How Does the Urban Environment Affect Health and Well-Being? A Systematic Review

Spatial characteristics of non-communicable diseases and their associations to social conditions in a large urban cohort in Germany-Results from the Hamburg City Health Study

BACKGROUND

Non-communicable diseases (NCDs) are responsible for many deaths. They are associated with several modifiable and metabolic risk factors and are therefore prone to significant regional variations on different scales. However, only few intra-urban studies examined spatial variation in NCDs and its association with social circumstances, especially in Germany. Thus, the present study aimed to identify associations of personal risk factors and local social conditions with NCDs in a large German city.

METHODS

This study is based on a population-based cohort of the Hamburg City Health Study including 10,000 probands. Six NCDs were analyzed (chronic obstructive pulmonary disease [COPD], coronary heart disease [CHD], diabetes mellitus, heart failure, depression, and hypertension) in 68 city district clusters. As risk factors, we considered socio-demographic variables (age, sex, education) and risk behaviour variables (smoking, alcohol consumption). Logistic regression analyses identified associations between the district clusters and the prevalence rates for each NCD. Regional variation was detected by Gini coefficients and spatial cluster analyses. Local social condition indexes were correlated with prevalence rates of NCDs on city district level and hot-spot analyses were performed for significant high or low values.

RESULTS

The analyses included 7,308 participants with a mean age of 63.1 years (51.5% female). The prevalence of hypertension (67.6%) was the highest. Risk factor associations were identified between smoking, alcohol consumption and education and the prevalence of NCDs (hypertension, diabetes, and COPD). Significant regional variations were detected and persisted after adjusting for personal risk factors. Correlations for prevalence rates with the local social conditions were significant for hypertension (r = 0.294, p < 0.02), diabetes (r = 0.259, p = 0.03), and COPD (r = 0.360, p < 0.01).

CONCLUSIONS

The study shows that regional differences in NCD prevalence persist even after adjusting for personal risk factors. This highlights the central role of both personal socio-economic status and behaviors such as alcohol and tobacco consumption. It also highlights the importance of other potential regional factors (e.g. the environment) in shaping NCD prevalence. This knowledge helps policy- and decision-makers to develop intervention strategies.

Water sources for street trees in mesic urban environments

Street trees support climate resiliency through a variety of pathways, such as offsetting urban heat and attenuating storm water runoff. While urban trees in arid and semiarid ecosystems have been shown to take up water from irrigation, it is unknown where street trees in mesic cities obtain their water. In this study, we use natural abundance stable isotopes to estimate the proportional sources of water taken up by Acer platanoides street trees in Boston, Massachusetts, United States, including precipitation, irrigation, groundwater, and wastewater. We use Bayesian multisource mixing models to estimate water sources by comparing the natural abundance isotopic ratios of hydrogen and oxygen across potential water sources with water extracted from tree stem samples. We find that during the summer of 2021, characterized by anomalously high rainfall, street trees predominantly utilized water from precipitation. Precipitation accounted for 72.3 % of water extracted from trees sampled in August and 65.6 % from trees sampled in September. Of the precipitation taken up by street trees, most water was traced back to large storm events in July, with July rainfall alone accounting for up to 84.0 % of water found within street trees. We find strong relationships between canopy cover fractions and the proportion of precipitation lost to evapotranspiration across the study domain, supporting the conclusion that tree planting initiatives result in storm water mitigation benefits due to utilization of water from precipitation by urban vegetation. However, while the mature trees studied here currently support their water demand from precipitation, the dependency of street trees on precipitation in mesic cities may lead to increased water stress in a changing climate characterized by a higher frequency and severity of drought.

Decomposing the rural-urban disparities in overweight and obesity among women of reproductive age in Nigeria

BACKGROUND

Overweight and obese women face various reproductive and other health challenges, and in some cases, even mortality. Despite evidence of rural-urban disparities in overweight and obesity among women of reproductive age, there is limited evidence regarding the predictors of these disparities. This study aims to investigate the factors associated with overweight and obesity and examine the contributors to rural-urban disparities in overweight and obesity among women of reproductive age in Nigeria.

METHODS

We utilized the 2018 Nigeria Demographic and Health Survey dataset. The survey employed a two-stage cluster sampling technique based on Nigeria's 2006 census enumeration areas for sample selection. Overweight and obesity were defined as a body mass index (BMI) ≥ 25. Data analyses were conducted using the Logistic Regression Model and the threefold Blinder-Oaxaca decomposition model (α0.05).

RESULTS

The study revealed that older women (OR = 2.44; CI = 2.11-2.83), those with higher wealth (OR = 2.05; CI = 1.81-2.31), contraceptive users (OR = 1.41; CI = 1.27-1.57), and residents of the South-South region (OR = 1.24; CI = 1.07-1.45) were more likely to be overweight/obese. The decomposition analysis indicated that the mean predicted prevalence of overweight and obesity is 35.5% in urban areas, compared to 21.1% in rural areas of Nigeria. Factors such as wealth status, educational level, media exposure, and contraceptive use were identified as significant contributors to these disparities.

CONCLUSION

The findings underscore the importance of addressing socioeconomic disparities when designing healthcare interventions to reduce the burden of overweight and obesity, particularly in urban areas. Prioritizing these factors can facilitate efforts to promote healthier lifestyles and enhance overall well-being.

Green-blue space exposure changes and impact on individual-level well-being and mental health: a population-wide dynamic longitudinal panel study with linked survey data

Background

Cross-sectional evidence suggests that living near green and blue spaces benefits mental health; longitudinal evidence is limited.

Objectives

To quantify the impact of changes in green and blue spaces on common mental health disorders, well-being and health service use.

Design

A retrospective, dynamic longitudinal panel study.

Setting

Wales, UK.

Participants

An e-cohort comprising 99,682,902 observations of 2,801,483 adults (≥ 16 years) registered with a general practice in Wales (2008-2019). A 5312-strong 'National Survey for Wales (NSW) subgroup' was surveyed on well-being and visits to green and blue spaces.

Main outcome measures

Common mental health disorders, general practice records; subjective well-being, Warwick-Edinburgh Mental Well-being Scale.

