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Klompmaker JO, Mork D, Zanobetti A, Braun D, Hankey S, Hart JE, Hystad P, Jimenez MP, Laden F, Larkin A, Lin PID, Suel E, Yi L, Zhang W, Delaney SW, James P. Associations of street-view greenspace with Parkinson's disease hospitalizations in an open cohort of elderly US Medicare beneficiaries. ENVIRONMENT INTERNATIONAL 2024; 188:108739. [PMID: 38754245 DOI: 10.1016/j.envint.2024.108739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 04/20/2024] [Accepted: 05/09/2024] [Indexed: 05/18/2024]
Abstract
INTRODUCTION Protective associations of greenspace with Parkinson's disease (PD) have been observed in some studies. Visual exposure to greenspace seems to be important for some of the proposed pathways underlying these associations. However, most studies use overhead-view measures (e.g., satellite imagery, land-classification data) that do not capture street-view greenspace and cannot distinguish between specific greenspace types. We aimed to evaluate associations of street-view greenspace measures with hospitalizations with a PD diagnosis code (PD-involved hospitalization). METHODS We created an open cohort of about 45.6 million Medicare fee-for-service beneficiaries aged 65 + years living in core based statistical areas (i.e. non-rural areas) in the contiguous US (2007-2016). We obtained 350 million Google Street View images across the US and applied deep learning algorithms to identify percentages of specific greenspace features in each image, including trees, grass, and other green features (i.e., plants, flowers, fields). We assessed yearly average street-view greenspace features for each ZIP code. A Cox-equivalent re-parameterized Poisson model adjusted for potential confounders (i.e. age, race/ethnicity, socioeconomic status) was used to evaluate associations with first PD-involved hospitalization. RESULTS There were 506,899 first PD-involved hospitalizations over 254,917,192 person-years of follow-up. We found a hazard ratio (95% confidence interval) of 0.96 (0.95, 0.96) per interquartile range (IQR) increase for trees and a HR of 0.97 (0.96, 0.97) per IQR increase for other green features. In contrast, we found a HR of 1.06 (1.04, 1.07) per IQR increase for grass. Associations of trees were generally stronger for low-income (i.e. Medicaid eligible) individuals, Black individuals, and in areas with a lower median household income and a higher population density. CONCLUSION Increasing exposure to trees and other green features may reduce PD-involved hospitalizations, while increasing exposure to grass may increase hospitalizations. The protective associations may be stronger for marginalized individuals and individuals living in densely populated areas.
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Affiliation(s)
- Jochem O Klompmaker
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
| | - Daniel Mork
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Antonella Zanobetti
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Danielle Braun
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA; Department of Data Science, Dana-Farber Cancer Institute, Boston, MA 02215, USA
| | - Steve Hankey
- Urban Affairs and Planning (UAP), School of Public and International Affairs, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Jaime E Hart
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Perry Hystad
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
| | | | - Francine Laden
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA
| | - Andrew Larkin
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
| | - Pi-I Debby Lin
- Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Esra Suel
- Faculty of the Built Environment, University College London, London, England
| | - Li Yi
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Wenwen Zhang
- Edward J Bloustein School of Planning and Public Policy, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
| | - Scott W Delaney
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Peter James
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA, USA; Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
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Kienast-von Einem C, Panter J, Ogilvie D, Reid A. Exploring residential relocation- differences between newcomers and settled residents in health, travel behaviour and neighbourhood perceptions. Health Place 2024; 87:103254. [PMID: 38701677 DOI: 10.1016/j.healthplace.2024.103254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 04/15/2024] [Accepted: 04/26/2024] [Indexed: 05/05/2024]
Abstract
This study explores whether people who have recently moved to an area differ from longer-term residents in their health, travel behaviour, and perceptions of the environment. Using a large, representative sample from the UKHLS, Newcomers demonstrate significantly lower mental and physical health, reduced car commuting, and a higher likelihood of liking their neighbourhood. Area deprivation, urbanicity, household income, and age emerge as influential moderators with i.e. Newcomers in affluent areas experiencing lower physical health than Settled Residents, and rural Newcomers expressing less neighbourhood satisfaction. Our findings highlight that Newcomers' perceptions of their environment diverge and environmental influences vary among population segments, potentially impacting related health behaviours such as active travel. Furthermore, residential relocation introduces Newcomers with distinct characteristics into areas, affecting the context in which potential population health interventions aiming to influence health behaviours operate. This necessitates a deeper understanding of what influences reactions to the environment as well as ongoing adaptation of environmental interventions to respond to changing contexts within the same location over time.
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Affiliation(s)
- Caroline Kienast-von Einem
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge CB2 0QQ, United Kingdom; Department of Geography, University of Cambridge, Downing Place, Cambridge CB2 3EN, United Kingdom.
| | - Jenna Panter
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge CB2 0QQ, United Kingdom.
| | - David Ogilvie
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge CB2 0QQ, United Kingdom.
| | - Alice Reid
- Department of Geography, University of Cambridge, Downing Place, Cambridge CB2 3EN, United Kingdom.
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Roscoe C, Grady ST, Hart JE, Iyer HS, Manson JE, Rexrode KM, Rimm EB, Laden F, James P. Association between Noise and Cardiovascular Disease in a Nationwide U.S. Prospective Cohort Study of Women Followed from 1988 to 2018. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:127005. [PMID: 38048103 PMCID: PMC10695265 DOI: 10.1289/ehp12906] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 10/30/2023] [Accepted: 11/08/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND Long-term noise exposure is associated with cardiovascular disease (CVD), including acute cardiovascular events such as myocardial infarction and stroke. However, longitudinal cohort studies in the U.S. of long-term noise and CVD are almost exclusively from Europe and few modeled nighttime noise, when an individual is likely at home or asleep, separately from daytime noise. We aimed to examine the prospective association of outdoor long-term nighttime and daytime noise from anthropogenic sources with incident CVD using a U.S.-based, nationwide cohort of women. METHODS We linked L 50 nighttime and L 50 daytime anthropogenic modeled noise estimates from a U.S. National Parks Service model (L 50 : sound pressure levels exceeded 50 percent of the time) to geocoded residential addresses of 114,116 participants in the Nurses' Health Study. We used time-varying Cox proportional hazards models to estimate risk of incident CVD, coronary heart disease (CHD), and stroke associated with long-term average (14-y measurement period) noise exposure, adjusted for potential individual- and area-level confounders and CVD risk factors (1988-2018; biennial residential address updates; monthly CVD updates). We assessed effect modification by population density, region, air pollution, vegetation cover, and neighborhood socioeconomic status, and explored mediation by self-reported average nightly sleep duration. RESULTS Over 2,548,927 person-years, there were 10,331 incident CVD events. In fully adjusted models, the hazard ratios for each interquartile range increase in L 50 nighttime noise (3.67 dBA) and L 50 daytime noise (4.35 dBA), respectively, were 1.04 (95% CI: 1.02, 1.06) and 1.04 (95% CI: 1.02, 1.07). Associations for total energy-equivalent noise level (L eq ) measures were stronger than for the anthropogenic statistical L 50 noise measures. Similar associations were observed for CHD and stroke. Interaction analyses suggested that associations of L 50 nighttime and L 50 daytime noise with CVD did not differ by prespecified effect modifiers. We found no evidence that inadequate sleep (< 5 h/night) mediated associations of L 50 nighttime noise and CVD. DISCUSSION Outdoor L 50 anthropogenic nighttime and daytime noise at the residential address was associated with a small increase in CVD risk in a cohort of adult female nurses. https://doi.org/10.1289/EHP12906.
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Affiliation(s)
- Charlotte Roscoe
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Division of Population Sciences, Dana Faber Cancer Institute, Boston, Massachusetts, USA
| | - Stephanie T. Grady
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Jaime E. Hart
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Hari S. Iyer
- Section of Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | - JoAnn E. Manson
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Kathryn M. Rexrode
- Division of Women’s Health, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Eric B. Rimm
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Francine Laden
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Peter James
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA
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Gailey S. Changes in Residential Greenspace and Birth Outcomes among Siblings: Differences by Maternal Race. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6790. [PMID: 37754649 PMCID: PMC10531468 DOI: 10.3390/ijerph20186790] [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: 06/30/2023] [Revised: 08/06/2023] [Accepted: 08/19/2023] [Indexed: 09/28/2023]
Abstract
Growing research investigates the perinatal health benefits of greenspace in a mother's prenatal environment. However, evidence of associations between residential greenspace and birth outcomes remains mixed, limiting the relevance this work holds for urban policy and greening interventions. Past research relies predominantly on cross-sectional designs that are vulnerable to residential selection bias, and rarely tests effect modification by maternal race/ethnicity, which may contribute to heterogeneous findings. This study uses a rigorous, longitudinal sibling comparison design and maternal fixed effect analyses to test whether increases in maternal exposure to residential greenspace between pregnancies precede improved birth outcomes among non-Hispanic (NH) white (n = 247,285) and Black (n = 54,995) mothers (mean age = 28 years) who had at least two consecutive live births in California between 2005 and 2015. Results show that increases in residential greenspace correspond with higher birthweight (coef. = 75.49, 95% CI: 23.48, 127.50) among Black, but not white (coef. = -0.51, 95% CI: -22.90, 21.90), infants. Additional analyses suggest that prior evidence of perinatal benefits associated with residential greenspace among white mothers may arise from residential selection; no such bias is observed for Black mothers. Taken together, these findings support urban greening initiatives in historically under-resourced neighborhoods. Efforts to evenly distribute residential greenspace may reduce persistent racial disparities in birth outcomes, an important step towards promoting health equity across the life course.
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Affiliation(s)
- Samantha Gailey
- Department of Forestry, Michigan State University, East Lansing, MI 48824, USA;
- Department of Public Health, Michigan State University, Flint, MI 48502, USA
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5
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Roscoe C, T Grady S, Hart JE, Iyer HS, Manson JE, Rexrode KM, Rimm EB, Laden F, James P. Exposure to Noise and Cardiovascular Disease in a Nationwide US Prospective Cohort Study of Women. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.06.07.23291083. [PMID: 37398490 PMCID: PMC10312856 DOI: 10.1101/2023.06.07.23291083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
Background: Long-term noise exposure is associated with cardiovascular disease (CVD), including acute cardiovascular events such as myocardial infarction and stroke. However, longitudinal cohort studies of long-term noise and CVD are almost exclusively from Europe, and few modelled nighttime and daytime noise separately. We aimed to examine the prospective association of outdoor long-term nighttime and daytime noise from anthropogenic sources with incident CVD using a US-based, nationwide cohort of women. Methods: We linked L50 (median) nighttime and L50 daytime modelled anthropogenic noise estimates from a US National Park Service model to geocoded residential addresses of 114,116 participants in the Nurses' Health Study. We used time-varying Cox proportional hazards models to estimate risk of incident CVD, coronary heart disease (CHD), and stroke associated with long-term average noise exposure, adjusted for potential individual- and area-level confounders and CVD risk factors (1988-2018). We assessed effect modification by population density, region, air pollution, vegetation cover, and neighborhood socioeconomic status, and explored mediation by self-reported average nightly sleep duration. Results: Over 2,544,035 person-years, there were 10,331 incident CVD events. In fully-adjusted models, the hazard ratios for each interquartile range increase in L50 nighttime noise (3.67 dBA) and L50 daytime noise (4.35 dBA), respectively, were 1.04 (95% CI 1.02, 1.06) and 1.04 (95% CI 1.02, 1.07). Similar associations were observed for CHD and stroke. Stratified analyses suggested that associations of nighttime and daytime noise with CVD did not differ by prespecified effect modifiers. We found no evidence that inadequate sleep (< 5 hours per night) mediated associations of noise and CVD. Discussion: Outdoor median nighttime and daytime noise at the residential address was associated with a small increase in CVD risk in a cohort of adult female nurses.
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6
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Cerin E, Barnett A, Wu YT, Martino E, Shaw JE, Knibbs LD, Poudel G, Jalaludin B, Anstey KJ. Do neighbourhood traffic-related air pollution and socio-economic status moderate the associations of the neighbourhood physical environment with cognitive function? Findings from the AusDiab study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 858:160028. [PMID: 36368384 DOI: 10.1016/j.scitotenv.2022.160028] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 11/02/2022] [Accepted: 11/03/2022] [Indexed: 06/16/2023]
Abstract
Characteristics of the neighbourhood environment, including the built and natural environment, area-level socio-economic status (SES) and air pollution, have been linked to cognitive health. However, most studies have focused on single neighbourhood characteristics and have not considered the extent to which the effects of environmental factors may interact. We examined the associations of measures of the neighbourhood built and natural environment, area-level SES and traffic-related air pollution (TRAP) with two cognitive function domains (memory and processing speed), and the extent to which area-level SES and TRAP moderated the associations. We used cross-sectional data from the AusDiab3 study, an Australian cohort study of adults (mean age: 61 years) in 2011-12 (N = 4141) for which geocoded residential addresses were available. Spatial data were used to create composite indices of built environment complexity (population density, intersection density, non-commercial land use mix, commercial land use) and natural environment (parkland and blue spaces). Area-level SES was obtained from national census indices and TRAP was based on estimates of annual average levels of nitrogen dioxide (NO2). Confounder-adjusted generalised additive mixed models were used to estimate the independent associations of the environmental measures with cognitive function and the moderating effects of area-level SES and TRAP. The positive associations between built environment complexity and memory were stronger in those living in areas with higher SES and lower NO2 concentrations. A positive association between the natural environment and memory was found only in those living in areas with lower NO2 concentrations and average or below-average SES. Built environment complexity and the natural environment were positively related to processing speed. Complex urban environments and access to nature may benefit cognitive health in ageing populations. For higher-order cognitive abilities, such as memory, these positive effects may be stronger in areas with lower levels of TRAP.
