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Cavuoto MG, Davies L, Rowsthorn E, Cribb LG, Yiallourou SR, Yassi N, Maruff P, Lim YY, Pase MP. Cross-sectional associations between neighborhood characteristics, cognition and dementia risk factor burden in middle-aged and older Australians. Prev Med Rep 2024; 41:102696. [PMID: 38586469 PMCID: PMC10997895 DOI: 10.1016/j.pmedr.2024.102696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 03/17/2024] [Accepted: 03/18/2024] [Indexed: 04/09/2024] Open
Abstract
Dementia disproportionately affects individuals from disadvantaged backgrounds, including those living in areas of lower neighborhood-level socioeconomic status. It is important to understand whether there are specific neighborhood characteristics associated with dementia risk factors and cognition which may inform dementia risk reduction interventions. We sought to examine whether greenspace, walkability, and crime associated with the cumulative burden of modifiable dementia risk factors and cognition. This was a cross-sectional analysis of 2016-2020 data from the Healthy Brain Project, a population-based cohort of community-dwelling individuals across Australia. Participants were aged 40-70 and free of dementia. Measures included greenspace (greenspace % in the local area, and distance to greenspace, n = 2,181); and intersection density (n = 1,159), and crime (rate of recorded offences; n = 1,159). Outcomes included a modified Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE) dementia risk score to index the burden of modifiable vascular dementia risk factors; and composite scores of both memory and attention, derived from the Cogstate Brief Battery. Linear regressions adjusted for age, sex, education, and personal socio-economic status, demonstrated distance to greenspace (b ± SE per 2-fold increase = 0.09 ± 0.03, p =.005) and crime rate (b ± SE per 2-fold increase = 0.07 ± 0.03, p =.018) were associated with higher modified CAIDE. Higher crime was associated with lower memory performance (b ± SE = -0.03 ± 0.01, p =.018). The association between distance to greenspace and modified CAIDE was only present in low-moderate socioeconomic status neighborhoods (p interaction = 0.004). Dementia prevention programs that address modifiable risk factors in midlife should consider the possible role of neighborhood characteristics.
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Affiliation(s)
- Marina G. Cavuoto
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
- National Ageing Research Institute, Royal Melbourne Hospital, VIC, Australia
| | - Liam Davies
- Centre for Urban Research, School of Global, Urban and Social Studies, RMIT University, City Campus, Melbourne, Victoria, Australia
| | - Ella Rowsthorn
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Lachlan G. Cribb
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Stephanie R. Yiallourou
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Nawaf Yassi
- Department of Medicine and Neurology, Melbourne Brain Centre at The Royal Melbourne Hospital, University of Melbourne, Parkville, VIC, Australia
- Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
| | - Paul Maruff
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
- Cogstate Ltd., Melbourne, Victoria, Australia
| | - Yen Ying Lim
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Matthew P. Pase
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
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Eisen AM, Bratman GN, Olvera-Alvarez HA. Susceptibility to stress and nature exposure: Unveiling differential susceptibility to physical environments; a randomized controlled trial. PLoS One 2024; 19:e0301473. [PMID: 38630650 PMCID: PMC11023441 DOI: 10.1371/journal.pone.0301473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 03/15/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Emerging epidemiological evidence indicates nature exposure could be associated with greater health benefits among groups in lower versus higher socioeconomic positions. One possible mechanism underpinning this evidence is described by our framework: (susceptibility) adults in low socioeconomic positions face higher exposure to persistent psychosocial stressors in early life, inducing a pro-inflammatory phenotype as a lifelong susceptibility to stress; (differential susceptibility) susceptible adults are more sensitive to the health risks of adverse (stress-promoting) environments, but also to the health benefits of protective (stress-buffering) environments. OBJECTIVE Experimental investigation of a pro-inflammatory phenotype as a mechanism facilitating greater stress recovery from nature exposure. METHODS We determined differences in stress recovery (via heart rate variability) caused by exposure to a nature or office virtual reality environment (10 min) after an acute stressor among 64 healthy college-age males with varying levels of susceptibility (socioeconomic status, early life stress, and a pro-inflammatory state [inflammatory reactivity and glucocorticoid resistance to an in vitro bacterial challenge]). RESULTS Findings for inflammatory reactivity and glucocorticoid resistance were modest but consistently trended towards better recovery in the nature condition. Differences in recovery were not observed for socioeconomic status or early life stress. DISCUSSION Among healthy college-age males, we observed expected trends according to their differential susceptibility when assessed as inflammatory reactivity and glucocorticoid resistance, suggesting these biological correlates of susceptibility could be more proximal indicators than self-reported assessments of socioeconomic status and early life stress. If future research in more diverse populations aligns with these trends, this could support an alternative conceptualization of susceptibility as increased environmental sensitivity, reflecting heightened responses to adverse, but also protective environments. With this knowledge, future investigators could examine how individual differences in environmental sensitivity could provide an opportunity for those who are the most susceptible to experience the greatest health benefits from nature exposure.
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Affiliation(s)
- Aaron M. Eisen
- School of Nursing, Oregon Health & Science University, Portland, OR, United States of America
| | - Gregory N. Bratman
- School of Environmental and Forest Sciences, University of Washington, Seattle, WA, United States of America
- Department of Psychology, University of Washington, Seattle, WA, United States of America
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, United States of America
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3
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Sullivan A, Armendariz M, Thierry AD. A Scoping Review of Neighborhoods and Cognitive Health Disparities Among US Midlife and Older Adults. J Aging Health 2024; 36:257-270. [PMID: 37350741 DOI: 10.1177/08982643231185379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Abstract
Objectives: The neighborhood environment may be an important determinant of racial/ethnic disparities in cognitive function. To understand how neighborhoods are linked to cognition across racial/ethnic groups, this scoping review organizes research investigating relationships between multiple neighborhood domains and cognitive function in diverse samples of US midlife and older adults. Methods: PubMed/MEDLINE, Web of Science, and CAHL were used to extract quantitative disparities-focused studies (n = 17) that included US adults ages 50+, racial/ethnic minoritized populations, cognitive dependent variable(s), and neighborhood-level independent variable(s) published from January 2010 to October 2021. Results: Studies demonstrate variation within and between racial/ethnic groups in how neighborhood factors are associated with cognition. Economically and socially advantaged neighborhoods were associated with better cognition. Findings were mixed for built and neighborhood composition measures. Discussion: More research with greater racial/ethnic representation is needed to disentangle which aspects of the neighborhood are most salient for specific cognitive function domains across diverse populations.
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Affiliation(s)
- Allison Sullivan
- Department of Public Health, Jackson State University, Jackson, MS, USA
| | - Marina Armendariz
- Department of Public Health, University of Texas at San Antonio, San Antonio, TX, USA
| | - Amy D Thierry
- Department of Public Health Sciences, Xavier University of Louisiana, New Orleans, LA, USA
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Li J, Hirsch JA, Michael YL, Besser LM, Auchincloss AH, Hughes TM, Sánchez BN. Spatial scale effects on associations between built environment and cognitive function: Multi-Ethnic Study of Atherosclerosis. Health Place 2024; 86:103181. [PMID: 38340497 DOI: 10.1016/j.healthplace.2024.103181] [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: 09/27/2023] [Revised: 12/26/2023] [Accepted: 01/22/2024] [Indexed: 02/12/2024]
Abstract
Built environments have the potential to favorably support cognitive function. Despite growing work on this topic, most of the work has ignored variation in the spatial scale of the effect. The issue with spatial scale effects is that the size and shape of the areal unit within which built environment characteristics are measured naturally influence the built environment exposure metric and thus the estimated associations with health. We used spatial distributed lag modeling (DLM) to estimate how associations between built environment exposures (walkable destinations [WD], social destinations [SD]) and change in cognition varied across distance of these destinations from participants' residences. Cognition was assessed as maintained/improved processing speed (PS) and global cognition (GC). Person-level data from Exam 5 (2010-2012) and Exam 6 (2016-2018) of the Multi-Ethnic Study of Atherosclerosis was used (N = 1380, mean age 67). Built environment data were derived from the National Establishment Time Series. Higher availability of walkable and social destinations at closer distance from participants' residence was associated with maintained/improved PS. The adjusted associations between maintained/improved PS and destinations waned with increasing distance from the residence; associations were evident until approximately 1.9-km for WD and 1.5-km for SD. Associations were most apparent for participants living in areas with high population density. We found little evidence for associations between change in GC and built environment at any distance. These results highlight the importance of identifying appropriate spatial scale to understand the mechanisms for built environment-cognition associations.
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Affiliation(s)
- Jingjing Li
- Department of Land Resources Management, School of Public Administration, China University of Geosciences, Wuhan, Hubei, 430074, China
| | - Jana A Hirsch
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, 19104, USA; Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, 19104, USA.
| | - Yvonne L Michael
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, 19104, USA; Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, 19104, USA
| | - Lilah M Besser
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Amy H Auchincloss
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, 19104, USA; Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, 19104, USA
| | - Timothy M Hughes
- Department of Internal Medicine, Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC, 27109, USA
| | - Brisa N Sánchez
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, 19104, USA; Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, 19104, USA
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5
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Mizen A, Thompson DA, Watkins A, Akbari A, Garrett JK, Geary R, Lovell R, Lyons RA, Nieuwenhuijsen M, Parker SC, Rowney FM, Song J, Stratton G, Wheeler BW, White J, White MP, Williams S, Rodgers SE, Fry R. The use of Enhanced Vegetation Index for assessing access to different types of green space in epidemiological studies. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2024:10.1038/s41370-024-00650-5. [PMID: 38424359 DOI: 10.1038/s41370-024-00650-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 01/24/2024] [Accepted: 01/24/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND Exposure to green space can protect against poor health through a variety of mechanisms. However, there is heterogeneity in methodological approaches to exposure assessments which makes creating effective policy recommendations challenging. OBJECTIVE Critically evaluate the use of a satellite-derived exposure metric, the Enhanced Vegetation Index (EVI), for assessing access to different types of green space in epidemiological studies. METHODS We used Landsat 5-8 (30 m resolution) to calculate average EVI for a 300 m radius surrounding 1.4 million households in Wales, UK for 2018. We calculated two additional measures using topographic vector data to represent access to green spaces within 300 m of household locations. The two topographic vector-based measures were total green space area stratified by type and average private garden size. We used linear regression models to test whether EVI could discriminate between publicly accessible and private green space and Pearson correlation to test associations between EVI and green space types. RESULTS Mean EVI for a 300 m radius surrounding households in Wales was 0.28 (IQR = 0.12). Total green space area and average private garden size were significantly positively associated with corresponding EVI measures (β = < 0.0001, 95% CI: 0.0000, 0.0000; β = 0.0001, 95% CI: 0.0001, 0.0001 respectively). In urban areas, as average garden size increases by 1 m2, EVI increases by 0.0002. Therefore, in urban areas, to see a 0.1 unit increase in EVI index score, garden size would need to increase by 500 m2. The very small β values represent no 'measurable real-world' associations. When stratified by type, we observed no strong associations between greenspace and EVI. IMPACT It is a widely implemented assumption in epidiological studies that an increase in EVI is equivalent to an increase in greenness and/or green space. We used linear regression models to test associations between EVI and potential sources of green reflectance at a neighbourhood level using satellite imagery from 2018. We compared EVI measures with a 'gold standard' vector-based dataset that defines publicly accessible and private green spaces. We found that EVI should be interpreted with care as a greater EVI score does not necessarily mean greater access to publicly available green spaces in the hyperlocal environment.
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Affiliation(s)
- Amy Mizen
- Swansea University Medical School, Swansea University, Swansea, UK.
| | | | - Alan Watkins
- Swansea University Medical School, Swansea University, Swansea, UK
| | - Ashley Akbari
- Swansea University Medical School, Swansea University, Swansea, UK
| | - Joanne K Garrett
- European Centre for Environment and Human Health, University of Exeter Medical School, University of Exeter, Truro, UK
| | - Rebecca Geary
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | - Rebecca Lovell
- European Centre for Environment and Human Health, University of Exeter Medical School, University of Exeter, Truro, UK
| | - Ronan A Lyons
- Swansea University Medical School, Swansea University, Swansea, UK
| | - Mark Nieuwenhuijsen
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Sarah C Parker
- Swansea University Medical School, Swansea University, Swansea, UK
| | - Francis M Rowney
- School of Geography, Earth and Environmental Sciences, University of Plymouth, Plymouth, UK
| | | | - Gareth Stratton
- ASTEM Research Centre, Faculty of Science and Engineering, Swansea University, Swansea, UK
| | - Benedict W Wheeler
- European Centre for Environment and Human Health, University of Exeter Medical School, University of Exeter, Truro, UK
| | - James White
- Centre for Trials Research, School of Medicine, Cardiff University, Cardiff, UK
| | - Mathew P White
- European Centre for Environment and Human Health, University of Exeter Medical School, University of Exeter, Truro, UK
- Cognitive Science Hub, University of Vienna, Vienna, Austria
| | | | - Sarah E Rodgers
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | - Richard Fry
- Swansea University Medical School, Swansea University, Swansea, UK
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Song Y, Liu Y, Bai X, Yu H. Effects of neighborhood built environment on cognitive function in older adults: a systematic review. BMC Geriatr 2024; 24:194. [PMID: 38408919 PMCID: PMC10898015 DOI: 10.1186/s12877-024-04776-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 02/03/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND In the background of an aging population, the risk of cognitive impairment in the older population is prominent. Exposure to complex neighborhood built environments may be beneficial to the cognitive health of older adults, and the purpose of this study was to systematically review the scientific evidence on the effects of neighborhood built environments on cognitive function in older adults. METHODS Keywords and references were searched in Web of Science, Pubmed, PsycINFO, and MEDLINE. Studies examining the relationship between the built environment and cognitive function in older adults were included. The neighborhood built environment as an independent variable was classified according to seven aspects: density, design, diversity, destination accessibility, public transportation distance, blue/green space, and built environment quality. The cognitive function as the dependent variable was classified according to overall cognitive function, domain-specific cognitive function, and incidence of dementia. The quality of the included literature was assessed using the National Institutes of Health's Observational Cohort and Cross-Sectional Study Quality Assessment Tool. RESULTS A total of 56 studies were included that met the inclusion criteria, including 31 cross-sectional studies, 23 longitudinal studies, 1 cross-sectional study design combined with a case-control design, and 1 longitudinal study design combined with a case-control design. Most of the studies reviewed indicate that the built environment factors that were positively associated with cognitive function in older adults were population density, street connectivity, walkability, number of public transportation stops around the residence, land use mix, neighborhood resources, green space, and quality of the neighborhood built environment. Built environment factors that were negatively associated with cognitive function in older adults were street integration, distance from residence to main road. The relationship between residential density, destination accessibility, and blue space with cognitive function in older adults needs to be further explored. CONCLUSION Preliminary evidence suggests an association between the neighborhood built environment and cognitive function in older adults. The causal relationship between the built environment and cognitive function can be further explored in the future using standardized and combined subjective and objective assessment methods, and longitudinal or quasi-experimental study designs. For public health interventions on the cognitive health of older adults, it is recommended that relevant authorities include the neighborhood built environment in their intervention programs.
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Affiliation(s)
- Yiling Song
- Department of Physical Education, Tsinghua University, Beijing, 100084, China
| | - Yunxi Liu
- Graduate School of Commerce, Waseda University, Tokyo, 169-8050, Japan
| | - Xiaotian Bai
- Department of Physical Education, Tsinghua University, Beijing, 100084, China
| | - Hongjun Yu
- Department of Physical Education, Tsinghua University, Beijing, 100084, China.