Data sources

Common mental health disorder and use of general practice services were extracted quarterly from the Welsh Longitudinal General Practice Dataset. Annual ambient greenness exposure, enhanced vegetation index and access to green and blue spaces (2018) from planning and satellite data. Data were linked within the Secure Anonymised Information Linkage Databank.

Methods

Multilevel regression models examined associations between exposure to green and blue spaces and common mental health disorders and use of general practice. For the National Survey for Wales subgroup, generalised linear models examined associations between exposure to green and blue spaces and subjective well-being and common mental health disorders.

Results and conclusions

Our longitudinal analyses found no evidence that changes in green and blue spaces through time impacted on common mental health disorders. However, time-aggregated exposure to green and blue spaces contrasting differences between people were associated with subsequent common mental health disorders. Similarly, our cross-sectional findings add to growing evidence that residential green and blue spaces and visits are associated with well-being benefits: Greater ambient greenness (+ 1 enhanced vegetation index) was associated with lower likelihood of subsequently seeking care for a common mental health disorder [adjusted odds ratio (AOR) 0.80, 95% confidence interval, (CI) 0.80 to 0.81] and with well-being with a U-shaped relationship [Warwick-Edinburgh Mental Well-being Scale; enhanced vegetation index beta (adjusted) -10.15, 95% CI -17.13 to -3.17; EVI2 beta (quadratic term; adj.) 12.49, 95% CI 3.02 to 21.97]. Those who used green and blue spaces for leisure reported better well-being, with diminishing extra benefit with increasing time (Warwick-Edinburgh Mental Well-being Scale: time outdoors (hours) beta 0.88, 95% CI 0.53 to 1.24, time outdoors2 beta -0.06, 95% CI -0.11 to -0.01) and had 4% lower odds of seeking help for common mental health disorders (AOR 0.96, 95% CI 0.93 to 0.99). Those in urban areas benefited most from greater access to green and blue spaces (AOR 0.89, 95% CI 0.89 to 0.89). Those in material deprivation benefited most from leisure time outdoors (until approximately four hours per week; Warwick-Edinburgh Mental Well-being Scale: time outdoors × in material deprivation: 1.41, 95% CI 0.39 to 2.43; time outdoors2 × in material deprivation -0.18, 95% CI -0.33 to -0.04) although well-being remained generally lower.

Limitations

Longitudinal analyses were restricted by high baseline levels and limited temporal variation in ambient greenness in Wales. Changes in access to green and blue spaces could not be captured annually due to technical issues with national-level planning datasets.

Future work

Further analyses could investigate mental health impacts in population subgroups potentially most sensitive to local changes in access to specific types of green and blue spaces. Deriving green and blue spaces changes from planning data is needed to overcome temporal uncertainties.

Funding

This project was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme (Project number 16/07/07) and will be published in full in Public Health Research; Vol. 11, No. 10. Sarah Rodgers is part-funded by the NIHR Applied Research Collaboration North West Coast.

Urban human settlements' resilience measurement and characteristics and their mechanism model in China

This study introduces the principle of resilience into the study of human settlements. In this study, a comprehensive evaluation model of urban human settlements' resilience based on the provincial region of China was constructed using the Driver-Pressure-State-Impact-Response framework. The spatio-temporal evolution characteristics of urban human settlements' resilience was explored. The influencing factors were analysed by geographical detectors, and the driving mechanism was constructed. Results show that the following. (1) The resilience level of human settlements in China continued to increase, and the resilience level of each province and city changed significantly. The overall clustering effect showed a tendency to fluctuate and weaken. The distribution of cold spot areas became less and less, and the hot spots were moving from northeast China to southeast China. (2) Significant differences existed in the intensity of the impact of different indicators on the resilience system. The value of the impact factor showed an overall upward trend, and the number of key impact factors increased. (3) Improving the ability of scientific and technological innovation, accelerating the transformation and upgrading of the regional economy, increasing the training of talents and making financial inclination in scientific and technological development and industrial pollution control were all important ways for developing and maintaining the resilience of urban human settlements. This study not only introduces a new evaluation of urban human settlements from the perspective of resilience but also explores key impact indices and driving mechanisms, which provides new ideas for studying urban human settlements.

Beside the Seaside: Reflections on Local Green and Blue Spaces from Adults Aged over 50 in a Coastal Community

This qualitative study examined the perceptions of potential wellbeing benefits of local green and blue spaces for adults aged over 50 years in a coastal town in North West England. At a population level, living close to green and blue spaces is associated with better mental and physical health, with the strength of the benefits being inversely related to the economic prosperity of an area. However, living in economically disadvantaged coastal communities may be associated with poorer health and wellbeing, particularly for older adults, despite the proximity to blue (and often green) space. Exploring this apparent paradox was the aim of the present study. Through semi-structured interviews with members of a community group, we gained insight into lived experiences of local green and blue spaces. The main themes we developed from analysis of the conversations were accessibility, amenities, social connections, quality of environment, and recuperation and escape. Our findings illustrate that participants valued natural spaces that were local and accessible, particularly when they felt connected to them, and were less likely to visit spaces that were further away and that were perceived as being less welcoming or accessible. This study provides insights into the experiences of adults aged over 50 living in coastal areas and suggests that policies and interventions aimed at promoting wellbeing in this demographic should consider the value of hyper-local green and blue spaces and their potential to promote connectedness to nature.

Visiting nature is associated with lower socioeconomic inequalities in well-being in Wales

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.

