Confronting the challenges in reconnecting urban planning and public health

Cross-Agency Collaboration to Address Rural Aging: The Role of County Government

Age-friendly community planning and design mainly focus on urban aging and may be less applicable in rural communities. We collaborated with the Tompkins County Age-Friendly Center for Excellence in New York State to assess strategies for rural aging. This commentary argues that density and mixed-use development, as age-friendly development strategies, leave rural communities underserved. County governments, by supporting cross-agency collaboration and encouraging civic engagement, can link the age-friendly domains regarding built environment, service delivery, and community together to help address age-friendly issues and support rural aging.

Digitally supported participation in the nexus between public health and urban planning

The nexus between urban planning and public health acknowledges the importance of creating cities that contribute to their residents' physical, mental, and social well-being. The Healthy Cities movement underlines that community participation and intersectoral work are important to create sustainable, equitable, and healthy cities.Several theoretical and practical participatory approaches form the foundation for participation in public health and urban planning. Growing digitalization has significantly transformed how participation is conducted in various fields. Digital technologies not only play a large role in daily life, but they have opened more opportunities for individuals to interact, share, and collaborate in the planning and design of cities.This article explores how digital technologies enable participation among residents and stakeholders in order to support the health-oriented planning of cities and neighborhoods. From the selective case studies presented in the paper, it can be ascertained that digital technologies can support various forms of participation by enabling different levels of engagement as well as both one-way and two-way interactions. Some forms of engagement can be supported entirely within digital platforms. However, in the case of higher engagement, which requires deeper insights into the problems and the codevelopment of solutions, other nondigital formats and traditional methods such as follow-up workshops and focus group discussions are necessary to complement the digital form of participation.

Climate change and cancer: the Environmental Justice perspective

Despite advances in cancer control-prevention, screening, diagnosis, treatment, and survivorship-racial disparities in cancer incidence and survival persist and, in some cases, are widening in the United States. Since 2020, there's been growing recognition of the role of structural racism, including structurally racist policies and practices, as the main factor contributing to historical and contemporary disparities. Structurally racist policies and practices have been present since the genesis of the United States and are also at the root of environmental injustices, which result in disproportionately high exposure to environmental hazards among communities targeted for marginalization, increased cancer risk, disruptions in access to care, and worsening health outcomes. In addition to widening cancer disparities, environmental injustices enable the development of polluting infrastructure, which contribute to detrimental health outcomes in the entire population, and to climate change, the most pressing public health challenge of our time. In this commentary, we describe the connections between climate change and cancer through an Environmental Justice perspective (defined as the fair treatment and meaningful involvement of people of all racialized groups, nationalities, or income, in all aspects, including development, implementation, and enforcement, of policies and practices that affect the environment and public health), highlighting how the expertise developed in communities targeted for marginalization is crucial for addressing health disparities, tackling climate change, and advancing cancer control efforts for the entire population.

What are the lessons from COVID-19 for creating healthy, sustainable, resilient future cities?

The COVID-19 pandemic has disrupted lives and the economy, reminding the global community of the devastating health and economic impacts of uncontrolled infectious disease. It has affected how and where people live, work, shop, and play, and exposed our cities' vulnerabilities, leading to calls for a health lens to be applied in designing, approving, and evaluating city plans. Socioeconomic, spatial and health inequities have been amplified, particularly for those living in inadequate or poorly designed housing, neighbourhoods, and cities. Hence, city mayors have committed to 'build back better' with all daily living amenities within a 15-min walking or cycling trip. Designed well, these cities have the potential to be healthier, more sustainable, equitable, and resilient. Yet their delivery requires a rethink of city planning. Drawing on lessons from the COVID-19 pandemic, we argue that to reduce the risk of future pandemics, we must mitigate climate change, limit urban expansion, and use nature-based solutions to protect natural habitats and biodiversity. We then explore how healthy, sustainable, and resilient 15-minute cities could be planned to reduce emissions and ensure our cities are more resilient in the event of future crises. Given that higher density housing underpins the success of 15-minute cities, we also examine how to create more resilient housing stock, through well-implemented health-supportive apartment design standards. Finally, we argue that to achieve all this, cross-sector leadership and investment will be vital.

The Role of Greenery in Stress Reduction among City Residents during the COVID-19 Pandemic

Cities, as places of social interactions and human relationships, face new challenges, problems, and threats, which are sources of stress for residents. An additional cause of stress in recent years has been the COVID-19 pandemic; it was urban dwellers who were most exposed to the virus and most affected by it. Chronic stress has led to the serious erosion of physical health and psychophysical well-being among urban dwellers, and so there is a need to seek new solutions in terms of building the resilience of cities and their residents to stress. This study aims to verify the hypothesis that greenery reduced the level of stress among urban dwellers during the pandemic. The verification of this hypothesis was achieved based on a literature analysis and the results of geo-questionnaire studies conducted involving 651 residents of Poznan-among the largest of Polish cities, where the share of green areas in the spatial structure is more than 30%. According to the analysis, the interviewees experienced above-average stress levels that went up during the pandemic, and the source was not so much the virus but the restrictions imposed. Green areas and outdoor activities helped in reducing this stress (being surrounded by and looking at greenery, garden work, or plant cultivation). Residents perceive a post-pandemic city as one that is more green, in which priority is given to unmanaged green areas. It has also been pointed out that a response to the reported need for urban re-construction towards stress resilience may be a biophilic city.

Examining African contributions to global health: Reflections on knowledge circulation and innovation

This article unites different disciplinary debates on 'southern innovation', 'theory from the South', and 'decolonisation of knowledge' in order to discuss existing understandings around the role of Africa in the production of health-related knowledge, public health policy, and medical innovation. Arguing that high-income countries have much to learn from the global South when it comes to health-related knowledge and practices, we propose an interdisciplinary research approach to uncovering and examining African contributions to global health, drawing on an ongoing collaborative project funded by the Swiss National Science Foundation. We present four empirical case studies concerning drug development, healthcare systems, and urban planning to critically enquire into both historical and contemporary transcontinental knowledge circulation and learning potentials, as much as cases of forgetting and silencing. On this basis, we argue that 'learning from the South' must mean more than transplanting quick and cheap technological fixes to serve societies in the global North, but rather recognising the vast contributions that Africans have made to global epistemologies, without losing sight of the asymmetries inherent in South-North knowledge exchanges. Lessons learned might apply to fields other than those discussed here and go far beyond 'reverse innovation'.