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7
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Song J, Ramírez MC, Okano JT, Service SK, de la Hoz J, Díaz-Zuluaga AM, Upegui CV, Gallago C, Arias A, Sánchez AV, Teshiba T, Sabatti C, Gur RC, Bearden CE, Escobar JI, Reus VI, Jaramillo CL, Freimer NB, Olde Loohuis LM, Blower S. Geospatial investigations in Colombia reveal variations in the distribution of mood and psychotic disorders. COMMUNICATIONS MEDICINE 2024; 4:26. [PMID: 38383761 PMCID: PMC10881503 DOI: 10.1038/s43856-024-00441-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 01/19/2024] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND Geographical variations in mood and psychotic disorders have been found in upper-income countries. We looked for geographic variation in these disorders in Colombia, a middle-income country. We analyzed electronic health records from the Clínica San Juan de Dios Manizales (CSJDM), which provides comprehensive mental healthcare for the one million inhabitants of Caldas. METHODS We constructed a friction surface map of Caldas and used it to calculate the travel-time to the CSJDM for 16,295 patients who had received an initial diagnosis of mood or psychotic disorder. Using a zero-inflated negative binomial regression model, we determined the relationship between travel-time and incidence, stratified by disease severity. We employed spatial scan statistics to look for patient clusters. RESULTS We show that travel-times (for driving) to the CSJDM are less than 1 h for ~50% of the population and more than 4 h for ~10%. We find a distance-decay relationship for outpatients, but not for inpatients: for every hour increase in travel-time, the number of expected outpatient cases decreases by 20% (RR = 0.80, 95% confidence interval [0.71, 0.89], p = 5.67E-05). We find nine clusters/hotspots of inpatients. CONCLUSIONS Our results reveal inequities in access to healthcare: many individuals requiring only outpatient treatment may live too far from the CSJDM to access healthcare. Targeting of resources to comprehensively identify severely ill individuals living in the observed hotspots could further address treatment inequities and enable investigations to determine factors generating these hotspots.
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Affiliation(s)
- Janet Song
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | | | - Justin T Okano
- Center for Biomedical Modeling, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Susan K Service
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Juan de la Hoz
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Ana M Díaz-Zuluaga
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | | | - Cristian Gallago
- Department of Mental Health and Human Behavior, University of Caldas, Manizales, Colombia
| | - Alejandro Arias
- Department of Psychiatry, University of Antioquía, Medellín, Colombia
| | | | - Terri Teshiba
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Chiara Sabatti
- Department of Biomedical Data Science, Stanford University, Stanford, CA, USA
| | - Ruben C Gur
- Department of Psychiatry, University of Pennsylvania School of Medicine and the Penn-CHOP Lifespan Brain Institute, Philadelphia, PA, USA
| | - Carrie E Bearden
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Javier I Escobar
- Department of Psychiatry, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Victor I Reus
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA
| | | | - Nelson B Freimer
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Loes M Olde Loohuis
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
| | - Sally Blower
- Center for Biomedical Modeling, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
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Goldblatt R, Holz N, Tate G, Sherman K, Ghebremicael S, Bhuyan SS, Al-Ajlouni Y, Santillanes S, Araya G, Abad S, Herting MM, Thompson W, Thapaliya B, Sapkota R, Xu J, Liu J, Schumann G, Calhoun VD. "Urban-Satellite" estimates in the ABCD Study: Linking Neuroimaging and Mental Health to Satellite Imagery Measurements of Macro Environmental Factors. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2023.11.06.23298044. [PMID: 37986844 PMCID: PMC10659457 DOI: 10.1101/2023.11.06.23298044] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
While numerous studies over the last decade have highlighted the important influence of environmental factors on mental health, globally applicable data on physical surroundings are still limited. Access to such data and the possibility to link them to epidemiological studies is critical to unlocking the relationship of environment, brain and behaviour and promoting positive future mental health outcomes. The Adolescent Brain Cognitive Development (ABCD) Study is the largest ongoing longitudinal and observational study exploring brain development and child health among children from 21 sites across the United States. Here we describe the linking of the ABCD study data with satellite-based "Urban-Satellite" (UrbanSat) variables consisting of 11 satellite-data derived environmental indicators associated with each subject's residential address at their baseline visit, including land cover and land use, nighttime lights, and population characteristics. We present these UrbanSat variables and provide a review of the current literature that links environmental indicators with mental health, as well as key aspects that must be considered when using satellite data for mental health research. We also highlight and discuss significant links of the satellite data variables to the default mode network clustering coefficient and cognition. This comprehensive dataset provides the foundation for large-scale environmental epidemiology research.
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Affiliation(s)
| | - Nathalie Holz
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim / Heidelberg University, Mannheim, Germany
| | - Garrett Tate
- New Light Technologies, Inc., Washington, DC 20012
| | - Kari Sherman
- New Light Technologies, Inc., Washington, DC 20012
| | | | - Soumitra S Bhuyan
- Edward J. Bloustein School of Planning and Public Policy, Rutgers University- New Brunswick
| | - Yazan Al-Ajlouni
- New York Medical College School of Medicine, Valhalla, NY 10595, USA
| | | | | | - Shermaine Abad
- Department of Radiology, University of California, San Diego, 92093
| | - Megan M. Herting
- University of Southern California, Keck School of Medicine of USC, Los Angeles, CA, 90089
| | - Wesley Thompson
- Laureate Institute for Brain Research, Tulsa, Oklahoma, 74136, USA
| | - Bishal Thapaliya
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State, Georgia Tech, Emory, Atlanta, GA 30303
| | - Ram Sapkota
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State, Georgia Tech, Emory, Atlanta, GA 30303
| | - Jiayuan Xu
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, P.R. China
| | - Jingyu Liu
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State, Georgia Tech, Emory, Atlanta, GA 30303
| | | | - Gunter Schumann
- Centre for Population Neuroscience and Stratified Medicine (PONS), ISTBI, Fudan University Shanghai, P.R. China
- PONS Centre, Dept. of Psychiatry and Neuroscience, CCM, Charite University Medicine Berlin, Germany
| | - Vince D. Calhoun
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State, Georgia Tech, Emory, Atlanta, GA 30303
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9
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Fian L, White MP, Arnberger A, Thaler T, Heske A, Pahl S. Nature visits, but not residential greenness, are associated with reduced income-related inequalities in subjective well-being. Health Place 2024; 85:103175. [PMID: 38266374 DOI: 10.1016/j.healthplace.2024.103175] [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: 09/27/2023] [Revised: 12/04/2023] [Accepted: 01/10/2024] [Indexed: 01/26/2024]
Abstract
Nature exposure can promote human health and well-being. Additionally, there is some, albeit mixed, evidence that this relationship is stronger for socio-economically disadvantaged groups (equigenesis). Using a cross-sectional survey of the Austrian population (N = 2300), we explored the relationships between both residential greenness and recreational nature visits, and affective (WHO-5 Well-Being Index) and evaluative (Personal Well-Being Index-7) subjective well-being. Partially supporting the equigenesis hypothesis, regression analyses controlling for potential confounders found that recreational visit frequency, but not residential greenness, moderated the effect of income-related disparities in both subjective well-being metrics. Results suggest that merely making neighborhoods greener may not itself help reduce inequalities in subjective well-being. Additionally, greater efforts are also needed to support individuals from all sectors of society to access natural settings for recreation as this could significantly improve the well-being of some of the poorest in society.
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Affiliation(s)
- Leonie Fian
- Urban and Environmental Psychology Group, Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria.
| | - Mathew P White
- Urban and Environmental Psychology Group, Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria; Cognitive Science HUB, University of Vienna, Vienna, Austria; Environment and Climate Research HUB, University of Vienna, Vienna, Austria
| | - Arne Arnberger
- Institute of Landscape Development, Recreation and Conservation Planning, University of Natural Resources and Life Sciences, Vienna, Austria
| | - Thomas Thaler
- Institute of Landscape Planning (ILAP), University of Natural Resources and Life Sciences, Vienna, Austria
| | - Anja Heske
- Urban and Environmental Psychology Group, Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Sabine Pahl
- Urban and Environmental Psychology Group, Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria; Environment and Climate Research HUB, University of Vienna, Vienna, Austria
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10
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Brown SC, Aitken WW, Lombard J, Parrish A, Dewald JR, Ma R, Messinger S, Liu S, Nardi MI, Rundek T, Szapocznik J. Longitudinal Impacts of Precision Greenness on Alzheimer's Disease. J Prev Alzheimers Dis 2024; 11:710-720. [PMID: 38706287 PMCID: PMC11061009 DOI: 10.14283/jpad.2024.38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 11/13/2023] [Indexed: 05/07/2024]
Abstract
BACKGROUND The potential for greenness as a novel protective factor for Alzheimer's disease (AD) requires further exploration. OBJECTIVES This study assesses prospectively and longitudinally the association between precision greenness - greenness measured at the micro-environmental level, defined as the Census block - and AD incidence. DESIGN Older adults living in consistently high greenness Census blocks across 2011 and 2016 were compared to those living in consistently low greenness blocks on AD incidence during 2012-2016. SETTING Miami-Dade County, Florida, USA. PARTICIPANTS 230,738 U.S. Medicare beneficiaries. MEASUREMENTS U.S. Centers for Medicare and Medicaid Services Chronic Condition Algorithm for AD based on ICD-9 codes, Normalized Difference Vegetation Index, age, sex, race/ethnicity, neighborhood income, and walkability. RESULTS Older adults living in the consistently high greenness tertile, compared to those in the consistently low greenness tertile, had 16% lower odds of AD incidence (OR=0.84, 95% CI: 0.76-0.94, p=0.0014), adjusting for age, sex, race/ethnicity, and neighborhood income. Age, neighborhood income and walkability moderated greenness' relationship to odds of AD incidence, such that younger ages (65-74), lower-income, and non-car dependent neighborhoods may benefit most from high greenness. CONCLUSIONS High greenness, compared to low greenness, is associated with lower 5-year AD incidence. Residents who are younger and/or who reside in lower-income, walkable neighborhoods may benefit the most from high greenness. These findings suggest that consistently high greenness at the Census block-level, may be associated with reduced odds of AD incidence at a population level.
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Affiliation(s)
- S C Brown
- William W. Aitken, M.D., on behalf of the University of Miami Built Environment, Behavior, and Health Research Group, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite #1065, Miami, FL 33136, USA. Tel.: +1 305-519-5136.
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11
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Yuan S, Li W, Ling Y, Huang X, Feng A, Tan S, He N, Li L, Li S, Xu A, Lyu J. Associations of screen-based sedentary activities with all cause dementia, Alzheimer's disease, vascular dementia: a longitudinal study based on 462,524 participants from the UK Biobank. BMC Public Health 2023; 23:2141. [PMID: 37919716 PMCID: PMC10621115 DOI: 10.1186/s12889-023-17050-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 10/23/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND Current drug treatments for dementia aren't effective. Studying gene-environment interactions can help develop personalized early intervention strategies for Alzheimer's disease (AD). However, no studies have examined the relationship between screen-based sedentary activities and genetic susceptibility to AD risk, and further understanding of the causal relationship is also crucial. METHODS This study included 462,524 participants from the UK Biobank with a follow-up of 13.6 years. Participants' screen-based sedentary activities time was categorized into three groups based on recorded time: ≥ 4 h/day, 2-3 h/day, and ≤ 1 h/day. Cox proportional risk models were used to analyze the association between computer use/TV viewing groups and the risk of all-cause dementia, AD and vascular dementia (VD). Generalized linear model (GLM) were used to examine the relationship between screen-based sedentary activities and brain structure. Bidirectional Mendelian randomization (MR) was used to validate the causal relationship between TV viewing and AD. RESULTS Compared to TV viewing ≤ 1 h/day, 1)TV viewing 2-3 h/day was correlated with a higher risk of all-cause dementia (HR = 1.09, 95% CI:1.01-1.18, P < 0.05), and TV viewing ≥ 4 h/day was associated with a higher risk of all-cause dementia (HR = 1.29, 95% CI: 1.19-1.40, P < 0.001), AD (HR = 1.25, 95% CI:1.1-1.42, P < 0.001), and VD (HR = 1.24, 95% CI: 1.04-1.49, P < 0.05); 2) TV viewing ≥ 4 h/day was correlated with a higher AD risk at intermediate (HR = 1.34, 95% CI: 1.03-1.75, P < 0.001) and high AD genetic risk score (AD-GRS) (HR = 2.18, 95% CI: 1.65-2.87, P < 0.001);3) TV viewing 2-3 h/day [β = (-94.8), 95% CI: (-37.9) -(-151.7), P < 0.01] and TV viewing ≥ 4 h/day [β = (-92.94), 95% CI: (-17.42) -(-168.46), P < 0.05] were correlated with a less hippocampus volume. In addition, a causal effect of TV viewing times was observed on AD analyzed using MR Egger (OR = 5.618, 95%CI:1.502-21.013, P < 0.05). CONCLUSIONS There was a causal effect between TV viewing time and AD analyzed using bidirectional MR, and more TV viewing time exposure was correlated with a higher AD risk. Therefore, it is recommended that people with intermediate and high AD-GRS should control their TV viewing time to be less than 4 h/ day or even less than 1 h/day.
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Affiliation(s)
- Shiqi Yuan
- Department of Neurology, Guangdong Province, The First Affiliated Hospital of Jinan University, No.613, Huangpu Road West, Guangzhou, 510630, China
| | - Wanyue Li
- Department of Rehabilitation, Guangdong Province, The First Affiliated Hospital of Jinan University, No.613, Huangpu Road West, Guangzhou, 510630, China
| | - Yitong Ling
- Department of Neurology, Guangdong Province, The First Affiliated Hospital of Jinan University, No.613, Huangpu Road West, Guangzhou, 510630, China
| | - Xiaxuan Huang
- Department of Neurology, Guangdong Province, The First Affiliated Hospital of Jinan University, No.613, Huangpu Road West, Guangzhou, 510630, China
| | - Aozi Feng
- Department of Clinical Research, Guangdong Province, The First Affiliated Hospital of Jinan University, No.613, Huangpu Road West, Guangzhou, 510630, China
| | - Shanyuan Tan
- Department of Neurology, Guangdong Province, The First Affiliated Hospital of Jinan University, No.613, Huangpu Road West, Guangzhou, 510630, China
| | - Ningxia He
- Department of Clinical Research, Guangdong Province, The First Affiliated Hospital of Jinan University, No.613, Huangpu Road West, Guangzhou, 510630, China
| | - Li Li
- Department of Clinical Research, Guangdong Province, The First Affiliated Hospital of Jinan University, No.613, Huangpu Road West, Guangzhou, 510630, China
| | - Shuna Li
- Department of Clinical Research, Guangdong Province, The First Affiliated Hospital of Jinan University, No.613, Huangpu Road West, Guangzhou, 510630, China
| | - Anding Xu
- Department of Neurology, Guangdong Province, The First Affiliated Hospital of Jinan University, No.613, Huangpu Road West, Guangzhou, 510630, China.
| | - Jun Lyu
- Department of Clinical Research, Guangdong Province, The First Affiliated Hospital of Jinan University, No.613, Huangpu Road West, Guangzhou, 510630, China.
- Guangdong Provincial Key Laboratory of Traditional Chinese Medicine Informatization, Guangzhou, 510630, Guangdong, China.
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12
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Asri AK, Yeh CH, Chang HT, Lee HY, Lung SCC, Spengler JD, Wu CD. Greenspace related to bipolar disorder in Taiwan: Quantitative benefits of saving DALY loss and increasing income. Health Place 2023; 83:103097. [PMID: 37595541 DOI: 10.1016/j.healthplace.2023.103097] [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: 04/28/2023] [Revised: 08/02/2023] [Accepted: 08/03/2023] [Indexed: 08/20/2023]
Abstract
Scientific evidence reported that surrounding greenspace could promote better mental health. Considering bipolar disorder as the health outcome, this study aimed to investigate the association between greenspace and bipolar disorder in Taiwan and quantified the benefits of greenspace on bipolar disorder adjusted for the international greenspace availability standard. By examining datasets across 348 townships, two quantitative measures (i.e., disability-adjusted life year loss and income) were used to represent the benefits. The incidence rate of bipolar disorder was obtained from Taiwan's National Health Insurance Research Database. Normalized different vegetation index (NDVI) was measured as a proxy for the greenspace availability. A generalized additive mixed model coupled with a sensitivity test were applied to evaluate the statistical association. The prevented fraction for the population (PFP) was then applied to develop a scenario for quantifying benefit. The result showed a significant negative association between greenspace and bipolar disorder in Taiwan. Compared to low greenspace, areas with medium and high greenspace may reduce the bipolar risk by 21% (RR = 0.79; 95% CI = 0.76-0.83) and 51% (RR = 0.49; 95% CI = 0.45-0.53). Calculating benefits, we found that the development of a scenario by increasing greenspace adjusted for availability indicator in township categorized as low greenspace could save in DALY loss due to bipolar disorder up to10.97% and increase in income up to 11.04% from the current situation. Lastly, this was the first study in Asia-Pacific to apply a customized greenspace increment scenario to quantify the benefits to a particular health burden such as bipolar disorder.
