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Zhu G. The effect of outdoor activities on the medical expenditure of older people: multiple chain mediating effects of health benefits. BMC Public Health 2024; 24:1227. [PMID: 38702631 PMCID: PMC11069142 DOI: 10.1186/s12889-024-18719-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 04/25/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND With the global aging population, attention to the health and medical issues of older adults is increasing. By analyzing the relationship between older people's participation in outdoor activities and medical expenditure, this study aims to provide a scientific basis for improving their quality of life and reducing the medical burden. METHODS Data on outdoor activity participation, medical expenditures, and relevant variables were collected through questionnaires and databases. A multi-chain mediation effect model was established to analyze the impact of outdoor activities on the medical expenditure of older people, considering mediation effects and heterogeneity. RESULTS Results revealed that increased participation in outdoor activities among older adults correlated with lower medical expenditures. Outdoor activities positively influenced their health by improving mental health, cognition, eating habits, and activities of daily living, resulting in reduced medical expenditures. Robustness tests confirmed the consistent effect of outdoor activities on older people's medical expenditure. CONCLUSION These findings contribute to understanding the relationship between outdoor activities, health, and medical expenditure in older people, guiding policy formulation and interventions. Encouraging and supporting older adults in outdoor activities can enhance their quality of life and alleviate medical resource strain. The study's conclusions can also inform health promotion measures for other populations and serve as a basis for future research in this area.
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Affiliation(s)
- Ge Zhu
- School of Economics, Trade and Management, Gansu University of Chinese Medicine, Lanzhou, Gansu, China.
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Výbošťok J, Pichlerová M, Lamatungga KE, Tamatam D, Önkal D, Halaj D, Pichler V. Preferences for woodland activities and forest features as predictors of well-being after forest visits: Evidence from a nationally representative survey in Slovakia. AMBIO 2024; 53:795-807. [PMID: 38324121 PMCID: PMC10992941 DOI: 10.1007/s13280-024-01982-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 11/07/2023] [Accepted: 01/10/2024] [Indexed: 02/08/2024]
Abstract
The link between subjective well-being (SWB) and forest visits is increasingly driving the development and preservation of restorative forest environments in numerous countries. However, there is limited knowledge regarding the effect of people's preferences for forest patterns and activities on this connection. Here we investigated whether associations exist between the preferences for certain forest features and activities, and the SWB increase and stress reduction in response to forest visits. A nationwide digital survey was administered to a representative sample of the Slovak population. The recollection-based data obtained from one thousand respondents were analysed through agglomerative clustering and ordinal regression. The analyses revealed that improved SWB and stress reduction were associated with preferences for uneven-aged forests, forest smell, as well as recreational, but not provisioning forest activities. The respective interrelationships explained up to 20% of SWB increase and stress reduction after forest visits. The results suggest that recollection-based study findings can be generalized for real-world forests and that forest management can contribute to the well-being of forest visitors by shaping the diversity of woodlands and their sensory experiences.
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Affiliation(s)
- Jozef Výbošťok
- Faculty of Forestry, Technical University in Zvolen, T. G. Masaryka 24, 960 01, Zvolen, Slovakia
| | - Magdaléna Pichlerová
- Faculty of Ecology and Environmental Sciences, Technical University in Zvolen, T. G. Masaryka 24, 960 01, Zvolen, Slovakia.