Understanding How Community Wellbeing is Affected by Climate Change: Evidence From a Systematic Literature Review

Social science studies view community wellbeing to be a cumulative construct of multiple dimensions which include social, economic, environmental, physical, political, health, education indicators and more. The study of community wellbeing is compounded by climate change as it increases the frequency of disasters affecting all dimensions of community wellbeing. It becomes crucial for communities to build community resilience and address the impact on community wellbeing in the context of Disaster Risk Reduction and sustainable development. This systematic literature aimed to understand how community wellbeing is affected by climate change. It analysed 23 papers from Scopus, Web of Science, ProQuest, and Google Scholar, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method, to address three research questions: (i) how do climate change scholars understand community wellbeing, (ii) how community wellbeing is affected by specific climate change factors/conditions and the nature of impact, and (iii) how the impact on community wellbeing as a result of climate change is being addressed. The study found that climate change scholars hold mixed and multiple views or understanding of community wellbeing and climate change led to mental stress decreasing community wellbeing. The solutions to improve community wellbeing in the context of climate change suggests that adaptation should be the main policy instrument supplemented by mitigation strategies and recommends building a vibrant research culture in wellbeing and climate studies, among others. This review provides insights into the complex relationship between community wellbeing and climate change and identifies areas for future research and policy development.

Placemaking and infrastructure through the lens of levelling up for health equity: A scoping review

The planning and delivery of infrastructure influences how places create health equity. The scholarship on place and health has recently been developed into 'levelling up' principles for equity focussed policy and planning. We conducted a scoping review of the literature on infrastructure through urban regeneration and placemaking interventions. We interrogated the 15 final selected articles for their use of one or more of the five 'levelling' up principles. No article encompassed all five principles. It was most common to find two or three principles in action. Reviewing the articles against the principles allows a deeper explanation of how infrastructure planning practice can positively impact on health equity. We conclude that applying all the principles in standard infrastructure planning practice has great potential for creating places that are positive for health equity.

Employing citizen science to enhance active and healthy ageing in urban environments

Engaging older residents in problem definition and solution-building is key to the success of place-based initiatives endeavouring to increase the age-friendliness of urban environments. This study employed the Our Voice framework, engaging older adult citizen scientists (n = 14) and community stakeholders (n = 15) across the city of Birmingham, UK. With the aim of identifying urban features impacting age friendliness and co-producing recommendations for improving local urban areas, citizen scientists participated in 12 technology-enabled walkability assessments, three in-person discussion groups, two one-to-one online discussions, and two workshops with community stakeholders. Together, citizen scientists co-produced 12 local and six city-wide recommendations. These recommendations were embedded into an implementation framework based on workshop discussions to identify age-friendly pathways in urban environments.

The Impact of Multi-Quality Renewal Elements of Residence on the Subjective Well-Being of the Older Adults - A Case Study of Dalian

Background

With the expansion of comprehensive renovation projects in China's old residential areas, residents' actual sense of access and well-being has become a source of concern. As the population in old residential areas ages, the results of old renovation will have a significant impact on the older adults quality of life and subjective well-being.

Purpose

To date, most relevant studies have focused on urban and community scales, with little discussion of the impact of neighborhood-level renewal outcomes on the well-being of older adults. As a result, the purpose of this research is to optimize the quality renewal elements of existing old residential areas based on the results of their renovation in order to create a more livable living environment for older adults in existing old residential areas.

Methods

Based on a survey of old neighborhoods in Dalian, the study examines the mediating effect of psychological resilience between multi-quality renewal elements and the subjective well-being of the older adults, and it discusses the influence of multi-quality renewal elements on the subjective well-being of the older adults in different residential types.

Results

According to the findings, multi-quality renewal elements of residence positively predicted the subjective well-being of the older adults; there was a significant mediating effect of psychological resilience between the renewal elements and subjective well-being of the older adults. The study confirms that multiple quality renewal elements can contribute to older people's subjective well-being, and that psychological resilience plays an important role in the selection of multiple quality renewal elements and older people's subjective well-being.

Conclusion

The research provides guidance for the establishment of health-oriented approaches to environmental restoration in residential areas for the sustainable development of communities and cities.

Human-built environment interactions: the relationship between subjective well-being and perceived neighborhood environment characteristics

The neighborhood is one of the most fundamental urban elements and acts as the intermediary link between the city and citizens to enhance the quality of life. The present study examined the significance of the relationship between the subjective well-being of citizens and perceived neighborhood environment characteristics in urban historical fabrics for creating healthy neighborhoods. To this end, a survey research method was employed, and the data were collected via questionnaires. The population consisted of all the citizens of the historical neighborhood of Sange Siah in Shiraz, Iran, who lived or worked in the neighborhood and used the neighborhood spaces daily. A Nonparametric Spearman correlation coefficient was run to assess the correlation between the variables. The results showed that the component of social inclusion from among the six components of subjective well-being had a significant positive correlation with perceived neighborhood environment characteristics (r = 0.712). In the following, the components of satisfaction with life (0.614), mental well-being (0.569), positive and negative effect (0.526), and feeling of happiness (0.468) had a moderate positive correlation; and the component of physical and mental health also had a weak positive correlation with perceived neighborhood environment characteristics (0.230). In addition, the concept of subjective well-being with a correlation coefficient of 0.579 had a moderate positive correlation with perceived neighborhood environment characteristics, which indicates that the structural characteristics of the neighborhood have a significant relationship with the subjective well-being of the people living in the neighborhood.

Exploring the role of exposure to green and blue spaces in preventing anxiety and depression among young people aged 14-24 years living in urban settings: A systematic review and conceptual framework

Despite the growing problem of anxiety and depression amongst young people aged 14-24 years living in urban settings, reviews about the role of exposure to green and blue spaces or nature in preventing anxiety and depression tend to focus on children, adults or sometimes adolescents. This review aims to explore whether exposure to green and blue spaces reduces the risk of anxiety and depression among young people aged 14-24 years living in urban settings and provide a conceptual framework. The academic databases CINAHL plus, Global Health, MEDLINE, ProQuest: Dissertations and Theses, PsycINFO, Scopus and OpenGrey were searched for research published in English between January 2000 and June 2020. All study designs were eligible. All included studies were assessed for quality. Searches identified 9208 sources with 48 meeting the inclusion criteria for the review. Experimental studies provided evidence that walking or being in a green space improves mood and state anxiety immediately following the intervention. Non-randomised evaluations and observational studies suggest that social interaction, physical activity, and mindfulness mediate the relationship between exposure to green space and mental health. We propose that the absence of noise and restorative qualities of green spaces promotes mindfulness and interrupt rumination, which in turn reduce the risk of anxiety disorders and depression. This review and the resulting conceptual framework provide evidence to healthcare professionals about the value of contact with nature and green social prescribing. For policymakers, it provides evidence about the value of bringing the benefits of forests, vegetation and nature into cities, and ensuring that these spaces are accessible and safe for young people to use.

