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Van Den Eeden SK, H E M Browning M, Becker DA, Shan J, Alexeeff SE, Thomas Ray G, Quesenberry CP, Kuo M. Association between residential green cover and direct healthcare costs in Northern California: An individual level analysis of 5 million persons. ENVIRONMENT INTERNATIONAL 2022; 163:107174. [PMID: 35306251 DOI: 10.1016/j.envint.2022.107174] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 02/17/2022] [Accepted: 03/07/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND AND OBJECTIVE Prior studies have shown higher green cover levels are associated with beneficial health outcomes. We sought to determine if residential green cover was also associated with direct healthcare costs. METHODS We linked residential Normalized Difference Vegetation Index (NDVI) satellite data for 5,189,303 members of Kaiser Permanente Northern California (KPNC) to direct individual healthcare costs for 2003-2015. Using generalized linear regression to adjust for confounding, we examined the association between direct healthcare costs and green cover within250, 500, and 1000 meters (m) of an individual's residence. Costs were determined from an internal cost accounting system that captures administrative and patient care costs for each clinical encounter. Sensitivity analyses included adjustments for comorbidity and an alternative measure of green cover, tree canopy. RESULTS We observed a significant inverse association between higher levels of residential green cover and lower direct healthcare costs. The relative rate of total cost for the highest compared to the lowest decile of NDVI was 0.92 (95% CI 0.90-0.93) for the 500 m buffer. The association was robust to adjustment from a broad array of confounders, found at each buffer size, and largely driven by hospitalization, and emergency department visits. Individuals in the top decile of residential green cover had adjusted healthcare costs of $374.04 (95% CI $307.31-$439.41) per person per year less than individuals living in the bottom or least green decile. Sensitivity analyses including tree canopy cover as the green space measure yielded similar findings. Analyses that included adjustment for comorbidity were consistent with the hypothesis that green cover reduces healthcare costs by improving health status. CONCLUSION Green cover was associated with lower direct healthcare costs, raising the possibility that residential greening can have a significant healthcare cost impact across the population.
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Affiliation(s)
| | - Matthew H E M Browning
- Department of Parks, Recreation and Tourism Management, Clemson University, Clemson, SC, USA
| | - Douglas A Becker
- Natural Resources and Environmental Sciences, University of Illinois, Urbana-Champaign, IL, USA
| | - Jun Shan
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Stacey E Alexeeff
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - G Thomas Ray
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | | | - Ming Kuo
- Natural Resources and Environmental Sciences, University of Illinois, Urbana-Champaign, IL, USA
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Ponjoan A, Blanch J, Alves-Cabratosa L, Martí-Lluch R, Comas-Cufí M, Cirach M, Nieuwenhuijsen M, Garcia-Gil MDM, Ramos R. Impact of residential greenness on myocardial infarction in the population with diabetes: A sex-dependent association? ENVIRONMENTAL RESEARCH 2022; 205:112449. [PMID: 34883080 DOI: 10.1016/j.envres.2021.112449] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 10/04/2021] [Accepted: 11/24/2021] [Indexed: 06/13/2023]
Abstract
Living in urban areas with abundant greenness might provide health benefits in general population. Literature suggests that sex/gender plays a role in the association between greenness and health outcomes. But the impact of greenness in populations with moderate to high cardiovascular risk, such as persons with diabetes, is still unknown. Our aim was to evaluate the relationship between urban greenness and myocardial infarction incidence in persons with type 2 diabetes in Barcelona (Catalonia, Spain), and seek potential gender/sex differences in this association. This retrospective cohort study is based on data from the System for the Development of Research in Primary Care (SIDIAP database). We used Cox models to estimate if a 0.01 increase in Normalized Difference Vegetation Index (NDVI) at census tract level was associated to reduced risk of developing a myocardial infarction. Models were adjusted by demographic and clinical characteristics at individual level, and by environmental and socioeconomic variables at census tract level. Amongst 41,463 persons with diabetes and 154,803.85 person-years of follow-up, we observed 449 incident cases of acute myocardial infarction. For each 0.01 increment in NDVI the risk of developing a myocardial infarction decreased by 6% (Hazard Ratio, HR = 0.94; 95%CI, 0.89-0.99) in the population with diabetes. When stratifying by sex, we observed a significant association only in men (HR = 0.91; 95%CI, 0.86-0.97). People with diabetes living in urban greener areas might benefit from reduced cardiovascular risk, specially men. We observed sex/gender disparities, which could be related to different exposures and activities performed in green spaces between men and women. Further studies are needed to confirm sex/gender disparities between greenness exposure and cardiovascular outcomes. Our findings contribute to improve the health of people with diabetes who should be recommended to spent time and exercise in green areas.