Relationship between Built-Up Environment, Air Pollution, Activity Frequency and Prevalence of Hypertension-An Empirical Analysis from the Main City of Lanzhou

In the process of promoting the strategy of a healthy China, the built environment, as a carrier of human activities, can effectively influence the health level of residents in the light of its functional types. Based on the POI data of four main urban areas in Lanzhou, this paper classifies the built environment in terms of function into four types. The association between different types of built environments and the prevalence of hypertension was investigated by using the community as the study scale, and activity frequency, air pollution and green space were used as mediating variables to investigate whether they could mediate the relationship between built environments and hypertension. The results indicate that communities with a high concentration of commercial service facilities, road and traffic facilities and industrial facilities have a relatively high prevalence of hypertension. By determining the direct, indirect and overall effects of different functional types of built environment on the prevalence of hypertension, it was learned that the construction of public management and service facilities can effectively mitigate the negative effects of hypertension in the surrounding residents. The results of the study contribute to the rational planning of the structure of the built environment, which is beneficial for optimizing the urban structure and preventing and controlling chronic diseases such as hypertension.

Inequitable Housing Practices and Youth Internalizing Symptoms: Mediation Via Perceptions of Neighborhood Cohesion

Disordered urban environments negatively impact mental health symptoms and disorders. While many aspects of the built environment have been studied, one influence may come from inequitable, discriminatory housing practices such as redlining, blockbusting, and gentrification. The patterns of disinvestment and reinvestment that follow may be an underlying mechanism predicting poor mental health. In this study, we examine pathways between such practices and internalizing symptoms (i.e., anxiety and depression) among a sample of African American youth in Baltimore, Maryland, considering moderation and mediation pathways including neighborhood social cohesion and sex. In our direct models, the inequitable housing practices were not significant predictors of social cohesion. In our sex moderation model, however, we find negative influences on social cohesion: for girls from gentrification, and for boys from blockbusting. Our moderated mediation model shows that girls in gentrifying neighborhoods who experience lower social cohesion have higher levels of internalizing symptoms. Likewise for boys, living in a formerly blockbusted neighborhood generates poorer social cohesion, which in turn drives higher rates of internalizing symptoms. A key implication of this work is that, in addition to standard measures of the contemporary built environment, considering other invisible patterns related to discriminatory and inequitable housing practices is important in understanding the types of neighborhoods where anxiety and depression are more prevalent. And while some recent work has discussed the importance of considering phenomena like redlining in considering long-term trajectories of neighborhoods, other patterns such as blockbusting and gentrification may be equally important.

Urban Air Pollution, Urban Heat Island and Human Health: A Review of the Literature

Many cities of the world suffer from air pollution because of poor planning and design and heavy traffic in rapidly expanding urban environments. These conditions are exacerbated due to the Urban Heat Island (UHI) effect. While there have been studies linking the built environment and air pollution with health, they have ignored the aggravating role of UHI. The past urban planning literature in this field has also ignored the science of materials, vehicles and air pollution, and technological solutions for reducing cumulative health impacts of air pollution and UHI. Air Pollution, built environment and human health are complex discussion factors that involve several different fields. The built environment is linked with human health through opportunities of physical activity and air quality. Recent planning literature focuses on creating compact and walkable urban areas dotted with green infrastructure to promote physical activity and to reduce vehicle emission-related air pollution. Reduced car use leading to reduced air pollution and UHI is implied in the literature. The literature from technology fields speaks to the issue of air pollution directly. Zero emission cars, green infrastructure and building materials that absorb air pollutants and reduce UHI fall within this category. This paper identifies main themes in the two streams of urban air pollution and UHI that impact human health and presents a systematic review of the academic papers, policy documents, reports and features in print media published in the last 10–20 years.

Constructing Taxonomies: Identifying Distinctive Class of HIV Support and Risk Networks among People Who Use Drugs (PWID) and Their Network Members in the HPTN 037 Randomized Controlled Trial

Injection drug use is a significant mode of HIV transmission. Social networks are potential avenues for behavior change among high-risk populations. Increasing knowledge should include a classification or taxonomy system of networks’ attributes, risks, and needs. The current study employed 232 networks comprising 232 indexes, with 464 network members enrolled in Philadelphia. LCA revealed a three-class solution, Low-Risk, Paraphernalia Risk, and High Sex/Moderate Paraphernalia Risk class, among participants. The analysis found receiving money or drugs for sex and employment status increased the odds of belonging to PR and PSR classes. Homelessness and incarceration increased the odds of belonging to the PR class when compared to the LR class. Our findings suggest that classes of risk among PWID comprise clusters of information concerning their members. These findings add depth to our understanding while extending our knowledge of the contextual environment that nurtures or exacerbates the problem.

A methodological proposal to evaluate the health hazard scenario from COVID-19 in Italy

2019 Coronavirus disease (COVID-19) had a big impact in Italy, mainly concentrated in the northern part of the Country. All this was mainly due to similarities of this area with Wuhan in Hubei Province, according to geographical, environmental and socio-economic points of view. The basic hypothesis of this research was that the presence of atmospheric pollutants can generate stress on health conditions of the population and determine pre-conditions for the development of diseases of the respiratory system and complications related to them. In most cases the attention on environmental aspects is mainly concentrated on pollution, neglecting issues such as land management which, in some way, can contribute to reducing the impact of pollution. The reduction of land take and the decrease in the loss of ecosystem services can represent an important aspect in improving environmental quality. In order to integrate policies for environmental change and human health, the main factors analyzed in this paper can be summarized in environmental, climatic and land management. The main aim of this paper was to produce three different hazard scenarios respectively related to environmental, climatic and land management-related factors. A Spatial Analytical Hierarchy Process (AHP) method has been applied over thirteen informative layers grouped in aggregation classes of environmental, climatic and land management. The results of the health hazard maps show a disparity in the distribution of territorial responses to the pandemic in Italy. The environmental components play an extremely relevant role in the definition of the red zones of hazard, with a consequent urgent need to renew sustainable development strategies. The comparison of hazard maps related to different scenarios provides decision makers with tools to orient policy choices with a different degree of priority according to a place-based approach. In particular, the geospatial representation of risks could be a tool for legitimizing the measures chosen by decision-makers, proposing a renewed approach that highlights and takes account of the differences between the spatial contexts to be considered - Regions, Provinces, Municipalities - also in terms of climatic and environmental variables.

Research on the Satisfaction Degree Characteristics of Residential Public Resources under Lockdowns for Pandemic Prevention and Control: A Case Study in the Changchun

In order to improve the ability of residential disaster prevention, control, and governance, it is important to objectively measure how nearby residents’ needs match the public resources of the residential area, and to understand the factors affecting the satisfaction of residents’ needs at the time of lockdowns. Taking Changchun City as an example, this paper used Structural Equation Modeling (SEM)-logit and Importance–Satisfaction (I–S) evaluation methods to discuss the impact mechanism and improvement strategies of residential public resource elements on the satisfaction of residents’ needs during the lockdown period. The results showed the influencing factors and the degree of importance of the satisfaction of residents’ needs under different types of settlements have obvious differentiation characteristics. The level of resource management can better affect the overall evaluation of residents in newly built settlements, and the quality of the conditions of the space environment is more important for the old residential communities. The satisfaction of residents in settlements has a more significant impact. Finally, the study explained the renovation proposals and their priority levels that meet the needs of residents to provide beneficial support for the resilience of urban settlements.