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Affiliation(s)
- Ester Cerin
- Mary MacKillop Institute for Health Research, Australian Catholic University, 215 Spring St., Melbourne, VIC, Australia; School of Public Health, The University of Hong Kong, 7 Sassoon Rd., Sandy Bay, Hong Kong; Baker Heart and Diabetes Institute, Melbourne, VIC, Australia; Department of Community Medicine, UiT The Artic University of Norway, Tromsø, Norway.
| | - Anthony Barnett
- Mary MacKillop Institute for Health Research, Australian Catholic University, 215 Spring St., Melbourne, VIC, Australia
| | - Yu-Tzu Wu
- Population Health Sciences Institute, Newcastle University, Newcastle NE4 5PL, United Kingdom
| | - Erika Martino
- School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Jonathan E Shaw
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; School of Life Sciences, La Trobe University, Melbourne, VIC, Australia
| | - Luke D Knibbs
- Sydney School of Public Health, The University of Sydney, Camperdown, NSW, Australia; Public Health Unit, Sydney Local Health District, Camperdown, NSW, Australia
| | - Govinda Poudel
- Mary MacKillop Institute for Health Research, Australian Catholic University, 215 Spring St., Melbourne, VIC, Australia
| | - Bin Jalaludin
- School of Population Health, University of New South Wales, Randwick, NSW, Australia
| | - Kaarin J Anstey
- School of Psychology, University of New South Wales, Randwick, NSW, Australia; Neuroscience Research Australia (NeuRA), Sydney, Australia; UNSW Ageing Futures Institute, Sydney, Australia
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Samadoulougou S, Letarte L, Lebel A. Association between Neighbourhood Deprivation Trajectories and Self-Perceived Health: Analysis of a Linked Survey and Health Administrative Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:486. [PMID: 36612807 PMCID: PMC9819741 DOI: 10.3390/ijerph20010486] [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: 11/14/2022] [Revised: 12/19/2022] [Accepted: 12/23/2022] [Indexed: 06/17/2023]
Abstract
Life course exposure to neighbourhood deprivation may have a previously unstudied relationship with health disparities. This study examined the association between neighbourhood deprivation trajectories (NDTs) and poor reported self-perceived health (SPH) among Quebec's adult population. Data of 45,990 adults with complete residential address histories from the Care-Trajectories-Enriched Data cohort, which links Canadian Community Health Survey respondents to health administrative data, were used. Accordingly, participants were categorised into nine NDTs (T1 (Privileged Stable)-T9 (Deprived Stable)). Using multivariate logistic regression, the association between trajectory groups and poor SPH was estimated. Of the participants, 10.3% (95% confidence interval [CI]: 9.9-10.8) had poor SPH status. This proportion varied considerably across NDTs: From 6.4% (95% CI: 5.7-7.2) for Privileged Stable (most advantaged) to 16.4% (95% CI: 15.0-17.8) for Deprived Stable (most disadvantaged) trajectories. After adjustment, the likelihood of reporting poor SPH was significantly higher among participants assigned to a Deprived Upward (odds ratio [OR]: 1.77; 95% CI: 1.48-2.12), Average Downward (OR: 1.75; CI: 1.08-2.84) or Deprived trajectory (OR: 1.81; CI: 1.45-2.86), compared to the Privileged trajectory. Long-term exposure to neighbourhood deprivation may be a risk factor for poor SPH. Thus, NDT measures should be considered when selecting a target population for public-health-related interventions.
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Affiliation(s)
- Sékou Samadoulougou
- Evaluation Platform on Obesity Prevention (PEPO), Quebec Heart and Lung Institute, Quebec, QC G1V 4G5, Canada
- Centre for Research on Planning and Development (CRAD), Université Laval, Quebec, QC G1V 0A6, Canada
| | - Laurence Letarte
- Evaluation Platform on Obesity Prevention (PEPO), Quebec Heart and Lung Institute, Quebec, QC G1V 4G5, Canada
- Centre for Research on Planning and Development (CRAD), Université Laval, Quebec, QC G1V 0A6, Canada
| | - Alexandre Lebel
- Evaluation Platform on Obesity Prevention (PEPO), Quebec Heart and Lung Institute, Quebec, QC G1V 4G5, Canada
- Centre for Research on Planning and Development (CRAD), Université Laval, Quebec, QC G1V 0A6, Canada
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Bhavsar NA, Yang LZ, Phelan M, Shepherd-Banigan M, Goldstein BA, Peskoe S, Palta P, Hirsch JA, Mitchell NS, Hirsch AG, Lunyera J, Mohottige D, Diamantidis CJ, Maciejewski ML, Boulware LE. Association between Gentrification and Health and Healthcare Utilization. J Urban Health 2022; 99:984-997. [PMID: 36367672 PMCID: PMC9727003 DOI: 10.1007/s11524-022-00692-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/13/2022] [Indexed: 11/13/2022]
Abstract
There is tremendous interest in understanding how neighborhoods impact health by linking extant social and environmental drivers of health (SDOH) data with electronic health record (EHR) data. Studies quantifying such associations often use static neighborhood measures. Little research examines the impact of gentrification-a measure of neighborhood change-on the health of long-term neighborhood residents using EHR data, which may have a more generalizable population than traditional approaches. We quantified associations between gentrification and health and healthcare utilization by linking longitudinal socioeconomic data from the American Community Survey with EHR data across two health systems accessed by long-term residents of Durham County, NC, from 2007 to 2017. Census block group-level neighborhoods were eligible to be gentrified if they had low socioeconomic status relative to the county average. Gentrification was defined using socioeconomic data from 2006 to 2010 and 2011-2015, with the Steinmetz-Wood definition. Multivariable logistic and Poisson regression models estimated associations between gentrification and development of health indicators (cardiovascular disease, hypertension, diabetes, obesity, asthma, depression) or healthcare encounters (emergency department [ED], inpatient, or outpatient). Sensitivity analyses examined two alternative gentrification measures. Of the 99 block groups within the city of Durham, 28 were eligible (N = 10,807; median age = 42; 83% Black; 55% female) and 5 gentrified. Individuals in gentrifying neighborhoods had lower odds of obesity (odds ratio [OR] = 0.89; 95% confidence interval [CI]: 0.81-0.99), higher odds of an ED encounter (OR = 1.10; 95% CI: 1.01-1.20), and lower risk for outpatient encounters (incidence rate ratio = 0.93; 95% CI: 0.87-1.00) compared with non-gentrifying neighborhoods. The association between gentrification and health and healthcare utilization was sensitive to gentrification definition.
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Affiliation(s)
- Nrupen A Bhavsar
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA.
- Department of Biostatistics & Bioinformatics, Duke University School of Medicine, Durham, NC, USA.
| | | | | | - Megan Shepherd-Banigan
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
- Durham VA Medical Center, Durham, NC, USA
| | - Benjamin A Goldstein
- Department of Biostatistics & Bioinformatics, Duke University School of Medicine, Durham, NC, USA
- Duke Clinical Research Institute, Durham, NC, USA
| | - Sarah Peskoe
- Department of Biostatistics & Bioinformatics, Duke University School of Medicine, Durham, NC, USA
| | - Priya Palta
- Department of Medicine, College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, USA
- Department of Epidemiology, Joseph P. Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY, USA
| | - Jana A Hirsch
- Dornsife School of Public Health, Urban Health Collaborative, Drexel University, Philadelphia, PA, USA
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Nia S Mitchell
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Annemarie G Hirsch
- Department of Epidemiology and Health Services Research, Geisinger, Danville, PA, USA
| | - Joseph Lunyera
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | | | - Clarissa J Diamantidis
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
- Durham VA Medical Center, Durham, NC, USA
| | - Matthew L Maciejewski
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
- Durham VA Medical Center, Durham, NC, USA
| | - L Ebony Boulware
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA
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9
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Donovan GH, Prestemon JP, Gatziolis D, Michael YL, Kaminski AR, Dadvand P. The association between tree planting and mortality: A natural experiment and cost-benefit analysis. ENVIRONMENT INTERNATIONAL 2022; 170:107609. [PMID: 36332494 DOI: 10.1016/j.envint.2022.107609] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 08/31/2022] [Accepted: 10/29/2022] [Indexed: 06/16/2023]
Abstract
Several recent longitudinal studies have found that exposure to the natural environment is associated with lower non-accidental mortality. However, most of these studies used the normalized difference vegetation index (NDVI) as an exposure metric; and because NDVI might not be sensitive enough to adequately capture changes in urban vegetation, these studies might lack true longitudinal variation in exposure. Therefore, we used a natural experiment to assess the impact of 30 years of tree planting by the nonprofit Friends of Trees on non-accidental, cardiovascular, lower-respiratory, and accidental mortality in Portland, Oregon (mortality data were provided by the Oregon Health Authority). We estimated autoregressive mixed models of Census-tract level mortality rate (deaths per 100,000 population) associated with trees planted, including a tract-level random effect. All models used data from the American Community Survey to control for year, race, education, income, and age. Each tree planted in the preceding 15 years was associated with significant reductions in non-accidental (-0.21, 95 % CI: -0.30, -0.12) and cardiovascular mortality (-0.066, 95 % CI: -0.11, -0.027). Furthermore, the dose-response association between tree planting and non-accidental mortality increased in magnitude as trees aged and grew. Each tree planted in the preceding 1-5 years was associated with a reduction in mortality rate of -0.154 (95 % CI: -0.323, 0.0146), whereas each tree planted in the last 6-10 and 11-15 years was associated with a reduction in mortality rate of -0.262 (95 % CI: -0.413, -0.110) and -0.306 (95 % CI: -0.527, -0.0841) respectively. Using US EPA estimates of a value of a statistical life, we estimated that planting a tree in each of Portland's 140 Census tracts would generate $14.2 million in annual benefits (95 % CI: $8.0 million to $20.4 million). In contrast, the annual cost of maintaining 140 trees would be $2,716-$13,720.
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Affiliation(s)
| | - Jeffrey P Prestemon
- USDA Forest Service, Southern Research Station, Research Triangle Park, NC, USA
| | | | - Yvonne L Michael
- Drexel University, Dornsife School of Public Health, Philadelphia, PA, USA
| | | | - Payam Dadvand
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
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10
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Gailey S. Moving to greener pastures: Health selection into neighborhood green space among a highly mobile and diverse population in California. Soc Sci Med 2022; 315:115411. [PMID: 36399985 PMCID: PMC10224763 DOI: 10.1016/j.socscimed.2022.115411] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 08/11/2022] [Accepted: 09/27/2022] [Indexed: 01/26/2023]
Abstract
Global urbanization has sparked substantial environmental, public health, and social science research on the importance of conserving and propagating natural environments. A large subset of this work focuses on the benefits of green space for health. An often-overlooked methodological concern when examining relations between green space and health, however, involves residential self-selection. The selective movement of individuals into greener neighborhoods on the basis of preexisting health and correlated social factors may bias associations, particularly in cross-sectional studies, which predominate existing green space/health research. To quantify the extent of residential self-selection bias, this study used a longitudinal sibling comparison design with repeated individual and neighborhood measures to estimate associations between pre-move health factors, including maternal body mass index (BMI) and infant birthweight, and post-move neighborhood green space in a residentially mobile sample of mothers in California, 2007 to 2015 (n = 288,333). Results show that better health before moving predicted higher levels of neighborhood green space after moving, providing evidence of health selection. Findings also indicate some support for differential health selection into neighborhood green space by race/ethnicity, including that evidence of selection emerges for white and Hispanic, but not Black, mothers. However, weak relations between pre-move individual factors and post-move neighborhood green space across analyses suggest that potential bias due to residential self-selection appears relatively minimal in a large, diverse, and highly mobile sample of families in California. Findings support calls to increase green space in historically marginalized neighborhoods as a means to promote environmental and health equity.
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Affiliation(s)
- Samantha Gailey
- Minnesota Population Center, University of Minnesota, Twin Cities, USA.
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11
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Buajitti E, Rosella LC. Neighbourhood socioeconomic improvement, residential mobility and premature death: a population-based cohort study and inverse probability of treatment weighting analysis. Int J Epidemiol 2022; 52:489-500. [PMID: 35656702 PMCID: PMC10114058 DOI: 10.1093/ije/dyac117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 05/20/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Causal inference using area-level socioeconomic measures is challenging due to risks of residual confounding and imprecise specification of the neighbourhood-level social exposure. By using multi-linked longitudinal data to address these common limitations, our study aimed to identify protective effects of neighbourhood socioeconomic improvement on premature mortality risk. METHODS We used data from the Canadian Community Health Survey, linked to health administrative data, including longitudinal residential history. Individuals aged 25-69, living in low-socioeconomic status (SES) areas at survey date (n = 8335), were followed up for neighbourhood socioeconomic improvement within 5 years. We captured premature mortality (death before age 75) until 2016. We estimated protective effects of neighbourhood socioeconomic improvement exposures using Cox proportional hazards models. Stabilized inverse probability of treatment weights (IPTW) were used to account for confounding by baseline health, social and behavioural characteristics. Separate analyses were carried out for three exposure specifications: any improvement, improvement by residential mobility (i.e. movers) or improvement in place (non-movers). RESULTS Overall, 36.9% of the study cohort experienced neighbourhood socioeconomic improvement either by residential mobility or improvement in place. There were noted differences in baseline health status, demographics and individual SES between exposure groups. IPTW survival models showed a modest protective effect on premature mortality risk of socioeconomic improvement overall (HR = 0.86; 95% CI 0.63, 1.18). Effects were stronger for improvement in place (HR = 0.67; 95% CI 0.48, 0.93) than for improvement by residential mobility (HR = 1.07, 95% 0.67, 1.51). CONCLUSIONS Our study provides robust evidence that specific neighbourhood socioeconomic improvement exposures are important for determining mortality risks.
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Affiliation(s)
- Emmalin Buajitti
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.,ICES, Toronto, ON, Canada
| | - Laura C Rosella
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,ICES, Toronto, ON, Canada.,Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada.,Department of Laboratory Medicine & Pathology, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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12
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Bennett EE, Lynch KM, Xu X, Park ES, Ying Q, Wei J, Smith RL, Stewart JD, Whitsel EA, Power MC. Characteristics of movers and predictors of residential mobility in the Atherosclerosis Risk in Communities (ARIC) cohort. Health Place 2022; 74:102771. [PMID: 35247797 PMCID: PMC9004423 DOI: 10.1016/j.healthplace.2022.102771] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 02/11/2022] [Accepted: 02/15/2022] [Indexed: 11/23/2022]
Abstract
Current efforts to characterize movers and identify predictors of moving have been limited. We used the ARIC cohort to characterize non-movers, short-distance movers, and long-distance movers, and employed best subset algorithms to identify important predictors of moving, including interactions between characteristics. Short- and long-distance movers were notably different from non-movers, and important predictors of moving differed based on the distance of the residential move. Importantly, systematic inclusion of interaction terms enhanced model fit and was substantively meaningful. This work has important implications for epidemiologic studies of contextual exposures and those treating residential mobility as an exposure.