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Affiliation(s)
- Anna Ponjoan
- Vascular Health Research Group (ISV)-Girona. Jordi Gol Institute for Primary Care Research (IDIAP Jordi Gol), 17002, Girona, Catalonia, Spain; Girona Biomedical Research Institute (IDIBGI), Dr.Trueta University Hospital, 17190, Girona, Catalonia, Spain.
| | - Jordi Blanch
- Vascular Health Research Group (ISV)-Girona. Jordi Gol Institute for Primary Care Research (IDIAP Jordi Gol), 17002, Girona, Catalonia, Spain.
| | - Lia Alves-Cabratosa
- Vascular Health Research Group (ISV)-Girona. Jordi Gol Institute for Primary Care Research (IDIAP Jordi Gol), 17002, Girona, Catalonia, Spain.
| | - Ruth Martí-Lluch
- Vascular Health Research Group (ISV)-Girona. Jordi Gol Institute for Primary Care Research (IDIAP Jordi Gol), 17002, Girona, Catalonia, Spain; Girona Biomedical Research Institute (IDIBGI), Dr.Trueta University Hospital, 17190, Girona, Catalonia, Spain.
| | - Marc Comas-Cufí
- Vascular Health Research Group (ISV)-Girona. Jordi Gol Institute for Primary Care Research (IDIAP Jordi Gol), 17002, Girona, Catalonia, Spain.
| | - Marta Cirach
- ISGlobal, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), 08002, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), 28029, Madrid, Spain.
| | - Mark Nieuwenhuijsen
- ISGlobal, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), 08002, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), 28029, Madrid, Spain.
| | - María Del Mar Garcia-Gil
- Vascular Health Research Group (ISV)-Girona. Jordi Gol Institute for Primary Care Research (IDIAP Jordi Gol), 17002, Girona, Catalonia, Spain.
| | - Rafel Ramos
- Vascular Health Research Group (ISV)-Girona. Jordi Gol Institute for Primary Care Research (IDIAP Jordi Gol), 17002, Girona, Catalonia, Spain; Translab Research Group, Department of Medical Sciences, School of Medicine, University of Girona, Girona, Catalonia, Spain.
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53
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Joint associations between neighborhood walkability, greenness, and particulate air pollution on cardiovascular mortality among adults with a history of stroke or acute myocardial infarction. Environ Epidemiol 2022; 6:e200. [PMID: 35434462 PMCID: PMC9005250 DOI: 10.1097/ee9.0000000000000200] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 01/29/2022] [Indexed: 11/26/2022] Open
Abstract
Fine particulate matter (PM2.5) is a known risk factor for cardiovascular disease (CVD). Neighborhood walkability and greenness may also be associated with CVD, but there is limited evidence on their joint or interacting effects with PM2.5.