The Effects of Urban Neighborhood Environmental Evaluation and Health Service Facilities on Residents' Self-Rated Physical and Mental Health: A Comparative and Empirical Survey

(1) Background: The neighborhood environment has been shown to be an essential factor affecting residents’ quality of life and health, but the relationship between the characteristics of health service facilities and health levels is rarely known. (2) Methods: This study used a representative sample (n = 591, 303 women; 288 men, age 18–85 years, lived in Chengdu for an extensive time) of residents living in Chengdu City, China, and took spatial point data and empirical research data to construct an ordered logistic regression model. We contrastively analyzed the influence of different variables in the neighborhood environment and health service facilities on self-rated physical health (SRPH) and self-rated mental health (SRMH). (3) Results: The frequency of use and accessibility of multiple facilities in the health service facilities were significantly associated with self-rated health (SRH). Significant differences occurred between residents’ perceived accessibility and actual accessibility of facilities in SRH. Comparing the results of SRPH and SRMH revealed that the influencing factors that affect the two vary. The factors that significantly affect SRMH include neighborhood physical environment evaluation; social environmental evaluation; the frequency of use of the parks and squares, and sports zones; and the accessibility of parks and squares, specialized hospitals, community hospitals, and pharmacies. However, the factors that significantly affect SRPH include the frequency of use of sports venues, general hospitals, and pharmacies and the accessibility of general hospitals. The social environment of the neighborhood is also a non-negligible part, and its interaction with the physical environment of the neighborhood affects the outcome of SRH. (4) Conclusions: Neighborhood environmental characteristics and the layout of health service facilities have significant differential effects on people’s physical and psychological health, and this information is of great value in promoting healthy city development and improving the quality of life of urban populations around the world.

Exploring the Impact of the COVID-19 Pandemic on Male Mental Health Emergencies Attended by Ambulances During the First National "Lockdown" in the East Midlands of the United Kingdom

The novel coronavirus disease 2019 (COVID-19) pandemic and associated mitigation strategies such as “lockdown” are having widespread adverse psychological effects, including increased levels of anxiety and depression. Most research using self-reported data highlights the pandemic’s impact on the psychological well-being of females, whereas data for mental health emergency presentations may reflect the impact on male mental health more accurately. We analyzed records of male mental health emergencies occurring in the East Midlands of the United Kingdom during the first national “lockdown.” We computed two binary logistic regression models to (a) compare male mental health emergencies occurring during “lockdown,” 2020 (5,779) with those occurring in the same period in 2019 (N = 4,744) and (b) compare male (N = 5,779) and female (N = 7,695) mental health emergencies occurring during “lockdown.” Comparisons considered the characteristics of mental health emergencies recorded by ambulance clinicians (Primary Impressions), and the socioeconomic characteristics of communities where emergencies use the Index of Multiple Deprivation. We found that during “lockdown,” male emergencies were more likely to involve acute anxiety (odds ratio [OR]: 1.42) and less likely to involve intentional drug overdose (OR: 0.86) or attempted suicide (OR: 0.71) compared with 2019. Compared with females, male emergencies were more likely to involve acute behavioral disturbance (OR: 1.99) and less likely to involve anxiety (OR: 0.67), attempted suicide (OR: 0.83), or intentional drug overdose (OR: 0.76). Compared with 2019, and compared with females, males experiencing mental health emergencies during “lockdown” were more likely to present in areas of high deprivation. Understanding the presentation of male mental health emergencies could inform improved patient care pathways.

Roles of Economic Development Level and Other Human System Factors in COVID-19 Spread in the Early Stage of the Pandemic

We identified four distinct clusters of 151 countries based on COVID-19 prevalence rate from 1 February 2020 to 29 May 2021 by performing nonparametric K-means cluster analysis (KmL). We forecasted future development of the clusters by using a nonlinear 3-parameter logistic (3PL) model, and found that peak points of development are the latest for Cluster I and earliest for Cluster IV. Based on partial least squares structural equation modeling (PLS-SEM) for the first twenty weeks after 1 February 2020, we found that the prevalence rate of COVID-19 has been significantly influenced by major elements of human systems. Better health infrastructure, more restriction of human mobility, higher urban population density, and less urban environmental degradation are associated with lower levels of prevalence rate (PR) of COVID-19. The most striking discovery of this study is that economic development hindered the control of COVID-19 spread among countries in the early stage of the pandemic. Highlights: While richer countries have advantages in health and other urban infrastructures that may alleviate the prevalence rate of COVID-19, the combination of high economic development level and low restriction on human mobility has led to faster spread of the virus in the first 20 weeks after 1 February 2020.

Creating Sustainable Buildings: Structural Design Based on the Criterion of Social Benefits for Building Users

Sustainable building involves reducing negative environmental impacts with a simultaneous increase in life quality. The aim is to optimize building performances while considering all aspects of sustainability: environmental, economic, and social. The building structure determines the building’s performances, and it should be designed and evaluated as a subsystem of the building, in line with the objectives of the system–building. This paper investigates structural design based on integrated design objectives within the criterion of social benefits for users throughout the use phase of the building, focusing on protection and safety, aspects of comfort, spatial organization, spatial adaptability, and maintenance. The problem was studied using integrative literature review methodology and system theory. The main findings of the research are a review and critical analysis of the representative literature and the derived conceptual framework for structural design based on the criterion of social benefits for building users, which should support more comprehensive and more efficient decision-making during systemic design and optimization of buildings. The presented integrated literature review indicates the need for the application of a systemic approach to structural design in order to create sustainable buildings.