| | - Kiki Ekiawan Lamatungga
- Faculty of Forestry, Technical University in Zvolen, T. G. Masaryka 24, 960 01, Zvolen, Slovakia
| | - Dhanalakshmi Tamatam
- Faculty of Forestry, Technical University in Zvolen, T. G. Masaryka 24, 960 01, Zvolen, Slovakia
| | - Dilek Önkal
- Department of Marketing, Operations and Systems, Newcastle Business School, Northumbria University, Newcastle upon Tyne , NE1 8ST, UK
| | - Daniel Halaj
- Faculty of Forestry, Technical University in Zvolen, T. G. Masaryka 24, 960 01, Zvolen, Slovakia
| | - Viliam Pichler
- Faculty of Forestry, Technical University in Zvolen, T. G. Masaryka 24, 960 01, Zvolen, Slovakia
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Morita E, Kadotani H, Yamada N, Sasakabe T, Kawai S, Naito M, Tamura T, Wakai K. The Inverse Association between the Frequency of Forest Walking (Shinrin-yoku) and the Prevalence of Insomnia Symptoms in the General Japanese Population: A Japan Multi-Institutional Collaborative Cohort Daiko Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:350. [PMID: 38541349 PMCID: PMC10970638 DOI: 10.3390/ijerph21030350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 03/01/2024] [Accepted: 03/03/2024] [Indexed: 04/07/2024]
Abstract
Since a single forest walk (Shinrin-yoku or forest bathing) session is reported to improve sleep temporarily, occasional forest walks may have a positive effect on daily sleep. Therefore, this study aimed to examine whether more frequent forest walking is associated with better daily sleep conditions. Data from the second survey of the Japan Multi-Institutional Collaborative Cohort (J-MICC) Daiko Study conducted among residents of Nagoya City, Japan, were used. The study design was a cross-sectional study. In total, 2044 participants (529 men and 1515 women; age, mean ± standard deviation: 58.8 ± 9.9 years) were included in the analysis. Frequent forest walks were associated with a low percentage of insomnia symptoms (Insomnia Severity Index ≥10) in women, but not in men. The adjusted odds ratio for the group that rarely took forest walks with reference to the group that engaged in the activity once a month or more often was 2.04 (95% confidence interval: 1.29-3.23) in women. Forest walk frequency was not significantly associated with sleep duration or sleep efficiency as measured by actigraphy in either men or women. In conclusion, the results suggested that increasing the frequency of forest walks or Shinrin-yoku may be effective in preventing insomnia in women.
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Grants
- Priority Areas of Cancer (No. 17015018) Ministry of Education, Culture, Sports, Science and Technology, Japan.
- Innovative Areas (No. 221S0001) Ministry of Education, Culture, Sports, Science and Technology, Japan.
- JSPS KAKENHI Grant (No. 16H06277, 18K11065, 21H02246, 22H04923 and No. 26507005) Ministry of Education, Culture, Sports, Science and Technology, Japan.
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Affiliation(s)
- Emi Morita
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Japan
- Forestry and Forest Products Research Institute, Forest Research and Management Organization, 1 Matsunosato, Tsukuba 305-8687, Japan
| | - Hiroshi Kadotani
- Department of Psychiatry, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu 520-2192, Japan; (H.K.); (N.Y.)
| | - Naoto Yamada
- Department of Psychiatry, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu 520-2192, Japan; (H.K.); (N.Y.)
- Kanbayashi Memorial Hospital, 89-1 Orikuchinishi, Okucho, Ichinomiya 491-0201, Japan
| | - Tae Sasakabe
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Nagoya 466-8550, Japan; (T.S.); (T.T.); (K.W.)
- Department of Public Health, Aichi Medical University School of Medicine, Nagakute 480-1195, Japan
| | - Sayo Kawai
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Nagoya 466-8550, Japan; (T.S.); (T.T.); (K.W.)
- Department of Public Health, Aichi Medical University School of Medicine, Nagakute 480-1195, Japan
| | - Mariko Naito
- Department of Oral Epidemiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan;
| | - Takashi Tamura
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Nagoya 466-8550, Japan; (T.S.); (T.T.); (K.W.)
| | - Kenji Wakai
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Nagoya 466-8550, Japan; (T.S.); (T.T.); (K.W.)