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Iyer HS, Hart JE, James P, Elliott EG, DeVille NV, Holmes MD, De Vivo I, Mucci LA, Laden F, Rebbeck TR. Impact of neighborhood socioeconomic status, income segregation, and greenness on blood biomarkers of inflammation. ENVIRONMENT INTERNATIONAL 2022; 162:107164. [PMID: 35255255 PMCID: PMC8985077 DOI: 10.1016/j.envint.2022.107164] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 02/15/2022] [Accepted: 02/23/2022] [Indexed: 05/06/2023]
Abstract
BACKGROUND Neighborhood deprivation is linked with inflammation, which may explain poorer health across populations. Behavioral risk factors are assumed to largely mediate these relationships, but few studies have examined this. We examined three neighborhood contextual factors that could exert direct effects on inflammation: (1) neighborhood socioeconomic status, (2) an index of concentration at extremes (that measures segregation), and (3) surrounding vegetation (greenness). METHODS Using blood samples and addresses collected from prospective cohorts of 7,930 male (1990-1994) and 16,183 female (1986-1990) health professionals with at least one inflammatory marker, we prospectively linked neighborhood contextual factors to inflammatory biomarkers (adiponectin, C-reactive protein, interleukin-6, soluble tumor necrosis factor receptor-2). Log-transformed, z-scaled component measures were used to calculate an inflammation score. Neighborhood socioeconomic status and index of concentration of extremes were obtained from the 1990 decennial census and linked to participant addresses. Surrounding greenness was assessed from satellite data and focal statistics were applied to generate exposures within 270 m and 1230 m of the participants' address. We fit multiple linear regression models adjusting for demographic, clinical, and behavioral risk factors. RESULTS Higher neighborhood socioeconomic status was associated with lower inflammation score in women (β for interquartile range increase = -27.7%, 95% CI: -34.9%, -19.8%) and men (β = -21.2%, 95% CI: -31.0%, -10.1%). Similarly, participants in neighborhoods with higher concentrations of high-income households were associated with lower inflammation score in women (β = -27.8%, 95% CI: -35.8%, -18.7%) and men (β = -16.4%, 95% CI: -29.7%, -0.56%). Surrounding greenness within 270 m of each participant's address was associated with lower inflammation score in women (β = -18.9%, 95% CI: -28.9%, -7.4%) but not men. Results were robust to sensitivity analyses to assess unmeasured confounding and selection bias. DISCUSSION Our findings support the hypothesis that adverse neighborhood environments may contribute to inflammation through pathways independent of behavioral risk factors, including psychosocial stress and toxic environments.
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Affiliation(s)
- Hari S Iyer
- Division of Population Sciences, Dana-Farber Cancer Institute, Boston, USA; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, USA.
| | - Jaime E Hart
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, USA; Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, USA
| | - Peter James
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, USA; Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Healthcare, Boston, USA
| | - Elise G Elliott
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, USA; Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, USA
| | - Nicole V DeVille
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, USA; Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, USA
| | - Michelle D Holmes
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, USA; Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, USA
| | - Immaculata De Vivo
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, USA; Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, USA
| | - Lorelei A Mucci
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, USA; Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, USA
| | - Francine Laden
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, USA; Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, USA; Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, USA
| | - Timothy R Rebbeck
- Division of Population Sciences, Dana-Farber Cancer Institute, Boston, USA; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, USA
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Jung J, Park JY, Myung W, Lee JY, Ko H, Lee H. Association between Residential Greenness and Incidence of Parkinson's Disease: A Population-Based Cohort Study in South Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063491. [PMID: 35329176 PMCID: PMC8951185 DOI: 10.3390/ijerph19063491] [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: 02/15/2022] [Revised: 03/10/2022] [Accepted: 03/11/2022] [Indexed: 11/16/2022]
Abstract
It is widely known that exposure to residential greenness is beneficial for health. However, few studies have analyzed the association between greenery and Parkinson’s disease (PD). We selected 313,355 participants who matched the inclusion criteria from the National Health Insurance Service-National Sample Cohort, followed up from 2007 to 2015. Residential greenness, represented by the normalized difference vegetation index (NDVI), was obtained from satellite measurements. We estimated hazard ratios of PD associated with a 0.1-unit increase in long-term greenness exposure at the district level for the previous 1 year of each year until a censoring/event occurred, using time-varying Cox proportional hazard models, adjusted for individual- and area-level characteristics. During the 2,745,389 person-years of follow-up, 2621(0.8%) participants developed PD. Exposure to higher levels of residential greenness was found to be associated with a decreased risk of PD incidence (21% per 0.1-unit increase, 95% confidence interval (CI): 0.74–0.84). In subgroup analyses, stronger protective effects were observed in participants aged over 50 years, females, overweight/obese participants, non-urban residents, non-smokers, alcoholics, and those with comorbidities. Long-term exposure to greenness was beneficial to incident PD, and our findings could aid in the development of public-health strategies.