Neighbourhood walkability and mortality: Findings from a 15-year follow-up of a nationally representative cohort of Canadian adults in urban areas

BACKGROUND

Using a nationally representative cohort of Canadian adults, we assessed associations between neighbourhood walkability and cause-specific mortality and investigated whether they differed by socioeconomic status.

METHODS

The study population was drawn from the 2001 Canadian Census Health and Environment Cohort, which contains individual-level data from a random sample of 20% of Canadian households mandated to complete the long-form census. We included those aged ≥ 25 years at baseline who lived in urban and suburban areas. The national death registry was used to ascertain annual vital status. Linkages to annual income tax data provided place of residence. The Canadian Active Living Environments, a national index that summarizes walkability across Canadian neighbourhoods, was assigned to individuals' residential history. The Cox proportional hazards model was used to assess associations between walkability and cause-specific mortality.

RESULTS

A total of 1.8 million participants (52.5% female) accrued 27.3 million person-years and 265 710 deaths during the 15-year follow-up. The adjusted hazard ratio (HR) for living in a highly walkable neighbourhood relative to living in the least walkable neighbourhoods was associated with a 9% (HR: 0.91 [0.88, 0.95]) and 3% (HR: 0.97 [0.94, 0.99]) reduced risk of cardiovascular and all non-accidental mortality, respectively. The strongest benefits of walkability were found among individuals within the lowest education and household income categories, and who lived in the most deprived neighbourhoods. There were no significant associations (most [class 5] versus least [class 1] walkable HR: 0.84 [0.61-1.16]) seen for accidental traffic mortality.

CONCLUSIONS

Canadian adults who live in walkable neighbourhoods have lower rates of cardiovascular and non-accidental mortality, with the greatest benefits seen in those from the lowest socioeconomic groups.

From SARS to COVID-19: Digital infrastructures of surveillance and segregation in exceptional times

The COVID-19 pandemic, an exceptional crisis, sparked the introduction of new digital infrastructure to halt the novel coronavirus's spread. This paper explores how such digital infrastructure's impact might reverberate over the long term, by comparing Singapore, Hong Kong, and mainland China's utilization of digital technology in response to the 2003 SARS outbreak, and their responses to the 2020 COVID-19 pandemic. We find that advancements in digital technology since 2003 have boosted governments' surveillance and segregation abilities substantially-most dramatically so in China. Even though some of these new digital interventions are ostensibly designed to be temporary ones to address the needs of the immediate crisis, we argue that the resultant extensions of state power experienced during COVID-19 are likely to have profound long-term effects because they fundamentally affect sociopolitical contexts, institutional capabilities, and digital cultures. We also find that the extent to which governments can extend digital surveillance and segregation abilities during the pandemic is contingent on their respective sociopolitical, institutional, and digital cultural contexts.

Place-based interventions and the epidemiology of violence prevention

Purpose of review

Violence is a leading cause of death, disability, and health inequity in the United States. This review summarizes the scientific literature on place-based interventions and violence, describes study design challenges, and suggests future directions for this group of interventions.

Recent findings

Violence prevention strategies commonly target high-risk individuals, but recent research has found that place-based interventions are practical, sustainable, and high-impact opportunities that benefit communities at large. This body of work has largely consisted of quasi-experimental studies of land and building place-based interventions and interpersonal violence.

Summary

Current epidemiological evidence suggests that place-based interventions are cost-effective solutions for violence prevention. Future work is needed using mixed methods to better understand their mechanisms of action and to inform implementation efforts. There are opportunities for the broader development of implementation science to bring promising and established place-based interventions to scale and to extend these interventions to other types of violence.

The impacts of the built environment on the incidence rate of COVID-19: A case study of King County, Washington

With COVID-19 prevalent worldwide, current studies have focused on the factors influencing the epidemic. In particular, the built environment deserves immediate attention to produce place-specific strategies to prevent the further spread of coronavirus. This research assessed the impact of the built environment on the incidence rate in King County, US and explored methods of researching infectious diseases in urban areas. Using principal component analysis and the Pearson correlation coefficient to process the data, we built multiple linear regression and geographically weighted regression models at the ZIP code scale. Results indicated that although socioeconomic indicators were the primary factors influencing COVID-19, the built environment affected COVID-19 cases from different aspects. Built environment density was positively associated with incidence rates. Specifically, increased open space was conducive to reducing incidence rates. Within each community, overcrowded households led to an increase in incidence rates. This study confirmed previous research into the importance of socioeconomic variables and extended the discussion on spatial and temporal variation in the impacts of urban density on the spread of COVID, effectively guiding sustainable urban development.

A health political science for health promotion

If health promotion as a field of change for human and ecological health is to maintain its urgency, it needs to continue building its policy credentials. This paper charts the development of policy as a concern for IUHE/IUHPE (International Union for Health Education/International Union for Health Promotion and Education) from the mid-1970s when 'health education policies' were prominent issues, to the launch of Healthy Public Policy (in the 1980s) and Health in All Policy (in the 2000s). We argue that solid conceptual and theoretical foundations exist to frame and develop the relevance and connectedness of health promotion more prominently. We start off with a brief introduction into (health) political science, and then illustrate the urgency of the argument with three case studies. The first takes a critical realist perspective on 'closing the gap' in Australian Indigenous populations. With recent evidence it demonstrates that the core of the policymaking process needs to re-align itself with an Indigenous narrative. The second case study reviews the politics of healthy urban planning and health equity in cities. Taking a critical theory institutionalist view, the case describes how the political and narrative parallels between urban theory and health equity have gone underexplored. With an explicit gaze to connect the two, the field could become a large and influential driver of enhanced health promotion and public health policy. The third case describes the languages, policy frames, and distinctions, in four urban/health paradigms. It shows that unconscious policy and practice bias exists in policy priorities and processes. We conclude with observations and recommendations on the role of health promotion as a conceptual realm and field of activity. We show that all health promoters should be aware of the political nature of their enterprise. Tools and analyses exist to help further action.