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Affiliation(s)
- Erin E Bennett
- Department of Epidemiology, The George Washington University Milken Institute School of Public Health, Washington, DC, USA.
| | - Katie M Lynch
- Department of Epidemiology, The George Washington University Milken Institute School of Public Health, Washington, DC, USA
| | - Xiaohui Xu
- Department of Epidemiology & Biostatistics, Texas A&M Health Science Center School of Public Health, College Station, TX, USA
| | - Eun Sug Park
- Texas A&M Transportation Institute, College Station, TX, USA
| | - Qi Ying
- Zachry Department of Civil & Environmental Engineering, Texas A&M University, College Station, TX, USA
| | - Jingkai Wei
- Department of Epidemiology, The George Washington University Milken Institute School of Public Health, Washington, DC, USA
| | - Richard L Smith
- Department of Statistics and Operations Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - James D Stewart
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Eric A Whitsel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Melinda C Power
- Department of Epidemiology, The George Washington University Milken Institute School of Public Health, Washington, DC, USA
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13
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Ohanyan H, Portengen L, Huss A, Traini E, Beulens JWJ, Hoek G, Lakerveld J, Vermeulen R. Machine learning approaches to characterize the obesogenic urban exposome. ENVIRONMENT INTERNATIONAL 2022; 158:107015. [PMID: 34991269 DOI: 10.1016/j.envint.2021.107015] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 11/26/2021] [Accepted: 11/29/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Characteristics of the urban environment may contain upstream drivers of obesity. However, research is lacking that considers the combination of environmental factors simultaneously. OBJECTIVES We aimed to explore what environmental factors of the urban exposome are related to body mass index (BMI), and evaluated the consistency of findings across multiple statistical approaches. METHODS A cross-sectional analysis was conducted using baseline data from 14,829 participants of the Occupational and Environmental Health Cohort study. BMI was obtained from self-reported height and weight. Geocoded exposures linked to individual home addresses (using 6-digit postcode) of 86 environmental factors were estimated, including air pollution, traffic noise, green-space, built environmental and neighborhood socio-demographic characteristics. Exposure-obesity associations were identified using the following approaches: sparse group Partial Least Squares, Bayesian Model Averaging, penalized regression using the Minimax Concave Penalty, Generalized Additive Model-based boosting Random Forest, Extreme Gradient Boosting, and Multiple Linear Regression, as the most conventional approach. The models were adjusted for individual socio-demographic variables. Environmental factors were ranked according to variable importance scores attributed by each approach and median ranks were calculated across these scores to identify the most consistent associations. RESULTS The most consistent environmental factors associated with BMI were the average neighborhood value of the homes, oxidative potential of particulate matter air pollution (OP), healthy food outlets in the neighborhood (5 km buffer), low-income neighborhoods, and one-person households in the neighborhood. Higher BMI levels were observed in low-income neighborhoods, with lower average house values, lower share of one-person households and smaller amount of healthy food retailers. Higher BMI levels were observed in low-income neighborhoods, with lower average house values, lower share of one-person households, smaller amounts of healthy food retailers and higher OP levels. Across the approaches, we observed consistent patterns of results based on model's capacity to incorporate linear or nonlinear associations. DISCUSSION The pluralistic analysis on environmental obesogens strengthens the existing evidence on the role of neighborhood socioeconomic position, urbanicity and air pollution.
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Affiliation(s)
- Haykanush Ohanyan
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Noord-Holland, the Netherlands; Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Utrecht, the Netherlands; Upstream Team, www.upstreamteam.nl. Amsterdam UMC, VU University Amsterdam, Amsterdam, Noord-Holland, the Netherlands.
| | - Lützen Portengen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Utrecht, the Netherlands
| | - Anke Huss
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Utrecht, the Netherlands
| | - Eugenio Traini
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Utrecht, the Netherlands
| | - Joline W J Beulens
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Noord-Holland, the Netherlands; Upstream Team, www.upstreamteam.nl. Amsterdam UMC, VU University Amsterdam, Amsterdam, Noord-Holland, the Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherland
| | - Gerard Hoek
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Utrecht, the Netherlands
| | - Jeroen Lakerveld
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Noord-Holland, the Netherlands; Upstream Team, www.upstreamteam.nl. Amsterdam UMC, VU University Amsterdam, Amsterdam, Noord-Holland, the Netherlands
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Utrecht, the Netherlands
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14
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Hagedoorn P, Helbich M. Longitudinal effects of physical and social neighbourhood change on suicide mortality: A full population cohort study among movers and non-movers in the Netherlands. Soc Sci Med 2021; 294:114690. [PMID: 34979332 DOI: 10.1016/j.socscimed.2021.114690] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 12/22/2021] [Accepted: 12/23/2021] [Indexed: 01/04/2023]
Abstract
Associations between the residential neighbourhood environment and suicide mortality are well-established; however, most evidence is cross-sectional and not capable of incorporating place-based and residential moving-related neighbourhood changes. We studied how suicide mortality is associated with changes in the physical and social neighbourhood environment for movers and non-movers. Our retrospective analysis was based on longitudinal register data for the entire Dutch population aged 25-64 years enriched with annually time-varying data on the residential neighbourhood environment between 2007 and 2016. A total of 8,741,021 people were followed-up between 2007 and 2016 of which 10,019 committed suicide. Upward and downward neighbourhood change was measured by comparing neighbourhood conditions separately at two time points. Cox proportional hazard models indicated that movers had a significantly lower risk of suicide compared to non-movers. Suicide risk was lower for people experiencing improvements in social fragmentation and deprivation compared to those remaining in poor conditions. Change from rural to urban conditions also resulted in lower suicide risk, while a gain in green space put people at increased risk. For those stable neighbourhood conditions over time, suicide mortality was lower for men and women in urban vs. rural neighbourhoods as well as for women in neighbourhoods with low vs. high social fragmentation. Stable exposure to high levels of green space resulted in higher suicide risk among women. Interactions and stratification by moving type revealed associations between neighbourhood change and suicide were more pronounced in non-movers. Our findings suggest that neighbourhood improvements might contribute to a lower suicide risk, especially for long-term residents in poor neighbourhood conditions.
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Affiliation(s)
- Paulien Hagedoorn
- Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Utrecht, the Netherlands.
| | - Marco Helbich
- Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Utrecht, the Netherlands
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15
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Hirsch AG, Nordberg CM, Chang A, Poulsen MN, Moon KA, Siegel KR, Rolka DB, Schwartz BS. Association of community socioeconomic deprivation with evidence of reduced kidney function at time of type 2 diabetes diagnosis. SSM Popul Health 2021; 15:100876. [PMID: 34377762 PMCID: PMC8327153 DOI: 10.1016/j.ssmph.2021.100876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/09/2021] [Accepted: 07/15/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND While there are known individual-level risk factors for kidney disease at time of type 2 diabetes diagnosis, little is known regarding the role of community context. We evaluated the association of community socioeconomic deprivation (CSD) and community type with estimated glomerular filtration rate (eGFR) when type 2 diabetes is diagnosed. METHODS This was a retrospective cohort study of 13,144 adults with newly diagnosed type 2 diabetes in Pennsylvania. The outcome was the closest eGFR measurement within one year prior to and two weeks after type 2 diabetes diagnosis, calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-Epi) equation. We used adjusted multinomial regression models to estimate associations of CSD (quartile 1, least deprivation) and community type (township, borough, city) with eGFR and used adjusted generalized estimating equation models to evaluate whether community features were associated with the absence of diabetes screening in the years prior to type 2 diabetes diagnosis. RESULTS Of the participants, 1279 (9.7%) had hyperfiltration and 1377 (10.5%) had reduced eGFR. Women were less likely to have hyperfiltration and more likely to have reduced eGFR. Black (versus White) race was positively associated with hyperfiltration when the eGFR calculation was corrected for race but inversely associated without the correction. Medical Assistance (ever versus never) was positively associated with reduced eGFR. Higher CSD and living in a city were each positively associated (odds ratio [95% confidence interval]) with reduced eGFR (CSD quartiles 3 and 4 versus quartile 1, 1.23 [1.04, 1.46], 1.32 [1.11, 1.58], respectively; city versus township, 1.38 [1.15, 1.65]). These features were also positively associated with the absence of a type 2 diabetes screening measure. CONCLUSIONS In a population-based sample, more than twenty percent had hyperfiltration or reduced eGFR at time of type 2 diabetes diagnosis. Individual- and community-level factors were associated with these outcomes.
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Affiliation(s)
- Annemarie G. Hirsch
- Department of Population Health Sciences, Geisinger, Danville, PA, USA
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Cara M. Nordberg
- Department of Population Health Sciences, Geisinger, Danville, PA, USA
| | - Alexander Chang
- Department of Population Health Sciences, Geisinger, Danville, PA, USA
| | | | - Katherine A. Moon
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Karen R. Siegel
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Deborah B. Rolka
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Brian S. Schwartz
- Department of Population Health Sciences, Geisinger, Danville, PA, USA
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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16
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Life Course Neighborhood Deprivation Effects on Body Mass Index: Quantifying the Importance of Selective Migration. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168339. [PMID: 34444095 PMCID: PMC8392830 DOI: 10.3390/ijerph18168339] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 08/03/2021] [Accepted: 08/04/2021] [Indexed: 01/19/2023]
Abstract
Neighborhood effects research is plagued by the inability to circumvent selection effects —the process of people sorting into neighborhoods. Data from two British Birth Cohorts, 1958 (ages 16, 23, 33, 42, 55) and 1970 (ages 16, 24, 34, 42), and structural equation modelling, were used to investigate life course relationships between body mass index (BMI) and area deprivation (addresses at each age linked to the closest census 1971–2011 Townsend score [TOWN], re-calculated to reflect consistent 2011 lower super output area boundaries). Initially, models were examined for: (1) area deprivation only, (2) health selection only and (3) both. In the best-fitting model, all relationships were then tested for effect modification by residential mobility by inclusion of interaction terms. For both cohorts, both BMI and area deprivation strongly tracked across the life course. Health selection, or higher BMI associated with higher area deprivation at the next study wave, was apparent at three intervals: 1958 cohort, BMI at age 23 y and TOWN at age 33 y and BMI at age 33 y and TOWN at age 42 y; 1970 cohort, BMI at age 34 y and TOWN at age 42 y, while paths between area deprivation and BMI at the next interval were seen in both cohorts, over all intervals, except for the association between TOWN at age 23 y and BMI at age 33 y in the 1958 cohort. None of the associations varied by moving status. In conclusion, for BMI, selective migration does not appear to account for associations between area deprivation and BMI across the life course.
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17
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Finlay J, Esposito M, Li M, Kobayashi LC, Khan AM, Gomez-Lopez I, Melendez R, Colabianchi N, Judd S, Clarke PJ. Can Neighborhood Social Infrastructure Modify Cognitive Function? A Mixed-Methods Study of Urban-Dwelling Aging Americans. J Aging Health 2021; 33:772-785. [PMID: 34301156 DOI: 10.1177/08982643211008673] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives: Socialization predicts cognitive aging outcomes. Neighborhoods may facilitate socially engaged aging and thus shape cognition. We investigated places where older adults socialized and whether availability of these sites was associated with cognitive outcomes. Methods: Qualitative analysis of interviews and ethnography with 125 older adults (mean age 71 years) in Minneapolis identified where participants socialized outside of home. This informed quantitative analysis of a national sample of 21,151 older Americans (mean age at baseline 67 years) from the Reasons for Geographic and Racial Differences in Stroke study. Multilevel generalized additive models described associations between access to key social places and cognitive function and decline. Results: Qualitative analysis identified eateries, senior centers, and civic groups as key places to socialize. We identified significant positive associations between kernel density of senior centers, civic/social organizations, and cognitive function. Discussion: Specific neighborhood social infrastructures may support cognitive health among older adults aging in place.
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Affiliation(s)
- Jessica Finlay
- Social Environment and Health Program, Survey Research Center, Institute for Social Research, 1259University of Michigan, Ann Arbor, MI, USA
| | - Michael Esposito
- Social Environment and Health Program, Survey Research Center, Institute for Social Research, 1259University of Michigan, Ann Arbor, MI, USA.,Department of Sociology, Washington University of St. Louis, St. Louis, 1259MO, USA
| | - Mao Li
- Social Environment and Health Program, Survey Research Center, Institute for Social Research, 1259University of Michigan, Ann Arbor, MI, USA.,Survey Methodology Program, Institute for Social Research, 1259University of Michigan, Ann Arbor, MI, USA
| | - Lindsay C Kobayashi
- Center for Social Epidemiology and Population Health, Department of Epidemiology, School of Public Health, 1259University of Michigan, Ann Arbor, MI, USA
| | - Anam M Khan
- Social Environment and Health Program, Survey Research Center, Institute for Social Research, 1259University of Michigan, Ann Arbor, MI, USA.,Center for Social Epidemiology and Population Health, Department of Epidemiology, School of Public Health, 1259University of Michigan, Ann Arbor, MI, USA
| | - Iris Gomez-Lopez
- Social Environment and Health Program, Survey Research Center, Institute for Social Research, 1259University of Michigan, Ann Arbor, MI, USA
| | - Robert Melendez
- Social Environment and Health Program, Survey Research Center, Institute for Social Research, 1259University of Michigan, Ann Arbor, MI, USA
| | - Natalie Colabianchi
- Social Environment and Health Program, Survey Research Center, Institute for Social Research, 1259University of Michigan, Ann Arbor, MI, USA.,School of Kinesiology, 1259University of Michigan, Ann Arbor, MI, USA
| | - Suzanne Judd
- School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Philippa J Clarke
- Social Environment and Health Program, Survey Research Center, Institute for Social Research, 1259University of Michigan, Ann Arbor, MI, USA.,Center for Social Epidemiology and Population Health, Department of Epidemiology, School of Public Health, 1259University of Michigan, Ann Arbor, MI, USA
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18
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Weng SS, Chan TC, Hsu PY, Niu SF. Neighbourhood Social Determinants of Health and Geographical Inequalities in Premature Mortality in Taiwan: A Spatiotemporal Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18137091. [PMID: 34281027 PMCID: PMC8297024 DOI: 10.3390/ijerph18137091] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 06/26/2021] [Accepted: 07/01/2021] [Indexed: 12/18/2022]
Abstract
Geographical inequalities in premature mortality and the role of neighbourhood social determinants of health (SDOH) have been less explored. This study aims to assess the geographical inequalities in premature mortality in Taiwan and how neighbourhood SDOH contribute to them and to examine the place-specific associations between neighbourhood SDOH and premature mortality. We used township-level nationwide data for the years 2015 to 2019, including age-standardized premature mortality rates and three upstream SDOH (ethnicity, education, and income). Space-time scan statistics were used to assess the geographical inequality in premature mortality. A geographical and temporal weighted regression was applied to assess spatial heterogeneity and how neighbourhood SDOH contribute to geographic variation in premature mortality. We found geographical inequality in premature mortality to be clearly clustered around mountainous rural and indigenous areas. The association between neighbourhood SDOH and premature mortality was shown to be area-specific. Ethnicity and education could explain nearly 84% variation in premature mortality. After adjusting for neighbourhood SDOH, only a handful of hotspots for premature mortality remained, mainly consisting of rural and indigenous areas in the central-south region of Taiwan. These findings provide empirical evidence for developing locally tailored public health programs for geographical priority areas.