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Affiliation(s)
- Jiyun Jung
- Data Management and Statistics Institute, Dongguk University Ilsan Hospital, Goyang 10326, Korea;
- Research Center for Chronic Disease and Environmental Medicine, College of Medicine, Dongguk University, Goyang 10326, Korea;
| | - Jae Yoon Park
- Research Center for Chronic Disease and Environmental Medicine, College of Medicine, Dongguk University, Goyang 10326, Korea;
- Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang 10326, Korea
- Department of Internal Medicine, College of Medicine, Dongguk University, Goyang 10326, Korea
| | - Woojae Myung
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Bundang-gu, Seongnam 13620, Korea;
- Department of Psychiatry, College of Medicine, Seoul National University, Seoul 08826, Korea
| | - Jun-Young Lee
- Department of Psychiatry, SMG-SNU Boramae Medical Center, College of Medicine, Seoul National University, Seoul 08826, Korea;
| | - Hyunwoong Ko
- Interdisciplinary Program in Cognitive Science, Seoul National University, Seoul 08826, Korea;
| | - Hyewon Lee
- Department of Health Administration and Management, College of Medical Sciences, Soonchunhyang University, Asan 31538, Korea
- Department of Software Convergence, Soonchunhyang University Graduate School, Asan 31538, Korea
- Correspondence: ; Tel.: +82-41-530-3045; Fax: +82-41-530-3085
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Powell-Wiley TM, Baumer Y, Baah FO, Baez AS, Farmer N, Mahlobo CT, Pita MA, Potharaju KA, Tamura K, Wallen GR. Social Determinants of Cardiovascular Disease. Circ Res 2022; 130:782-799. [PMID: 35239404 PMCID: PMC8893132 DOI: 10.1161/circresaha.121.319811] [Citation(s) in RCA: 256] [Impact Index Per Article: 128.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Social determinants of health (SDoH), which encompass the economic, social, environmental, and psychosocial factors that influence health, play a significant role in the development of cardiovascular disease (CVD) risk factors as well as CVD morbidity and mortality. The COVID-19 pandemic and the current social justice movement sparked by the death of George Floyd have laid bare long-existing health inequities in our society driven by SDoH. Despite a recent focus on these structural drivers of health disparities, the impact of SDoH on cardiovascular health and CVD outcomes remains understudied and incompletely understood. To further investigate the mechanisms connecting SDoH and CVD, and ultimately design targeted and effective interventions, it is important to foster interdisciplinary efforts that incorporate translational, epidemiological, and clinical research in examining SDoH-CVD relationships. This review aims to facilitate research coordination and intervention development by providing an evidence-based framework for SDoH rooted in the lived experiences of marginalized populations. Our framework highlights critical structural/socioeconomic, environmental, and psychosocial factors most strongly associated with CVD and explores several of the underlying biologic mechanisms connecting SDoH to CVD pathogenesis, including excess stress hormones, inflammation, immune cell function, and cellular aging. We present landmark studies and recent findings about SDoH in our framework, with careful consideration of the constructs and measures utilized. Finally, we provide a roadmap for future SDoH research focused on individual, clinical, and policy approaches directed towards developing multilevel community-engaged interventions to promote cardiovascular health.