Exploring the potential for planning support systems to bridge the research-translation gap between public health and urban planning

BACKGROUND

There is consensus that planning professionals need clearer guidance on the features that are likely to produce optimal community-wide health benefits. However, much of this evidence resides in academic literature and not in tools accessible to the diverse group of professionals shaping our cities. Incorporating health-related metrics into the planning support systems (PSS) provides an opportunity to apply empirical evidence on built environment relationships with health-related outcomes to inform real-world land use and transportation planning decisions. This paper explores the role of planning support systems (PSS) to facilitate the translation and application of health evidence into urban planning and design practices to create healthy, liveable communities.

METHODS

A review of PSS software and a literature review of studies featuring a PSS modelling built environmental features and health impact assessment for designing and creating healthy urban areas was undertaken. Customising existing software, a health impact PSS (the Urban Health Check) was then piloted with a real-world planning application to evaluate the usefulness and benefits of a health impact PSS for demonstrating and communicating potential health impacts of design scenarios in planning practice.

RESULTS

Eleven PSS software applications were identified, of which three were identified as having the capability to undertake health impact analyses. Three studies met the inclusion criteria of presenting a planning support system customised to support health impact assessment with health impacts modelled or estimated due to changes to the built environment. Evaluation results indicated the Urban Health Check PSS helped in four key areas: visualisation of how the neighbourhood would change in response to a proposed plan; understanding how a plan could benefit the community; Communicate and improve understanding health of planning and design decisions that positively impact health outcomes.

CONCLUSIONS

The use of health-impact PSS have the potential to be transformative for the translation and application of health evidence into planning policy and practice, providing those responsible for the policy and practice of designing and creating our communities with access to quantifiable, evidence-based information about how their decisions might impact community health.

Municipal health promotion programs: is childhood obesity a concern at local level in Portugal?

Health promotion programs, targeted at distinct health outcomes such as childhood obesity, at local level are increasingly used worldwide. Therefore, there is a need to better understand the role of local governments (municipalities) as key public health promoters namely in the prevention of obesity in children. We aimed to provide some input regarding this issue in Portugal. First, we identified health-enhancing programs promoted by Portuguese municipalities in which children could participate. Then, we conducted a document analysis to provide clues about how municipalities conceptualized child health by retrieving information on which topics the programs were focused in, or acted upon, and identifying which socio-ecological model levels were addressed (or not) by each program. The 77 identified programs were promoted by 30 of the 308 Portuguese municipalities and only 11 programs addressed childhood obesity. Most programs focused in the individual health determinants and provided limited information which disabled its deeper analysis. Portuguese municipalities seem to disregard their potential as public health promoters. Childhood obesity is a major public health concern at national (and global) level but the same does not emerge locally. Municipalities are the closest government entities to the population, and it is their responsibility to ensure the population's quality of life, by addressing the social determinants and the physical environments. Therefore, municipalities should acknowledge health in their actions and delineate health improvement programs considering current evidence, specifically in the case of childhood obesity prevention that besides being a health problem in itself, is a risk factor for non-communicable diseases.

Green Space and Health Equity: A Systematic Review on the Potential of Green Space to Reduce Health Disparities

Disadvantaged groups worldwide, such as low-income and racially/ethnically minoritized people, experience worse health outcomes than more privileged groups, including wealthier and white people. Such health disparities are a major public health issue in several countries around the world. In this systematic review, we examine whether green space shows stronger associations with physical health for disadvantaged groups than for privileged groups. We hypothesize that disadvantaged groups have stronger protective effects from green space because of their greater dependency on proximate green space, as they tend to lack access to other health-promoting resources. We use the preferred reporting items for systematic reviews and meta-analyses (PRISMA) method and search five databases (CINAHL, Cochrane, PubMed, Scopus, and Web of Science) to look for articles that examine whether socioeconomic status (SES) or race/ethnicity modify the green space-health associations. Based on this search, we identify 90 articles meeting our inclusion criteria. We find lower-SES people show more beneficial effects than affluent people, particularly when concerning public green spaces/parks rather than green land covers/greenness. Studies in Europe show stronger protective effects for lower-SES people versus higher-SES people than do studies in North America. We find no notable differences in the protective effects of green space between racial/ethnic groups. Collectively, these results suggest green space might be a tool to advance health equity and provide ways forward for urban planners, parks managers, and public health professionals to address health disparities.

Urban poverty and nutrition challenges associated with accessibility to a healthy diet: a global systematic literature review

BACKGROUND

There is an increasing global trend towards urbanization. In general, there are less food access issues in urban than rural areas, but this "urban advantage" does not benefit the poorest who face disproportionate barriers to accessing healthy food and have an increased risk of malnutrition.

OBJECTIVES

This systematic literature review aimed to assess urban poverty as a determinant of access to a healthy diet, and to examine the contribution of urban poverty to the nutritional status of individuals.

METHODS

Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) methodology, our review included quantitative and qualitative studies published in English or in Spanish between 2000 and 2019. The articles were eligible if they focused on nutrition access (i.e. access to a healthy diet) or nutrition outcomes (i.e., anemia, overweight and obesity, micronutrient deficiency, micronutrient malnutrition) among urban poor populations. Articles were excluded if they did not meet pre-established criteria. The quality of the quantitative studies was assessed by applying Khan et al.'s methodology. Similarly, we assessed the quality of qualitative articles through an adapted version of the National Institute for Health and Care Excellence (NICE) methodology checklist. Finally, we systematically analyzed all papers that met the inclusion criteria based on a qualitative content and thematic analysis.

RESULTS

Of the 68 papers included in the systematic review, 55 used quantitative and 13 used qualitative methods. Through the analysis of the literature we found four key themes: (i) elements that affect access to healthy eating in individuals in urban poverty, (ii) food insecurity and urban poverty, (iii) risk factors for the nutritional status of urban poor and (iv) coping strategies to limited access to food. Based on the systematization of the literature on these themes, we then proposed a conceptual framework of urban poverty and nutrition.

CONCLUSIONS

This systematic review identified distinct barriers posed by urban poverty in accessing healthy diets and its association with poorer nutrition outcomes, hence, questioning the "urban advantage". A conceptual framework emerging from the existing literature is proposed to guide future studies and policies.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO Registration number: CRD42018089788 .

Integrating the Built and Social Environment into Health Assessments for Maternal and Child Health: Creating a Planning-Friendly Index

Environmental and community context earliest in the life course have a profound effect on life-long health outcomes. Yet, standard needs assessments for maternal and child health (MCH) programs often overlook the full range of influences affecting health in-utero and early childhood. To address this, we developed a methodology for assessing community risk in MCH based on six domains integrating 66 indicators across community, environment, socioeconomic indicators, and MCH outcomes. We pilot this methodology in Pennsylvania, and share examples of how local governments, planners, and public health officials across the geographic spectrum can integrate this data into community planning for improved maternal and child health.