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Affiliation(s)
- Shiue-Shan Weng
- Institute of Public Health, National Yang Ming Chiao Tung University, Taipei 112, Taiwan; (S.-S.W.); (T.-C.C.)
- Department of Nursing, College of Nursing, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
| | - Ta-Chien Chan
- Institute of Public Health, National Yang Ming Chiao Tung University, Taipei 112, Taiwan; (S.-S.W.); (T.-C.C.)
- Research Center for Humanities and Social Sciences, Academia Sinica, Taipei 115, Taiwan
| | - Pei-Ying Hsu
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei 112, Taiwan;
| | - Shu-Fen Niu
- Department of Nursing, Shin Kong Wu Ho-Su Memorial Hospital, Taipei 111, Taiwan
- Department of Nursing, Fu Jen Catholic University, Taipei 242, Taiwan
- Correspondence:
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19
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Schwartz GL, Leifheit KM, Berkman LF, Chen JT, Arcaya MC. Health Selection Into Eviction: Adverse Birth Outcomes and Children's Risk of Eviction Through Age 5 Years. Am J Epidemiol 2021; 190:1260-1269. [PMID: 33454765 PMCID: PMC8484772 DOI: 10.1093/aje/kwab007] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 01/08/2021] [Accepted: 01/11/2021] [Indexed: 01/02/2023] Open
Abstract
Adverse birth outcomes put children at increased risk of poor future health. They also put families under sudden socioeconomic and psychological strain, which has poorly understood consequences. We tested whether infants experiencing an adverse birth outcome-low birthweight or prematurity, as well as lengthy hospital stays-were more likely to be evicted in early childhood, through age 5 years. We analyzed 5,655 observations contributed by 2,115 participants in the Fragile Families and Child Wellbeing Study-a national, randomly sampled cohort of infants born in large US cities between 1998 and 2000-living in rental housing at baseline. We fitted proportional hazards models using piecewise logistic regression, controlling for an array of confounders and applying inverse probability of selection weights. Having been born low birthweight or preterm was associated with a 1.74-fold increase in children's hazard of eviction (95% confidence interval: 1.02, 2.95), and lengthy neonatal hospital stays were independently associated with a relative hazard of 2.50 (95% confidence interval: 1.15, 5.44) compared with uncomplicated births. Given recent findings that unstable housing during pregnancy is associated with adverse birth outcomes, our results suggest eviction and health may be cyclical and co-constitutive. Children experiencing adverse birth outcomes are vulnerable to eviction and require additional supports.
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Affiliation(s)
- Gabriel L Schwartz
- Correspondence to Dr. Gabriel L. Schwartz, Institute for Health Policy Studies, University of California San Francisco, 995 Potrero Avenue, Building 80, Ward 83, San Francisco, CA 94110 (e-mail: )
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Melo J, Ribeiro AI, Aznar S, Pizarro A, Santos MP. Urban Green Spaces, Greenness Exposure and Species Richness in Residential Environments and Relations with Physical Activity and BMI in Portuguese Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6588. [PMID: 34207424 PMCID: PMC8296418 DOI: 10.3390/ijerph18126588] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 06/08/2021] [Accepted: 06/16/2021] [Indexed: 12/20/2022]
Abstract
Environmental factors play an important role in obesity-related behaviors. Evidence indicates significant associations between weight and urban green spaces in adults, but it is not clear whether this relationship applies to adolescents. Therefore, our aim was to determine the associations between urban green spaces, greenness exposure and species richness in residential environments with physical activity and body mass index. Sixty-two adolescents between 12 and 18 years of age answered a self-administered questionnaire, providing information on height, weight, age, sex and home address. Data on socioeconomic deprivation were obtained from the European Index of Deprivation for Small Portuguese Areas. Physical activity levels were assessed using accelerometers. Urban green space counts and the normalized difference vegetation index values were measured using buffers along the roads with distances of 300, 500, 1000 and 1500 m from each participant's residence. To quantify the species richness, the species richness index was used. Linear regression models were fitted to analyze whether urban green spaces, exposure to green spaces and species richness counts for each distance were associated with physical activity and self-reported body mass index. We did not find significant associations between the independent variables and the probability of overweight or obesity. The relationship between environmental variables, adolescents' physical activity and body weight seems to be complex and further studies may contribute to better understanding of the topic.
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Affiliation(s)
- Juliana Melo
- Research Center in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sports, University of Porto (FADEUP), Rua Dr. Placido Costa, 91, 4200-450 Porto, Portugal; (A.P.); (M.P.S.)
| | - Ana Isabel Ribeiro
- EPIUnit, Instituto de Saúde Pública da Universidade do Porto, Rua das Taipas 135, 4050-600 Porto, Portugal;
- Laboratory for Integrative and Translational Research in Population Health (ITR), Rua das Taipas 135, 4050-600 Porto, Portugal
| | - Susana Aznar
- PAFS Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha (UCLM), Avda. Carlos III s/n, 45071 Toledo, Spain;
- Biomedical Research Networking Center on Frailty and Healthy Aging (CIBERFES), 28029 Madrid, Spain
| | - Andreia Pizarro
- Research Center in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sports, University of Porto (FADEUP), Rua Dr. Placido Costa, 91, 4200-450 Porto, Portugal; (A.P.); (M.P.S.)
- Laboratory for Integrative and Translational Research in Population Health (ITR), Rua das Taipas 135, 4050-600 Porto, Portugal
| | - Maria Paula Santos
- Research Center in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sports, University of Porto (FADEUP), Rua Dr. Placido Costa, 91, 4200-450 Porto, Portugal; (A.P.); (M.P.S.)
- EPIUnit, Instituto de Saúde Pública da Universidade do Porto, Rua das Taipas 135, 4050-600 Porto, Portugal;
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de Courrèges A, Occelli F, Muntaner M, Amouyel P, Meirhaeghe A, Dauchet L. The relationship between neighbourhood walkability and cardiovascular risk factors in northern France. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 772:144877. [PMID: 33770881 DOI: 10.1016/j.scitotenv.2020.144877] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 10/30/2020] [Accepted: 12/28/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Although walkability is known to be associated with obesity and hypertension through increased physical activity; data on cardiovascular risk factors (especially in the Europe) are scarce. We assessed the relationship between neighbourhood walkability and cardiometabolic factors (including obesity, hypertension, the blood lipid profile, and serum glycated haemoglobin (HbA1c) levels) among adults living in northern France. METHODS Data were extracted from the ELISABET study database (2011-2013). The participants (aged between 40 and 65) resided in or around the cities of Lille and Dunkirk. For each residential address, we determined a neighbourhood walkability index (using a geographic information system) and the Walk Score®. Multilevel linear and logistic models were used to assess the relationships between neighbourhood walkability on one hand and body mass index (BMI), obesity, blood pressure, hypertension, serum HDLC, LDL-C, triglyceride and HbA1c levels, and physical activity level on the other. RESULTS 3218 participants were included. After adjusting for individual and neighbourhood variables, we found that a higher neighbourhood walkability index was associated with a lower BMI (-0.23 kg.m-2; 95% confidence interval (CI) [-0.44;-0.01] for a one interquartile range (IQR) increment), a lower systolic blood pressure (-1.66 mmHg; 95% CI [-2.46;-0.85] per IQR), a lower prevalence of hypertension (% of increase: -7.12, 95% CI [-13.56;-0.52] per IQR), and a higher prevalence of moderate or high physical activity (% of increase = 6.9; 95% CI [1.2;12.72] per IQR). The walkability index was not significantly associated with other cardiovascular risk factors. Similar results were observed for the Walk Score®. CONCLUSION Our results showed that residence in a more walkable neighbourhood was associated with a lower prevalence of vascular risk factors. Promoting neighbourhood walkability might help to improve the population's cardiovascular health.
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Affiliation(s)
- Antoine de Courrèges
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1167 - RID-AGE - Facteurs de risque et déterminants moléculaires des maladies liées au vieillissement, F-59000 Lille, France.
| | - Florent Occelli
- Univ. Lille, IMT Lille Douai, Univ. Artois, Yncrea Hauts-de-France, ULR 4515 - LGCgE, Laboratoire de Génie Civil et géo-Environnement, F-5activity000 Lille, France.
| | - Manon Muntaner
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1167 - RID-AGE - Facteurs de risque et déterminants moléculaires des maladies liées au vieillissement, F-59000 Lille, France.
| | - Philippe Amouyel
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1167 - RID-AGE - Facteurs de risque et déterminants moléculaires des maladies liées au vieillissement, F-59000 Lille, France.
| | - Aline Meirhaeghe
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1167 - RID-AGE - Facteurs de risque et déterminants moléculaires des maladies liées au vieillissement, F-59000 Lille, France.
| | - Luc Dauchet
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1167 - RID-AGE - Facteurs de risque et déterminants moléculaires des maladies liées au vieillissement, F-59000 Lille, France.
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Associations of the Neighborhood Built Environment With Physical Activity Across Pregnancy. J Phys Act Health 2021; 18:541-547. [PMID: 33863851 DOI: 10.1123/jpah.2020-0510] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 01/29/2021] [Accepted: 02/01/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Several features of the neighborhood built environment have been shown to promote leisure-time physical activity (PA) in the general population, but few studies have examined its impact on PA during pregnancy. METHODS Data were extracted from 8362 Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be cohort participants (2010-2013). Residential address information was linked to 3 built environment characteristics: number of gyms and recreation areas within a 3-km radius of residence and census block level walkability. Self-reported leisure-time PA was measured in each trimester and dichotomized as meeting PA guidelines or not. Relative risks for cross-sectional associations between neighborhood characteristics and meeting PA guidelines were estimated using Poisson regression. RESULTS More gyms and recreation areas were each associated with a greater chance of meeting PA guidelines in models adjusted for sociodemographic characteristics and preexisting conditions. Associations were strongest in the third trimester where each doubling in counts of gyms and recreation areas was associated with 10% (95% confidence interval, 1.07-1.13) and 8% (95% confidence interval, 1.03-1.12), respectively, greater likelihood of meeting PA guidelines. Associations were similar though weaker for walkability. CONCLUSIONS Results from a large, multisite cohort suggest that these built environment characteristics have similar PA-promoting benefits in pregnant women as seen in more general populations.
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Longitudinal exposure assessments of neighbourhood effects in health research: What can be learned from people's residential histories? Health Place 2021; 68:102543. [PMID: 33676125 DOI: 10.1016/j.healthplace.2021.102543] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 02/17/2021] [Accepted: 02/19/2021] [Indexed: 01/10/2023]
Abstract
Health research into neighbourhood effects has generally examined neighbourhoods cross-sectionally, ignoring the fact that neighbourhood exposures might accumulate over people's lives and affect health outcomes later in life. Using longitudinal Dutch register data with complete 15-year residential address histories, we examined whether health effects of neighbourhood socioeconomic characteristics differ between cumulative and current exposures. We illustrated these differences between exposure assessments using suicide mortality among middle-aged adults. All suicides aged 40-64 years between 2012 and 2016 were matched with 10 random controls in a nested case-control design. We measured neighbourhood exposures longitudinally for circular buffers around residential addresses at the current address and through three accumulative measures, each incorporating the residential address history with increasing detail. Covariate-adjusted conditional logistic regressions were used to assess associations between suicide and neighbourhood social fragmentation, population density and unemployment rate. Our results showed that total and male suicide mortality was significantly lower in highly fragmented neighbourhoods when using accumulative exposures, but not when using the current residential address. However, we observed few differences in coefficients between exposures assessments for neighbourhood urbanicity and unemployment rate. None of the neighbourhood characteristics showed evidence that detailed cumulative exposures were a stronger predictor of suicide compared to more crude measures. Our findings provide little evidence that socioeconomic neighbourhood characteristics measured cumulatively along people's residential histories are stronger predictors of suicide mortality than cross-sectional exposures.
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Galán I, Rodríguez-Blázquez C, Simón L, Ortiz C, López-Cuadrado T, Merlo J. Small area influences on the individual unhealthy lifestyle behaviors: A multilevel analysis of discriminatory accuracy. Health Place 2021; 67:102506. [PMID: 33461156 DOI: 10.1016/j.healthplace.2021.102506] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 12/11/2020] [Accepted: 01/05/2021] [Indexed: 11/24/2022]
Abstract
We estimated the discriminatory power of area of residence (census tract) on the prevalence of main risk factors for chronic diseases. Results, based on a sample of 21,007 participants from the 2011-2012 National Health Survey of Spain, show a differential influence of the geosocial environment on the four health risk factors. Accounting for census tracts substantially increases the discriminatory power regarding at-risk alcohol consumption, unbalanced diet, and leisure-time sedentarism but not tobacco consumption. However, the socioeconomic characteristics of the tracts played a minor role. Further research on the specific geosocial contextual variables explaining variability in these risk factors is necessary.
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Affiliation(s)
- Iñaki Galán
- National Centre for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain; Department of Preventive Medicine and Public Health, Autonomous University of Madrid/IdiPAZ, Madrid, Spain.
| | | | - Lorena Simón
- National Centre for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Cristina Ortiz
- National Centre for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Teresa López-Cuadrado
- National Centre for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain; Department of Preventive Medicine and Public Health, Autonomous University of Madrid/IdiPAZ, Madrid, Spain
| | - Juan Merlo
- Research Unit of Social Epidemiology, Faculty of Medicine, Lund University, Malmö, Sweden; Centre for Primary Health Care Research, Region Skåne, Malmö, Sweden
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Bao WW, Yang BY, Zou ZY, Ma J, Jing J, Wang HJ, Luo JY, Zhang X, Luo CY, Wang H, Zhao HP, Pan DH, Gui ZH, Zhang JS, Guo YM, Ma YH, Dong GH, Chen YJ. Greenness surrounding schools and adiposity in children and adolescents: Findings from a national population-based study in China. ENVIRONMENTAL RESEARCH 2021; 192:110289. [PMID: 33027626 DOI: 10.1016/j.envres.2020.110289] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 09/23/2020] [Accepted: 09/28/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Previous studies have indicated that exposure to green space may benefit human health. However, the available evidence concerning the effects of greenness, especially school-based greenness, on pediatric obesity is scarce. OBJECTIVE To explore the association between school-based greenness and adiposity in children and adolescents in China. METHOD We conducted a nationwide cross-sectional study of 56,620 children and adolescents (aged 6-18 years) in seven provinces/municipalities across China. School-based greenness was assessed using satellite-derived Normalized Difference Vegetation Index (NDVI) and Soil Adjusted Vegetation Index (SAVI) within 100-, 500-, and 1000-m circular buffers around each school's address. Generalized linear mixed regression models were used to estimate associations of greenness with BMI z-scores (zBMI), waist circumference, and prevalent overweight/obesity. We also explored the potential mediating role of ambient air pollution and physical activity in the greenness-adiposity associations. RESULT In the adjusted model, an IQR increase in NDVI-1000m was associated with lower zBMI (β: -0.11, 95% confidence interval[CI]: -0.13,-0.09) and waist circumference (β: -0.64, 95%CI: -0.78,-0.50). Consistently, an IQR increase in NDVI-100m, NDVI-500m, NDVI-1000m was associated with 7-20% lower odds of overweight/obesity in the adjusted models. Air pollutants mediated 6.5-29.1% of the association between greenness and zBMI. No significant mediation effect was observed for physical activity. CONCLUSION Higher school-based greenness levels were associated with lower zBMI, waist circumference, and lower odds of overweight and obesity in children and adolescents. Ambient air pollutants may partially mediate the greenness-adiposity associations.