From Comparative and Statistical Assessments of Liveability and Health Conditions of Districts in Hong Kong towards Future City Development

Liveability is an indispensable component in future city planning and is practically linked with the health status of individuals and communities. However, there was nor comprehensive and universal district-level framework for assessing liveability due to geospatial and social discrepancies among different countries. In this study, using Hong Kong, a highly dense and international city as an example, the Liveability and Health Index (LHI-HK) consisting of 30 indicators was established, with 21 of them related to education, economy, housing, walkability/transport, environment, and health facilities aspects, while the health conditions of citizens in individual districts were examined by other 9 indicators. Respective scoring allocation was determined by statistical reasoning, and was applied to quantify the connections between liveability and health among the 18 districts of Hong Kong in both 2016 and 2019. Temporal changes of spatial features could be traced by this quantitative framework, and obvious correlations between liveability and health were attained, with R values of 0.496 and 0.518 in 2016 and 2019, and corresponding slopes of 0.80 and 0.88, respectively. Based on the statistical results, it was found that Sai Kung and Kwun Tong are the most and the least liveable district of Hong Kong in 2019. The LHI-HK index was well-validated by renowned AARP liveability index and The California Healthy Places Index (HPI), with R values of 0.90 and 0.70, and the potential uncertainties due to data projection were less than 2.5% for all districts, which implicates its relevancy and appropriateness in conducting similar spatial assessments in international cities. Further, both favorable and unfavorable spatial arrangements of each of the 3 district types in Hong Kong were identified, namely residential, commercial, and industrial districts. This opens new windows in enhancing liveability and health status within communities, with the aim of promoting the sustainability of cities in the long run.

Exposure to green space and prevention of anxiety and depression among young people in urban settings: a global scoping review

Purpose

There is a mental health crisis, particularly among young people. Despite many young people living in urban settings, reviews about the association between exposure to green or natural environments and mental health tend to focus on either children or adults. The aim of this review is to examine the scope of the global literature for this age group, to inform a systematic review on the role of exposure to green space in preventing anxiety and depression amongst young people aged 14–24 years.

Design/methodology/approach

Seven databases were searched for quantitative and qualitative sources published from January 2000 to June 2020. This identified 201 sources and their characteristics are described here. Gaps in the literature are also highlighted.

Findings

The number of relevant studies published per year has increased over time. Most studies are set in North America (28%) or Europe (39%). The most common study designs were observational (34%) or experimental (28%). A wide range of exposures and interventions are described.

Research limitations/implications

This review included literature from predominantly high-income countries and has shown the under-representation of low-middle income countries and lack of ethnic diversity in study populations. It has also highlighted the lack of clinical measures of anxiety and depression as outcomes.

Originality/value

This inter-disciplinary review has contributed to the field by describing the geographic distribution of the literature and the broad range of exposures to green spaces being reported. Unlike previous scoping reviews, this review focused specifically on young people and on measures of anxiety and depression and their pre-cursers.

The role of social vs. physical environmental nuisances in affecting stress among Jewish and Muslim women in Israel

We calculate the effects of selected social and physical environmental nuisances on the autonomic nervous system balance among Jewish and Muslim mothers. Seventy-two Jewish and Muslim young healthy mothers from an Arab and Jewish neighboring city were tested in seven urban environments. Three social mediators (social discomfort, participation in household's decision-making and freedom of movement) and three physical mediators (thermal load, carbon monoxide and noise) were considered. Mean differences between Jewish and Muslim heart rate variability (HRV) and the effects of the mediating variables were calculated by ANOVA and stepwise multiple regressions. The results suggest that HRV was predominantly affected by social discomfort. Jewish and Muslim mothers experienced similar levels of social discomfort albeit; their responses differed by type of environment. Jewish mothers experienced stronger social discomfort in outdoor environments while Muslim mothers felt stronger social discomfort at home. Crossing ethnic boundaries was associated with increase in stress in both groups. Social discomfort played a stronger role in predicting stress in inter-ethnic environments. In conclusion, the study shows that social discomfort is a predominant environmental factor in predicting stress and related risk to health as reflected in the ANS balance across ethnicities. In addition ethnic specific factors like women freedom of movement played a minor role in effecting stress. At the same time the physical environmental aspects played essential role in effecting stress.

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

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

Spatial Equity of Public Parks: A Case Study of Kabul City, Afghanistan

Accessibility, the size of the land area, the design and build quality, and the number of parks and their correlation with population density are key elements in fostering ecological spatial equity within cities. This study analyzed different spatial equity attributes of existing parks in Kabul City using onsite observations, measurement analyses, and mapping and buffering of satellite imagery using computer-aided design methods. The results revealed that, presently, 309 ha of urban land is covered by parks, which accounts for 0.78% of the total land area of 394.78 km2. On average, a quarter of city residents can access a park with basic amenities within 300 to 600 m of their residence, and parks currently provide a land coverage distribution per resident of 0.69 m2. However, the majority of parks lack certain amenities like playground and sports facilities desired by different user groups. This article also explored the inequitable distribution of parks at the city scale, underlining the scarcity or concentration of parks in certain areas and stressing the importance of allocating additional land for park provision.

Investigating the malleable socioeconomic resilience pathway to urban cohesion: a case of Taipei metropolitan area

It is known that globalization has led first- and second-tier cities' urban restructuring trajectories, excreted pressures, and caused tremendous socioeconomic volatility. This resulted in marginalized communities in dire of social empowerment, employment structure variance, and industry sectoral adjustment. Moreover, recent successive climate and health crisis unfolded and affirmed the state of our urban incompetence to sustain socioeconomic resilience or otherwise; lacking swift responses in providing critical management and services, cites are facing multifaceted challenges. Urban well-being and resilience are at stake. Although the environmental and health dimensional effects are apparent, this study ascertains that the transept multi-scalar analysis within the urban socioeconomic structure is crucial in sustaining core resilience to foster health and well-being of the community. As an integral part of the investigation, the revised DPSIR assessment framework is applied to evaluate the sectoral shift; spatial structure disarray and urban codependence degree are examined within the Taipei metropolitan area (TMA), a medium size but densely populated metropolitan area in Taiwan. The place-based DPSIR analysis ascertained the states and impacts in TMA: (1) A population decline speeded the restructuring of the urban core, while the impact of demographic aging and shrinkage rate mandates proper management and planning responses to the decline process; (2) the socioeconomic state effect is determined but does not critically affect the periphery zone, while an uneven demographic shift within the urban core necessitates dynamic adjustment responses to appropriately provide intergenerational services; (3) the uneven sector redistribution stimulated the core's spatial and structural inter-dependency with peripheral zones, requiring governance with tighter cross-administration cooperation among respective public sectors; and (4) facing the sector/temporal and demographic pressure, urban cohesiveness in the TMA is greatly affected, which in turn disrupts the resilience pathway toward a cohesion. The study ascertained that the revised DPSIR framework could provide cities facing pressing socioeconomic drivers with effective analysis to allocate pressures, states, and impacts and formulate the necessary responses. To assure the socioeconomic resilience and urban cohesiveness, planning policy should carefully monitor and evaluate socio-demographic and sector redistribution factors to promote the urban resilience.