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Affiliation(s)
- Aji Kusumaning Asri
- Department of Geomatics, College of Engineering, National Cheng Kung University, Tainan, 70101, Taiwan.
| | - Chia-Hao Yeh
- Department of Geomatics, College of Engineering, National Cheng Kung University, Tainan, 70101, Taiwan.
| | - Hao-Ting Chang
- Department of Geomatics, College of Engineering, National Cheng Kung University, Tainan, 70101, Taiwan.
| | - Hsiao-Yun Lee
- Department of Leisure Industry and Health Promotion, National Taipei University of Nursing and Health Sciences, Taipei, 112, Taiwan.
| | - Shih-Chun Candice Lung
- Research Center for Environmental Changes, Academia Sinica, Taipei, 115, Taiwan; Department of Atmospheric Sciences, National Taiwan University, Taipei, Taiwan; Institute of Environmental Health, School of Public Health, National Taiwan University, Taipei, Taiwan.
| | - John D Spengler
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States.
| | - Chih-Da Wu
- Department of Geomatics, College of Engineering, National Cheng Kung University, Tainan, 70101, Taiwan; National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, 35053, Taiwan; Innovation and Development Center of Sustainable Agriculture, National Chung Hsing University, Taichung City, 402, Taiwan.
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13
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Ryan SC, Sugg MM, Runkle JD, Matthews JL. Spatial Analysis of Greenspace and Mental Health in North Carolina: Consideration of Rural and Urban Communities. FAMILY & COMMUNITY HEALTH 2023; 46:181-191. [PMID: 37083718 PMCID: PMC10806433 DOI: 10.1097/fch.0000000000000363] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Greenspace positively impacts mental health. Previous research has focused on the greenspace-mental health relationship in urban areas. Yet, little work has looked at rural areas despite rural communities reporting similar rates of poor mental health outcomes and higher rates of suicide mortality compared with urban areas. This ecological research study examined the following research questions: (1) Do public and/or private greenspaces affect the spatial distribution of mental health outcomes in North Carolina? (2) Does this relationship change with rurality? Emergency department data for 6 mental health conditions and suicide mortality data from 2009 to 2018 were included in this analysis. Spatial error and ordinary least squares regressions were used to examine the influence of public and private greenspace quantity on mental health in rural and urban communities. Results suggest greenspace benefits mental health in rural and urban communities. The strength of this relationship varies with urbanity and between public and private greenspaces, suggesting a more complex causal relationship. Given the high case counts and often lower density of mental health care facilities in rural areas, focusing attention on low-cost mental health interventions, such as greenspace, is important when considering rural mental health care.
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Affiliation(s)
- Sophia C Ryan
- Department of Geography and Planning, Appalachian State University, Boone, North Carolina (Ms Ryan and Dr Sugg); North Carolina Institute for Climate Studies, North Carolina State University, Raleigh (Dr Runkle); and NOAA's National Centers for Environmental Information (NCEI), Asheville, North Carolina (Dr Matthews)
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14
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Garrett JK, Rowney FM, White MP, Lovell R, Fry RJ, Akbari A, Geary R, Lyons RA, Mizen A, Nieuwenhuijsen M, Parker C, Song J, Stratton G, Thompson DA, Watkins A, White J, Williams SA, Rodgers SE, Wheeler BW. Visiting nature is associated with lower socioeconomic inequalities in well-being in Wales. Sci Rep 2023; 13:9684. [PMID: 37322030 PMCID: PMC10272170 DOI: 10.1038/s41598-023-35427-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 05/17/2023] [Indexed: 06/17/2023] Open
Abstract
Natural environments can promote well-being through multiple mechanisms. Many studies have investigated relationships between residential green/blue space (GBS) and well-being, fewer explore relationships with actual use of GBS. We used a nationally representative survey, the National Survey for Wales, anonymously linked with spatial GBS data to investigate associations of well-being with both residential GBS and time in nature (N = 7631). Both residential GBS and time spent in nature were associated with subjective well-being. Higher green-ness was associated with lower well-being, counter to hypotheses (predicting the Warwick and Edinburgh Mental Well-Being Scale (WEMWBS): Enhanced vegetation index β = - 1.84, 95% confidence interval (CI) - 3.63, - 0.05) but time spent in nature was associated with higher well-being (four hours a week in nature vs. none β = 3.57, 95% CI 3.02, 4.13). There was no clear association between nearest GBS proximity and well-being. In support of the equigenesis theory, time spent in nature was associated with smaller socioeconomic inequalities in well-being. The difference in WEMWBS (possible range 14-70) between those who did and did not live in material deprivation was 7.7 points for those spending no time in nature, and less at 4.5 points for those spending time in nature up to 1 h per week. Facilitating access and making it easier for people to spend time in nature may be one way to reduce socioeconomic inequalities in well-being.
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Affiliation(s)
- Joanne K Garrett
- European Centre for Environment and Human Health, University of Exeter Medical School, Truro, UK.
| | - Francis M Rowney
- European Centre for Environment and Human Health, University of Exeter Medical School, Truro, UK
- School of Geography, Earth and Environmental Sciences, University of Plymouth, Plymouth, UK
| | - Mathew P White
- European Centre for Environment and Human Health, University of Exeter Medical School, Truro, UK
- Cognitive Science HUB, University of Vienna, Vienna, Austria
| | - Rebecca Lovell
- European Centre for Environment and Human Health, University of Exeter Medical School, Truro, UK
| | - Rich J Fry
- Department of Population Data Science, Faculty of Medicine, Health and Life Science, Swansea University Medical School, Swansea University, Swansea, UK
| | - Ashley Akbari
- Department of Population Data Science, Faculty of Medicine, Health and Life Science, Swansea University Medical School, Swansea University, Swansea, UK
| | - Rebecca Geary
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | - Ronan A Lyons
- Department of Population Data Science, Faculty of Medicine, Health and Life Science, Swansea University Medical School, Swansea University, Swansea, UK
| | - Amy Mizen
- Department of Population Data Science, Faculty of Medicine, Health and Life Science, Swansea University Medical School, Swansea University, Swansea, UK
| | - Mark Nieuwenhuijsen
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Chrissie Parker
- Department of Population Data Science, Faculty of Medicine, Health and Life Science, Swansea University Medical School, Swansea University, Swansea, UK
| | | | - Gareth Stratton
- Faculty of Science and Engineering, ASTEM Research Centre, Swansea University, Swansea, UK
| | - Daniel A Thompson
- Department of Population Data Science, Faculty of Medicine, Health and Life Science, Swansea University Medical School, Swansea University, Swansea, UK
| | - Alan Watkins
- Department of Population Data Science, Faculty of Medicine, Health and Life Science, Swansea University Medical School, Swansea University, Swansea, UK
| | - James White
- Centre for Trials Research, School of Medicine, Cardiff University, Cardiff, UK
| | | | - Sarah E Rodgers
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | - Benedict W Wheeler
- European Centre for Environment and Human Health, University of Exeter Medical School, Truro, UK
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15
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Li F, Liu W, Hu C, Tang M, Zhang Y, Ho HC, Peng S, Li Z, Wang Q, Li X, Xu B, Li F. Global association of greenness exposure with risk of nervous system disease: A systematic review and meta-analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 877:162773. [PMID: 36933739 DOI: 10.1016/j.scitotenv.2023.162773] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 03/06/2023] [Accepted: 03/06/2023] [Indexed: 05/06/2023]
Abstract
Nervous system disease (NSD) is a global health burden with increasing prevalence in the last 30 years. There is evidence that greenness can improve nervous system health through a variety of mechanisms; however, the evidence is inconsistent. In the present systematic review and meta-analysis, we examined the relationship between greenness exposure and NSD outcomes. Studies on the relationship between greenness and NSD health outcomes published till July 2022 were searched in PubMed, Cochrane, Embase, Scopus, and Web of Science. In addition, we searched the cited literature and updated our search on Jan 20, 2023, to identify any new studies. We included human epidemiological studies that assess the association of greenness exposure with the risk of NSD. Greenness exposure was measured using NDVI (the normalized difference vegetation index) and the outcome was the mortality or morbidity of NSD. The pooled relative risks (RRs) were estimated using a random effects model. Of 2059 identified studies, 15 studies were included in our quantitative evaluation, in which 11 studies found a significant inverse relationship between the risk of NSD mortality or incidence/prevalence and an increase in surrounding greenness. The pooled RRs for cerebrovascular diseases (CBVD), neurodegenerative diseases (ND), and stroke mortality were 0.98 (95 % CI: 0.97, 1.00), 0.98 (95 % CI: 0.98, 0.99), and 0.96 (95 % CI: 0.93, 1.00), respectively. The pooled RRs for PD incidence and stroke prevalence/incidence were 0.89 (95 % CI: 0.78, 1.02) and 0.98 (95 % CI: 0.97, 0.99), respectively. The confidence of evidence for ND mortality, stroke mortality, and stroke prevalence/incidence was downgraded to "low", while CBVD mortality and PD incidence were downgraded to "very low" due to inconsistency. We found no evidence of publication bias and the sensitivity analysis results of all subgroups are robust except for the stroke mortality subgroup. This is the first comprehensive meta-analysis of greenness exposure and NSD outcomes in which an inverse relationship was observed. It is necessary to conduct further research to ascertain the role greenness exposure plays in various NSDs and the management of greenness should be considered a public health strategy.
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Affiliation(s)
- Fangzheng Li
- School of Landscape Architecture, Beijing Forestry University, Beijing 100083, China.
| | - Wei Liu
- School of Art, Qufu Normal University, Rizhao 276826, China
| | - Chengyang Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, China
| | - Mingcheng Tang
- School of Landscape Architecture and Forestry, Qingdao Agricultural University, Qingdao 266109, China
| | - Yunquan Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Hung Chak Ho
- Department of Anaesthesiology, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Shijia Peng
- Charles Davis's Lab Department of Organismic and Evolutionary Biology, Harvard University, Cambridge, MA 02138, USA
| | - Zhouyuan Li
- School of Grassland Science, Beijing Forestry University, Beijing 100083, China
| | - Qing Wang
- China CDC Key Laboratory of Environment and Population Health/National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Xiong Li
- School of Landscape Architecture, Beijing Forestry University, Beijing 100083, China
| | - Bing Xu
- Department of Earth System Science, Tsinghua University, 10084 Beijing, China
| | - Fengyi Li
- School of Landscape Architecture and Forestry, Qingdao Agricultural University, Qingdao 266109, China.
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16
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Besser LM, Meyer OL, Streitz M, Farias ST, Olichney J, Mitsova D, Galvin JE. Perceptions of greenspace and social determinants of health across the life course: The Life Course Sociodemographics and Neighborhood Questionnaire (LSNEQ). Health Place 2023; 81:103008. [PMID: 37003018 PMCID: PMC10176197 DOI: 10.1016/j.healthplace.2023.103008] [Citation(s) in RCA: 1] [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: 10/15/2022] [Revised: 02/06/2023] [Accepted: 03/10/2023] [Indexed: 04/03/2023]
Abstract
We developed the Life Course Sociodemographics and Neighborhood Questionnaire (LSNEQ) to query older adults about perceived neighborhood greenspaces across the life course (i.e., distance to park, number of neighborhood parks/playgrounds, and neighborhood greenness) and about characteristics hypothesized to confound or moderate/mediate greenspace-health associations. Six perceived life course indices are derived from the LSNEQ: neighborhood socioeconomic status, neighborhood walking/biking, urbanicity, neighborhood amenities, neighborhood park access, and neighborhood greenness. Older adults from St. Louis, Missouri, and Sacramento, California, completed the LSNEQ in 2020-2021. The indices demonstrated borderline acceptable to good internal consistency (alpha = 0.60-0.79) and good to excellent test-retest reliability (ICC = 0.71-0.96) and detected different patterns of park access and neighborhood greenness by racialized group and location. Individuals with index scores indicating more neighborhood walking/biking and greater presence of neighborhood amenities over their life course were more likely to report neighborhood-based walking in older age. Overall, the LSNEQ is a reliable instrument to assess perceptions of life course social determinants of health including neighborhood greenspaces.
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Affiliation(s)
- Lilah M Besser
- Comprehensive Center for Brain Health, Department of Neurology, University of Miami Miller School of Medicine, 7700 W Camino Real, Suite 200, Boca Raton, FL, 33433, USA.
| | - Oanh L Meyer
- Department of Neurology, University of California, Davis, 4860 Y Street, Suite 3900, Sacramento, CA, 95817, USA.
| | - Marissa Streitz
- Department of Neurology, Washington University School of Medicine, 4488 Forest Park, Suite 101, Saint Louis, MO, 63108, USA.
| | - Sarah T Farias
- Department of Neurology, University of California, Davis, 4860 Y Street, Suite 3900, Sacramento, CA, 95817, USA.
| | - John Olichney
- Department of Neurology, University of California, Davis, 4860 Y Street, Suite 3900, Sacramento, CA, 95817, USA.
| | - Diana Mitsova
- Department of Urban and Regional Planning, Florida Atlantic University, 777 Glades Road, SO 284, Boca Raton, FL, 33431, USA.
| | - James E Galvin
- Comprehensive Center for Brain Health, Department of Neurology, University of Miami Miller School of Medicine, 7700 W Camino Real, Suite 200, Boca Raton, FL, 33433, USA.
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Besser LM, Jimenez MP, Reimer CJ, Meyer OL, Mitsova D, George KM, Adkins-Jackson PB, Galvin JE. Diversity of Studies on Neighborhood Greenspace and Brain Health by Racialized/Ethnic Group and Geographic Region: A Rapid Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5666. [PMID: 37174185 PMCID: PMC10178609 DOI: 10.3390/ijerph20095666] [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: 03/03/2023] [Revised: 04/16/2023] [Accepted: 04/21/2023] [Indexed: 05/15/2023]
Abstract
Studies examining associations between greenspace and Alzheimer's disease and related dementia (ADRD) outcomes are rapidly on the rise, yet no known literature reviews have summarized the racialized/ethnic group and geographic variation of those published studies. This is a significant gap given the known disparities in both greenspace access and ADRD risk between racialized/ethnic groups and between developed versus developing countries. In this rapid literature review, we (1) describe the diversity of published greenspace-brain health studies with respect to racialized/ethnic groups and geographic regions; (2) determine the extent to which published studies have investigated racialized/ethnic group differences in associations; and (3) review methodological issues surrounding studies of racialized/ethnic group disparities in greenspace and brain health associations. Of the 57 papers meeting our inclusion criteria as of 4 March 2022, 21% (n = 12) explicitly identified and included individuals who were Black, Hispanic/Latinx, and/or Asian. Twenty-one percent of studies (n = 12) were conducted in developing countries (e.g., China, Dominican Republic, Mexico), and 7% (n = 4) examined racialized/ethnic group differences in greenspace-brain health associations. None of the studies were framed by health disparities, social/structural determinants of health, or related frameworks, despite the known differences in both greenspace availability/quality and dementia risk by racialized/ethnic group and geography. Studies are needed in developing countries and that directly investigate racialized/ethnic group disparities in greenspace-brain health associations to target and promote health equity.