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Affiliation(s)
- Tiffany M. Powell-Wiley
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, National Heart, Lung, and Blood Institute (T.M.P.-W., Y.B., F.O.B., A.S.B., C.T.M., M.A.P., K.A.P.), National Institutes of Health, Bethesda, MD
- Intramural Research Program, National Institute on Minority Health and Health Disparities (T.M.P.-W.), National Institutes of Health, Bethesda, MD
| | - Yvonne Baumer
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, National Heart, Lung, and Blood Institute (T.M.P.-W., Y.B., F.O.B., A.S.B., C.T.M., M.A.P., K.A.P.), National Institutes of Health, Bethesda, MD
| | - Foster Osei Baah
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, National Heart, Lung, and Blood Institute (T.M.P.-W., Y.B., F.O.B., A.S.B., C.T.M., M.A.P., K.A.P.), National Institutes of Health, Bethesda, MD
| | - Andrew S. Baez
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, National Heart, Lung, and Blood Institute (T.M.P.-W., Y.B., F.O.B., A.S.B., C.T.M., M.A.P., K.A.P.), National Institutes of Health, Bethesda, MD
| | - Nicole Farmer
- Translational Biobehavioral and Health Disparities Branch, National Institutes of Health, Clinical Center, Bethesda, MD (N.F., G.R.W.)
| | - Christa T. Mahlobo
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, National Heart, Lung, and Blood Institute (T.M.P.-W., Y.B., F.O.B., A.S.B., C.T.M., M.A.P., K.A.P.), National Institutes of Health, Bethesda, MD
- The Pennsylvania State University (C.T.M.)
| | - Mario A. Pita
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, National Heart, Lung, and Blood Institute (T.M.P.-W., Y.B., F.O.B., A.S.B., C.T.M., M.A.P., K.A.P.), National Institutes of Health, Bethesda, MD
| | - Kameswari A. Potharaju
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, National Heart, Lung, and Blood Institute (T.M.P.-W., Y.B., F.O.B., A.S.B., C.T.M., M.A.P., K.A.P.), National Institutes of Health, Bethesda, MD
| | - Kosuke Tamura
- Neighborhood Social and Geospatial Determinants of Health Disparities Laboratory, Population and Community Sciences Branch, Intramural Research Program, National Institute on Minority Health and Health Disparities (K.T.), National Institutes of Health, Bethesda, MD
| | - Gwenyth R. Wallen
- Translational Biobehavioral and Health Disparities Branch, National Institutes of Health, Clinical Center, Bethesda, MD (N.F., G.R.W.)
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Avellaneda-Gómez C, Vivanco-Hidalgo RM, Olmos S, Lazcano U, Valentin A, Milà C, Ambrós A, Roquer J, Tonne C. Air pollution and surrounding greenness in relation to ischemic stroke: A population-based cohort study. ENVIRONMENT INTERNATIONAL 2022; 161:107147. [PMID: 35180670 DOI: 10.1016/j.envint.2022.107147] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/28/2022] [Accepted: 02/08/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Evidence for the association between environmental exposures and ischemic stroke (IS) is limited and inconsistent. We aimed to assess the relationship between exposure to air pollutants, residential surrounding greenness, and incident IS, and to identify population subgroups particularly sensitive to these exposures. METHODS We used data from administrative health registries of the public healthcare system in Catalonia, Spain to construct a cohort of individuals aged 18 years and older without a previous stroke diagnosis at 1st January 2016 (n = 3 521 274). We collected data on sociodemographic characteristics and cerebrovascular risk factors, and derived exposure at the participant's residence to ambient levels of fine particulate matter (PM2.5), black carbon (BC), nitrogen dioxide (NO2), and Normalized Difference Vegetation Index (NDVI) in a 300 m buffer as an indicator of greenness. The primary outcome was IS diagnosis at any point during the follow-up. We used Cox proportional hazards models to estimate associations between environmental exposures and incident IS and stratified analyses to investigate effect modification. RESULTS Between 1st January 2016 and 31st December 2017, 10 865 individuals were admitted to public hospitals with an IS diagnosis. Median exposure levels were: 17 µg/m3 PM2.5, 35 µg/m3 NO2, 2.28 µg/m3 BC and 0.27 NDVI. Individuals with higher residential exposure to air pollution were at greater risk of IS: HR 1·04 (95% CI:0·99-1·10) per 5 µg/m3 of PM2.5; HR 1.05 (95% CI:1·00-1·10) per 1 µg/m3 of BC; HR 1·04 (95% CI:1·03-1·06) per 10 µg/m3 of NO2. Conversely, individuals with higher residential surrounding green space, had lower risk of IS (HR 0·84; CI 95%:0·7-1.0). There was no evidence of effect modification by individual characteristics. CONCLUSIONS Higher incidence of IS was observed in relation to long-term exposures to air pollution, particularly NO2, in a region that meets European health-based air quality standards. Residential surrounding greenness was associated with lower incidence of IS.