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Affiliation(s)
- Wen-Wen Bao
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Bo-Yi Yang
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Zhi-Yong Zou
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, 100191, China
| | - Jun Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, 100191, China
| | - Jin Jing
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Hai-Jun Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, 100191, China
| | - Jia-You Luo
- Department of Maternal and Child Health, School of Public Health, Central South University, Changsha, 410078, China
| | - Xin Zhang
- School of Public Health, Tianjin Medical University, Tianjin, 300070, China
| | - Chun-Yan Luo
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai Institute of Preventive Medicine, Shanghai, 200336, China
| | - Hong Wang
- Department of Maternal and Child Health, School of Public Health and Management, Chongqing Medical University, Chongqing, 400016, China
| | - Hai-Ping Zhao
- School of Public Health and Management, Ningxia Medical University, Ningxia, 750004, China
| | - De-Hong Pan
- Liaoning Health Supervision Bureau, Shenyang, 110005, China
| | - Zhao-Huan Gui
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Jing-Shu Zhang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Yu-Ming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Ying-Hua Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, 100191, China.
| | - Guang-Hui Dong
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
| | - Ya-Jun Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
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Teo C, Chum A. The effect of neighbourhood cohesion on mental health across sexual orientations: A longitudinal study. Soc Sci Med 2020; 265:113499. [PMID: 33213945 DOI: 10.1016/j.socscimed.2020.113499] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 10/30/2020] [Accepted: 10/31/2020] [Indexed: 11/17/2022]
Abstract
Given the persistent mental health disparities between sexual minorities and the general population, social epidemiological research should address this disparity by investigating the differential impact of neighbourhood social environments across sexual orientations. There is growing evidence that neighbourhood cohesion, conceptualized as a sense of belonging and social connection, is an important social determinant of mental health in the general population, but little is known about its impact across sexual orientations. Using data from the UK household longitudinal study (2009-2018) including waves 1, 3, 6, and 9 ( n = 52,903), this paper examined the longitudinal relationship between neighbourhood cohesion and mental health (using GHQ-12) across sexual orientations. A fixed-effect regression approach was taken to model the within-person change over time in GHQ predicted by neighbourhood cohesion with disaggregated analyses by gender and sexual orientation. Across all sexual orientations and genders, individuals who experienced an increase in neighbourhood cohesion also saw an improvement in their mental health over time. Moreover, the effect of neighbourhood cohesion on mental health over time differed by sexual orientation. Each 1-point increase in neighbourhood cohesion (on a 5-point scale) lead to mental health improvements of -0.8 GHQ score (95%CI -0.89 to -0.71) for heterosexual males at the lowest end, and up to -1.71 GHQ score (95%CI -2.31 to - 1.11) for homosexual men at the highest end. Given that the study demonstrates notable differences in the effects of neighbourhood social environment across gender and sexual orientations, this points to the need to consider sexual orientation (along with gender) as a key modifier in research involving neighbourhood effects. Future studies should evaluate the effectiveness of specific policies aimed at improving neighbourhood social environment for sexual minorities to help close mental health disparities.
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Affiliation(s)
- Celine Teo
- Brock University, 1812 Sir Isaac Brock Way, St. Catharines, Ontario, L2S 3A1, Canada.
| | - Antony Chum
- Brock University, 1812 Sir Isaac Brock Way, St. Catharines, Ontario, L2S 3A1, Canada; Unity Health Toronto, 30 Bond Street, Toronto, Ontario, M5B 1W8, Canada.
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Cardiometabolic Profiles and Change in Neighborhood Food and Built Environment Among Older Adults: A Natural Experiment. Epidemiology 2020; 31:758-767. [PMID: 33003147 DOI: 10.1097/ede.0000000000001243] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The association between neighborhood environment and health may be biased due to confounding by residential self-selection. The displacement of disaster victims can act as a natural experiment that exposes residents to neighborhood environments they did not select, allowing for the study of neighborhood effects on health. METHODS We leveraged data from a cohort of older adults 65 years of age or older living in Iwanuma, Japan, located 80 km west of the 2011 Great East Japan Earthquake and Tsunami. Surveys were conducted 7 months before the disaster, as well as 2.5 and 5.5 years afterward, and linked with medical records. We classified each individual's type of exposure to neighborhood environment based on proximity to local food and recreation destinations and walkability. RESULTS Fixed-effect models indicated that change in the exposure type from low to high urban density was associated with increased body mass index (0.46 kg/m; 95% confidence interval [CI] = 0.20, 0.73), waist circumference (1.8 cm; 95% CI = 0.56, 3.0), low-density lipoprotein cholesterol (11 mg/dl; 95% CI = 5.0, 17), and decreased high-density lipoprotein cholesterol (-3.1 mg/dl; 95% CI = -5.0, -1.3). We observed similar trends when we analyzed only the individuals who experienced postdisaster relocation to temporary homes. CONCLUSIONS Increased proximity to food outlets was simultaneously correlated with greater walkability and accessibility to recreational destinations; however, any protective association of physical activity-promoting built environment appeared to be offset by proximity to unhealthy food outlets, especially fast-food restaurants and bars.
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Helbich M, O'Connor RC, Nieuwenhuijsen M, Hagedoorn P. Greenery exposure and suicide mortality later in life: A longitudinal register-based case-control study. ENVIRONMENT INTERNATIONAL 2020; 143:105982. [PMID: 32712421 DOI: 10.1016/j.envint.2020.105982] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 06/24/2020] [Accepted: 07/12/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Exposure to residential greenery accumulates over people's lifetimes, and possibly has a protective association with suicide later in life. OBJECTIVES To examine the associations between suicide mortality and long-term residential greenery exposure in male and female adults. METHODS Our population-based nested case-control study used longitudinally georeferenced Dutch register data. Suicide cases aged 18-64 years between 2007 and 2016 were matched by gender, age, and date of suicide to 10 random controls. We measured long-term greenery exposure along people's 10-year residential address histories through longitudinal normalized difference vegetation indices (NDVI) from Landsat satellite imagery between 1997 and 2016. We assigned accumulated greenery exposures, weighted by people's exposure duration, within 300, 600, and 1,000 m concentric buffers around home addresses. To assess associations between suicide and greenery, we estimated gender-specific conditional logistic regressions without and with adjustment for individual-level and area-level confounders. Stratified models were fitted for areas with a high/low level of urbanicity and movers/non-movers. RESULTS Our study population consisted of 9,757 suicide cases and 95,641 controls. In our models adjusted for age, gender, and date of suicide, the odds ratios decreased significantly with higher quartiles of accumulated NDVI scores. NDVI associations were attenuated and did not remain significant after adjustment for socioeconomics, urbanicity, air pollution, social fragmentation, etc. for either males or females. For females, but not males, our model with 300 m buffers for areas with a low level of urbanicity showed a significant suicide risk reduction with increasing levels of NDVI. Individual risk factors (e.g., lack of labor market participation) outweighed the contribution of greenery. CONCLUSION We found limited evidence that long-term greenery exposure over people's lifetimes contributes to resilience against suicide mortality. Ensuring exposure to greenery may contribute to suicide prevention for specific population groups, but the effectiveness of such exposure should not be overstated.
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Affiliation(s)
- Marco Helbich
- Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Utrecht, the Netherlands.
| | - Rory C O'Connor
- Suicidal Behaviour Research Laboratory, Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland, United Kingdom.
| | | | - Paulien Hagedoorn
- Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Utrecht, the Netherlands.
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Mason KE, Pearce N, Cummins S. Do neighbourhood characteristics act together to influence BMI? A cross-sectional study of urban parks and takeaway/fast-food stores as modifiers of the effect of physical activity facilities. Soc Sci Med 2020; 261:113242. [DOI: 10.1016/j.socscimed.2020.113242] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 05/12/2020] [Accepted: 07/20/2020] [Indexed: 10/23/2022]
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Schröders J, Dewi FST, Nilsson M, Nichter M, Sebastian MS. Effects of social network diversity in the disablement process: a comparison of causal inference methods and an outcome-wide approach to the Indonesian Family Life Surveys, 2007-2015. Int J Equity Health 2020; 19:128. [PMID: 32736632 PMCID: PMC7393827 DOI: 10.1186/s12939-020-01238-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 07/14/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Social networks (SN) have been proven to be instrumental for healthy aging and function as important safety nets, particular for older adults in low and middle-income countries (LMICs). Despite the importance of interpreting health outcomes in terms of SN, in many LMICs - including Indonesia - epidemiological studies and policy responses on the health effects of SN for aging populations are still uncommon. Using outcome-wide multi-method approaches to longitudinal panel data, this study aims to outline more clearly the role of SN diversity in the aging process in Indonesia. We explore whether and to what degree there is an association of SN diversity with adult health outcomes and investigate potential gender differences, heterogeneous treatment effects, and effect gradients along disablement processes. METHODS Data came from the fourth and fifth waves of the Indonesian Family Life Survey fielded in 2007-08 and 2014-15. The analytic sample consisted of 3060 adults aged 50+ years. The primary exposure variable was the diversity of respondents' SN at baseline. This was measured through a social network index (SNI), conjoining information about household size together with a range of social ties with whom respondents had active contact across six different types of role relationships. Guided by the disablement process model, a battery of 19 outcomes (8 pathologies, 5 impairments, 4 functional limitations, 2 disabilities) were included into analyses. Evidence for causal effects of SN diversity on health was evaluated using outcome-wide multivariable regression adjustment (RA), propensity score matching (PSM), and instrumental variable (IV) analyses. RESULTS At baseline, 60% of respondents had a low SNI. Results from the RA and PSM models showed greatest concordance and that among women a diverse SN was positively associated with pulmonary outcomes and upper and lower body functions. Both men and women with a high SNI reported less limitations in performing activities of daily living (ADL) and instrumental ADL (IADL) tasks. A high SNI was negatively associated with C-reactive protein levels in women. The IV analyses yielded positive associations with cognitive functions for both men and women. CONCLUSIONS Diverse SN confer a wide range of strong and heterogeneous long-term health effects, particularly for older women. In settings with limited formal welfare protection, intervening in the SN of older adults and safeguarding their access to diverse networks can be an investment in population health, with manifold implications for health and public policy.
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Affiliation(s)
- Julia Schröders
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden.
| | - Fatwa Sari Tetra Dewi
- Department of Health Behaviour, Environment and Social Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Maria Nilsson
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Mark Nichter
- School of Anthropology, University of Arizona, Tucson, AZ, USA
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Jacobson M, Crossa A, Liu SY, Locke S, Poirot E, Stein C, Lim S. Residential mobility and chronic disease among World Trade Center Health Registry enrollees, 2004-2016. Health Place 2020; 61:102270. [PMID: 32329735 DOI: 10.1016/j.healthplace.2019.102270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 11/04/2019] [Accepted: 12/09/2019] [Indexed: 11/30/2022]
Abstract
Residential mobility is hypothesized to impact health through changes to the built environment and disruptions in social networks, and may vary by neighborhood deprivation exposure. However, there are few longitudinal investigations of residential mobility in relation to health outcomes. This study examined enrollees from the World Trade Center Health Registry, a longitudinal cohort of first responders and community members in lower Manhattan on September 11, 2001. Enrollees who completed ≥2 health surveys between 2004 and 2016 and did not have diabetes (N = 44,089) or hypertension (N = 35,065) at baseline (i.e., 2004) were included. Using geocoded annual home addresses, residential mobility was examined using two indicators: moving frequency and displacement. Moving frequency was defined as the number of times someone was recorded as living in a different neighborhood; displacement as any moving to a more disadvantaged neighborhood. We fit adjusted Cox proportional hazards models with time-dependent exposures (moving frequency and displacement) and covariates to evaluate associations with incident diabetes and hypertension. From 2004 to 2016, the majority of enrollees never moved (54.5%); 6.5% moved ≥3 times. Those who moved ≥3 times had a similar hazard of diabetes (hazard ratio (HR) = 0.78; 95% Confidence Interval (CI): 0.40, 1.53) and hypertension (HR = 0.99; 95% CI: 0.68, 1.43) compared with those who never moved. Similarly, displacement was not associated with diabetes or hypertension. Residential mobility was not associated with diabetes or hypertension among a cohort of primarily urban-dwelling adults.
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Affiliation(s)
- Melanie Jacobson
- New York City Department of Health and Mental Hygiene, Division of Epidemiology, World Trade Center Health Registry, NY, NY, USA; New York University School of Medicine, Department of Pediatrics, Division of Environmental Pediatrics, New York, NY 10016, USA.
| | - Aldo Crossa
- New York City Department of Health and Mental Hygiene, Division of Epidemiology, Bureau of Epidemiology Services, Long Island City, NY, USA
| | - Sze Yan Liu
- New York City Department of Health and Mental Hygiene, Division of Epidemiology, Bureau of Epidemiology Services, Long Island City, NY, USA
| | - Sean Locke
- New York City Department of Health and Mental Hygiene, Division of Epidemiology, World Trade Center Health Registry, NY, NY, USA
| | - Eugenie Poirot
- New York City Department of Health and Mental Hygiene, Division of Epidemiology, Bureau of Epidemiology Services, Long Island City, NY, USA
| | - Cheryl Stein
- New York City Department of Health and Mental Hygiene, Division of Epidemiology, World Trade Center Health Registry, NY, NY, USA
| | - Sungwoo Lim
- New York City Department of Health and Mental Hygiene, Division of Epidemiology, Bureau of Epidemiology Services, Long Island City, NY, USA
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The association between neighborhood greenness and incidence of lethal prostate cancer: A prospective cohort study. Environ Epidemiol 2020; 4:e091. [PMID: 32656487 PMCID: PMC7319229 DOI: 10.1097/ee9.0000000000000091] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 03/04/2020] [Indexed: 01/21/2023] Open
Abstract
Supplemental Digital Content is available in the text. Growing evidence suggests that neighborhood contextual environment could influence risk factors and, therefore, incidence of lethal prostate cancer. We studied the association between neighborhood greenness and lethal prostate cancer incidence and assessed mediation by vigorous physical activity.