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Affiliation(s)
- Lilah M. Besser
- Comprehensive Center for Brain Health, Miller School of Medicine, University of Miami, Miami, FL 33433, USA
| | - Marcia Pescador Jimenez
- Department of Epidemiology, School of Public Health, Boston University, Boston, MA 02118, USA
| | - Cameron J. Reimer
- Department of Earth & Environment, Boston University, Boston, MA 02118, USA
| | - Oanh L. Meyer
- Department of Neurology, School of Medicine, University of California Davis, Sacramento, CA 95817, USA
| | - Diana Mitsova
- School of Urban and Regional Planning, Florida Atlantic University, Boca Raton, FL 33431, USA
| | - Kristen M. George
- Department of Public Health Sciences, School of Medicine, University of California Davis, Davis, CA 95817, USA
| | - Paris B. Adkins-Jackson
- Departments of Epidemiology and Sociomedical Sciences, Columbia University, New York, NY 10032, USA
| | - James E. Galvin
- Comprehensive Center for Brain Health, Miller School of Medicine, University of Miami, Miami, FL 33433, USA
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18
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Chan OF, Liu Y, Guo Y, Lu S, Chui CHK, Ho HC, Song Y, Cheng W, Chiu RLH, Webster C, Lum TYS. Neighborhood built environments and cognition in later life. Aging Ment Health 2023; 27:466-474. [PMID: 35285762 DOI: 10.1080/13607863.2022.2046697] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Objectives: Maintaining good cognition is crucial in later life. However, most existing research has focused on individual factors impacting cognition, and few studies have investigated the association between neighborhood built environment and older adults' cognition. This study examined the association between neighborhood built environment and cognition among community-dwelling older adults and identified variations in this association between different age groups in the older population.Methods: Data were derived from a cross-sectional survey of 1873 people aged 65 years and above in Hong Kong. We merged individual data from the survey with neighborhood built environment data based on community auditing and geographical information system. After controlling for individual covariates, we used multivariable linear regression to examine the association between neighborhood built environment and cognition.Results: Residents aged 80 and younger in neighborhoods with a higher land-use mix and more public transport terminals exhibited better cognition. Only the number of community centers in a neighborhood was positively associated with cognition for people older than 80.Conclusion: The built environment creates diverse impacts on different age groups among older adults. Our findings provide useful information for urban planners and policymakers for planning community facilities and built environments that consider the needs of different age groups within the older population.
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Affiliation(s)
- On Fung Chan
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
| | - Yuqi Liu
- Department of Urban Planning, South China University of Technology, Guangzhou, China
| | - Yingqi Guo
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Shiyu Lu
- Department of Social and Behavioral Sciences, City University of Hong Kong, Hong Kong
| | - Cheryl Hiu Kwan Chui
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
| | - Hung Chak Ho
- Department of Urban Planning and Design, The University of Hong Kong, Hong Kong
| | - Yimeng Song
- Department of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic University, Hong Kong
| | - Wei Cheng
- Department of Urban Planning and Design, The University of Hong Kong, Hong Kong
| | | | - Chris Webster
- Healthy High Density Cities Lab, The University of Hong Kong, Hong Kong
| | - Terry Yat Sang Lum
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
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Yu W, Esposito M, Li M, Clarke P, Judd S, Finlay J. Neighborhood 'Disamenities': local barriers and cognitive function among Black and white aging adults. BMC Public Health 2023; 23:197. [PMID: 36717795 PMCID: PMC9885664 DOI: 10.1186/s12889-023-15026-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 01/11/2023] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND This study examined the association between cognitive function and three neighborhood 'disamenities' that may pose local barriers to utilizing community resources and increase risk for cognitive decline. METHOD Using national data from 21,165 urban- and suburban-dwelling Black and white adults (mean age: 67 years) in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study, we assessed global cognitive function through a factor score of five cognitive screening tests. General Additive Mixed Models (GAMM) tested whether residing in areas with more polluting sites, highways, and limited walkability was associated with worse cognitive function. RESULTS Limited walkability and the presence of polluting sites had a significant negative association with cognitive function after controlling for individual and neighborhood factors. CONCLUSION Neighborhood disamenities may be linked to cognitive function among aging residents. Identifying neighborhood factors that pose barriers to accessing community resources may inform upstream policy applications to reduce risk for cognitive decline.
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Affiliation(s)
- Wenshan Yu
- Program in Survey and Data Science, Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI, 48104, USA. .,Social Environment and Health, Survey Research Center, Institute for Social Research, University of Michigan 426 Thompson Street, Ann Arbor, MI, United States, 48104.
| | - Michael Esposito
- Social Environment and Health, Survey Research Center, Institute for Social Research, University of Michigan 426 Thompson Street, Ann Arbor, MI United States 48104 ,grid.4367.60000 0001 2355 7002Department of Sociology, Washington University in St. Louis, St. Louis, MO 63130 USA
| | - Mao Li
- Program in Survey and Data Science, Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI 48104 USA ,Social Environment and Health, Survey Research Center, Institute for Social Research, University of Michigan 426 Thompson Street, Ann Arbor, MI United States 48104
| | - Philippa Clarke
- Social Environment and Health, Survey Research Center, Institute for Social Research, University of Michigan 426 Thompson Street, Ann Arbor, MI United States 48104 ,grid.214458.e0000000086837370Center for Social Epidemiology and Population Health, Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109 USA
| | - Suzanne Judd
- grid.265892.20000000106344187School of Public Health, University of Alabama at Birmingham, 1665 University Blvd, Birmingham, AL 35233 USA
| | - Jessica Finlay
- Social Environment and Health, Survey Research Center, Institute for Social Research, University of Michigan 426 Thompson Street, Ann Arbor, MI United States 48104 ,grid.214458.e0000000086837370Center for Social Epidemiology and Population Health, Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109 USA
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Hu HY, Ma YH, Deng YT, Ou YN, Cheng W, Feng JF, Tan L, Yu JT. Residential greenness and risk of incident dementia: A prospective study of 375,342 participants. ENVIRONMENTAL RESEARCH 2023; 216:114703. [PMID: 36334822 DOI: 10.1016/j.envres.2022.114703] [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: 08/20/2022] [Revised: 10/25/2022] [Accepted: 10/28/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Incorporation of greenspace may be a novel environmental policy that might result in positive health effects; hence, this study aimed to investigate the association between residential greenness and dementia incidence. The effects of particulate air pollution on mediating dementia were also determined. METHODS A prospective cohort study involving 375,342 UK biobank participants was conducted, in which Cox regression models were used to determine the association of greenspace exposure with the risks of all-cause dementia (ACD), Alzheimer's disease (AD) and vascular dementia (VD). Sociodemographic variables, lifestyle or dietary characteristics and apolipoprotein E4 status were controlled using two levels of adjusted models. Mediation analyses were performed to determine the mediation effects of PMs. RESULTS The results indicated that there were 4929 ACD, 2132 AD, and 1184 VD incidents throughout the 8-year study. In the multi-adjusted model, each interquartile increment in greenspace (buffer 300m) conferred the lower risks of ACD (HR = 0.968, 95% confidence intervals [CI]: 0.938-1.000]) and VD (HR = 0.926, 95% CI: 0.867-0.989). The fourth greenspace quartile conferred also reduced risks of ACD (HR = 0.891, 95% CI: 0.804-0.989) and VD (HR = 0.778, 95% CI: 0.630-0.960) in reference to the first quartile. With regard to 1000m catchment, each interquartile increment conferred a 5.0% (95% CI: 1.8-8.1) lower risk of ACD, and the fourth greenspace quartile conferred a 10.9% (95% CI: 0.9-19.8) lower risk of ACD compared to the first quartile. The protective effect of greenness might be mediated based on the reduction of PM2.5 and PM10 (Pindirect effect<0.05). CONCLUSIONS Increasing greenness reduces the risk of dementia. This study suggests that greenspace is an environmental strategy that helps prevent dementia.
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Affiliation(s)
- He-Ying Hu
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China.
| | - Ya-Hui Ma
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China.
| | - Yue-Ting Deng
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China.
| | - Ya-Nan Ou
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China.
| | - Wei Cheng
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China.
| | - Jian-Feng Feng
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China.
| | - Lan Tan
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China.
| | - Jin-Tai Yu
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China.
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Ma L, Huang Y, Liu T. Unequal impact of the COVID-19 pandemic on mental health: Role of the neighborhood environment. SUSTAINABLE CITIES AND SOCIETY 2022; 87:104162. [PMID: 36092492 PMCID: PMC9443661 DOI: 10.1016/j.scs.2022.104162] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 07/17/2022] [Accepted: 09/01/2022] [Indexed: 06/01/2023]
Abstract
The COVID-19 pandemic has taken a significant toll on people's mental wellbeing. Few studies have investigated how the neighborhood environment might help to moderate the mental health impact in a natural disaster context. We aim to investigate the unequal impact of the pandemic on mental health between different population groups, and the role of the neighborhood environment in alleviating this impact. We collected survey data (n=2,741) on mental health, neighborhood environment, and pandemic-related behaviors in Beijing metropolitan region between July 10 and 28, 2020, and then applied the partial proportional odds model. Overall, we found that the pandemic has disproportionately affected the lower-income people. The lower-income residents experienced a greater psychological impact than the higher-income residents. We further found that distance to an urban park was a key built environment variable that moderates mental health impact. Residents who lived near urban parks were 4.2 to 4.6% less likely to report an increase in negative emotions, and therefore are more resilient to the mental health impact. In addition to the built environment, a cohesive neighborhood environment may have also helped to mitigate the negative mental health impacts. These findings can inform planning policies that aim to promote healthy and resilient communities.
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Affiliation(s)
- Liang Ma
- College of Urban and Environmental Sciences, Peking University, Beijing 100871, China
- Center for Urban Future Research, Peking University, Beijing 100871, China
- Key Laboratory of Territorial Spatial Planning and Development-Protection, Ministry of Natural Resources of China, Beijing 100871, China
| | - Yan Huang
- College of Urban and Environmental Sciences, Peking University, Beijing 100871, China
- Center for Urban Future Research, Peking University, Beijing 100871, China
- Key Laboratory of Territorial Spatial Planning and Development-Protection, Ministry of Natural Resources of China, Beijing 100871, China
| | - Tao Liu
- College of Urban and Environmental Sciences, Peking University, Beijing 100871, China
- Center for Urban Future Research, Peking University, Beijing 100871, China
- Key Laboratory of Territorial Spatial Planning and Development-Protection, Ministry of Natural Resources of China, Beijing 100871, China
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22
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Fernández Núñez MB, Campos Suzman L, Maneja R, Bach A, Marquet O, Anguelovski I, Knobel P. The Differences by Sex and Gender in the Relationship Between Urban Greenness and Cardiometabolic Health: A Systematic Review. J Urban Health 2022; 99:1054-1067. [PMID: 36180810 PMCID: PMC9727044 DOI: 10.1007/s11524-022-00685-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
In an increasingly urbanized world, where cardiometabolic issues in cities have raised public health concerns, urban greenness is known to be beneficial for some of the most common health issues. However, the examination of the contribution of sex and gender regarding the benefits of urban greenness for people's cardiometabolic health is lacking. For that reason, we conducted a systematic review of previous literature on the topic following the PRISMA methodology. Additionally, we assessed the quality of the included articles, which we found satisfactory as most papers were of very good or good quality. We explored the relationship between urban greenness exposure and cardiovascular risk factors, cardiovascular diseases, and mortality from cardiovascular diseases. Results suggest that urban greenness is protective against cardiovascular risk factors, diseases, and mortality. When stratifying results by sex and gender, findings point to urban greenness being more beneficial for women and females in stroke and cardiovascular risk factors, except for hypertension and lipid accumulation product. On the other hand, males were more protected by urban greenness in terms of cardiovascular diseases and CVD-related mortality, thus proving that sex and gender health inequalities exist. Furthermore, looking towards the future, research needs to use the proper terminology for sex and gender and policy makers should design urban greenness with a gender perspective.
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Affiliation(s)
| | - Lia Campos Suzman
- Environmental Science and Technology Institute (ICTA), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Roser Maneja
- Forest Science and Technology Center of Catalonia, Ctra. de St. Llorenç de Morunys, km 2, 25280, Solsona, Spain
- Environment and Human Health Laboratory (EH2 Lab), Ctra. de St. Llorenç de Morunys, km 2, 25280, Solsona, Spain
- Geography Department, Autonomous University of Barcelona, Barcelona, Spain
| | - Albert Bach
- Forest Science and Technology Center of Catalonia, Ctra. de St. Llorenç de Morunys, km 2, 25280, Solsona, Spain
- Environment and Human Health Laboratory (EH2 Lab), Ctra. de St. Llorenç de Morunys, km 2, 25280, Solsona, Spain
| | - Oriol Marquet
- Geography Department, Autonomous University of Barcelona, Barcelona, Spain
| | - Isabelle Anguelovski
- Environmental Science and Technology Institute (ICTA), Universitat Autònoma de Barcelona, Barcelona, Spain
- ICREA, Institució Catalana de Recerca I Estudis Avançats, Barcelona, Spain
| | - Pablo Knobel
- Icahn School of Medicine at Mount Sinai, Department of Environmental Medicine and Public Health, 1 Gustave L. Levy Place, Box 1057, New York, NY, 10029, USA.
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Yu H, Xu S, Li H, Wang X, Sun Q, Wang Y. A man-made divide: Investigating the effect of urban–rural household registration and subjective social status on mental health mediated by loneliness among a large sample of university students in China. Front Psychol 2022; 13:1012393. [DOI: 10.3389/fpsyg.2022.1012393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 10/28/2022] [Indexed: 11/18/2022] Open
Abstract
IntroductionThe urban–rural household registration system in China has been documented with profound social consequences in almost all areas of people’s life. This study aims to investigate the underlying mechanism of the rural and urban discrepancies on mental health conditions among a large sample of college students in China.MethodsA survey was distributed among college students in China. A total of 96,218 college students from 63 colleges completed the survey, answering questions on their urban–rural household registration, disposable household income, subjective social status, feelings of loneliness, and anxiety and depression symptoms. Confirmatory Factor Analysis (CFA) and Structural Equation Modelling (SEM) analyses were conducted, testing the effect of urban–rural registration on one’s mental health, mediated by subjective social status, and loneliness.ResultsStructural Equation Modelling (SEM) results revealed that the urban–rural household registration showed a direct effect on anxiety (B = −0.03, 95% CI [−0.038, −0.022], β = −0.03, p < 0.001) and depression (B = −0.03, 95% CI [−0.035, −0.023], β = −0.03, p < 0.001), indicating that rural household registration had a negative association with anxiety and depression symptoms, albeit the standardised estimate being very small. The indirect path from the urban–rural registration mediated through subjective social status and loneliness to anxiety and depression was both significant, with B = 0.01, 95% CI [0.010, 0.010], β = 0.01, p < 0.001, and B = 0.01, 95% CI [0.0090, 0.0090], β = 0.01, p < 0.001, respectively. The results of the indirect paths demonstrated that students of the rural household registration reported higher anxiety and depression symptoms through a lower subjective social status and higher level of loneliness.ConclusionThis study indicated that decreasing the disparity of social status and tackling loneliness is the key to improve the overall mental health of college students. The urban–rural household registration system may have a very small direct effect on the college students’ mental health; but students of urban registration enjoyed higher subjective social status, which had a clear protective effect against anxiety and depression symptoms.
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Hautekiet P, Saenen ND, Aerts R, Martens DS, Roels HA, Bijnens EM, Nawrot TS. Higher buccal mtDNA content is associated with residential surrounding green in a panel study of primary school children. ENVIRONMENTAL RESEARCH 2022; 213:113551. [PMID: 35654156 DOI: 10.1016/j.envres.2022.113551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 05/18/2022] [Accepted: 05/19/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Mitochondria are known to respond to environmental stressors but whether green space is associated with mitochondrial abundance is unexplored. Furthermore, as exposures may affect health from early life onwards, we here evaluate if residential green space is associated with mitochondria DNA content (mtDNAc) in children. METHODS In primary schoolchildren (COGNAC study), between 2012 and 2014, buccal mtDNAc was repeatedly (three times) assessed using qPCR. Surrounding low (<3m), high (≥3m) and total (sum of low and high) green space within different radii (100m-1000m) from the residence and distance to the nearest large green space (>0.5ha) were estimated using a remote sensing derived map. Given the repeated measures design, we applied a mixed-effects model with school and subject as random effect while adjusting for a priori chosen fixed covariates. RESULTS mtDNAc was assessed in 246 children with a total of 436 measurements (mean age 10.3 years). Within a 1000m radius around the residential address, an IQR increment in low (11.0%), high (9.5%), and total (13.9%) green space was associated with a respectively 15.2% (95% CI: 7.2%-23.7%), 10.8% (95% CI: 4.5%-17.5%), and 13.4% (95% CI: 7.4%-19.7%) higher mtDNAc. Conversely, an IQR increment (11.6%) in agricultural area in the same radius was associated with a -3.4% (95% CI: 6.7% to -0.1%) lower mtDNAc. Finally, a doubling in distance to large green space was associated with a -5.2% (95% CI: 7.9 to -2.4%) lower mtDNAc. CONCLUSION To our knowledge, this is the first study evaluating associations between residential surrounding green space and mtDNAc in children. Our results showed that green space was associated with a higher mtDNAc in children, which indicates the importance of the early life environment. To what extent these findings contribute to later life health effects should be further examined.