Successes and failures of built environment interventions: Using concept mapping to assess stakeholder perspectives in four Canadian cities

BACKGROUND

Healthy communities can be supported through built environment interventions that redesign cities for improved health outcomes. Understanding the context of these interventions is critical for assessing how an intervention impacts population health; such context is often poorly documented. This study uses concept mapping to capture stakeholders' perspectives on the factors that influence the success and failure of built environment interventions across cities.

METHODS

The INTErventions, Research, and Action in Cities Team (INTERACT) research program undertook concept mapping exercises related to interventions in four Canadian cities: public bike share program (Vancouver); a cycling network (Victoria); a bus rapid transit program (Saskatoon); and interventions related to the Montreal Sustainability Plan (Montreal). Concept mapping synthesised stakeholder perceptions and Go zones were used to prioritise factors based on importance and feasibility. Resulting themes were integrated into implementation science frameworks.

RESULTS

Across four cities, 95 stakeholders participated. An average of 38 factors were identified in each city, resulting in 5 emerging clusters in Victoria and Montreal and 6 clusters in Vancouver and Saskatoon. Clusters covered domains of economic and political context, intervention planning, equity considerations, user experience, and stakeholder engagement. Common across all cities was the importance of stakeholder engagement. Concerns for citizen safety were prominent in Victoria, Vancouver, and Saskatoon. Interventions in Saskatoon and Vancouver were related to programs, and reliability of service and ease of use emerged. Go zones highlighted 2-5 items in each city, which can inform priority actions.

CONCLUSION

Our study provides stakeholders' collective thinking on the contextual factors that influence the success and failure of built environment interventions. Organising context within an implementation science framework can provide a common language to synthesise stakeholder perspectives across settings. Go zone items can inform city-specific priority actions to support a common vision around implementing built environment interventions in pursuit of designing equitable and healthy cities.

Smart City and High-Tech Urban Interventions Targeting Human Health: An Equity-Focused Systematic Review

Urban infrastructure systems responsible for the provision of energy, transportation, shelter, and communication to populations are important determinants of health and health equity. The term “smart city” has been used synonymously with other terms, such as “digital city”, “sustainable city”, and “information city”, even though definitional distinctions exist between terms. In this review, we use “smart cities” as a catch-all term to refer to an emerging concept in urban governance practice and scholarship that has been increasingly applied to achieve public health aims. The objective of this systematic review was to document and analyze the inclusion of equity considerations and dimensions (i.e., a measurement, analytical, or dialectical focus on systematic disparities in health between groups) in smart city interventions aimed to improve human health and well-being. Systematic searches were carried out in the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Psychological Information Database (PsycINFO), the PubMed database from the National Center for Biotechnology Information, Elsevier’s database Scopus, and Web of Science, returning 3219 titles. Ultimately, 28 articles were retained, assessed, and coded for their inclusion of equity characteristics using the Cochrane PROGRESS-Plus tool (referring to (P) place of residence, (R) race, (O) occupation, (G) gender, (R) religion, (E) education, (S) socio-economic status (SES), and (S) social capital). The most frequently included equity considerations in smart city health interventions were place of residence, SES, social capital, and personal characteristics; conversely, occupation, gender or sex, religion, race, ethnicity, culture, language, and education characteristics were comparatively less featured in such interventions. Overall, it appears that most of intervention evaluations assessed in this review are still in the early testing phases, and thus did not include or feature robust evaluative designs or commercially available technologies

Does changing to brighter road lighting improve road safety? Multilevel longitudinal analysis of road traffic collision frequency during the relighting of a UK city

Background

A step change in the night environment is taking place, with the large-scale installation of bright, broad-spectrum road lighting such as white light-emitting diodes (LEDs). One justification for this is a reduction in road traffic collisions (RTCs). This study aimed to estimate the effect of new lighting on personal injury RTCs within a large UK city.

Methods

We analysed a 9-year time series of weekly RTC personal injury counts in 132 areas of the city using multilevel modelling. The RTC rate over a full 24-hour period was the primary outcome; darkness and daylight RTC rates were secondary. The background change in RTC rate was separated from the change associated with the number of newly installed bright lamps by including a polynomial underlying time trend for the logarithm of the mean number of collisions per week for each area. The study was based on a rigorous, predesigned and archived protocol.

Results

Within-area coefficients for the broad lighting effect were positive; as the number of bright lamps in an area increased, so did the RTC rate. The estimate for the increase in the within-area 24-hour RTC rate is 11% (95% CI 2% to 20%). The estimate of darkness-only RTCs is 16% (95% CI 2% to 32%). If the effect of lighting on darkness RTC rate is adjusted by that for daylight, one obtains 4% (95% CI −12% to +23%).

Conclusion

No evidence was found for bright lamps leading to an improvement in road safety in any of the analyses. For this city, introducing brighter road lighting may have compromised safety rather than reducing harm.

Urban Health Multidisciplinary Actions Promoting Health in an Urban Environment

The crisis faced by the Western lifestyle model when dealing with problems associated with climate change and the new roles that cities and buildings must play in a world of globalisation fosters the rise of a new approach that marks a necessary turning point for our civilisation. For decades now, the fight against climate change has seen many of the world’s most important countries committing themselves to agreements—from the Kyoto Protocol of 1992 to the Paris COP21 in 2015—that are gradually getting better at establishing goals, strategies and actions for improving quality of life and protecting the entire planet, even if some venture doubts on the concrete possibility of achieving them.

Systems approaches for localising the SDGs: co-production of place-based case studies

BACKGROUND

Localisation is a pervasive challenge in achieving sustainable development. Contextual particularities may render generalized strategies to achieve the Sustainable Development Goals (SDGs) unfeasible, impractical, or ineffective. Furthermore, many localities are resource- and data-poor, limiting applicability of the global SDG indicator framework. Tools to enable local actors to make sense of complex problems, communicate this understanding, and act accordingly hold promise in their ability to improve results.

AIM

Systems approaches can help characterise local causal systems, identify useful leverage points, and foster participation needed to localise and catalyse development action. Critically, such efforts must be deeply rooted in place, involving local actors in mapping decision-processes and causation within local physical, social and policy environments. Given that each place has a unique geographical or spatial extent and therein lies its unique characters and problems, we term these activities "placially explicit." We describe and reflect on a process used to develop placially explicit, systems-based (PESB) case studies on issues that intersect with and impact urban health and wellbeing, addressing the perspectives of various actors to produce place-based models and insights that are useful for SDG localisation.

METHODS

Seven case studies were co-produced by one or more Partners with place-based knowledge of the case study issue and a Systems Thinker. In each case, joint delineation of an appropriate framing was followed by iterative dialogue cycles to uncover key contextual factors, with attention to institutional and societal structures and paradigms and the motivations and constraints of other actors. Casual loop diagrams (CLDs) were iteratively developed to capture complex narratives in a simple visual way.