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Godina SL, Rosso AL, Hirsch JA, Besser LM, Lovasi GS, Donovan GH, Garg PK, Platt JM, Fitzpatrick AL, Lopez OL, Carlson MC, Michael YL. Neighborhood greenspace and cognition: The cardiovascular health study. Health Place 2023; 79:102960. [PMID: 36603455 PMCID: PMC9928891 DOI: 10.1016/j.healthplace.2022.102960] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 11/04/2022] [Accepted: 12/14/2022] [Indexed: 01/04/2023]
Abstract
OBJECTIVES We examined whether greenspace measures (overall percent greenspace and forest, and number of greenspace types) were associated with clinically adjudicated dementia status. METHODS In a sample of non-demented older adults (n = 2141, average age = 75.3 years) from the Cardiovascular Health and Cognition Study, Cox proportional hazard and logistic regression analyses were used to estimate associations of baseline greenspace with risks of incident dementia and MCI, respectively, while adjusting for demographics, co-morbidities, and other neighborhood factors. We derived quartiles of percent greenness (greenspace), forest (percent tree canopy cover), and tertiles of greenspace diversity (number of greenspace types) for 5-km radial buffers around participant's residences at study entry (1989-1990) from the 1992 National Land Cover Dataset. Dementia status and mild cognitive impairment (MCI) over 10 years was clinically adjudicated. RESULTS We observed no significant association between overall percent greenspace and risk of mild cognitive impairment or dementia and mostly null results for forest and greenspace diversity. Forest greenspace was associated with lower odds of MCI (OR quartile 4 versus 1: 0.54, 95% CI: 0.29-0.98) and greenspace diversity was associated with lower hazard of incident dementia (HR tertile 2 versus 1: 0.70, 95% CI = 0.50-0.99). DISCUSSION We found divergent results for different types of greenspace and mild cognitive impairment or dementia. Improved greenspace type and diversity measurement could better characterize the association between greenspace and cognition.
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Affiliation(s)
- Sara L Godina
- University of Pittsburgh Graduate School of Public Health, Department of Epidemiology, 130 DeSoto Street, Pittsburgh, PA, 15261, USA.
| | - Andrea L Rosso
- University of Pittsburgh Graduate School of Public Health, Department of Epidemiology, 130 DeSoto Street, Pittsburgh, PA, 15261, USA
| | - Jana A Hirsch
- Drexel University Dornsife School of Public Health, Urban Health Collaborative, 3600 Market Street, 7th Floor, Philadelphia, PA, 19104, USA
| | - Lilah M Besser
- Comprehensive Center for Brain Health, University of Miami Miller School of Medicine, 7700 W Camino Real, Suite 200, Boca Raton, FL, 33433, USA
| | - Gina S Lovasi
- Drexel University Dornsife School of Public Health, Urban Health Collaborative, 3600 Market Street, 7th Floor, Philadelphia, PA, 19104, USA
| | - Geoffrey H Donovan
- U.S. Department of Agriculture Forest Service, PNW Research Station, 620 SW Main, Suite 502, Portland, OR, 97205, USA
| | - Parveen K Garg
- University of Southern California Keck School of Medicine, 1975 Zonal Avenue, Los Angeles, CA, 90033, USA
| | - Jonathan M Platt
- The University of Iowa, College of Public Health, 145 N. Riverside Drive, Iowa City, IA, 52242, USA
| | - Annette L Fitzpatrick
- University of Washington School of Public Health, Department of Epidemiology, 3980 15th Avenue NE, Seattle, WA, 98195, USA
| | - Oscar L Lopez
- University of Pittsburgh School of Medicine, Department of Neurology, Kaufmann Medical Building, 3471 Fifth Avenue, Pittsburgh, PA, 15213, USA
| | - Michelle C Carlson
- Johns Hopkins Bloomberg School of Public Health, Department of Mental Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Yvonne L Michael
- Drexel University Dornsife School of Public Health, Urban Health Collaborative, 3600 Market Street, 7th Floor, Philadelphia, PA, 19104, USA
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