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Traoré M, Vuillermoz C, Chauvin P, Deguen S. Influence of Individual and Contextual Perceptions and of Multiple Neighborhoods on Depression. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E1958. [PMID: 32192057 PMCID: PMC7143570 DOI: 10.3390/ijerph17061958] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 03/02/2020] [Accepted: 03/09/2020] [Indexed: 11/16/2022]
Abstract
The risk of depression is related to multiple various determinants. The consideration of multiple neighborhoods daily frequented by individuals has led to increased interest in analyzing socio-territorial inequalities in health. In this context, the main objective of this study was (i) to describe and analyze the spatial distribution of depression and (ii) to investigate the role of the perception of the different frequented spaces in the risk of depression in the overall population and in the population stratified by gender. Data were extracted from the 2010 SIRS (a French acronym for "health, inequalities and social ruptures") cohort survey. In addition to the classic individual characteristics, the participants reported their residential neighborhoods, their workplace neighborhoods and a third one: a daily frequented neighborhood. A new approach was developed to simultaneously consider the three reported neighborhoods to better quantify the level of neighborhood socioeconomic deprivation. Multiple simple and cross-classified multilevel logistic regression models were used to analyze the data. Depression was reported more frequently in low-income (OR = 1.89; CI = [1.07-3.35]) or middle-income (OR = 1.91; CI = [1.09-3.36]) neighborhoods and those with cumulative poverty (OR = 1.64; CI = [1.10-2.45]). In conclusion, a cumulative exposure score, such as the one presented here, may be an appropriate innovative approach to analyzing their effects in the investigation of socio-territorial inequalities in health.
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Affiliation(s)
- Médicoulé Traoré
- INSERM, Sorbonne Université, Institut Pierre Louis d’Épidémiologie et de Santé Publique, IPLESP, Department of social epidemiology, F75012 Paris, France; (C.V.); (P.C.); (S.D.)
| | - Cécile Vuillermoz
- INSERM, Sorbonne Université, Institut Pierre Louis d’Épidémiologie et de Santé Publique, IPLESP, Department of social epidemiology, F75012 Paris, France; (C.V.); (P.C.); (S.D.)
| | - Pierre Chauvin
- INSERM, Sorbonne Université, Institut Pierre Louis d’Épidémiologie et de Santé Publique, IPLESP, Department of social epidemiology, F75012 Paris, France; (C.V.); (P.C.); (S.D.)
| | - Séverine Deguen
- INSERM, Sorbonne Université, Institut Pierre Louis d’Épidémiologie et de Santé Publique, IPLESP, Department of social epidemiology, F75012 Paris, France; (C.V.); (P.C.); (S.D.)
- EHESP School of Public Health, F35043 Rennes, France
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Schnake-Mahl A, Sommers BD, Subramanian SV, Waters MC, Arcaya M. Effects of gentrification on health status after Hurricane Katrina. Health Place 2020; 61:102237. [PMID: 31740125 PMCID: PMC7183421 DOI: 10.1016/j.healthplace.2019.102237] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 10/09/2019] [Accepted: 10/21/2019] [Indexed: 11/19/2022]
Abstract
Despite substantial debate about the impacts of gentrification on cities, neighborhoods, and their residents, there is limited evidence to demonstrate the implications of gentrification for health. We examine the impacts of gentrification on several health measures using a unique individual-level longitudinal data set. We employ data from the Resilience in Survivors of Hurricane Katrina (RISK) project, a study of low-income parents, predominantly non-Hispanic Black single mothers, who participated in a New Orleans-based study before and after Hurricane Katrina. After Katrina, all participants were displaced, at least temporarily, from New Orleans, and had little or no control over neighborhood placement immediately following the storm. This near-random displacement after Katrina created a natural experiment. We employ a quasi-experimental intent to treat design to assess the causal effects of gentrification on health in the RISK population. We do not find evidence of significant main effects of being displaced to a gentrified neighborhood on BMI, self-rated health, or psychological distress. The analysis employs a quasi-experimental design and has several additional unique features--homogeneous population, limited selection bias, and longitudinal data collection-- that improve our ability to draw causal conclusions about the relationship between gentrification and health. However, the unique context of displacement by natural disaster may limit the generalizability of our findings to other circumstances or residents experiencing gentrification.
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Affiliation(s)
- Alina Schnake-Mahl
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA.
| | - Benjamin D Sommers
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA; Brigham and Women's Hospital, 75 Francis St, Boston, MA, 02115, USA
| | - S V Subramanian
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA; Harvard Center for Population and Development Studies, Harvard University, 9 Bow St, Cambridge, MA, 02138, USA
| | - Mary C Waters
- Department of Sociology, Harvard University, 33 Kirkland St. Cambridge, MA, 02138, USA
| | - Mariana Arcaya
- Department of Urban Studies and Planning, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA, 02139, USA
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Nichani V, Vena JE, Friedenreich CM, Christie C, McCormack GR. A population-based study of the associations between neighbourhood walkability and different types of physical activity in Canadian men and women. Prev Med 2019; 129:105864. [PMID: 31654728 DOI: 10.1016/j.ypmed.2019.105864] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 10/01/2019] [Accepted: 10/11/2019] [Indexed: 11/19/2022]
Abstract
Few Canadian studies have examined whether or not associations between neighbourhood walkability and physical activity differ by sex. We estimated associations between perceived neighbourhood walkability and physical activity among Canadian men and women. This study included cross-sectional survey data from participants in 'Alberta's Tomorrow Project' (Canada; n = 14,078), a longitudinal cohort study. The survey included socio-demographic items as well as the International Physical Activity Questionnaire (IPAQ) and the abbreviated Neighbourhood Environment Walkability Scale (NEWS-A), which captured perceived neighbourhood built characteristics. We computed subscale and overall walkability scores from NEWS-A responses. Covariate-adjusted generalized linear models estimated the associations of participation (≥10 min/week) and minutes of different types of physical activity, including transportation walking (TW), leisure walking (LW), moderate-intensity physical activity (MPA), and vigorous-intensity physical activity (VPA) with walkability scores. Walkability was positively associated with participation in TW, LW, MPA and VPA and minutes of TW, LW, and VPA. Among men, a negative association was found between street connectivity and VPA participation. Additionally, crime safety was negatively associated with VPA minutes among men. Among women, pedestrian infrastructure was positively associated with LW participation and overall walkability was positively associated with VPA minutes. Notably, overall walkability was positively associated with LW participation among men and women. Different perceived neighbourhood walkability characteristics might be associated with participation and time spent in different types of physical activity among men and women living in Alberta. Interventions designed to modify perceptions of neighbourhood walkability might influence initiation or maintenance of different types of physical activity.
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Affiliation(s)
- Vikram Nichani
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, TRW 3rd floor, 3280 Hospital Drive NW, Calgary, Alberta T2N 4Z6, Canada.
| | - Jennifer E Vena
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, TRW 3rd floor, 3280 Hospital Drive NW, Calgary, Alberta T2N 4Z6, Canada; CancerControl Alberta, Alberta Health Services, Richmond Road Diagnostic and Treatment Centre, 1820 Richmond Road SW, Calgary, Alberta T2T 5C7, Canada.
| | - Christine M Friedenreich
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, 2210 2nd St SW, Calgary, Alberta T2S 3C3, Canada; Department of Community Health Sciences and Department of Oncology, Cumming School of Medicine, University of Calgary, TRW 3rd floor, 3280 Hospital Drive NW, Calgary, Alberta T2N 4Z6, Canada.
| | - Chelsea Christie
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, TRW 3rd floor, 3280 Hospital Drive NW, Calgary, Alberta T2N 4Z6, Canada.
| | - Gavin R McCormack
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, TRW 3rd floor, 3280 Hospital Drive NW, Calgary, Alberta T2N 4Z6, Canada.
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Jia P, Lakerveld J, Wu J, Stein A, Root ED, Sabel CE, Vermeulen R, Remais JV, Chen X, Brownson RC, Amer S, Xiao Q, Wang L, Verschuren WMM, Wu T, Wang Y, James P. Top 10 Research Priorities in Spatial Lifecourse Epidemiology. ENVIRONMENTAL HEALTH PERSPECTIVES 2019; 127:74501. [PMID: 31271296 PMCID: PMC6791465 DOI: 10.1289/ehp4868] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 06/07/2019] [Accepted: 06/14/2019] [Indexed: 05/21/2023]
Abstract
The International Initiative on Spatial Lifecourse Epidemiology (ISLE) convened its first International Symposium on Lifecourse Epidemiology and Spatial Science at the Lorentz Center in Leiden, Netherlands, 16–20 July 2018. Its aim was to further an emerging transdisciplinary field: Spatial Lifecourse Epidemiology. This field draws from a broad perspective of scientific disciplines including lifecourse epidemiology, environmental epidemiology, community health, spatial science, health geography, biostatistics, spatial statistics, environmental science, climate change, exposure science, health economics, evidence-based public health, and landscape ecology. The participants, spanning 30 institutions in 10 countries, sought to identify the key issues and research priorities in spatial lifecourse epidemiology. The results published here are a synthesis of the top 10 list that emerged out of the discussion by a panel of leading experts, reflecting a set of grand challenges for spatial lifecourse epidemiology in the coming years. https://doi.org/10.1289/EHP4868.
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Affiliation(s)
- Peng Jia
- GeoHealth Initiative, Department of Earth Observation Science, Faculty of Geo-information Science and Earth Observation (ITC), University of Twente, Enschede, Netherlands
- International Initiative on Spatial Lifecourse Epidemiology (ISLE)
| | - Jeroen Lakerveld
- International Initiative on Spatial Lifecourse Epidemiology (ISLE)
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
- Global Geo Health Data Center, Utrecht University, Utrecht, Netherlands
| | - Jianguo Wu
- School of Life Sciences, Arizona State University, Tempe, Arizona, USA
- School of Sustainability and Julie A. Wrigley Global Institute of Sustainability, Arizona State University, Tempe, Arizona, USA
- Center for Human-Environment System Sustainability, State Key Laboratory of Earth Surface Processes and Resource Ecology, Beijing Normal University, Beijing, China
| | - Alfred Stein
- GeoHealth Initiative, Department of Earth Observation Science, Faculty of Geo-information Science and Earth Observation (ITC), University of Twente, Enschede, Netherlands
- International Initiative on Spatial Lifecourse Epidemiology (ISLE)
| | - Elisabeth D. Root
- Department of Geography, Ohio State University, Columbus, Ohio, USA
- Division of Epidemiology, Ohio State University, Columbus, Ohio, USA
| | - Clive E. Sabel
- Department of Environmental Science, Aarhus University, Aarhus, Denmark
- Big Data Center for Environment and Health, Aarhus University, Aarhus, Denmark
| | - Roel Vermeulen
- International Initiative on Spatial Lifecourse Epidemiology (ISLE)
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
| | - Justin V. Remais
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, California, USA
| | - Xi Chen
- International Initiative on Spatial Lifecourse Epidemiology (ISLE)
- Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut, USA
- Yale Climate Change and Health Initiative, New Haven, Connecticut, USA
| | - Ross C. Brownson
- Prevention Research Center in St. Louis, Brown School at Washington University in St. Louis, St. Louis, Missouri, USA
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, Missouri, USA
- Alvin J. Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, Missouri, USA
| | - Sherif Amer
- International Initiative on Spatial Lifecourse Epidemiology (ISLE)
- Department of Urban and Regional Planning and Geo-information Management, ITC, University of Twente, Enschede, Netherlands
| | - Qian Xiao
- International Initiative on Spatial Lifecourse Epidemiology (ISLE)
- Department of Health and Human Physiology, University of Iowa, Iowa City, Iowa, USA
- Department of Epidemiology, University of Iowa, Iowa City, Iowa, USA
| | - Limin Wang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - W. M. Monique Verschuren
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Tong Wu
- International Initiative on Spatial Lifecourse Epidemiology (ISLE)
- Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, China
| | - Youfa Wang
- International Initiative on Spatial Lifecourse Epidemiology (ISLE)
- Fisher Institute of Health and Well-Being, College of Health, Ball State University, Muncie, Indiana, USA
- Department of Nutrition and Health Sciences, College of Health, Ball State University, Muncie, Indiana, USA
- Global Health Institute; Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Peter James
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA
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Drewnowski A, Arterburn D, Zane J, Aggarwal A, Gupta S, Hurvitz P, Moudon A, Bobb J, Cook A, Lozano P, Rosenberg D. The Moving to Health (M2H) approach to natural experiment research: A paradigm shift for studies on built environment and health. SSM Popul Health 2019; 7:100345. [PMID: 30656207 PMCID: PMC6329830 DOI: 10.1016/j.ssmph.2018.100345] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 12/22/2018] [Accepted: 12/26/2018] [Indexed: 12/02/2022] Open
Abstract
Improving the built environment (BE) is viewed as one strategy to improve community diets and health. The present goal is to review the literature on the effects of BE on health, highlight its limitations, and explore the growing use of natural experiments in BE research, such as the advent of new supermarkets, revitalized parks, or new transportation systems. Based on recent studies on movers, a paradigm shift in built-environment health research may be imminent. Following the classic Moving to Opportunity study in the US, the present Moving to Health (M2H) strategy takes advantage of the fact that changing residential location can entail overnight changes in multiple BE variables. The necessary conditions for applying the M2H strategy to Geographic Information Systems (GIS) databases and to large longitudinal cohorts are outlined below. Also outlined are significant limitations of this approach, including the use of electronic medical records in lieu of survey data. The key research question is whether documented changes in BE exposure can be linked to changes in health outcomes in a causal manner. The use of geo-localized clinical information from regional health care systems should permit new insights into the social and environmental determinants of health.