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Affiliation(s)
- C Avellaneda-Gómez
- Neurology Department, IMIM-Hospital del Mar, Barcelona, Spain; Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; Complex Hospitalari Moisès Broggi, Consorci Sanitari Integral, Barcelona, Spain.
| | - R M Vivanco-Hidalgo
- Neurology Department, IMIM-Hospital del Mar, Barcelona, Spain; Agency for Health Quality and Assessment of Catalonia (AQuAS), Barcelona, Spain.
| | - S Olmos
- ISGlobal, Barcelona, Spain; CIBER epidemiología y salud pública (CIBERESP), Madrid, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain.
| | - U Lazcano
- Agency for Health Quality and Assessment of Catalonia (AQuAS), Barcelona, Spain.
| | - A Valentin
- ISGlobal, Barcelona, Spain; CIBER epidemiología y salud pública (CIBERESP), Madrid, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain.
| | - C Milà
- ISGlobal, Barcelona, Spain; CIBER epidemiología y salud pública (CIBERESP), Madrid, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain.
| | - A Ambrós
- ISGlobal, Barcelona, Spain; CIBER epidemiología y salud pública (CIBERESP), Madrid, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain.
| | - J Roquer
- Neurology Department, IMIM-Hospital del Mar, Barcelona, Spain; Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.
| | - C Tonne
- ISGlobal, Barcelona, Spain; CIBER epidemiología y salud pública (CIBERESP), Madrid, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain.
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Huang Y, Lin T, Zhang G, Jones L, Xue X, Ye H, Liu Y. Spatiotemporal patterns and inequity of urban green space accessibility and its relationship with urban spatial expansion in China during rapid urbanization period. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 809:151123. [PMID: 34699811 DOI: 10.1016/j.scitotenv.2021.151123] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 10/08/2021] [Accepted: 10/17/2021] [Indexed: 06/13/2023]
Abstract
Equitable access to urban green spaces (UGS) is an important component of social justice and can be quantified using indices such as urban green space accessibility (UGSA). However, the spatiotemporal patterns and inequity of UGSA among cities with different developments during rapid urbanization are unclear, especially lack evidence at a macroscopic national scale during rapid urbanization. Therefore, we evaluated the UGSA in 366 cities of China during 1990-2015 by the Gaussian-based two-step floating catchment area method (Gaussian-based 2SFCA). Then, the inequity pattern of UGSA among cities with different economic developments was analyzed by the concentration curve and concentration index. Finally, the relationship between UGSA and urban spatial expansion was explored quantitatively by the spatial econometric model. The results showed that: (1) The overall UGSA in China declined significantly by nearly 57.23% during 1990-2015. From the regional perspective, the UGSA in the southeastern region was always lower than that in the northwestern region, the Eastern zone presented a downward trend. From the perspective of different sizes cities, the UGSA of the megacities kept decreasing during 1990-2015, while UGSA of the large, medium, and small cities had turned to increase since 2010. (2) During rapid urbanization, the equity of UGSA among the cities gradually improved, while the cities with low economic developments tended to have higher UGSA. (3) Urban spatial expansion led to the decrease of UGSA during 1990-2015, while the impact had spatiotemporal heterogeneity, and UGSA had a positive spatial spillover effect. Our research provides a comparative baseline for the improvement of UGSA from a macroscopic perspective for China's urbanization policy in the future and novel insights into the green justice issue. The results can be compared with the development of UGS in other countries at different urbanization stages to promote UGS design and policy.