The Influence of Environmental Pollution and Drought on the Satisfaction With Life of Entrepreneurs in Zambia’s Mining Sector

Following contemporary trends of entrepreneurship research, measures of entrepreneurship, in terms of corporate social responsibility in relation to business performance (as an indicator of welfare, which is monetary well-being), has been investigated abundantly in developing countries. However, the consequences of climate change and natural disasters, such as environmental pollution and drought, have hardly been studied on the satisfaction with life (i.e., well-being) of entrepreneurs in developing countries. Therefore based on questionnaires administered to 132 entrepreneurs in the mining sector of the Copperbelt Province and North-Western Province of Zambia (i.e., the developing country context of this study), this chapter shows that environmental pollution and drought have a negative effect on satisfaction with life. Moreover, environmental pollution and drought have negative effects on both business’ profitability and decision-making. The results involve contributions to the existing literature and practical suggestions for entrepreneurs, policymakers, and educators.

Assessing Social Sustainability for Achieving Sustainable Architecture

Sustainability is an inherent urban and architectural problem. It is simultaneously characterized by many different dimensions, pursuing heterogeneous and often conflicting objectives. To help address these complexities in a structured way, this paper illustrates an integrated assessment framework to tackle social sustainability, in order to support the decision-making process towards sustainable architecture. This integrated decision support framework was applied to a case study concerning a new cultural centre at the Politecnico di Torino in Italy. The aim of this paper is to propose a decision support methodological framework for the analysis, graphical visualization and evaluation of social sustainability of architectural projects. It combines three methods: first, Strengths, Weaknesses, Opportunities, Threats (SWOT) analysis, to get a guided understanding of the project and detect the best design strategies; second, the Stakeholder Analysis (SA), to develop a strategic view of the actors involved; third, the Social Return of the Investment (SROI) as a methodological tool for social impact assessment. This framework, presented through the discussion of some project solutions, helps us to analyse the architectural material effect of social sustainability and answer the question: Are we investing properly and creating spaces sufficiently functional to build better conditions for our community and our city?

Physical Disorders and Poor Self-Rated Health in Adults Living in Four Latin American Cities: A Multilevel Approach

Considering that urban environments may affect self-rated health through behavioral and psychosocial mechanisms, the aim of this study was to investigate the association between self-rated health and perceived urban environment characteristics among adults living in four Latin American cities. Data is from a population-based survey by Development Bank of Latin America, encompassing adults between 20 and 60 years old in Buenos Aires, Lima, Mexico City, and Panama City. Self-rated health was measured using a single question and the response options were categorized as poor and good. The explanatory variables were empirical Bayes estimates of self-reported area physical disorder, social disorder, access to services, and access to leisure spaces derived from the survey. The covariates were: individual age, sex, education, wealth index, and length of residency in the neighborhood; and an area social environment index. Multilevel logistic regressions with two levels (individual and sub-city areas) were fitted. Poor self-rated health was reported by 34.73% (95% CI: 33.17 to 36.29) of the participants and was associated with physical disorder (OR = 1.16 per SD; 95% CI: 1.02 to 1.32). Our findings suggest that public policies to promote population health should consider area urban environment factors, especially those associated with disorder.

Dealing with Green Gentrification and Vertical Green-Related Urban Well-Being: A Contextual-Based Design Framework

Urbanization and climate change have generated ever-increased pressure to the ecosystem, bringing critical resilience challenges to densely congested cities. The resulted displaced and encroached habitat in need of recuperation demands a comprehensive overhaul to the customary urban planning practices; further, the deteriorating public health state of urban residents calls for strategies in dealing with green deprivation and gentrification issues. Frequently, urban greening strategies are envisaged at a macro-scale on a dedicated horizontal track of land, rendering local implementation in a densely built neighborhood a challenged undertaking. Communities lacking green and land resources could promote vertical greening to enable and enhance social and psychological well-being. This study ascertains that vertical greenery closest to the inhabitants could be allocated on a building facade. It can contribute to a more sustainable ecology. The article presents the systemic design approach to urban vertical greening thinking and its role in well-being provision. We propose an interdisciplinary multicriteria contextual-based scalable framework to assess vertical green infrastructure; the prototype requires an innovative approach to balance architecture, human needs, and the local environment. The vertical greening application provides an alternative paradigm in the design implementation for urban green. We proposed the locality and place to be incorporated into the vertical greening design framework. The research concludes the three-tiered consideration framework resulted: (1) in line with the human-habitat ecosystem, the local environment-social dimension is explored; (2) the well-being criteria encourage the design practice’s support for localized driven community vitality; (3) the design paradigm requires integration with the increasing demand for green space as well as taking into account the impact of severe climate; and (4) the framework should achieve the strengthening of health and well-being of the community.

Nature-based activities improve the well-being of older adults

Current literature shows that interaction with urban greenery can have a wide range of positive health outcomes. Targeted nature-based programs, such as therapeutic horticulture, have been shown to result in multiple health benefits for older adults residing in temperate environments, but much less research has been carried out on populations with different phenotypes, such as older Asian adults in the tropics. The current study investigated the effects of a 24-session therapeutic horticulture program on 47 older participants in Singapore, with an experimental pretest posttest design. We found that participants maintained healthy sleep patterns and psychological health, as well as showed reduced anxiety and improved cognitive functioning (p < 0.05). In addition, they reported an increase in mean happiness score after each session. This study provides new evidence using a comprehensive set of indicators across the affective, cognitive, functional, psychosocial and physical domains, supporting current literature on the benefits of nature programs, with a novel focus on tropical environments. It provides evidence that the nature-based intervention has the potential to be translated to programs to benefit older adults in the tropics.