RESULTS

Case study development facilitated transfer of local knowledge and development of systems thinking capacity. Partners reported new insights, including a shifting of problem frames and corresponding solution spaces to higher systems levels. Such changes led partners to re-evaluate their roles and goals, and thence to new actions and strategies. CLD-based narratives also proved useful in ongoing communications.

CONCLUSION

Co-production of PESB case studies are a useful component of transdisciplinary toolsets for local SDG implementation, building the capacity of local actors to explore complex problems, identify new solutions and indicators, and understand the systemic linkages inherent in SDG actions across sectors and scales.

Housing as a Platform for Health and Equity: Evidence and Future Directions

The links between housing and health are now known to be strong and multifaceted and to generally span across 4 key pillars: stability, affordability, quality and safety, and neighborhood opportunity. Housing disparities in the United States are tenaciously patterned along axes of social inequality and contribute to the burden related to persistently adverse health outcomes in affected groups. Appreciating the multidimensional relationship between housing and health is critical in moving the housing and health agenda forward to inspire greater equity.We assessed the current state of research on housing and health disparities, and we share recommendations for achieving opportunities for health equity centered on a comprehensive framing of housing.Despite the vastness of existing research, we must contextualize the housing and health disparities nexus in a broader web of interrelated variables emerging from the same roots of structural inequalities. There is more we can do to maximize the extent to which existing research furthers our understanding of housing's relationship to health and potential related interventions; however, there are also several areas where new research is warranted.

Redefining the Use of Big Data in Urban Health for Increased Liveability in Smart Cities

Policy decisions and urban governance are being influenced by an emergence of data from internet of things (IoT), which forms the backbone of Smart Cities, giving rise to Big Data which is processed and analyzed by Artificial Intelligence models at speeds unknown to mankind decades ago. This is providing new ways of understanding how well cities perform, both in terms of economics as well as in health. However, even though cities have been increasingly digitalized, accelerated by the concept of Smart Cities, the exploration of urban health has been limited by the interpretation of sensor data from IoT devices, omitting the inclusion of data from human anatomy and the emergence of biological data in various forms. This paper advances the need for expanding the concept of Big Data beyond infrastructure to include that of urban health through human anatomy; thus, providing a more cohesive set of data, which can lead to a better knowledge as to the relationship of people with the city and how this pertains to the thematic of urban health. Coupling both data forms will be key in supplementing the contemporary notion of Big Data for the pursuit of more contextualized, resilient, and sustainable Smart Cities, rendering more liveable fabrics, as outlined in the Sustainable Development Goal (SDG) 11 and the New Urban Agenda.

Interdisciplinary Collaboration on Green Infrastructure for Urban Watershed Management: An Ohio Case Study

Many older Midwestern cities of the United States are challenged by costly aging water infrastructure while working to revitalize urban areas. These cities developed much of their water infrastructure before the Clean Water Act became law and have struggled to mitigate contaminant loading to surface waters. An increasingly common approach to resolving these challenges is the integration of green infrastructure with gray infrastructure improvements to manage point and non-point source pollution. Stakeholder engagement and collaboration during green infrastructure planning can help address impairments and promote community involvement through the revitalization process. Mill Creek watershed in Cincinnati, OH, USA has seen improvement in watershed integrity indicators after being impaired for many decades by flashy hydrology, combined sewer overflows, and water quality degradation. A workshop was conducted to examine how integrated green and gray infrastructure has contributed to improvements in Mill Creek over the past several decades. This effort sought to examine internal and external factors that influence a multi-stakeholder watershed approach to planning, implementing, and evaluating green infrastructure techniques. Community investment and physical infrastructure, access to datasets, and skills and knowledge exchange were essential in improving use attainment in the Mill Creek. Strategic placement of green infrastructure has the potential to maximize water quality benefits and ecosystem services. However, green infrastructure deployment has been more opportunistic due to the diversity of stakeholder and decision maker interests. Future work should consider collaborative approaches to address scaling challenges and workforce development to maximize green infrastructure benefits.

Validating a comprehensive plan scoring system for healthy community design in League City, Texas

Comprehensive plans provide an overall vision for a city's land use and development and influence community health conditions. As part of a community-engaged research project, a Healthy Living and Active Design Scorecard was applied to the comprehensive plan of League City, Texas, to identify health-promoting design and planning strategies. Although the plan scored similarly to published examples, several areas of improvement aligned with priorities from a community health assessment were identified, including improving public transportation and access to exercise and recreation. Future revisions of the plans and neighbourhood scaled designs targeting these issues could improve the health of the community.

Network influences on the development and implementation of active transportation policies in six U.S. cities

Many communities have prioritized policy and built environment changes to promote active transportation (AT). However, limited information exists on the partnerships and processes necessary to develop and implement such policy and environmental changes, particularly among organizations in non-health sectors. Within the transportation sector, metropolitan planning organizations (MPOs) are increasingly recognized as organizations that can support AT policies. This study examined inter-organizational relationships among MPOs and their partners working to advance AT policies in six U.S. cities. In fall 2015, an average of 22 organizations in each city participated in an online survey about partnerships with MPOs and other organizations developing and implementing AT policies. Measures included organizational characteristics and relational attributes including: level of AT policy collaboration, information transmission, resource sharing, and perceived decisional power. Descriptive network analysis and exponential random graph modeling were used to examine organizational attributes and relational predictors associated with inter-organizational collaboration in each network. MPOs served as collaborative intermediaries, connecting other organizations around AT policies, in half of the cities examined. Organizations in each city were more likely to collaborate around AT policies when partners communicated at least quarterly. In half of the cities, the probability of AT policy collaboration was higher when two agencies exchanged resources and when organizations had perceived decisional authority. Network analysis helped identify factors likely to improve partnerships around AT policies. Results may contribute to best practices for collaboration among researchers, practitioners, policymakers, and advocates across diverse sectors seeking to promote population-level physical activity.

Blue and Green Spaces as Therapeutic Landscapes: Health Effects of Urban Water Canal Areas of Isfahan

Blue and green spaces contribute to the quality of cities in various ways—ranging from providing air corridors and visual amenities to positively affecting public psychological health and wellbeing. Urban blue and green spaces had geopolitical and agricultural functions in the past. These functions are still evident in many cities. They also provide ecological qualities for the surrounding (sub)urban neighborhoods. While in recent decades, many studies have explored the features and characteristics of urban blue and green spaces that are associated with positive health benefits, the healthy lifestyle promoting role of artificial water canals has received little attention. This case report investigates the canals in Isfahan from Iran that branch off from the Zayandeh Rood River and provide blue and green corridors to the city. The aim of this case report study is to explore the health aspects of urban water canals in physical, mental, and social dimensions based on the residents’ experiences. The study develops a framework for assessing the quality of therapeutic effect of canals in Isfahan, Iran. The paper employs qualitative content analysis as the methodological approach. In total, 200 people from the residential neighborhoods of the Niasarm Canal participated in semi-structured interviews in early 2018. The results of this research reveal that the canal—with ‘upgrade of active life’, ‘sense of rehabilitation, relaxation and concentration along with the canal’, ‘promotion of social life’, and ‘place identity’ characteristics—plays an important therapeutic role on the physical, psychological, and social health conditions of local residents.