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Affiliation(s)
- Pauline Hautekiet
- Centre for Environmental Sciences, Hasselt University, Agoralaan Gebouw D, BE-3590, Hasselt, Belgium; Risk and Health Impact Assessment, Sciensano (Belgian Institute of Health), Juliette Wytsmanstraat 14, BE-1050, Brussels, Belgium
| | - Nelly D Saenen
- Centre for Environmental Sciences, Hasselt University, Agoralaan Gebouw D, BE-3590, Hasselt, Belgium; Risk and Health Impact Assessment, Sciensano (Belgian Institute of Health), Juliette Wytsmanstraat 14, BE-1050, Brussels, Belgium
| | - Raf Aerts
- Centre for Environmental Sciences, Hasselt University, Agoralaan Gebouw D, BE-3590, Hasselt, Belgium; Risk and Health Impact Assessment, Sciensano (Belgian Institute of Health), Juliette Wytsmanstraat 14, BE-1050, Brussels, Belgium; Department of Ecology, Evolution and Biodiversity Conservation, University of Leuven (KU Leuven), Kasteelpark Arenberg 31-2435, BE-3001, Leuven, Belgium
| | - Dries S Martens
- Centre for Environmental Sciences, Hasselt University, Agoralaan Gebouw D, BE-3590, Hasselt, Belgium
| | - Harry A Roels
- Centre for Environmental Sciences, Hasselt University, Agoralaan Gebouw D, BE-3590, Hasselt, Belgium; Louvain Centre for Toxicology and Applied Pharmacology, Université Catholique de Louvain, Av. Hippocrate 57, BE-1200, Woluwe-Saint-Lambert, Belgium
| | - Esmée M Bijnens
- Centre for Environmental Sciences, Hasselt University, Agoralaan Gebouw D, BE-3590, Hasselt, Belgium; Department of Human Structure and Repair, Ghent University Hospital, Corneel Heymanslaan 10, BE-9000, Ghent, Belgium
| | - Tim S Nawrot
- Centre for Environmental Sciences, Hasselt University, Agoralaan Gebouw D, BE-3590, Hasselt, Belgium; Department of Public Health & Primary Care, University of Leuven (KU Leuven), O&N I Herestraat 49 - Bus 706, BE-3000, Leuven, Belgium.
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Finlay J, Esposito M, Langa KM, Judd S, Clarke P. Cognability: An Ecological Theory of neighborhoods and cognitive aging. Soc Sci Med 2022; 309:115220. [PMID: 35926362 PMCID: PMC9661364 DOI: 10.1016/j.socscimed.2022.115220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 05/19/2022] [Accepted: 07/13/2022] [Indexed: 11/17/2022]
Abstract
While a growing body of evidence points to potentially modifiable individual risk factors for dementia, the built and social environments in which people develop and navigate cognitive decline are largely overlooked. This paper proposes a new theoretical concept, Cognability, to conceptualize how supportive an area is to cognitive health among aging residents. Cognability incorporates a constellation of both positive and negative neighborhood features related to physical activity, social interaction and cognitive stimulation in later life. We analyzed data from the REasons for Geographic And Racial Differences in Stroke Study, a national sample of older Black and white adults in the United States (n = 21,151; mean age at assessment = 67; data collected 2006-2017). Generalized additive multilevel models examined how cognitive function varied by neighborhood features. Access to civic and social organizations, recreation centers, fast-food and coffee establishments, arts centers, museums, and highways were significantly associated with cognitive function. Race-, gender-, and education-specific models did not yield substantial improvements to the full-model. Our results suggest that the unequal distribution of amenities and hazards across neighborhoods may help account for considerable inequities observed in cognitive health among older adults. Cognability advances ecological theories of aging through an innovative "whole neighborhood" approach. It aims to identify which specific neighborhood features are most protective of cognitive health among aging adults to inform upstream public health initiatives, community interventions, and policy.
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Affiliation(s)
- Jessica Finlay
- Social Environment and Health Program, Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI, 48104, United States; Center for Social Epidemiology and Population Health, Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, United States.
| | - Michael Esposito
- Department of Sociology, Washington University in St. Louis, St. Louis, MO, 63130, United States
| | - Kenneth M Langa
- Department of Internal Medicine, Division of General Medicine, 2800 Plymouth Road, Ann Arbor, MI, 48109, United States
| | - Suzanne Judd
- School of Public Health, University of Alabama at Birmingham, 1665 University Blvd, Birmingham, AL, 35233, United States
| | - Philippa Clarke
- Social Environment and Health Program, Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI, 48104, United States; Center for Social Epidemiology and Population Health, Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, United States
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John EE, Astell-Burt T, Yu P, Brennan-Horley C, Feng X. Green Space and Inequities in Healthy Ageing: Are Grasses Greener on the Socioeconomically Advantaged Side? ECOPSYCHOLOGY 2022. [DOI: 10.1089/eco.2021.0042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Eme Eseme John
- Population Wellbeing and Environment Research Lab (PowerLab), New South Wales, Australia
| | - Thomas Astell-Burt
- Population Wellbeing and Environment Research Lab (PowerLab), New South Wales, Australia
- School of Health and Society, Faculty of Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia
| | - Ping Yu
- Centre for IT Enabled Transformation, School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, Australia
| | - Chris Brennan-Horley
- School of Geography and Sustainable Communities, Australian Centre for Culture, Environment, Society and Space (ACCESS), University of Wollongong, Wollongong, Australia
| | - Xiaoqi Feng
- Population Wellbeing and Environment Research Lab (PowerLab), New South Wales, Australia
- School of Health and Society, Faculty of Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
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27
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Firouraghi N, Kiani B, Jafari HT, Learnihan V, Salinas-Perez JA, Raeesi A, Furst M, Salvador-Carulla L, Bagheri N. The role of geographic information system and global positioning system in dementia care and research: a scoping review. Int J Health Geogr 2022; 21:8. [PMID: 35927728 PMCID: PMC9354285 DOI: 10.1186/s12942-022-00308-1] [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: 04/20/2022] [Accepted: 07/25/2022] [Indexed: 11/10/2022] Open
Abstract
Background Geographic Information System (GIS) and Global Positioning System (GPS), vital tools for supporting public health research, provide a framework to collect, analyze and visualize the interaction between different levels of the health care system. The extent to which GIS and GPS applications have been used in dementia care and research is not yet investigated. This scoping review aims to elaborate on the role and types of GIS and GPS applications in dementia care and research. Methods A scoping review was conducted based on Arksey and O’Malley’s framework. All published articles in peer-reviewed journals were searched in PubMed, Scopus, and Web of Science, subject to involving at least one GIS/GPS approach focused on dementia. Eligible studies were reviewed, grouped, and synthesized to identify GIS and GPS applications. The PRISMA standard was used to report the study. Results Ninety-two studies met our inclusion criteria, and their data were extracted. Six types of GIS/GPS applications had been reported in dementia literature including mapping and surveillance (n = 59), data preparation (n = 26), dementia care provision (n = 18), basic research (n = 18), contextual and risk factor analysis (n = 4), and planning (n = 1). Thematic mapping and GPS were most frequently used techniques in the dementia field. Conclusions Even though the applications of GIS/GPS methodologies in dementia care and research are growing, there is limited research on GIS/GPS utilization in dementia care, risk factor analysis, and dementia policy planning. GIS and GPS are space-based systems, so they have a strong capacity for developing innovative research based on spatial analysis in the area of dementia. The existing research has been summarized in this review which could help researchers to know the GIS/GPS capabilities in dementia research. Supplementary Information The online version contains supplementary material available at 10.1186/s12942-022-00308-1.
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Affiliation(s)
- Neda Firouraghi
- Department of Medical Informatics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Behzad Kiani
- Department of Medical Informatics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. .,École de Santé Publique de L'Université de Montréal (ESPUM), Québec, Montréal, Canada.
| | - Hossein Tabatabaei Jafari
- Visual and Decision Analytics Lab, Health Research Institute, Faculty of Health, University of Canberra, Canberra, Australia
| | - Vincent Learnihan
- Health Research Institute, University of Canberra, Building 23 Office B32, University Drive, Bruce, Canberra, ACT, 2617, Australia
| | - Jose A Salinas-Perez
- Department of Quantitative Methods,, Universidad Loyola Andalucía, Spain Faculty of Medicine, University of Canberra, Canberra, Australia
| | - Ahmad Raeesi
- Department of Medical Informatics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - MaryAnne Furst
- Health Research Institute, University of Canberra, Building 23 Office B32, University Drive, Bruce, Canberra, ACT, 2617, Australia
| | - Luis Salvador-Carulla
- Mental Health Policy Unit, Health Research Institute, Faculty of Health, University of Canberra, Canberra, Australia.,Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Nasser Bagheri
- Department of Medical Informatics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Perceived Qualities, Visitation and Felt Benefits of Preferred Nature Spaces during the COVID-19 Pandemic in Australia: A Nationally-Representative Cross-Sectional Study of 2940 Adults. LAND 2022. [DOI: 10.3390/land11060904] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
We investigated how the perceived quality of natural spaces influenced levels of visitation and felt benefits during the COVID-19 pandemic in Australia via a nationally representative online and telephone survey conducted on 12–26 October (Social Research Centre’s Life in AustraliaTM panel aged > 18 years, 78.8% response, n = 3043). Our sample was restricted to those with complete information (n = 2940). Likert scale responses to 18 statements regarding the quality of local natural spaces that participants preferred to visit were classified into eight quality domains: access; aesthetics; amenities; facilities; incivilities; potential usage; safety; and social. These domains were then summed into an overall nature quality score (mean = 5.8, range = 0–16). Associations between these quality variables and a range of nature visitation and felt benefits were tested using weighted multilevel models, adjusted for demographic and socioeconomic confounders. Compared with participants in the lowest perceived nature quality quintile, those in the highest quality quintile had higher odds of spending at least 2 h in their preferred local nature space in the past week (Odds Ratio [OR] = 3.40; 95% Confidence Interval [95%CI] = 2.38–4.86), of visiting their preferred nature space almost every day in the past four weeks (OR = 3.90; 2.77–5.47), and of reporting increased levels of nature visitation in comparison with before the COVID-19 pandemic (OR = 3.90; 2.54–6.00). Participants in the highest versus lowest perceived nature quality quintile also reported higher odds of feeling their visits to nature enabled them to take solace and respite during the pandemic (OR = 9.49; 6.73–13.39), to keep connected with their communities (OR = 5.30; 3.46–8.11), and to exercise more often than they did before the pandemic (OR = 3.88; 2.57–5.86). Further analyses of each quality domain indicated time in and frequency of visiting nature spaces were most affected by potential usage and safety (time in nature was also influenced by the level of amenity). Feelings of connection and solace were most affected by potential usage and social domains. Exercise was most influenced by potential usage, social and access domains. In conclusion, evidence reported in this study indicates that visits to nature and various health-related benefits associated with it during the COVID-19 pandemic were highly contingent upon numerous qualities of green and blue spaces.
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Alegría M, Zhen-Duan J, O’Malley IS, DiMarzio K. A New Agenda for Optimizing Investments in Community Mental Health and Reducing Disparities. Am J Psychiatry 2022; 179:402-416. [PMID: 35599537 PMCID: PMC9205621 DOI: 10.1176/appi.ajp.21100970] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The Biden-Harris Administration's FY22 budget includes $1.6 billion for the Community Mental Health Services Block Grant program, more than double the FY21 allocation, given the rising mental health crises observed across the nation. This is timely since there have been two interrelated paradigm shifts: one giving attention to the role of the environmental context as central in mental health outcomes, the other moving upstream to earlier mental health interventions at the community level rather than only at the individual level. An opportunity to reimagine and redesign the agenda of mental health research and service delivery with marginalized communities opens the door to more community-based care interventions. This involves establishing multisector partnerships to address the social and psychological needs that can be addressed at the community level rather than the clinical level. This will require a shift in training, delivery systems, and reimbursement models. The authors describe the scientific evidence justifying these programs and elaborate on opportunities to target investments in community mental health that can reduce disparities and improve well-being for all. They select levers where there is some evidence that such approaches matter substantially, are modifiable, and advance the science and public policy practice. They conclude with specific recommendations and the logistical steps needed to support this transformational shift.
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Affiliation(s)
- Margarita Alegría
- Disparities Research Unit, Massachusetts General Hospital, Boston, MA, USA,Department of Medicine, Harvard Medical School, Boston, MA, USA,Department of Psychiatry, Harvard Medical School, Boston, MA, USA,Correspondence: Margarita Alegría, Massachusetts General Hospital Disparities Research Unit, Department of Medicine, 50 Staniford Street, Suite 830, Boston, MA 02114; ; Phone: 617-724-1237; Fax: 617-726-4120
| | - Jenny Zhen-Duan
- Disparities Research Unit, Massachusetts General Hospital, Boston, MA, USA,Department of Medicine, Harvard Medical School, Boston, MA, USA
| | | | - Karissa DiMarzio
- Department of Psychology, Florida International University, Miami, FL, USA
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Santos CJ, Paciência I, Ribeiro AI. Neighbourhood Socioeconomic Processes and Dynamics and Healthy Ageing: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116745. [PMID: 35682327 PMCID: PMC9180257 DOI: 10.3390/ijerph19116745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 05/26/2022] [Accepted: 05/30/2022] [Indexed: 02/05/2023]
Abstract
Elderly citizens are concentrated in urban areas and are particularly affected by the immediate residential environment. Cities are unequal and segregated places, where there is an intensification of urban change processes such as gentrification and displacement. We aimed to understand how neighbourhood socioeconomic processes and dynamics influence older people’s health. Three bibliographic databases—PubMed, Web of Science, and Scopus—were used to identify evidence of the influence of neighbourhood socioeconomic deprivation, socio-spatial segregation, urban renewal, and gentrification on healthy ageing. We followed the method of Arksey and O’Malley, Levac and colleagues, the Joanna Briggs Institute, and the PRISMA-ScR. The included studies (n = 122) were published between 2001 and 2021. Most evaluated neighbourhood deprivation (n = 114), followed by gentrification (n = 5), segregation (n = 2), and urban renewal (n = 1). Overall, older people living in deprived neighbourhoods had worse healthy ageing outcomes than their counterparts living in more advantaged neighbourhoods. Older adults pointed out more negative comments than positive ones for gentrification and urban renewal. As to segregation, the direction of the association was not entirely clear. In conclusion, the literature has not extensively analysed the effects of segregation, gentrification, and urban renewal on healthy ageing, and more quantitative and longitudinal studies should be conducted to draw better inferences.