Influence of Wind Buffers on the Aero-Thermal Performance of Skygardens

Many high-rise buildings have semi-enclosed landscaped spaces, which act as design elements to improve the social and environmental aspects of the building. Designs such as skygardens are open to outdoor airflow and allow occupants to observe the city skyline from a height. Due to their often high location, they are subjected to strong wind speeds and extreme environmental conditions. The current study investigates the effects of three common wind buffers (railing, hedges, and trees) located at a height of 92 m on the performance of a skygarden, in terms of occupants’ wind comfort. Computational fluid dynamics (CFD) simulations were carried out using the realisable k-epsilon method, where the vegetation was modelled as a porous zone with cooling capacity. The computational modelling of the high-rise building and vegetation were validated using previous works. The quality class (QC) of the Lawson comfort criteria was used for the evaluation of the wind comfort across the skygarden. The results indicate that, although the three wind buffers offer varying levels of wind reduction in the skygarden, the overall wind conditions generated are suitable for occupancy. Furthermore, vegetation is also able to offer slight temperature reductions in its wake. The right combination and dimension of these elements can greatly assist in generating aero-thermal comfort across skygardens.

Deep Learning to Unveil Correlations between Urban Landscape and Population Health

The global healthcare landscape is continuously changing throughout the world as technology advances, leading to a gradual change in lifestyle. Several diseases such as asthma and cardiovascular conditions are becoming more diffuse, due to a rise in pollution exposure and a more sedentary lifestyle. Healthcare providers deal with increasing new challenges, and thanks to fast-developing big data technologies, they can be faced with systems that provide direct support to citizens. In this context, within the EU-funded Participatory Urban Living for Sustainable Environments (PULSE) project, we are implementing a data analytic platform designed to provide public health decision makers with advanced approaches, to jointly analyze maps and geospatial information with healthcare and air pollution data. In this paper we describe a component of such platforms, which couples deep learning analysis of urban geospatial images with healthcare indexes collected by the 500 Cities project. By applying a pre-learned deep Neural Network architecture, satellite images of New York City are analyzed and latent feature variables are extracted. These features are used to derive clusters, which are correlated with healthcare indicators by means of a multivariate classification model. Thanks to this pipeline, it is possible to show that, in New York City, health care indexes are significantly correlated to the urban landscape. This pipeline can serve as a basis to ease urban planning, since the same interventions can be organized on similar areas, even if geographically distant.

The role of cities in reducing the cardiovascular impacts of environmental pollution in low- and middle-income countries

BACKGROUND

As low- and middle-income countries urbanize and industrialize, they must also cope with pollution emitted from diverse sources.

MAIN TEXT

Strong and consistent evidence associates exposure to air pollution and lead with increased risk of cardiovascular disease occurrence and death. Further, increasing evidence, mostly from high-income countries, indicates that exposure to noise and to both high and low temperatures may also increase cardiovascular risk. There is considerably less research on the cardiovascular impacts of environmental conditions in low- and middle-income countries (LMICs), where the levels of pollution are often higher and the types and sources of pollution markedly different from those in higher-income settings. However, as such evidence gathers, actions to reduce exposures to pollution in low- and middle-income countries are warranted, not least because such exposures are very high. Cities, where pollution, populations, and other cardiovascular risk factors are most concentrated, may be best suited to reduce the cardiovascular burden in LMICs by applying environmental standards and policies to mitigate pollution and by implementing interventions that target the most vulnerable. The physical environment of cities can be improved though municipal processes, including infrastructure development, energy and transportation planning, and public health actions. Local regulations can incentivize or inhibit the polluting behaviors of industries and individuals. Environmental monitoring can be combined with public health warning systems and publicly available exposure maps to inform residents of environmental hazards and encourage the adoption of pollution-avoiding behaviors. Targeted individual or neighborhood interventions that identify and treat high-risk populations (e.g., lead mitigation, portable air cleaners, and preventative medications) can also be leveraged in the very near term. Research will play a key role in evaluating whether these approaches achieve their intended benefits, and whether these benefits reach the most vulnerable.

CONCLUSION

Cities in LMICs can play a defining role in global health and cardiovascular disease prevention in the next several decades, as they are well poised to develop innovative, multisectoral approaches to pollution mitigation, while also protecting the most vulnerable.

Active and Fit Communities. Associations between Neighborhood Walkability and Health-Related Fitness in Adults

There are many health benefits of regular physical activity and improving physical fitness levels can reduce the risk of chronic disease. Accumulating evidence suggests the neighborhood built environment is important for supporting physical activity; however, few studies have investigated the contribution of the neighborhood built environment to fitness levels. We examined the associations between objectively-determined and self-reported neighborhood walkability and overall and specific components of perceived health-related fitness (cardiorespiratory, muscular strength, and flexibility) in a random sample of 592 adults from two areas of Calgary (Canada). Participants provided complete data to an online questionnaire capturing perceived cardiorespiratory fitness (CRF), muscular strength (MST), flexibility, moderate-to-vigorous intensity physical activity (MVPA), resistance training, and sociodemographic characteristics. The questionnaire also captured participant’s perceptions of their neighborhood’s walkability (Physical Activity Neighborhood Environment Scale; PANES) and the physical activity supportiveness of neighborhood parks (Park Perceptions Index; PPI). Objectively-measured neighborhood walkability was estimated using Walk Score^®. The average (SD) age of participants was 46.6 (14.8) years and 67.2% were female. Participants, on average, participated in at least 30-minutes of MVPA on 3.4 (2.1) days/week and undertook resistance training 2.0 (1.8) days/week. Adjusting for covariates, Walk Score^® was not associated with any fitness outcomes. Adjusting for covariates, the PANES index was positively associated (p < 0.05) with CRF, MST, flexibility, and overall fitness and the PPI was positively associated (p < 0.05) with all fitness outcomes except MST. Our findings provide novel preliminary evidence suggesting the neighborhood built environment may be important for supporting higher health-related fitness levels in adults.

