] < 120 mmHg and diastolic BP [DBP] < 80 mmHg), multivariable-adjusted hazard ratios (95% confidence intervals) of cardiovascular events were 1.98 (1.49-2.65), 2.10 (1.58-2.77), 3.48 (2.33-5.19), 4.12 (2.22-7.64), and 7.81 (3.99-15.30) for high normal BP (SBP120-129 mmHg and DBP < 80 mmHg), elevated BP (SBP130-139 mmHg and/or DBP80-89 mmHg), stage 1 hypertension (SBP140-159 mmHg and DBP90-99 mmHg), stage 2 hypertension (SBP160-179 mmHg and/or DBP100-109 mmHg), and stage 3 hypertension (SBP ≥ 180 mmHg and/or DBP ≥ 110 mmHg), respectively. The highest population attributable fraction was observed in elevated BP (17.8%), followed by stage 1 hypertension (14.1%). The present data suggest that JSH2019 may help identify Japanese workers at a higher cardiovascular risk.

Impact of Shifting From Office Work to Telework on Workers' Physical Health: A Longitudinal Study

OBJECTIVE

The aim of the study is to clarify the longitudinal association between teleworking and physical health changes of Japanese workers before and during the COVID-19 pandemic.

METHODS

Participants were in a certain company who received mandatory health examinations in 2019 and 2020. In June 2020, the participants were asked about frequency of teleworking, which was introduced owing to the COVID-19. Whether physical health differed by the frequency of teleworking was analyzed.

RESULTS

The participants were 3689 workers. Frequency of teleworking were associated with more deleterious changes in diastolic blood pressure, antilipidemic drug use, low-density lipoprotein (LDL) cholesterol, Glutamic Oxaloacetic Transaminase(GOT), Glutamic Pyruvic Transaminase(GPT), metabolic syndrome, and insufficient walking time among men. In contrast, no significant changes were observed in women.

CONCLUSIONS

Male workers who teleworked more frequently were more likely to experience a deterioration in their physical health within 1-year compared with those who worked at the office.

Impact of changes in commuting mode on body weight among Japanese workers: a longitudinal study

OBJECTIVE

The health benefits of active commuting have been reported. However, few studies have assessed commuting modes using objective methods. This study clarified the association between changes in objectively measured commuting modes and body weight among Japanese workers.

METHODS

This longitudinal study used data from the annual health examinations and personnel records of a company with branches in all prefectures of Japan. Data from 2018 and 2019 were used as the baseline and follow-up data, respectively. The commuting mode was assessed using the commuting mode code included in the personnel records and classified into 3 types: walking, public transport, and car or motorcycle. The participants were classified into 9 categories based on the combination of their commuting modes in 2018 and 2019. Body weight was measured objectively during health examinations. The 1-year changes in body weight were calculated for the 9 categories and assessed using an analysis of covariance with adjustments for covariates.

RESULTS

The analysis included 6551 workers (men: 86.8%; mean age: 42.8 years). Overall, body weights tended to increase (+0.40 kg/y). The participants who switched to more active commuting, such as from car or motorcycle to walking (-0.13 kg/y), from car or motorcycle to public transport (+0.10 kg/y), and from public transport to walking (-0.07 kg/y), exhibited small weight gains or losses. A similar trend was observed even after adjustment.

CONCLUSIONS

Changing to a more active commuting mode may prevent weight gain among workers.

Leisure-time, occupational, and commuting physical activity and the risk of chronic kidney disease in a working population

Physical activity has been linked to a lower risk of chronic kidney disease (CKD); however, evidence on the relationship between domain-specific physical activity and CKD is scarce. This study aimed to examine the risk of CKD in relation to leisure-time, occupational, and commuting physical activities in a large occupational cohort in Japan. Participants were 17,331 workers (20-65 years old) without CKD and were followed-up for a maximum period of 13 years. Incident CKD was defined as an estimated glomerular filtration rate of < 60 mL/min/1.73 m² and/or proteinuria determined using the dipstick test. The Cox proportional hazards models were used to examine the associations. During 147,752 person-years of follow-up, 4013 participants developed CKD. Workers who were standing or walking at work and those who were fairly active at work had adjusted hazard ratios of 0.88 (95% confidence interval 0.86-0.96) and 0.89 (95% confidence interval 0.78-1.02), respectively, for developing CKD than sedentary workers. Leisure-time physical activity and walking for commute were not associated with CKD risk. Our findings suggest that occupational, but not leisure-time and commuting physical activities, is associated with a lower CKD risk.

Obesity Trends and Associations with Types of Physical Activity and Sedentary Behavior in US Adults: National Health and Nutrition Examination Survey, 2007-2016

OBJECTIVE

Physical activity (PA) and sedentary behavior (SB) have been linked to adult adiposity. This research aims to explore 10-year (2007-2016) trends in obesity and abdominal obesity prevalence and associations with different types of PA and SB among US adults.

METHODS

National Health and Nutrition Examination Survey (NHANES) data were used with 20- to 64-year-old adults (n = 20,360; mean age: 41.9 years; male: 50.5%; non-Hispanic White: 64.3%). Sex- and sex- and race-specific linear trends in the prevalence of obesity, abdominal obesity, and moderate and vigorous work- and recreation-related PA and SB were estimated. Weighted logistic models explored the association between risk of obesity or abdominal obesity with each type of PA and SB by sex, adjusted for relevant confounders.

RESULTS

There were significant increasing trends in obesity and abdominal obesity in both sexes and in Hispanic adults. Men at higher vigorous work-related PA levels (P = 0.045) and women at higher moderate recreational-related PA (P = 0.005) levels had decreased risk of abdominal obesity. Women at the highest versus the lowest level of SB had increased risk of abdominal obesity (P = 0.017).

CONCLUSIONS

There was a significantly reduced risk for abdominal obesity with a few types of PA among both sexes and an increased risk with SB among women only.