Associations of neighborhood socioeconomic, natural and built environmental characteristics with a 13-year trajectory of non-work physical activity among civil servants in Rio de Janeiro, Brazil: The Pro-Saude Study

Positive influences of natural and built environment characteristics on human physical activity have been observed mainly in high-income countries, but mixed results exist. We explored these relationships in Rio de Janeiro, Brazil, where exuberant nature coexists with high levels of social inequality and urban violence. Data originated from questionnaires self-administered by 1731 civil servants at university campuses who participated in 4 waves (1999, 2001, 2007, 2012) of a longitudinal study, and had their residential addresses geocoded. In multinomial regression models, adjusted for individual sociodemographic characteristics, mutually adjusted associations were estimated between 13-year trajectories of non-work physical activity and 8 contextual variables: distances from waterfronts, cycle paths, outdoor gym equipment, and squares; 2 indicators of exposure to greenness (a vegetation index - NDVI - derived from satellite images, and trees close to home); an indicator of walkability (street density), and neighborhood average income. Compared to participants living in the upper quartile of distance to waterfronts, those living in its lowest quartile had 2.6-fold higher odds (aOR: 2.62, 95% CI: 1.37-5.01) of reporting non-work PA in all 4 study waves. Similar results were observed in relation to distance to cycle paths; no independent associations were observed with other natural and built environment variables.

Mapping the Hidden Hazards: Community-Led Spatial Data Collection of Street-Level Environmental Stressors in a Degraded, Urban Watershed

We utilized a participatory mapping approach to collect point locations, photographs, and descriptive data about select built environment stressors identified and prioritized by community residents living in the Proctor Creek Watershed, a degraded, urban watershed in Northwest Atlanta, Georgia. Residents (watershed researchers) used an indicator identification framework to select three watershed stressors that influence urban livability: standing water, illegal dumping on land and in surface water, and faulty stormwater infrastructure. Through a community⁻university partnership and using Geographic Information Systems and digital mapping tools, watershed researchers and university students designed a mobile application (app) that enabled them to collect data associated with these stressors to create a spatial narrative, informed by local community knowledge, that offers visual documentation and representation of community conditions that negatively influence the environment, health, and quality of life in urban areas. By elevating the local knowledge and lived experience of community residents and codeveloping a relevant data collection tool, community residents generated fine-grained, street-level, actionable data. This process helped to fill gaps in publicly available datasets about environmental hazards in their watershed and helped residents initiate solution-oriented dialogue with government officials to address problem areas. We demonstrate that community-based knowledge can contribute to and extend scientific inquiry, as well as help communities to advance environmental justice and leverage opportunities for remediation and policy change.

Urban Green Space and Its Impact on Human Health

Background: Over half of the world's population now lives in urban areas, and this proportion is expected to increase. While there have been numerous reviews of empirical studies on the link between nature and human health, very few have focused on the urban context, and most have examined almost exclusively cross-sectional research. This review is a first step toward assessing the possibility of causal relationships between nature and health in urban settings. Methods: Through systematic review of published literature, we explored the association between urban green space and human health. Results: We found consistent negative association between urban green space exposure and mortality, heart rate, and violence, and positive association with attention, mood, and physical activity. Results were mixed, or no association was found, in studies of urban green space exposure and general health, weight status, depression, and stress (via cortisol concentration). The number of studies was too low to generalize about birth outcomes, blood pressure, heart rate variability, cancer, diabetes, or respiratory symptoms. Conclusions: More studies using rigorous study design are needed to make generalizations, and meta-analyses, of these and other health outcomes possible. These findings may assist urban managers, organizations, and communities in their efforts to increase new or preserve existing green space.

Canadian policy perspectives on promoting physical activity across age-friendly communities: lessons for advocacy and action

Population ageing combined with physical inactivity has critical implications for the public health of communities in the twenty-first century. In the last decade, the World Health Organization launched the age-friendly cities agenda, aiming to address population ageing through whole-systems, rights-based, health equity-focused approaches. An important intervention for age-friendly communities is modifying built environments to support population-level physical activity. Physical activity can help mitigate impacts of chronic diseases and social isolation on older adults. Need for advocacy and action in this area raises questions of how to develop supportive environments for physical activity across age-friendly community types. In Canada, a substantial proportion of older adults live outside large urban municipalities, for which scant research exists on fostering age-friendly built environments. To this end, we conducted qualitative research involving semi-structured interviews with 21 municipal policy influencers in Alberta, Canada to gather perspectives on development and early implementation of an age-friendly policy framework in the small urban and rural context. Our findings are organised by three main themes providing key lessons for advocacy and action, namelypursuing comprehensive planning,promoting public engagementandprioritising the needs of older adults. This research informs advocacy and action priorities in promoting built environment modification for routine physical activity as part of an age-friendliness agenda for small urban and rural regions of Canada and other countries.

Is the Grass Always Greener in Suburban Neighborhoods? Outdoors Play in Suburban and Inner-City Neighborhoods

Children's outdoors play (OP) is an important source of physical activity that has been decreasing in recent years due to changes in neighborhood design, parent safety concerns and child sedentary leisure. However, few studies examined such determinants from children's perspectives. This study explores environmental and socio-cultural aspects of children's OP using a qualitative and quantitative approach. Data was collected in two phases: (1) a survey on OP and related variables among 5th and 6th graders (10-12 years old) (n = 573); and (2) a mapping activity and semi-structured interview among a subsample of the survey (n = 80). The most common locations for routine OP were parks (40%) followed by public facilities (26%) and streets (17%). OP was significantly associated with perceived environment, independent mobility and gender, but not with neighborhood type. Inner-city participants reported a higher number and greater variety of OP areas (23 vs. 14). Three main barriers of OP were identified-low quality and poorly maintained play areas, other people in public spaces, and social norms that undermine OP. Thus, in order to encourage routine OP, environmental change to create safe and attractive OP settings should be accompanied by community interventions to enhance social norms that are supportive of OP.