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Affiliation(s)
- A. Drewnowski
- Center for Public Health Nutrition, 305 Raitt Hall, #353410, University of Washington, Seattle, WA 98195-03410, USA
| | - D. Arterburn
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave. Suite 1600, Seattle, WA 98101, USA
| | - J. Zane
- Center for Public Health Nutrition, 305 Raitt Hall, #353410, University of Washington, Seattle, WA 98195-03410, USA
| | - A. Aggarwal
- Center for Public Health Nutrition, 305 Raitt Hall, #353410, University of Washington, Seattle, WA 98195-03410, USA
| | - S. Gupta
- Center for Public Health Nutrition, 305 Raitt Hall, #353410, University of Washington, Seattle, WA 98195-03410, USA
| | - P.M. Hurvitz
- Urban Form Lab, Department of Urban Design and Planning, College of Built Environments, University of Washington, 1107 NE 45th Street, Suite 535, Seattle, WA 98195-4802, USA
| | - A.V. Moudon
- Urban Form Lab, Department of Urban Design and Planning, College of Built Environments, University of Washington, 1107 NE 45th Street, Suite 535, Seattle, WA 98195-4802, USA
| | - J. Bobb
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave. Suite 1600, Seattle, WA 98101, USA
| | - A. Cook
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave. Suite 1600, Seattle, WA 98101, USA
| | - P. Lozano
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave. Suite 1600, Seattle, WA 98101, USA
| | - D. Rosenberg
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave. Suite 1600, Seattle, WA 98101, USA
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Abstract
Purpose of review Limited physical activity (PA) and obesity are two primary risk factors for cardiovascular disease (CVD). Within a socio-ecological framework, neighborhood social environment may play a key role in influencing PA and obesity. However, the mechanisms underlying this relationship remain ambiguous. Our goals in this review are: (1) to summarize findings from the recent studies on neighborhood social environment in relation to PA and obesity as CVD risk factors, and (2) to briefly describe several innovative approaches to assessing neighborhood social environment. Recent findings Almost all recent studies assessed neighborhood social environment around residential areas. There were consistent associations between neighborhood social environment and PA and obesity, with some exceptions (indicating null associations or paradoxical associations). However, a focus on residential social environment may limit results because these studies did not account for any exposures occurring away from individuals' homes. Additionally, the majority of studies utilized a cross-sectional design, which limits our ability to make inferences regarding the causality of the association between social environment and PA or obesity as CV risk factors. Summary The majority of the studies on neighborhood social environment characterized factors around residential areas and assessed participant activity via self-reported surveys. Future research should leverage tools to account for the spatial mismatch between environmental exposures and outcomes by using global positioning systems, ecological momentary assessments, virtual neighborhood audits, and simulation modeling. These approaches can overcome major limitations by tracking individuals' daily activity and real-time perceptions of neighborhood social environments linked to CVD events.
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Orstad SL, McDonough MH, James P, Klenosky DB, Laden F, Mattson M, Troped PJ. Neighborhood walkability and physical activity among older women: Tests of mediation by environmental perceptions and moderation by depressive symptoms. Prev Med 2018; 116:60-67. [PMID: 30092314 PMCID: PMC6260982 DOI: 10.1016/j.ypmed.2018.08.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 07/06/2018] [Accepted: 08/04/2018] [Indexed: 11/16/2022]
Abstract
Features that enhance neighborhood walkability (higher population density, street connectivity and access to destinations) are associated with higher levels of physical activity among older adults. The perceived neighborhood environment appears to mediate associations between the objective built environment and physical activity. The role of depressed mood in these associations is poorly understood. We examined the degree to which depressive symptoms moderated indirect associations between the objective neighborhood environment and physical activity via the perceived neighborhood environment in older women. We analyzed data on 60,133 women (mean age = 73.1 ± 6.7 years) in the U.S. Nurses' Health Study cohort who completed the 2008 questionnaire. Self-reported measures included the Geriatric Depression Scale, perceived presence of recreational facilities, retail destinations, sidewalks, and crime, and participation in recreational physical activity and neighborhood walking. We created an objective walkability index by summing z-scores of intersection and facility counts within 1200-meter residential network buffers and census tract-level population density. We used multiple regression with bootstrap-generated 95% bias-corrected confidence intervals (BC CIs) to test for mediation and moderated mediation. Objective walkability was associated with 1.99 times greater odds of neighborhood walking (95% BC CI = 1.92, 2.06) and 1.38 times greater odds of meeting physical activity recommendations (95% BC CI = 1.34, 1.43) via the perceived neighborhood environment. These indirect associations were weaker among women with higher depressive symptom scores. Positive associations between objective neighborhood walkability and physical activities such as walking among older women may be strengthened with a reduction in their depressive symptoms.
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Affiliation(s)
- Stephanie L Orstad
- Division of General Internal Medicine and Clinical Innovation, New York University School of Medicine, 462 1st Avenue, New York, NY 10016, USA.
| | - Meghan H McDonough
- Faculty of Kinesiology, University of Calgary, KNB 250, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada.
| | - Peter James
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 655 Longwood Avenue, Boston, MA 02115, USA.
| | - David B Klenosky
- Department of Health and Kinesiology, Purdue University, Lambert Fieldhouse, 800 West Stadium Avenue, West Lafayette, IN 47907, USA.
| | - Francine Laden
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 655 Longwood Avenue, Boston, MA 02115, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, 401 Park Drive, 4th Floor West, Boston, MA 02215, USA; Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, 401 Park Drive, 3rd Floor West, Boston, MA 02215, USA.
| | - Marifran Mattson
- Brian Lamb School of Communication, Purdue University, Beering Hall of Liberal Arts and Education, 100 North University Street, West Lafayette, IN 47907, USA.
| | - Philip J Troped
- Department of Exercise and Health Sciences, University of Massachusetts Boston, 100 Morrissey Boulevard, Boston, MA 02125, USA.
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Yang TC, South SJ. Neighborhood effects on body mass: Temporal and spatial dimensions. Soc Sci Med 2018; 217:45-54. [PMID: 30292876 DOI: 10.1016/j.socscimed.2018.09.055] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Revised: 08/21/2018] [Accepted: 09/25/2018] [Indexed: 12/31/2022]
Abstract
Research examining the effects of neighborhood characteristics on obesity and excess body weight has generally neglected the influence of both life-course exposure and geographically-proximate communities. Using data on 9357 respondents to the National Longitudinal Survey of Youth, 1979 Cohort, in conjunction with tract-level data from the 1980-2010 U.S. censuses, this study examines how black, Hispanic, and white individuals' cumulative exposure to varying levels of neighborhood poverty and co-ethnic density from their mid-teens through mid-adulthood, as well as the levels of poverty and co-ethnic density in nearby, or "extralocal," neighborhoods, are associated with their body mass index (BMI). Fixed-effect regression models show that, among Hispanics and whites, cumulative exposure to co-ethnic neighbors is a stronger positive predictor of BMI than the co-ethnic density of the immediate, point-in-time neighborhood. Among whites, cumulative exposure to neighborhood poverty is a stronger positive predictor of BMI than is the poverty rate of the current neighborhood of residence. And among both blacks and whites, the distance-weighted poverty rate of extralocal neighborhoods is significantly and inversely related to BMI, suggesting that relative affluence in nearby neighborhoods engenders relative deprivation among residents of the focal neighborhood, leading to increased BMI. Overall, the results suggest that greater attention to both the temporal and spatial dimensions of neighborhood effects has the potential to enhance our understanding of how neighborhoods affect obesity and related health outcomes.
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Affiliation(s)
- Tse-Chuan Yang
- Department of Sociology, Center for Social and Demographic Analysis, University at Albany, SUNY, 1400 Washington Avenue, Albany, NY, 12222, USA.
| | - Scott J South
- Department of Sociology, Center for Social and Demographic Analysis, University at Albany, SUNY, 1400 Washington Avenue, Albany, NY, 12222, USA.
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Moore THM, Kesten JM, López-López JA, Ijaz S, McAleenan A, Richards A, Gray S, Savović J, Audrey S. The effects of changes to the built environment on the mental health and well-being of adults: Systematic review. Health Place 2018; 53:237-257. [PMID: 30196042 DOI: 10.1016/j.healthplace.2018.07.012] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 06/01/2018] [Accepted: 07/17/2018] [Indexed: 10/28/2022]
Abstract
There is increasing interest in the influence of place on health, and the need to distinguish between environmental and individual level factors. For environmental-level factors, current evidence tends to show associations through cross-sectional and uncontrolled longitudinal analyses rather than through more robust study designs that can provide stronger causal evidence. We restricted this systematic review to randomised (or cluster) randomised controlled trials and controlled before-and-after studies of changes to the built environment. Date of search was December 2016. We identified 14 studies. No evidence was found of an effect on mental health from 'urban regeneration' and 'improving green infrastructure' studies. Beneficial effects on quality-of-life outcomes from 'improving green infrastructure' were found in two studies. One 'improving green infrastructure' study reported an improvement in social isolation. Risk-of-bias assessment indicated robust data from only four studies. Overall, evidence for the impact of built environment interventions on mental health and quality-of-life is weak. Future research requires more robust study designs and interdisciplinary research involving public health, planning and urban design experts.
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Affiliation(s)
- T H M Moore
- The National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West) at University Hospitals Bristol NHS Foundation Trust, UK; Bristol Medical School, University of Bristol, 39 Whatley Road, Bristol BS8 2PS, UK.
| | - J M Kesten
- The National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West) at University Hospitals Bristol NHS Foundation Trust, UK; The National Institute for Health Research Health Protection Research Unit in Evaluation of Interventions, Bristol Medical School, University of Bristol, UK
| | - J A López-López
- Bristol Medical School, University of Bristol, 39 Whatley Road, Bristol BS8 2PS, UK
| | - S Ijaz
- The National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West) at University Hospitals Bristol NHS Foundation Trust, UK; Bristol Medical School, University of Bristol, 39 Whatley Road, Bristol BS8 2PS, UK
| | - A McAleenan
- Bristol Medical School, University of Bristol, 39 Whatley Road, Bristol BS8 2PS, UK
| | - A Richards
- The National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West) at University Hospitals Bristol NHS Foundation Trust, UK
| | - S Gray
- Department of Health and Applied Social Science, University of the West of England, Bristol BS16 1QY, UK
| | - J Savović
- The National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West) at University Hospitals Bristol NHS Foundation Trust, UK; Bristol Medical School, University of Bristol, 39 Whatley Road, Bristol BS8 2PS, UK
| | - S Audrey
- Bristol Medical School, University of Bristol, 39 Whatley Road, Bristol BS8 2PS, UK
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Relationships between the neighborhood environment and depression in older adults: a systematic review and meta-analysis. Int Psychogeriatr 2018; 30:1153-1176. [PMID: 29223174 DOI: 10.1017/s104161021700271x] [Citation(s) in RCA: 97] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
UNLABELLED ABSTRACTBackground:While depression is a growing public health issue, the percentage of individuals with depression receiving treatment is low. Physical and social attributes of the neighborhood may influence the level of depressive symptoms and the prevalence of depression in older adults. METHODS This review systematically examined the literature on neighborhood environmental correlates of depression in older adults. Findings were analyzed according to three depression outcomes: depressive symptoms, possible depression, and clinical depression. Based on their description in the article, environmental variables were assigned to one of 25 categories. The strength of evidence was statistically quantified using a meta-analytical approach with articles weighted for sample size and study quality. Findings were summarized by the number of positive, negative, and statistically non-significant associations by each combination of environmental attribute - depression outcome and by combining all depression outcomes. RESULTS Seventy-three articles met the selection criteria. For all depression outcomes combined, 12 of the 25 environmental attribute categories were considered to be sufficiently studied. Three of these, neighborhood socio-economic status, collective efficacy, and personal/crime-related safety were negatively associated with all depression outcomes combined. Moderating effects on associations were sparsely investigated, with 52 articles not examining any. Attributes of the physical neighborhood environment have been understudied. CONCLUSION This review provides support for the potential influence of some neighborhood attributes on population levels of depression. However, further research is needed to adequately examine physical attributes associated with depression and moderators of both social and physical neighborhood environment attribute - depression outcome associations.
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Exploring the cross-sectional association between outdoor recreational facilities and leisure-time physical activity: the role of usage and residential self-selection. Int J Behav Nutr Phys Act 2018; 15:55. [PMID: 29914517 PMCID: PMC6006552 DOI: 10.1186/s12966-018-0689-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 06/04/2018] [Indexed: 11/22/2022] Open
Abstract
Background The availability of outdoor recreational facilities is associated with increased leisure-time physical activity (PA). We investigated how much of this association is attributable to selection effects, and explored whether usage of recreational facilities was an explanatory mechanism. Methods We analysed data from 5199 participants in the SPOTLIGHT survey residing in five European urban regions. Adults completed a survey and a Google Street View-based virtual audit was conducted to objectively measure the availability of outdoor recreational facilities in the residential neighbourhood. We used negative binomial GEE models to examine the association between objective and subjective availability of outdoor recreational facilities and leisure-time PA, and explored whether this association was attenuated after adjustment for socioeconomic status and preference for neighbourhoods with recreational facilities (as indicators of self-selection). We examined whether reported use of recreational facilities was associated with leisure-time PA (as explanatory mechanism), and summarized the most important motivations for (not) using recreational facilities. Results Subjective – but not objective – availability of outdoor recreational facilities was associated with higher levels of total leisure-time PA. After adjustment for self-selection (which attenuated the association by 25%), we found a 25% difference in weekly minutes of total leisure-time PA between individuals with and without self-reported availability of outdoor recreational facilities. For our study population, this translates to about 28 min per week. Participants who reported outdoor recreational facilities to be present but indicated not to use them (RR = 1.19, 95% CI = 1.03;1.22), and those reporting outdoor recreational facilities to be present and to use them (RR = 1.33, 95% CI = 1.22, 1.45) had higher levels of total leisure-time PA than those who reported outdoor recreational facilities not to be present. Proximity to outdoor recreational facilities was the most important motivation for use. Conclusion The modest attenuation in the association between availability of outdoor recreational facilities and self-reported leisure-time PA suggests that individuals’ higher activity levels may be due more to the perceived availability of outdoor recreational facilities than to self-selection. The use of these facilities seemed to be an important underlying mechanism, and proximity was the main motivator for using recreational facilities. Electronic supplementary material The online version of this article (10.1186/s12966-018-0689-x) contains supplementary material, which is available to authorized users.
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Abstract
BACKGROUND Recent studies have linked urban environmental factors and body mass index (BMI); however, such factors are often examined in isolation, ignoring correlations across exposures. METHODS Using data on Nurses' Health Study participants living in the Northeastern United States in 2006, we estimated associations between neighborhood walkability (a composite of population density, street connectivity, and business access), greenness (from satellite imagery), and ambient air pollution (from satellite-based spatiotemporally resolved PM2.5 predictions and weighted monthly average concentrations of NO2 from up to five nearest monitors) and self-reported BMI using generalized additive models, allowing for deviations from linearity using penalized splines. RESULTS Among 23,435 women aged 60-87 years, we observed nonlinear associations between walkability and BMI and between PM2.5 and BMI in single-exposure models adjusted for age, race, and individual- and area-level socioeconomic status. When modeling all exposures simultaneously, only the association between walkability and BMI remained nonlinear and nonmonotonic. Increasing walkability was associated with increasing BMI at lower levels of walkability (walkability index <1.8), while increasing walkability was linked to lower BMI in areas of higher walkability (walkability index >1.8). A 10 percentile increase in walkability, right above 1.8 was associated with a 0.84% decrease in log BMI. The relationship between walkability and BMI existed only among younger participants (<71 years old). CONCLUSIONS Neighborhood walkability was nonlinearly linked to lower BMI independent of air pollution and greenness. Our findings highlight the importance of accounting for nonlinear confounding by interrelated urban environmental factors when investigating associations between the environment and BMI.