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

BACKGROUND

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

AIM

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

METHODS

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

RESULTS

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

CONCLUSION

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

Using Google Earth™ and Geographical Information System data as method to delineate sample domains for an urban household surveys: the case of Maroua (Far North Region-Cameroon)

Background

Getting a random household sample during a survey can be expensive and very difficult especially in urban area and non-specialist. This study aimed to test an alternative method using freely available aerial imagery.

Methods

A gridded map and random selection method was used to select households for interviews. A hundred numbered of points were put along the edges of an updated map of Maroua. Then two numbers were randomly draw at a time and a line was drawn between those two numbers. A lot of different kinds of shapes of different sizes obtained were numbered. Ten shapes were randomly draw and the one selected were considered as ‘neighbourhoods’. A grid of 30 m × 30 m was drawn over each and then numbered. 202 grids considered here as households were randomly selected from the ten neighbourhoods for interviews.

Results

Out of 202 households visited, only 4 were found to be something other than a house. In addition, 30 sampled households (14.85%) were abandoned or the occupants had relocated elsewhere. This method resulted in an accuracy level of 72%, its advantage is the ability to generate efficient random sample at relatively low cost as well the time required.

Conclusions

The method proposed in this study was efficient and cost-effective when compared to the infield generation of a household inventory or Global Positioning System (GPS) tracking of households. It can then be used by researchers in low-incomes countries where funding for research is a challenge. However, this method needs to train the investigators on how to use the GPS.

The role of the physical environment in adolescent mental health

The existing literature suggests an association between the physical environment and mental health but also complex relationships between the social and the physical environment as well as between objective and subjective measures of the environment. In this study, we attempted to explore the role of the residential neighbourhood's physical environment in adolescent mental health, taking this complexity into account. Using data on 3683 ten- to 15-year-olds from England and Wales who participated in Understanding Society, we investigated the role of neighbourhood greenspace and air pollution in adolescent mental health (measured with the Strengths and Difficulties Questionnaire) while controlling for measures of neighbourhood and family socio-economic disadvantage as well as subjective perceptions of social cohesion, crime, safety, and noise in the neighbourhood. In linear regression models, greenspace and air pollution could not predict mental health. However, fear of being a victim of crime was a consistent predictor of mental health and behaviour, indicating the essential role of young people's subjective experience of their neighbourhoods for their mental health and well-being.

Is urban living good for mental health?

PURPOSE OF REVIEW

The questions of urban living, mental health and well-being are complex issues correlated to many interacting factors. The purpose of this review is to provide data on mental health challenges of urban life and perspectives to address these challenges.

RECENT FINDINGS

Urbanization may cause mental health problems, such as psychotic experiences, depression and stress-related disorders, particularly in vulnerable individuals. Challenges of urban living are even greater in developing countries, because of other urgent problems these countries are facing. New findings identified distinct neural mechanisms for an established environmental risk factor, linking the urban environment to social stress processing. Nature-based solutions may be helpful in preventing mental disorders and in alleviating psychological symptoms.

SUMMARY

The data of impact of urban living on mental health are still controversial and mechanism of association is unclear. Urban living may be related to biological or social/environmental factors or both. Most probably, urbanicity has a synergistic effect with genetic vulnerability. Interdisciplinary and intersectoral actions are needed to meet urban living challenges, such as providing access to green space and mental health services, decrease of poverty, homelessness and emerging problems of immigration to cities.

Improving Sustainability in Architectural Research: Biopsychosocial Requirements in the Design of Urban Spaces

There is an ever increasing interest in identifying the links between architecture and public health and in how urban design can positively influence the latter. The psychology of sustainability and sustainable development represents an innovative research area as a recent contribution to sustainability science and its trans-disciplinary configuration. The research topic deals with the importance and the centrality of the user-centered approach in the observation of the relationships among mankind, technological systems, and built environments, for projects that guarantee the conditions of physical, mental, and social well-being. Starting from the plurality of different disciplinary sectors, from anthropometry and sociology to psychology, “human experience” and user’s expectations are explored, understood, and systematized. The analysis of the relationship between health and urban design has allowed researchers to identify design strategies to improve the level of urban livability. The city of Pisa is the case study; mobility within the city is redefined through various levels of the use of space so that paths and areas of inclusion and socialization are re-valued, while new scenarios for some urban spaces open up. In this perspective, the design strategies synthetically follow two main directions: the re-appropriation of these places by the citizens and, at the same time, the promotion of their well-being from both a physical and psychological point of view.

Cyclists’ Multiple Environmental Urban Exposures—Comparing Subjective and Objective Measurements

Citizens in urban areas are exposed to multiple environmental stressors like noise, heat, and air pollution, with impact on human health. There is a great deal of evidence that connects human health, objective environmental exposure, and place of residence. However, little is known about subjective and objective multiple personal exposures while being mobile. To address this research gap, this paper presents results from a mixed-methods exploratory study with cyclists in the City of Leipzig, Germany. In the summer of 2017, cyclists (n = 66) wore a unique combination of sensors that measured particle number counts (PNC), noise, humidity, temperature, geolocation, and the subjective perception of each exposure on everyday routes for one week (n = 730). A smartphone application was developed to question participants about their perception of subjective exposure. The data were analyzed with three aims: (i) to compare the multiple exposure profiles of the cyclists, (ii) to contrast the objective data and subjective individual perception, and (iii) to examine the role of route decision-making and awareness of health impacts for healthier route choices. The results indicate distinct differences between the exposure profiles of cyclists. Over 80% of the cyclists underestimated their exposure to noise and air pollution. Except for heat, no significant associations between the objective and subjective data were found. This reveals an exposure awareness gap that needs to be considered in urban health planning and risk communication. It is argued that knowledge about health impacts and route characteristics plays a crucial role in decision-making about route choices. The paper concludes with suggestions to harness smart sensing for exposure mitigation and research in health geography.