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Affiliation(s)
- Cláudia Jardim Santos
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal;
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), 4050-600 Porto, Portugal
- Correspondence: ; Tel.: +351-222-061-820
| | - Inês Paciência
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, P.O. Box 5000, 90570 Oulu, Finland;
- Biocenter Oulu, University of Oulu, P.O. Box 5000, 90570 Oulu, Finland
| | - Ana Isabel Ribeiro
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal;
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), 4050-600 Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, 4200-319 Porto, Portugal
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Rodriguez-Loureiro L, Gadeyne S, Bauwelinck M, Lefebvre W, Vanpoucke C, Casas L. Long-term exposure to residential greenness and neurodegenerative disease mortality among older adults: a 13-year follow-up cohort study. Environ Health 2022; 21:49. [PMID: 35525977 PMCID: PMC9077872 DOI: 10.1186/s12940-022-00863-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 04/29/2022] [Indexed: 05/04/2023]
Abstract
BACKGROUND Living in greener areas is associated with slower cognitive decline and reduced dementia risk among older adults, but the evidence with neurodegenerative disease mortality is scarce. We studied the association between residential surrounding greenness and neurodegenerative disease mortality in older adults. METHODS We used data from the 2001 Belgian census linked to mortality register data during 2001-2014. We included individuals aged 60 years or older and residing in the five largest Belgian urban areas at baseline (2001). Exposure to residential surrounding greenness was assessed using the 2006 Normalized Difference Vegetation Index (NDVI) within 500-m from residence. We considered all neurodegenerative diseases and four specific outcomes: Alzheimer's disease, vascular dementia, unspecified dementia, and Parkinson's disease. We fitted Cox proportional hazard models to obtain hazard ratios (HR) and 95% confidence intervals (CI) of the associations between one interquartile range (IQR) increment in surrounding greenness and neurodegenerative disease mortality outcomes, adjusted for census-based covariates. Furthermore, we evaluated the potential role of 2010 air pollution (PM2.5 and NO2) concentrations, and we explored effect modification by sociodemographic characteristics. RESULTS From 1,134,502 individuals included at baseline, 6.1% died from neurodegenerative diseases during follow-up. After full adjustment, one IQR (0.22) increment of surrounding greenness was associated with a 4-5% reduction in premature mortality from all neurodegenerative diseases, Alzheimer's disease, vascular and unspecified dementia [e.g., for Alzheimer's disease mortality: HR 0.95 (95%CI: 0.93, 0.98)]. No association was found with Parkinson's disease mortality. Main associations remained for all neurodegenerative disease mortality when accounting for air pollution, but not for the majority of specific mortality outcomes. Associations were strongest in the lower educated and residents from most deprived neighbourhoods. CONCLUSIONS Living near greener spaces may reduce the risk of neurodegenerative disease mortality among older adults, potentially independent from air pollution. Socioeconomically disadvantaged groups may experience the greatest beneficial effect.
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Affiliation(s)
| | - Sylvie Gadeyne
- Interface Demography, Department of Sociology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Mariska Bauwelinck
- Interface Demography, Department of Sociology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Wouter Lefebvre
- Flemish Institute for Technological Research (VITO), Mol, Belgium
| | | | - Lidia Casas
- Department of Family Medicine and Population Health, Social Epidemiology and Health Policy, University of Antwerp, Wilrijk, Belgium
- Institute for Environment and Sustainable Development (IMDO), University of Antwerp, Antwerp, Belgium
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Lu S, Oh W, Ooka R, Wang L. Effects of Environmental Features in Small Public Urban Green Spaces on Older Adults’ Mental Restoration: Evidence from Tokyo. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095477. [PMID: 35564870 PMCID: PMC9100600 DOI: 10.3390/ijerph19095477] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 04/25/2022] [Accepted: 04/27/2022] [Indexed: 01/27/2023]
Abstract
Exposure to small public urban green spaces (SPUGS) has been demonstrated to have mental benefits for older adults. However, studies on identifying the objective environmental features of SPUGS and their effects on mental restoration for older adults remain limited. This study employed a multilevel regression model to investigate the restorative and vitalizing effects of the environmental features of 11 SPUGS in Tokyo. Onsite measurements were conducted in Kita-Ku, and 202 older adults were surveyed. The results showed that: (1) The fitting curve of the green view index and Restoration Outcome Scale (ROS) score showed an inverted U shape—both green view index and boundary enclosure had a strong impact on the mental restoration of older adults; (2) The colorfulness index showed the strongest relationship with the vitalizing effect. (3) The sky view factor and number of seats only influenced the ROS score, while the results of revitalization suggest that large areas of water should be avoided. (4) Physiological Equivalent Temperature (PET) was also confirmed to have negative effects on the mental restoration of older adults in autumn. These empirical findings can be used as a resource to promote the mental health of older adults in the design of SPUGS in high-density Asian countries.
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Affiliation(s)
- Shan Lu
- Department of Architecture, School of Architecture, Tianjin University, Tianjin 300072, China;
| | - Wonseok Oh
- Institute of Industrial Science, The University of Tokyo, Tokyo 153-8505, Japan; (W.O.); (R.O.)
| | - Ryozo Ooka
- Institute of Industrial Science, The University of Tokyo, Tokyo 153-8505, Japan; (W.O.); (R.O.)
| | - Lijun Wang
- Department of Architecture, School of Architecture, Tianjin University, Tianjin 300072, China;
- Correspondence:
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Koh C, Kondo MC, Rollins H, Bilal U. Socioeconomic Disparities in Hypertension by Levels of Green Space Availability: A Cross-Sectional Study in Philadelphia, PA. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042037. [PMID: 35206224 PMCID: PMC8872624 DOI: 10.3390/ijerph19042037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 02/08/2022] [Accepted: 02/08/2022] [Indexed: 01/18/2023]
Abstract
Green spaces have been proposed as equigenic factors, potentially mitigating health disparities. We used data from the 3887 participants residing in Philadelphia who participated in the Public Health Management Corporation’s Southeastern Pennsylvania Household Health Survey in 2014–2015 to assess whether socioeconomic disparities in hypertension are modified by availability of neighborhood-level green spaces. Socioeconomic status (SES) was measured using individual-level education and neighborhood-level median household income. Green space availability was measured using surrounding percent tree canopy cover, mean normalized difference vegetation index (NDVI), and proximity to nearest park. Using logistic regression models adjusted for age, sex, and race/ethnicity, we found that adults with higher educational attainment had significantly lower levels of hypertension (OR = 0.63, 0.57, and 0.36 for high school, some college, and college graduates, respectively, as compared to those with less than high school education), and this pattern was similar for median household income (higher prevalence in lower income areas). We found no significant interaction between education and percent tree canopy cover (p = 0.83), meaning that educational disparities in hypertension were similar across all levels of green space availability. These results held when using mean NDVI or distance to nearest park as availability measures, or when considering neighborhood-level median household income as the socioeconomic measure, although the specific patterns and significance of interactions varied by exposure and modifier. While socioeconomic disparities in hypertension are strong for adults residing in Philadelphia, green spaces did not seem to modify them.
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Affiliation(s)
- Celina Koh
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, 3215 Market St., Philadelphia, PA 19104, USA;
- Urban Health Collaborative, Drexel University Dornsife School of Public Health, 3600 Market St., Philadelphia, PA 19104, USA;
| | - Michelle C. Kondo
- Northern Research Station, United States Department of Agriculture–Forest Service, 100 N. St., Ste 205, Philadelphia, PA 19103, USA;
| | - Heather Rollins
- Urban Health Collaborative, Drexel University Dornsife School of Public Health, 3600 Market St., Philadelphia, PA 19104, USA;
| | - Usama Bilal
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, 3215 Market St., Philadelphia, PA 19104, USA;
- Urban Health Collaborative, Drexel University Dornsife School of Public Health, 3600 Market St., Philadelphia, PA 19104, USA;
- Correspondence: ; Tel.: +1-267-359-6378
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Slawsky ED, Hajat A, Rhew IC, Russette H, Semmens EO, Kaufman JD, Leary CS, Fitzpatrick AL. Neighborhood greenspace exposure as a protective factor in dementia risk among U.S. adults 75 years or older: a cohort study. Environ Health 2022; 21:14. [PMID: 35033073 PMCID: PMC8760791 DOI: 10.1186/s12940-022-00830-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 01/06/2022] [Indexed: 05/05/2023]
Abstract
BACKGROUND Research suggests that greenspace may confer neurocognitive benefits. This study examines whether residential greenspace is associated with risk of dementia among older adults. METHODS Greenspace exposure was computed for 3047 participants aged 75 years and older enrolled in the Gingko Evaluation of Memory Study (GEMS) across four U.S. sites that prospectively evaluated dementia and its subtypes, Alzheimer's disease (AD), vascular dementia (VaD), and mixed pathologies, using neuropsychiatric evaluations between 2000 and 2008. After geocoding participant residences at baseline, three greenspace metrics-Normalized Difference Vegetative Index, percent park overlap within a 2-km radius, and linear distance to nearest park-were combined to create a composite residential greenspace measure categorized into tertiles. Cox proportional hazards models estimated the associations between baseline greenspace and risk of incident all-cause dementia, AD, and Mixed/VaD. RESULTS Compared to low residential greenspace, high residential greenspace was associated with a reduced risk of dementia (HR = 0.76 95% CI: 0.59,0.98) in models adjusted for multiple covariates. After additional adjustment for behavioral characteristics, Apolipoprotein E ɛ4 status, and other covariates, the association was slightly attenuated (HR = 0.82; 95% CI:0.63,1.06). Those exposed to medium levels of greenspace also had 28% lower risk (HR = 0.72; CI: 0.55, 0.95) of dementia compared to those with low greenspace in adjusted models. Subtype associations between high residential greenspace and AD were not statistically significant. Greenspace was not found to be significantly associated with mixed/vascular pathologies. CONCLUSIONS This study showed evidence for an association between residential greenspace and all-cause dementia among older adults. Future research with larger sample size, precise characterization of different dementia subtypes, and assessment of residential greenspace earlier in life may help clarify the role between exposure to greenspace and dementia risk.
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Tran I, Sabol O, Mote J. The relationship between greenspace exposure and psychopathology symptoms: A systematic review. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2022; 2:206-222. [PMID: 36325036 PMCID: PMC9616266 DOI: 10.1016/j.bpsgos.2022.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 12/15/2021] [Accepted: 01/16/2022] [Indexed: 11/29/2022] Open
Abstract
Greenspace exposure is associated with psychological benefits. In this systematic review, we summarized and critically evaluated the literature on the relationship between greenspace exposure (i.e., objective and subjective assessments of interactions with nature) and psychopathology incidence and symptom severity in those with and without a clinical diagnosis. A secondary aim of our review was to examine potential interactions between greenspace exposure and urban environmental features (e.g., pollution, population density) associated with poorer mental health. We identified 40 studies published between January 1, 1981, and July 31, 2020, from PubMed and PsycINFO electronic database search. Although heterogeneous in assessments of greenspace exposure and psychopathology symptom domain, the majority of cross-sectional and longitudinal evidence found that objectively assessed greenspace exposure (e.g., satellite measures of greenery) was related to less severe symptoms and lower incidence of psychopathology in children (e.g., attention-deficit/hyperactivity disorder symptoms) and adults (e.g., depression symptoms). In addition, five studies that assessed urban environmental features suggest that greenspace exposure may show a net positive relationship with psychopathology over and above the absence of urban features. We discuss limitations of the literature and future directions, including more mechanistic work to delineate the potential cognitive, affective, and behavioral factors that may contribute to the beneficial relationship between greenspace exposure and psychological health.
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Affiliation(s)
- Ivy Tran
- Department of Psychology, Hofstra University, Hempstead, New York
- Address correspondence to Ivy Tran, M.A.
| | - Olivia Sabol
- Department of Occuptional Therapy, Tufts University, Medford, Massachusetts
| | - Jasmine Mote
- Department of Occuptional Therapy, Tufts University, Medford, Massachusetts
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Abstract
With the expected rise in Alzheimer's disease and related dementias (ADRD) in the coming decades due to the aging population and a lack of effective disease-modifying treatments, there is a need for preventive strategies that may tap into resilience parameters. A wide array of resilience strategies has been proposed including genetics, socioeconomic status, lifestyle modifications, behavioral changes, and management of comorbid disease. These different strategies can be broadly classified as distinguishing between modifiable and non-modifiable risk factors, some of which can be quantified so that their clinical intervention can be effectively accomplished. A clear shift in research focus from dementia risk to addressing disease resistance and resilience is emerging that has provided new potential therapeutic targets. Here we review and summarize the latest investigations of resilience mechanisms and methods of quantifying resilience for clinical research. These approaches include identifying genetic variants that may help identify novel pathways (e.g., lipid metabolism, cellular trafficking, synaptic function, inflammation) for therapeutic treatments and biomarkers for use in a precision medicine-like regimen. In addition, innovative structural and molecular neuroimaging analyses may assist in detecting and quantifying pathological changes well before the onset of clinical symptoms setting up the possibility of primary and secondary prevention trials. Lastly, we summarize recent studies demonstrating the study of resilience in caregivers of persons living with dementia may have direct and indirect impact on the quality of care and patient outcomes.
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Affiliation(s)
- Mahesh S. Joshi
- Comprehensive Center for Brain Health, Department of Neurology, University of Miami Miller School of Medicine, Boca Raton, FL, USA
| | - James E. Galvin
- Comprehensive Center for Brain Health, Department of Neurology, University of Miami Miller School of Medicine, Boca Raton, FL, USA
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Zagnoli F, Filippini T, Jimenez MP, Wise LA, Hatch EE, Vinceti M. Is Greenness Associated with Dementia? A Systematic Review and Dose-Response Meta-analysis. Curr Environ Health Rep 2022; 9:574-590. [PMID: 35857243 PMCID: PMC9729322 DOI: 10.1007/s40572-022-00365-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2022] [Indexed: 01/31/2023]
Abstract
PURPOSE OF REVIEW We assessed the relation between environmental greenness and risk of dementia and cognitive impairment, based on a systematic review and meta-analysis up to March 30, 2022, characterizing whenever possible the shape of the association using dose-response meta-analysis. RECENT FINDINGS Twelve studies were included in this review, either using normalized difference vegetation index (NDVI) or land use/cover (LU/LC) methodology to assess greenness. Comparing the highest versus lowest exposure categories of greenness assessed using the NDVI (6 studies) or LU/LC (6 studies), we found no association with dementia. Dose-response meta-analysis of the association between greenness measured by LU/LC and dementia, based on only 3 studies, indicated a U-shaped association, but estimates were imprecise. Our systematic review and meta-analysis provided some evidence of a slight inverse association between greenness and dementia at intermediate exposure levels, but not at high levels. Potential methodological limitations, such as exposure misclassification and unmeasured confounding, may have affected the results.
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Affiliation(s)
- Federico Zagnoli
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia Medical School, 287 Via Campi, 41125 Modena, Italy
| | - Tommaso Filippini
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia Medical School, 287 Via Campi, 41125 Modena, Italy ,School of Public Health, University of California Berkeley, Berkeley, CA 94704 USA
| | - Marcia P. Jimenez
- Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118 USA
| | - Lauren A. Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118 USA
| | - Elizabeth E. Hatch
- Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118 USA
| | - Marco Vinceti
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia Medical School, 287 Via Campi, 41125 Modena, Italy ,Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118 USA
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Asri AK, Tsai HJ, Pan WC, Guo YL, Yu CP, Wu CS, Su HJ, Lung SCC, Wu CD, Spengler JD. Exploring the Potential Relationship Between Global Greenness and DALY Loss Due to Depressive Disorders. Front Psychiatry 2022; 13:919892. [PMID: 35836657 PMCID: PMC9273782 DOI: 10.3389/fpsyt.2022.919892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 06/07/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Prior studies have shown that greenness can reduce the burden of depressive disorders. However, most were focused on local-scale analyses while limited evaluated globally. We aimed to investigate the association between greenness and the burden of depressive disorders using data from 183 countries worldwide. METHODS We used the normalized difference vegetation index (NDVI) to estimate greenness. Country-level disability-adjusted life year (DALY) loss due to depressive disorders was used to represent depressive disorder burdens. A generalized linear mixed model was applied to assess the relationship between greenness and depressive disorders after controlling for covariates. Stratified analyses were conducted to determine the effects of greenness across several socio-demographic levels. RESULTS The findings showed a significant negative association between greenness and the health burden of depressive disorders with a coefficient of -0.196 (95% CI: -0.356, -0.035) in the DALY changes per interquartile unit increment of NDVI. The stratified analyses suggested beneficial effects of greenness on depressive disorders across sex, various age groups especially for those aged <49 years, with low-income and/or those living in highly urbanized countries. CONCLUSIONS Our study noted that greenness exposure was significant negative association with the burden of depressive disorders. The findings should be viewed as recommendations for relevant authorities in supporting environmental greenness enhancement to reduce the mental burdens.