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Besser LM, Rodriguez DA, McDonald N, Kukull WA, Fitzpatrick AL, Rapp SR, Seeman T. Neighborhood built environment and cognition in non-demented older adults: The Multi-Ethnic Study of Atherosclerosis. Soc Sci Med 2018; 200:27-35. [PMID: 29355828 PMCID: PMC5893410 DOI: 10.1016/j.socscimed.2018.01.007] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 01/05/2018] [Accepted: 01/08/2018] [Indexed: 12/16/2022]
Abstract
Preliminary studies suggest that neighborhood social and built environment (BE) characteristics may affect cognition in older adults. Older adults are particularly vulnerable to the neighborhood environment due to a decreasing range of routine travel with increasing age. We examined if multiple neighborhood BE characteristics are cross-sectionally associated with cognition in a diverse sample of older adults, and if the BE-cognition associations vary by individual-level demographics. The sample included 4539 participants from the Multi-Ethnic Study of Atherosclerosis. Multivariable linear regression was used to examine the associations between five BE measures and four cognitive measures, and effect modification by individual-level education and race/ethnicity. In the overall sample, increasing social destination density, walking destination density, and intersection density were associated with worse overall cognition, whereas increasing proportion of land dedicated to retail was associated with better processing speed. Effect modification results suggest that the association between urban density and worse cognition may be limited to or strongest in those of non-white race/ethnicity. Although an increase in neighborhood retail destinations was associated with better cognition in the overall sample, these results suggest that certain BE characteristics in dense urban environments may have a disproportionately negative association with cognition in vulnerable populations. However, our findings must be replicated in longitudinal studies and other regional samples.
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Affiliation(s)
- Lilah M Besser
- National Alzheimer's Coordinating Center, Department of Epidemiology, University of Washington, 4311 11th Ave NE, Suite 300, Seattle, WA 98105, USA.
| | - Daniel A Rodriguez
- Department of City and Regional Planning, Institute for Transportation Studies, University of California, Berkeley, Office 313B, Wurster Hall #1820, Berkeley, CA, 94720, USA.
| | - Noreen McDonald
- Department of City and Regional Planning, University of North Carolina at Chapel Hill, 317 New East Building, CB 3140, Chapel Hill, NC 27599, USA.
| | - Walter A Kukull
- National Alzheimer's Coordinating Center, Department of Epidemiology, University of Washington, 4311 11th Ave NE, Suite 300, Seattle, WA 98105, USA.
| | - Annette L Fitzpatrick
- Departments of Family Medicine, Epidemiology and Global Health, University of Washington, 1959 NE Pacific Street, Health Sciences Building, F-350, Box 357230, Seattle, WA 98195, USA.
| | - Stephen R Rapp
- Department of Psychiatry and Behavioral Medicine, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157, USA.
| | - Teresa Seeman
- Department of Medicine, Division of Geriatrics, University of California, Los Angeles, 10945 Le Conte Avenue, Suite 2339, Los Angeles, CA 90095, USA.
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Méline J, Chaix B, Pannier B, Ogedegbe G, Trasande L, Athens J, Duncan DT. Neighborhood walk score and selected Cardiometabolic factors in the French RECORD cohort study. BMC Public Health 2017; 17:960. [PMID: 29258476 PMCID: PMC5735827 DOI: 10.1186/s12889-017-4962-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 11/29/2017] [Indexed: 11/21/2022] Open
Abstract
Background Walkable neighborhoods are purported to impact a range of cardiometabolic outcomes through increased walking, but there is limited research that examines multiple cardiometabolic outcomes. Additionally, few Walk Score (a novel measure of neighborhood walkability) studies have been conducted in a European context. We evaluated associations between neighborhood Walk Score and selected cardiometabolic outcomes, including obesity, hypertension and heart rate, among adults in the Paris metropolitan area. Methods and results We used data from the second wave of the RECORD Study on 5993 participants recruited in 2011–2014, aged 34–84 years, and residing in Paris (France). To this existing dataset, we added Walk Score values for participants’ residential address. We used multilevel linear models for the continuous outcomes and modified Poisson models were used for our categorical outcomes to estimate associations between the neighborhood Walk Score (both as a continuous and categorical variable) (0–100 score) and body mass index (BMI) (weight/height2 in kg/m2), obesity (kg/m2), waist circumference (cm), systolic blood pressure (SBP) (mmHg), diastolic blood pressure (DBP) (mmHg), hypertension (mmHg), resting heart rate (RHR) (beats per minute), and neighborhood recreational walking (minutes per week). Most participants lived in Walker’s Paradise (48.3%). In multivariate models (adjusted for individual variables, neighborhood variables, and risk factors for cardiometabolic outcomes), we found that neighborhood Walk Score was associated with decreased BMI (β: -0.010, 95% CI: -0.019 to −0.002 per unit increase), decreased waist circumference (β: -0.031, 95% CI: -0.054 to −0.008), increased neighborhood recreational walking (β: +0.73, 95% CI: +0.37 to +1.10), decreased SBP (β: -0.030, 95% CI: -0.063 to −0.0004), decreased DBP (β: -0.028, 95% CI: -0.047 to −0.008), and decreased resting heart rate (β: -0.026 95% CI: -0.046 to −0.005). Conclusions In this large population-based study, we found that, even in a European context, living in a highly walkable neighborhood was associated with improved cardiometabolic health. Designing walkable neighborhoods may be a viable strategy in reducing cardiovascular disease prevalence at the population level.
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Affiliation(s)
- Julie Méline
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, 1 rue Victor Cousin, 75230, 05, Paris cedex, France.,Inserm, UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, 56, boulevard Vincent Auriol CS 81393, 75646, Paris Cedex 13, France
| | - Basile Chaix
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, 1 rue Victor Cousin, 75230, 05, Paris cedex, France.,Inserm, UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, 56, boulevard Vincent Auriol CS 81393, 75646, Paris Cedex 13, France
| | - Bruno Pannier
- IPC Medical Center, 6 Rue la Pérouse, 75016, Paris, France
| | - Gbenga Ogedegbe
- Department of Population Health, New York University School of Medicine, 227 East 30th Street, New York, NY, 10016, USA
| | - Leonardo Trasande
- Department of Population Health, New York University School of Medicine, 227 East 30th Street, New York, NY, 10016, USA.,Departments of Pediatrics and Environmental Medicine, New York University School of Medicine, 550 First Avenue, New York, NY, 10016, USA
| | - Jessica Athens
- Department of Population Health, New York University School of Medicine, 227 East 30th Street, New York, NY, 10016, USA
| | - Dustin T Duncan
- Department of Population Health, New York University School of Medicine, 227 East 30th Street, New York, NY, 10016, USA. .,Spatial Epidemiology Lab, Department of Population Health, New York University School of Medicine, 227 East 30th Street, 6th Floor, Room 621, New York, NY, 10016, USA.
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Walkable neighborhoods and obesity: Evaluating effects with a propensity score approach. SSM Popul Health 2017; 6:9-15. [PMID: 30105287 PMCID: PMC6086390 DOI: 10.1016/j.ssmph.2017.11.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 11/12/2017] [Accepted: 11/13/2017] [Indexed: 11/22/2022] Open
Abstract
Background Research investigating the connection between neighborhood walkability and obesity often overlooks the issue of nonrandom residential selection. Methods We use propensity score methods to adjust for the nonrandom selection into residential neighborhoods in this cross-sectional, observational study. The sample includes 103,912 women residing in Salt Lake County, Utah age 20 or older. We measured percentage living in neighborhoods with more walkability, area level measures of neighborhood characteristics, and obesity (body mass index (BMI) > 30). Results Our findings confirm previous work that observes an association between living in more walkable neighborhoods and lower obesity. After adjusting for nonrandom selection, the odds of being obese when living in a less walkable neighborhood increase. Specifically, the odds ratio for being obese without the propensity score correction is 1.12. After adjusting for nonrandom selection, the odds ratio for being obese is 1.19, an increase of six percent. Conclusion Results demonstrate that residential selection bias inherent in cross-sectional analysis slightly attenuates the true association between neighborhood walkability and obesity. Results lend support to the growing body of research suggesting that more walkable neighborhoods have residents with a lower prevalence of obesity. Absent propensity score controls, the causal relationship between environment and obesity would be underestimated by 6%. Our analysis suggests there is an association between neighborhood walkability and obesity.
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Affuso O, Singleton CR, Brown SC, Perrino T, Huang S, Szapocznik J. Associations between neighborhood socioeconomic environment and physical activity in Cuban immigrants. SSM Popul Health 2017; 2:130-135. [PMID: 28920072 PMCID: PMC5600286 DOI: 10.1016/j.ssmph.2016.02.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Physical inactivity is a major public health concern because it is a determinant of obesity and obesity-related chronic diseases. Few longitudinal studies have examined the association between neighborhood socioeconomic (SES) environment and change in physical activity behaviors. Additionally, few studies have examined this association in immigrant groups or Hispanic subgroups such as Cubans. This research aimed to determine if neighborhood SES is associated with longitudinal change in moderate-to-vigorous physical activity (MVPA) among Cuban immigrants who participate in the Cuban Health Study in Miami, Florida. Data on 280 participants [mean age: 37.4 (±4.6), 48.9% women, mean body mass index: 25.0 (±2.5)] collected at baseline, 12 months and 24 months were analyzed. Minutes of MVPA were objectively measured during each data collection period using accelerometers. A neighborhood SES score was calculated for each participant’s residential census tract from American Community Survey data on median household income, median housing value, educational attainment and occupation. The neighborhood SES score was grouped into tertiles, reflecting low, moderate and high neighborhood SES environment. Multilevel linear models were used to examine the relationship between neighborhood SES and change in MVPA over 24 months. At baseline, 94 (33.6%), 108 (38.6%) and 78 (27.9%) participants resided in low, moderate, and high SES neighborhoods, respectively. After adjusting for age, sex, and body mass index, no difference in average change in MVPA over time was observed between participants residing in low and moderate SES neighborhoods (p=0.48) or low and high SES neighborhoods (p=0.62). In Cuban immigrants, longitudinal change in MVPA may not vary by neighborhood socioeconomic environment. Objectively measured time spent in MVPA was calculated among new Cuban immigrant adults. Longitudinal associations between neighborhood SES and MVPA were assessed. Study participants, on average, increased their physical activity over two years. Multilevel modeling indicated that neighborhood SES and change in MVPA were not associated.
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Affiliation(s)
- Olivia Affuso
- Department of Epidemiology, University of Alabama at Birmingham, 1665 University Blvd., Suite 220, Birmingham, AL 35924, USA.,Nutrition & Obesity Research Center, University of Alabama at Birmingham, 1675 University Blvd., Suite 568, Birmingham, AL 35294, USA.,Center for Exercise Medicine, University of Alabama at Birmingham, 1918 University Blvd., Room 966, Birmingham, AL 35294, USA
| | - Chelsea R Singleton
- Institute for Health Research and Policy, University of Illinois at Chicago, 1747 W Roosevelt, Office 441, Chicago, IL 60608, USA
| | - Scott C Brown
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, 1120 NW 14th Street, Suite 1020, Miami, FL 33136, USA
| | - Tatiana Perrino
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, 1120 NW 14th Street, Suite 1020, Miami, FL 33136, USA
| | - Shi Huang
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, 1120 NW 14th Street, Suite 1020, Miami, FL 33136, USA
| | - José Szapocznik
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, 1120 NW 14th Street, Suite 1020, Miami, FL 33136, USA
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Linton SL, Haley DF, Hunter-Jones J, Ross Z, Cooper HLF. Social causation and neighborhood selection underlie associations of neighborhood factors with illicit drug-using social networks and illicit drug use among adults relocated from public housing. Soc Sci Med 2017; 185:81-90. [PMID: 28554162 DOI: 10.1016/j.socscimed.2017.04.055] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 04/28/2017] [Accepted: 04/30/2017] [Indexed: 12/20/2022]
Abstract
Theories of social causation and social influence, which posit that neighborhood and social network characteristics are distal causes of substance use, are frequently used to interpret associations among neighborhood characteristics, social network characteristics and substance use. These associations are also hypothesized to result from selection processes, in which substance use determines where people live and who they interact with. The potential for these competing selection mechanisms to co-occur has been underexplored among adults. This study utilizes path analysis to determine the paths that relate census tract characteristics (e.g., economic deprivation), social network characteristics (i.e., having ≥ 1 illicit drug-using network member) and illicit drug use, among 172 African American adults relocated from public housing in Atlanta, Georgia and followed from 2009 to 2014 (7 waves). Individual and network-level characteristics were captured using surveys. Census tract characteristics were created using administrative data. Waves 1 (pre-relocation), 2 (1st wave post-relocation), and 7 were analyzed. When controlling for individual-level sociodemographic factors, residing in census tracts with prior economic disadvantage was significantly associated with illicit drug use at wave 1; illicit drug use at wave 1 was significantly associated with living in economically-disadvantaged census tracts at wave 2; and violent crime at wave 2 was associated with illicit drug-using social network members at wave 7. Findings from this study support theories that describe social causation and neighborhood selection processes as explaining relationships of neighborhood characteristics with illicit drug use and illicit drug-using social networks. Policies that improve local economic and social conditions of neighborhoods may discourage substance use. Future studies should further identify the barriers that prevent substance users from obtaining housing in less disadvantaged neighborhoods.
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Affiliation(s)
- Sabriya L Linton
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA.
| | - Danielle F Haley
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA; Institute for Global Health and Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill, 130 Mason Farm Rd CB#7030, Chapel Hill, NC 27599, USA
| | - Josalin Hunter-Jones
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA
| | - Zev Ross
- ZevRoss Spatial Analysis, 120 N Aurora Street, Suite 3A, Ithaca, NY 14850, USA
| | - Hannah L F Cooper
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA
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Does contextual unemployment matter for health status across the life course? A longitudinal multilevel study exploring the link between neighbourhood unemployment and functional somatic symptoms. Health Place 2016; 43:113-120. [PMID: 27997864 DOI: 10.1016/j.healthplace.2016.11.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 09/27/2016] [Accepted: 11/17/2016] [Indexed: 11/22/2022]
Abstract
This study examines whether neighbourhood unemployment is related to functional somatic symptoms, independently of the individual employment, across the life course and at four specific life course periods (age 16, 21, 30 and 42). Self-reported questioner data was used from a 26-year prospective Swedish cohort (n=1010) with complementary neighbourhood register data. A longitudinal and a set of age-specific cross-sectional hierarchal linear regressions was carried out. The results suggest that living in a neighbourhood with high unemployment has implications for residents' level of functional somatic symptoms, regardless of their own unemployment across time, particularly at age 30.
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