Citizen-sensor-networks to confront government decision-makers: Two lessons from the Netherlands

This paper presents one emerging social-technical innovation: The evolution of citizen-sensor-networks where citizens organize themselves from the 'bottom up', for the sake of confronting governance officials with measured information about environmental qualities. We have observed how citizen-sensor-networks have been initiated in the Netherlands in cases where official government monitoring and business organizations leave gaps. The formed citizen-sensor-networks collect information about issues that affect the local community in their quality-of-living. In particular, two community initiatives are described where the sensed environmental information, on noise pollution and gas-extraction induced earthquakes respectively, is published through networked geographic information methods. Both community initiatives pioneered in developing an approach that comprises the combined setting-up of sensor data flows, real-time map portals and community organization. Two particular cases are analyzed to trace the emergence and network operation of such 'networked geo-information tools' in practice: (1) The Groningen earthquake monitor, and (2) The Airplane Monitor Schiphol. In both cases, environmental 'externalities' of spatial-economic activities play an important role, having economic dimensions of national importance (e.g. gas extraction and national airport development) while simultaneously affecting the regional community with environmental consequences. The monitoring systems analyzed in this paper are established bottom-up, by citizens for citizens, to serve as 'information power' in dialogue with government institutions. The goal of this paper is to gain insight in how these citizen-sensor-networks come about: how the idea for establishing a sensor network originated, how their value gets recognized and adopted in the overall 'system of governance'; to what extent they bring countervailing power against vested interests and established discourses to the table and influence power-laden conflicts over environmental pressures; and whether or not they achieve (some form of) institutionalization and, ultimately, policy change. We find that the studied-citizen-sensor networks gain strength by uniting efforts and activities in crowdsourcing data, providing factual, 'objectivized data' or 'evidence' of the situation 'on the ground' on a matter of local community-wide concern. By filling an information need of the local community, a process of 'collective sense-making' combined with citizen empowerment could grow, which influenced societal discourse and challenged prevailing truth-claims of public institutions. In both cases similar, 'competing' web-portals were developed in response, both by the gas-extraction company and the airport. But with the citizen-sensor-networks alongside, we conclude there is a shift in power balance involved between government and affected communities, as the government no longer has information monopoly on environmental measurements.

Policy, Research and Residents' Perspectives on Built Environments Implicated in Heart Disease: A Concept Mapping Approach

An underrepresentation of stakeholder perspectives within urban health research arguably limits our understanding of what is a multi-dimensional and complex relationship between the built environment and health. By engaging a wide range of stakeholders using a participatory concept mapping approach, this study aimed to achieve a more holistic and nuanced understanding of the built environments shaping disease risk, specifically cardiometabolic risk (CMR). Moreover, this study aimed to ascertain the importance and changeability of identified environments through government action. Through the concept mapping process, community members, researchers, government and non-government stakeholders collectively identified eleven clusters encompassing 102 built environmental domains related to CMR, a number of which are underrepresented within the literature. Among the identified built environments, open space, public transportation and pedestrian environments were highlighted as key targets for policy intervention. Whilst there was substantive convergence in stakeholder groups' perspectives concerning the built environment and CMR, there were disparities in the level of importance government stakeholders and community members respectively assigned to pedestrian environments and street connectivity. These findings support the role of participatory methods in strengthening how urban health issues are understood and in affording novel insights into points of action for public health and policy intervention.

Transforming Life: A Broad View of the Developmental Origins of Health and Disease Concept from an Ecological Justice Perspective

The influential scientist Rene J. Dubos (1901–1982) conducted groundbreaking studies concerning early-life environmental exposures (e.g., diet, social interactions, commensal microbiota, housing conditions) and adult disease. However, Dubos looked beyond the scientific focus on disease, arguing that “mere survival is not enough”. He defined mental health as fulfilling human potential, and expressed concerns about urbanization occurring in tandem with disappearing access to natural environments (and elements found within them); thus modernity could interfere with health via “missing exposures”. With the advantage of emerging research involving green space, the microbiome, biodiversity and positive psychology, we discuss ecological justice in the dysbiosphere and the forces—financial inequity, voids in public policy, marketing and otherwise—that interfere with the fundamental rights of children to thrive in a healthy urban ecosystem and learn respect for the natural environment. We emphasize health within the developmental origins of health and disease (DOHaD) rubric and suggest that greater focus on positive exposures might uncover mechanisms of resiliency that contribute to maximizing human potential. We will entrain our perspective to socioeconomic disadvantage in developed nations and what we have described as “grey space”; this is a mental as much as a physical environment, a space that serves to insidiously reinforce unhealthy behavior, compromise positive psychological outlook and, ultimately, trans-generational health. It is a dwelling place that cannot be fixed with encephalobiotics or the drug-class known as psychobiotics.

3D Participatory Sensing with Low-Cost Mobile Devices for Crop Height Assessment--A Comparison with Terrestrial Laser Scanning Data

The integration of local agricultural knowledge deepens the understanding of complex phenomena such as the association between climate variability, crop yields and undernutrition. Participatory Sensing (PS) is a concept which enables laymen to easily gather geodata with standard low-cost mobile devices, offering new and efficient opportunities for agricultural monitoring. This study presents a methodological approach for crop height assessment based on PS. In-field crop height variations of a maize field in Heidelberg, Germany, are gathered with smartphones and handheld GPS devices by 19 participants. The comparison of crop height values measured by the participants to reference data based on terrestrial laser scanning (TLS) results in R² = 0.63 for the handheld GPS devices and R² = 0.24 for the smartphone-based approach. RMSE for the comparison between crop height models (CHM) derived from PS and TLS data is 10.45 cm (GPS devices) and 14.69 cm (smartphones). Furthermore, the results indicate that incorporating participants’ cognitive abilities in the data collection process potentially improves the quality data captured with the PS approach. The proposed PS methods serve as a fundament to collect agricultural parameters on field-level by incorporating local people. Combined with other methods such as remote sensing, PS opens new perspectives to support agricultural development.

Nature-Based Strategies for Improving Urban Health and Safety

Place-based programs are being noticed as key opportunities to prevent disease and promote public health and safety for populations at-large. As one key type of place-based intervention, nature-based and green space strategies can play an especially large role in improving health and safety for dwellers in urban environments such as US legacy cities that lack nature and greenery. In this paper, we describe the current understanding of place-based influences on public health and safety. We focus on nonchemical environmental factors, many of which are related to urban abandonment and blight. We then review findings from studies of nature-based interventions regarding impacts on health, perceptions of safety, and crime. Based on our findings, we suggest that further research in this area will require (1) refined measures of green space, nature, and health and safety for cities, (2) interdisciplinary science and cross-sector policy collaboration, (3) observational studies as well as randomized controlled experiments and natural experiments using appropriate spatial counterfactuals and mixed methods, and (4) return-on-investment calculations of potential economic, social, and health costs and benefits of urban greening initiatives.