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Affiliation(s)
| | - Hui-Ju Tsai
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Wen-Chi Pan
- Institute of Environmental and Occupational Health Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yue Leon Guo
- Department of Environmental and Occupational Medicine, National Taiwan University (NTU) and NTU Hospital, Taipei, Taiwan.,National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Chia-Pin Yu
- School of Forestry and Resource Conservation, National Taiwan University, Taipei, Taiwan
| | - Chi-Shin Wu
- Department of Psychiatry, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan
| | - Huey-Jen Su
- Department of Environmental and Occupational Health, National Cheng Kung University, Tainan, Taiwan
| | - Shih-Chun Candice Lung
- Research Center for Environmental Changes, Academia Sinica, Taipei, Taiwan.,Department of Atmospheric Sciences, National Taiwan University, Taipei, Taiwan.,Institute of Environmental Health, School of Public Health, National Taiwan University, Taipei, Taiwan
| | - Chih-Da Wu
- Department of Geomatics, National Cheng Kung University, Tainan, Taiwan.,National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - John D Spengler
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States
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Chen X, Lee C, Huang H. Neighborhood built environment associated with cognition and dementia risk among older adults: A systematic literature review. Soc Sci Med 2021; 292:114560. [PMID: 34776284 DOI: 10.1016/j.socscimed.2021.114560] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 11/04/2021] [Accepted: 11/06/2021] [Indexed: 12/25/2022]
Abstract
Cognitive impairment associated with aging is a serious and growing public health problem. This systematic literature review contributes to better understanding the current state of knowledge on the roles of neighborhood environments in supporting cognitive health in later life. Literature search was carried out in 2020 using the seven databases most relevant to the topic. This review was restricted to peer-reviewed observational and quantitative studies that focused on 1) community-dwelling older adults as target populations; 2) neighborhood built environments as independent variables; and 3) cognition or dementia as outcome variables. Thirty-seven studies published between 1989 and 2020 met the inclusion criteria. The neighborhood built environment domains covered in these included urbanity/rurality, land use, neighborhood physical disorder, transportation infrastructure, urban design, and urban nature. Neighborhood resources and green space exposure were most frequently studied and linked to cognition-related outcomes. Neighborhood built environment was shown to be more pertinent to older adults' global cognition, memory, and dementia. Physical activity showed a mediating role between neighborhood built environment and cognition. The effect of neighborhood built environment on cognitive function was stronger among older women and those with disabilities or lower socioeconomic status. Evidence on the relationship between neighborhood built environment and cognition/dementia among older adults is moderate. Our findings highlight the need for more standardized and longitudinal measures of neighborhood built environment and high-sensitivity cognitive tests that capture the specific and relevant domains of cognition, to facilitate further exploration of the mediating and moderating effects of neighborhood built environment with cognition/dementia in older adults. This review offers insights for future research and policy efforts toward creating communities to support cognitive health and aging in place.
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Affiliation(s)
- Xi Chen
- Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University, 3137 TAMU, College Station, TX, 77843 3137, USA.
| | - Chanam Lee
- Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University, 3137 TAMU, College Station, TX, 77843 3137, USA
| | - Hao Huang
- Department of Architecture, College of Architecture, Texas A&M University, 3137 TAMU, College Station, TX, 77843 3137, USA
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Moran MR, Bilal U, Dronova I, Ju Y, Gouveia N, Caiaffa WT, Friche AADL, Moore K, Miranda JJ, Rodríguez DA. The equigenic effect of greenness on the association between education with life expectancy and mortality in 28 large Latin American cities. Health Place 2021; 72:102703. [PMID: 34753000 PMCID: PMC8633763 DOI: 10.1016/j.healthplace.2021.102703] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 10/18/2021] [Accepted: 10/22/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Recent studies highlight the equigenic potential of greenspaces by showing narrower socioeconomic health inequalities in greener areas. However, results to date have been inconsistent and derived from high-income countries. We examined whether urban greenness modifies the associations between area-level education, as a proxy for socioeconomic status, and life expectancy and cause-specific mortality in Latin American cities. METHODS We included 28 large cities, >137 million inhabitants, in nine Latin American countries, comprising 671 sub-city units, for 2012-2016. Socioeconomic status was assessed through a composite index of sub-city level education, and greenness was calculated using the normalized difference vegetation index. We fitted multilevel models with sub-city units nested in cities, with life expectancy or log(mortality) as the outcome. FINDINGS We observed a social gradient, with higher levels of education associated with higher life expectancy and lower cause-specific mortality. There was weak evidence supporting the equigenesis hypothesis as greenness differentially modified the association between education and mortality outcomes. We observed an equigenic effect, with doubling magnitudes in the violence-related mortality reduction by education in areas with low greenness compared to medium-high greenness areas among men (16% [95% CI 12%-20%] vs 8% [95% CI 4%-11%] per 1 SD increase in area-level education). However, in contradiction to the equigenesis hypothesis, the magnitude in cardiovascular diseases (CVD) mortality reduction by education was stronger in areas with medium-high greenness compared to areas with low greenness (6% [95% CI 4%-7%] vs 1% [95% CI -1%-3%] and 5% [95% CI 3%-7%] vs 1% [95% CI -1%-3%] per 1 SD increase in area-level education, in women and men, respectively). Similarly, each 1-SD increase in greenness widened the educational inequality in life expectancy by 0.15 years and 0.20 years, in women and men, respectively. The equigenic effect was not observed in violence-related mortality among women and in mortality due to communicable diseases, maternal, neonatal and nutritional conditions (CMNN). INTERPRETATION Our results confirm socioeconomic health inequalities in Latin American cities and show that the equigenic properties of greenspace vary by health outcome. Although mixed, our findings suggest that future greening policies should account for local social and economic conditions to ensure that greenspaces provide health benefits for all, and do not further exacerbate existing health inequalities in the region. FUNDING Wellcome Trust (Grant, 205177/Z/16/Z).
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Affiliation(s)
- Mika R Moran
- Institute for Urban and Regional Development, University of California Berkeley, Berkeley, CA, USA.
| | - Usama Bilal
- Urban Health Collaborative, Drexel Dornsife School of Public Health, Philadelphia, PA, USA.
| | - Iryna Dronova
- Department of Landscape Architecture and Environmental Planning, College of Environmental Design, University of California Berkeley, Berkeley, CA, USA; Department of Environmental Science, Policy, and Management, University of California, Berkeley, CA, USA
| | - Yang Ju
- Institute for Urban and Regional Development, University of California Berkeley, Berkeley, CA, USA
| | - Nelson Gouveia
- Departamento de Medicina Preventiva, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Waleska Teixeira Caiaffa
- Observatório de Saúde Urbana de Belo Horizonte, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Amélia Augusta de Lima Friche
- Observatório de Saúde Urbana de Belo Horizonte, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Kari Moore
- Urban Health Collaborative, Drexel Dornsife School of Public Health, Philadelphia, PA, USA
| | - J Jaime Miranda
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Daniel A Rodríguez
- Department of City and Regional Planning and Institute for Transportation Studies, University of California Berkeley, Berkeley, CA, USA
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Bagheri N, Mavoa S, Tabatabaei-Jafari H, Knibbs LD, Coffee NT, Salvador-Carulla L, Anstey KJ. The Impact of Built and Social Environmental Characteristics on Diagnosed and Estimated Future Risk of Dementia. J Alzheimers Dis 2021; 84:621-632. [PMID: 34569946 DOI: 10.3233/jad-210208] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Dementia is a major global health challenge and the impact of built and social environments' characteristics on dementia risk have not yet been fully evaluated. OBJECTIVE To investigate associations between built and social environmental characteristics and diagnosed dementia cases and estimated dementia risk. METHODS We recruited 25,511 patients aged 65 and older from family physicians' practices. We calculated a dementia risk score based on risk and protective factors for patients not diagnosed with dementia. Our exposure variables were estimated for each statistical area level 1: social fragmentation, nitrogen dioxide, public open spaces, walkability, socio-economic status, and the length of main roads. We performed a multilevel mixed effect linear regression analysis to allow for the hierarchical nature of the data. RESULTS We found that a one standard deviation (1-SD) increase in NO2 and walkability score was associated with 10% higher odds of any versus no dementia (95% CI: 1%, 21% for NO2 and 0%, 22% for walkability score). For estimated future risk of dementia, a 1-SD increase in social fragmentation and NO2 was associated with a 1% increase in dementia risk (95% CI: 0, 1%). 1-SD increases in public open space and socioeconomic status were associated with 3% (95% CI: 0.95, 0.98) and 1% decreases (95% CI: 0.98, 0.99) in dementia risk, respectively. There was spatial heterogeneity in the pattern of diagnosed dementia and the estimated future risk of dementia. CONCLUSION Associations of neighborhood NO2 level, walkability, public open space, and social fragmentation with diagnosed dementia cases and estimated future risk of dementia were statistically significant, indicating the potential to reduce the risk through changes in built and social environments.
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Affiliation(s)
- Nasser Bagheri
- Centre for Mental Health Research, the Research School of Population Health, the Australian National University, Australia.,The Australian Geospatial Health Lab, Health Research Institute, The University of Canberra, Australia
| | - Suzanne Mavoa
- Melbourne School of Population and Global Health, the University of Melbourne, Australia
| | - Hossein Tabatabaei-Jafari
- Centre for Mental Health Research, the Research School of Population Health, the Australian National University, Australia
| | - Luke D Knibbs
- The School of Public Health, The University of Sydney, Australia
| | - Neil T Coffee
- The Australian Geospatial Health Lab, Health Research Institute, The University of Canberra, Australia
| | - Luis Salvador-Carulla
- Centre for Mental Health Research, the Research School of Population Health, the Australian National University, Australia.,Menzies Centre for Health Policy, Faculty of Medicine and Health, University of Sydney
| | - Kaarin J Anstey
- UNSW Ageing Futures Institute, the University of New South Wales, Australia.,Neuroscience Research Australia, Australia
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Boumenna T, Scott TM, Lee JS, Zhang X, Kriebel D, Tucker KL, Palacios N. MIND Diet and Cognitive Function over Eight Years in Puerto Rican Older Adults. J Gerontol A Biol Sci Med Sci 2021; 77:605-613. [PMID: 34551094 DOI: 10.1093/gerona/glab261] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Healthy diets have been associated with better cognitive function. Socio-economic factors including education, poverty and job complexity may modify the relationship between diet and cognition. METHODS We used adjusted linear mixed models to examine the association between long-term adherence to the Mediterranean-Dietary Approaches to Stop Hypertension - Intervention for Neurodegenerative Delay (MIND) diet and cognitive function over 8 years of follow-up in Puerto Rican adults residing in the Boston, MA area (aged 45 to 75 years at baseline). We also examined whether the MIND diet - cognition association was confounded or modified by socioeconomic measures. RESULTS In both cross-sectional and longitudinal analyses the highest, vs lowest, MIND quintile was associated with better cognition function (ß = 0.093; 95% CI: 0.035, 0.152; P trend = 0.0019), but not with cognitive trajectory over 8 years. Education <=8 th grade (ß = -0.339; 95% CI: 0.394, -0.286; P < 0.0001) and income-to-poverty ratio <120% (ß = -0.049; 95% CI: -0.092, -0.007; P = 0.024) were significantly associated with lower cognitive function, while higher job complexity (ß = 0.008; 95% CI: 0.006, 0.011; P < 0.0001) was associated with better cognition function. These variables acted confounders, but not effect modifiers of the MIND-diet - cognitive function relationship. CONCLUSION Adherence to the MIND diet was associated with better cognitive function at baseline and over 8 years of follow-up, however MIND diet was not associated with 8-year cognitive trajectory. More studies are needed to better understand whether the MIND diet is protective against long-term cognitive decline.
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Affiliation(s)
- Tahani Boumenna
- Department of Public Health, University of Massachusetts Lowell
| | - Tammy M Scott
- Friedman School of Nutrition Science and Policy at Tufts University, and Department of Psychiatry, Tufts University School of Medicine, Boston, MA
| | - Jong-Soo Lee
- Center for Population Health, University of Massachusetts Lowell, Lowell, MA.,Department of Mathematical Sciences, University of Massachusetts Lowell
| | - Xiyuan Zhang
- Center for Population Health, University of Massachusetts Lowell, Lowell, MA
| | - David Kriebel
- Department of Public Health, University of Massachusetts Lowell
| | - Katherine L Tucker
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA.,Center for Population Health, University of Massachusetts Lowell, Lowell, MA
| | - Natalia Palacios
- Department of Public Health, University of Massachusetts Lowell.,Center for Population Health, University of Massachusetts Lowell, Lowell, MA.,Department of Nutrition, Harvard School of Public Health, Boston MA.,Geriatric Research Education Clinical Center, Edith Nourse Rogers Memorial Veterans Hospital, Bedford MA
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Aitken WW, Lombard J, Wang K, Toro M, Byrne M, Nardi MI, Kardys J, Parrish A, Dong C, Szapocznik J, Rundek T, Brown SC. Relationship of Neighborhood Greenness to Alzheimer's Disease and Non-Alzheimer's Dementia Among 249,405 U.S. Medicare Beneficiaries. J Alzheimers Dis 2021; 81:597-606. [PMID: 33814426 DOI: 10.3233/jad-201179] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Neighborhood greenness (vegetative presence) has been linked to multiple health outcomes, but its relationship to Alzheimer's disease (AD) and non-Alzheimer's (non-AD) dementia has been less studied. OBJECTIVE This study examines the relationship of greenness to both AD and non-AD dementia in a population-based sample of Medicare beneficiaries. METHODS Participants were 249,405 US Medicare beneficiaries aged > 65 years living in Miami-Dade County, FL, from 2010 to 2011. Multi-level analyses examined the relationship of greenness, assessed by mean Census block level Normalized Difference Vegetation Index (NDVI), to odds of each of AD, Alzheimer's disease and related dementias (ADRD), and non-AD dementia, respectively. Covariates included age, gender, race/ethnicity, number of comorbid health conditions, and neighborhood income. RESULTS Higher greenness was associated with reduced risk of AD, ADRD, and non-AD dementia, respectively, adjusting for individual and neighborhood sociodemographics. Compared to the lowest greenness tertile, the highest greenness tertile was associated with reduced odds of AD by 20%(odds ratio, 0.80; 95%CI, 0.75-0.85), ADRD by 18%(odds ratio, 0.82; 95%CI, 0.77-0.86), and non-AD dementia by 11%(odds ratio, 0.89; 95%CI, 0.82-0.96). After further adjusting for number of comorbidities, compared to the lowest greenness tertile, the highest greenness tertile was associated with reduced odds of AD (OR, 0.94; 95%CI, 0.88-1.00) and ADRD (OR, 0.93; 95%CI, 0.88-0.99), but not non-AD dementia (OR, 1.01; 95%CI, 0.93-1.08). CONCLUSION High neighborhood greenness may be associated with lower odds of AD and ADRD. Environmental improvements, such as increasing neighborhood vegetation, may be a strategy to reduce risk for AD and possibly other dementias.
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Affiliation(s)
- William W Aitken
- Cardiovascular Division, Department of Medicine, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Joanna Lombard
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA.,University of Miami School of Architecture, Coral Gables, FL, USA
| | - Kefeng Wang
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Matthew Toro
- Arizona State University Library, Temple, AZ, USA
| | | | - Maria I Nardi
- Miami-Dade County Department of Parks, Recreation and Open Spaces (MDPROS), Miami, FL, USA
| | - Jack Kardys
- Miami-Dade County Department of Parks, Recreation and Open Spaces (MDPROS), Miami, FL, USA
| | | | - Chuanhui Dong
- Department of Neurology and Evelyn F. McKnight Brain Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - José Szapocznik
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA.,University of Miami School of Architecture, Coral Gables, FL, USA
| | - Tatjana Rundek
- Department of Neurology and Evelyn F. McKnight Brain Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Scott C Brown
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA.,University of Miami School of Architecture, Coral Gables, FL, USA
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Besser LM, Lovasi GS, Michael YL, Garg P, Hirsch JA, Siscovick D, Hurvitz P, Biggs ML, Galvin JE, Bartz TM, Longstreth WT. Associations between neighborhood greenspace and brain imaging measures in non-demented older adults: the Cardiovascular Health Study. Soc Psychiatry Psychiatr Epidemiol 2021; 56:1575-1585. [PMID: 33388800 PMCID: PMC8253869 DOI: 10.1007/s00127-020-02000-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 11/25/2020] [Indexed: 12/12/2022]
Abstract
PURPOSE Greater neighborhood greenspace has been associated with brain health, including better cognition and lower odds of Alzheimer's disease in older adults. We investigated associations between neighborhood greenspace and brain-based magnetic resonance imaging (MRI) measures and potential effect modification by sex or apolipoprotein E genotype (APOE), a risk factor for Alzheimer's disease. METHODS We obtained a sample of non-demented participants 65 years or older (n = 1125) from the longitudinal, population-based Cardiovascular Health Study (CHS). Greenspace data were derived from the National Land Cover Dataset. Adjusted multivariable linear regression estimated associations between neighborhood greenspace five years prior to the MRI and left and right hippocampal volume and 10-point grades of ventricular size and burden of white matter hyperintensity. Interaction terms tested effect modification by APOE genotype and sex. CHS data (1989-1999) were obtained/analyzed in 2020. RESULTS Participants were on average 79 years old [standard deviation (SD) = 4], 58% were female, and 11% were non-white race. Mean neighborhood greenspace was 38% (SD = 28%). Greater proportion of greenspace in the neighborhood five years before MRI was borderline associated with lower ventricle grade (estimate: - 0.30; 95% confidence interval: - 0.61, 0.00). We observed no associations between greenspace and the other MRI outcome measures and no evidence of effect modification by APOE genotype and sex. CONCLUSION This study suggests a possible association between greater greenspace and less ventricular enlargement, a measure reflecting global brain atrophy. If confirmed in other longitudinal cohort studies, interventions and policies to improve community greenspaces may help to maintain brain health in older age.
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Affiliation(s)
- Lilah M Besser
- Institute for Human Health and Disease Intervention, Department of Urban and Regional Planning, Florida Atlantic University, 777 Glades Rd, SO-44, Room 284H, Boca Raton, FL, 33431, USA.
| | - Gina S Lovasi
- Urban Health Collaborative and Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, 19104, USA
| | - Yvonne L Michael
- Department of Epidemiology and Biostatistics, Dornslife School of Public Health, Drexel University, Philadelphia, PA, 19104, USA
| | - Parveen Garg
- Division of Cardiology, Keck School of Medicine, University of Southern California, 1510 San Pablo Street Suite #322, Los Angeles, CA, 90033, USA
| | - Jana A Hirsch
- Urban Health Collaborative and Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, 19104, USA
| | - David Siscovick
- Division of Research, Evaluation, and Policy, The New York Academy of Medicine, New York, NY, 10029, USA
| | - Phil Hurvitz
- Center for Studies in Demography and Ecology and Urban Form Lab, University of Washington, Seattle, WA, 98195, USA
| | - Mary L Biggs
- Department of Biostatistics, School of Public Health, University of Washington, Seattle, WA, 98195, USA
| | - James E Galvin
- Comprehensive Center for Brain Health, Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, 33136, USA
| | - Traci M Bartz
- Department of Biostatistics, University of Washington, Seattle, WA, 98195, USA
| | - W T Longstreth
- Departments of Neurology and Epidemiology, University of Washington, Seattle, WA, 98195-9775, USA
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Finlay J, Esposito M, Li M, Colabianchi N, Zhou H, Judd S, Clarke P. Neighborhood active aging infrastructure and cognitive function: A mixed-methods study of older Americans. Prev Med 2021; 150:106669. [PMID: 34087319 PMCID: PMC8316307 DOI: 10.1016/j.ypmed.2021.106669] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 05/20/2021] [Accepted: 05/29/2021] [Indexed: 01/22/2023]
Abstract
Physical exercise benefits cognitive functioning and can protect against neurodegeneration. Neighborhood environments may be pivotal to physically active aging, and thus help shape older adults' cognitive function. This mixed-methods study investigated where older adults exercised outside the home, and whether availability of these neighborhood sites was associated with cognitive function. We thematically analyzed qualitative data from semi-structured interviews in 2015 with 125 older adults (mean age = 71) in the Minneapolis (MN) metropolitan area. Results identified nearby public parks, fitness/sports amenities, and walkable destinations as motivators for recreational exercise and active transit among participants. These findings informed quantitative analysis of the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, a national sample of older Black and white Americans (n = 21,151; mean age at assessment = 67; data collected 2006-2017). We used generalized additive multilevel models to examine whether neighborhood features that qualitative participants identified as encouraging physical activity were associated with elevated levels of cognitive function. Results indicated that residing in neighborhoods with greater availability of local parks, access to recreational amenities, and business density was associated with higher levels of cognitive function. We found no evidence to suggest a significant association between availability of these neighborhood resources and rate of cognitive decline. This study identifies specific neighborhood active aging infrastructure that may support cognitive function among older adults aging in place.
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Affiliation(s)
- Jessica Finlay
- Social Environment and Health, Survey Research Center, Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI 48104, United States; Center for Social Epidemiology and Population Health, Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, United States.
| | - Michael Esposito
- Social Environment and Health, Survey Research Center, Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI 48104, United States; Department of Sociology, Washington University of St. Louis, St. Louis, MO 63130, United States
| | - Mao Li
- Social Environment and Health, Survey Research Center, Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI 48104, United States; Survey Methodology Program, Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI 48104, United States
| | - Natalie Colabianchi
- School of Kinesiology, University of Michigan, 1402 Washington Heights, Ann Arbor, MI 48109, United States
| | - Huajun Zhou
- Social Environment and Health, Survey Research Center, Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI 48104, United States; Biostatistics Program, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, United States
| | - Suzanne Judd
- School of Public Health, University of Alabama at Birmingham, 1665 University Blvd, Birmingham, AL 35233, United States
| | - Philippa Clarke
- Social Environment and Health, Survey Research Center, Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI 48104, United States; Center for Social Epidemiology and Population Health, Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, United States
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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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Klompmaker JO, Janssen NAH, Bloemsma LD, Marra M, Lebret E, Gehring U, Hoek G. Effects of exposure to surrounding green, air pollution and traffic noise with non-accidental and cause-specific mortality in the Dutch national cohort. Environ Health 2021; 20:82. [PMID: 34261495 PMCID: PMC8281461 DOI: 10.1186/s12940-021-00769-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 07/05/2021] [Indexed: 05/20/2023]
Abstract
BACKGROUND Everyday people are exposed to multiple environmental factors, such as surrounding green, air pollution and traffic noise. These exposures are generally spatially correlated. Hence, when estimating associations of surrounding green, air pollution or traffic noise with health outcomes, the other exposures should be taken into account. The aim of this study was to evaluate associations of long-term residential exposure to surrounding green, air pollution and traffic noise with mortality. METHODS We followed approximately 10.5 million adults (aged ≥ 30 years) living in the Netherlands from 1 January 2013 until 31 December 2018. We used Cox proportional hazard models to evaluate associations of residential surrounding green (including the average Normalized Difference Vegetation Index (NDVI) in buffers of 300 and 1000 m), annual average ambient air pollutant concentrations [including particulate matter (PM2.5), nitrogen dioxide (NO2)] and traffic noise with non-accidental and cause-specific mortality, adjusting for potential confounders. RESULTS In single-exposure models, surrounding green was negatively associated with all mortality outcomes, while air pollution was positively associated with all outcomes. In two-exposure models, associations of surrounding green and air pollution attenuated but remained. For respiratory mortality, in a two-exposure model with NO2 and NDVI 300 m, the HR of NO2 was 1.040 (95%CI: 1.022, 1.059) per IQR increase (8.3 µg/m3) and the HR of NDVI 300 m was 0.964 (95%CI: 0.952, 0.976) per IQR increase (0.14). Road-traffic noise was positively associated with lung cancer mortality only, also after adjustment for air pollution or surrounding green. CONCLUSIONS Lower surrounding green and higher air pollution were associated with a higher risk of non-accidental and cause-specific mortality. Studies including only one of these correlated exposures may overestimate the associations with mortality of that exposure.
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Affiliation(s)
- Jochem O. Klompmaker
- National Institute for Public Health and the Environment (RIVM), Antonie van Leeuwenhoeklaan 9, 3721 MA Bilthoven, The Netherlands
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - Nicole A. H. Janssen
- National Institute for Public Health and the Environment (RIVM), Antonie van Leeuwenhoeklaan 9, 3721 MA Bilthoven, The Netherlands
| | - Lizan D. Bloemsma
- National Institute for Public Health and the Environment (RIVM), Antonie van Leeuwenhoeklaan 9, 3721 MA Bilthoven, The Netherlands
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - Marten Marra
- National Institute for Public Health and the Environment (RIVM), Antonie van Leeuwenhoeklaan 9, 3721 MA Bilthoven, The Netherlands
| | - Erik Lebret
- National Institute for Public Health and the Environment (RIVM), Antonie van Leeuwenhoeklaan 9, 3721 MA Bilthoven, The Netherlands
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - Ulrike Gehring
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - Gerard Hoek
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
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Russette H, Graham J, Holden Z, Semmens EO, Williams E, Landguth EL. Greenspace exposure and COVID-19 mortality in the United States: January-July 2020. ENVIRONMENTAL RESEARCH 2021; 198:111195. [PMID: 33932476 PMCID: PMC8079939 DOI: 10.1016/j.envres.2021.111195] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 02/26/2021] [Accepted: 04/14/2021] [Indexed: 05/07/2023]
Abstract
BACKGROUND Mortality from the novel coronavirus disease-2019 (COVID-19) continues to rise across the United States. Evidence is emerging that environmental factors may contribute to susceptibility to disease and mortality. Greenspace exposure promotes enhanced immunity and may protect against risk of mortality among those with COVID-19. OBJECTIVES Our objective was to determine if high county level greenspace exposure is associated with reduced risk of COVID-19 mortality. METHODS Greenspace exposure was characterized in 3049 counties across the conterminous United States using Leaf Area Index (LAI) deciles that were derived from satellite imagery via Moderate Resolution Imaging Spectroradiometer from 2011 to 2015. COVID-19 mortality data were obtained from the Center for Systems Science and Engineering at Johns Hopkins University. We used a generalized linear mixed model to evaluate the association between county level LAI and COVID-19 mortality rate in analyses adjusted for 2015-2019 county level average total county population, older population, race, overcrowding in home, Medicaid, education, and physical inactivity. RESULTS A dose-response association was found between greenness and reduced risk of COVID-19 mortality. COVID-19 mortality was negatively associated with LAI deciles 8 [MRR = 0.82 (95% CI: 0.72, 0.93)], 9 [MRR = 0.78 (95% CI: 0.68, 0.89)], and 10 [MRR = 0.59 (95% CI: 0.50, 0.69)]. Aside from LAI decile 5, no associations were found between the remaining LAI deciles and COVID-19 mortality. Increasing prevalence of counties with older age residents, low education attainment, Native Americans, Black Americans, and housing overcrowding were significantly associated with increased risk of COVID-19 mortality, whereas Medicaid prevalence was associated with a reduced risk. DISCUSSION Counties with a higher amount of greenspace may be at a reduced risk of experiencing mortality due to COVID-19.
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Affiliation(s)
- Helen Russette
- Center for Population Health Research, School of Public and Community Health Sciences, University of Montana, 32 Campus Drive, Missoula, MT, 59812, USA.
| | - Jon Graham
- Center for Population Health Research, School of Public and Community Health Sciences, University of Montana, 32 Campus Drive, Missoula, MT, 59812, USA; Mathematical Sciences, University of Montana, 32 Campus Drive, Missoula, MT, 59812, USA
| | | | - Erin O Semmens
- Center for Population Health Research, School of Public and Community Health Sciences, University of Montana, 32 Campus Drive, Missoula, MT, 59812, USA
| | - Elizabeth Williams
- Center for Population Health Research, School of Public and Community Health Sciences, University of Montana, 32 Campus Drive, Missoula, MT, 59812, USA; All Nations Health Center, Missoula, MT, 59801, USA
| | - Erin L Landguth
- Center for Population Health Research, School of Public and Community Health Sciences, University of Montana, 32 Campus Drive, Missoula, MT, 59812, USA
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Methods to Address Self-Selection and Reverse Causation in Studies of Neighborhood Environments and Brain Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126484. [PMID: 34208454 PMCID: PMC8296350 DOI: 10.3390/ijerph18126484] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 06/11/2021] [Accepted: 06/13/2021] [Indexed: 11/17/2022]
Abstract
Preliminary evidence suggests that neighborhood environments, such as socioeconomic disadvantage, pedestrian and physical activity infrastructure, and availability of neighborhood destinations (e.g., parks), may be associated with late-life cognitive functioning and risk of Alzheimer’s disease and related disorders (ADRD). The supposition is that these neighborhood characteristics are associated with factors such as mental health, environmental exposures, health behaviors, and social determinants of health that in turn promote or diminish cognitive reserve and resilience in later life. However, observed associations may be biased by self-selection or reverse causation, such as when individuals with better cognition move to denser neighborhoods because they prefer many destinations within walking distance of home, or when individuals with deteriorating health choose residences offering health services in neighborhoods in rural or suburban areas (e.g., assisted living). Research on neighborhood environments and ADRD has typically focused on late-life brain health outcomes, which makes it difficult to disentangle true associations from associations that result from reverse causality. In this paper, we review study designs and methods to help reduce bias due to reverse causality and self-selection, while drawing attention to the unique aspects of these approaches when conducting research on neighborhoods and brain aging.
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Finlay J, Yu W, Clarke P, Lia M, Judd S, Esposito M. Neighborhood cognitive amenities? A mixed-methods study of intellectually-stimulating places and cognitive function among older Americans. WELLBEING, SPACE AND SOCIETY 2021; 2:100040. [PMID: 37396718 PMCID: PMC10312622 DOI: 10.1016/j.wss.2021.100040] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
Neighborhoods structure health and wellbeing in later life. Local spaces can encourage physically active and socially engaged aging in place, and may also nurture opportunities for cognitively-stimulating creative and complex activities such as reading; playing and listening to music; learning; and engagement in galleries, performing arts, and museums. These activities are associated with better cognitive health outcomes. In this exploratory sequential mixed-methods study, thematic analysis of interviews and ethnographic fieldwork with 125 diverse older adults in the Minneapolis (MN) metropolitan area (mean age 71 years) explored how and where older adults participated in intellectually-stimulating neighborhood activities. Thematic analysis indicated that libraries, higher education campuses, and sites of arts and culture were frequented intellectually-stimulating places, with racial differences in perception and usage. The qualitative findings informed quantitative investigation of associations between these amenities and cognitive function in a large national sample of aging Black and white Americans (n=21,165, mean age 67 years) in the Reasons for Geographic and Racial Differences in Stroke Study. We used multilevel linear regression models to examine whether living in a neighborhood with higher kernel densities of libraries, higher education campuses, and arts/cultural sites had a net positive effect on cognitive function. Analysis identified statistically significant positive associations between arts/cultural sites and cognitive function, with a significantly larger effect size for white versus Black participants. The study contributes new evidence to the emerging ecological model of cognitive health. It critically considers racial disparities in access to health-promoting neighborhood infrastructure and opportunities to age well in place.
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Affiliation(s)
- Jessica Finlay
- Social Environment and Health Program, Survey Research Center, Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI, USA, 48104
- Center for Social Epidemiology and Population Health, Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, USA, 48109
| | - Wenshan Yu
- Social Environment and Health Program, Survey Research Center, Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI, USA, 48104
- Survey Methodology Program, Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI, USA, 48104
| | - Philippa Clarke
- Social Environment and Health Program, Survey Research Center, Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI, USA, 48104
- Center for Social Epidemiology and Population Health, Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, USA, 48109
| | - Mao Lia
- Survey Methodology Program, Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI, USA, 48104
| | - Suzanne Judd
- School of Public Health, University of Alabama at Birmingham, 1665 University Blvd, Birmingham, AL, USA, 35233
| | - Michael Esposito
- Social Environment and Health Program, Survey Research Center, Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI, USA, 48104
- Department of Sociology, Washington University of St. Louis, St. Louis, MO, United States, 63130
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