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Affiliation(s)
- Yiyi Huang
- Key Laboratory of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021, China; Coastal and Ocean Management Institute, Xiamen University, Xiamen 361102, China
| | - Tao Lin
- Key Laboratory of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021, China; University of Chinese Academy of Sciences, Beijing 100049, China.
| | - Guoqin Zhang
- Key Laboratory of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Laurence Jones
- UK Centre for Ecology & Hydrology, Environment Centre Wales, Bangor LL57 2UW, UK
| | - Xiongzhi Xue
- Coastal and Ocean Management Institute, Xiamen University, Xiamen 361102, China
| | - Hong Ye
- Key Laboratory of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Yuqin Liu
- Key Laboratory of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021, China; University of Chinese Academy of Sciences, Beijing 100049, China
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Bikomeye JC, Beyer AM, Kwarteng JL, Beyer KMM. Greenspace, Inflammation, Cardiovascular Health, and Cancer: A Review and Conceptual Framework for Greenspace in Cardio-Oncology Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:2426. [PMID: 35206610 PMCID: PMC8872601 DOI: 10.3390/ijerph19042426] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 02/12/2022] [Accepted: 02/17/2022] [Indexed: 02/04/2023]
Abstract
Cardiovascular disease (CVD) is a leading cause of global morbidity and mortality. Cancer survivors have significantly elevated risk of poor cardiovascular (CV) health outcomes due to close co-morbid linkages and shared risk factors between CVD and cancer, as well as adverse effects of cancer treatment-related cardiotoxicity. CVD and cancer-related outcomes are exacerbated by increased risk of inflammation. Results from different pharmacological interventions aimed at reducing inflammation and risk of major adverse cardiovascular events (MACEs) have been largely mixed to date. Greenspaces have been shown to reduce inflammation and have been associated with CV health benefits, including reduced CVD behavioral risk factors and overall improvement in CV outcomes. Greenspace may, thus, serve to alleviate the CVD burden among cancer survivors. To understand pathways through which greenspace can prevent or reduce adverse CV outcomes among cancer survivors, we review the state of knowledge on associations among inflammation, CVD, cancer, and existing pharmacological interventions. We then discuss greenspace benefits for CV health from ecological to multilevel studies and a few existing experimental studies. Furthermore, we review the relationship between greenspace and inflammation, and we highlight forest bathing in Asian-based studies while presenting existing research gaps in the US literature. Then, we use the socioecological model of health to present an expanded conceptual framework to help fill this US literature gap. Lastly, we present a way forward, including implications for translational science and a brief discussion on necessities for virtual nature and/or exposure to nature images due to the increasing human-nature disconnect; we also offer guidance for greenspace research in cardio-oncology to improve CV health outcomes among cancer survivors.
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Affiliation(s)
- Jean C. Bikomeye
- Institute for Health and Equity, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA; (J.C.B.); (J.L.K.)
- PhD Program in Public and Community Health, Division of Epidemiology & Social Sciences, Institute for Health and Equity, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA
| | - Andreas M. Beyer
- Department of Medicine, Division of Cardiology, Cardiovascular and Cancer Center, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA
| | - Jamila L. Kwarteng
- Institute for Health and Equity, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA; (J.C.B.); (J.L.K.)
- MCW Cancer Center, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA
| | - Kirsten M. M. Beyer
- Institute for Health and Equity, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA; (J.C.B.); (J.L.K.)
- PhD Program in Public and Community Health, Division of Epidemiology & Social Sciences, Institute for Health and Equity, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA
- MCW Cancer Center, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA
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Environmental exposure to volatile organic compounds is associated with endothelial injury. Toxicol Appl Pharmacol 2022; 437:115877. [PMID: 35045333 PMCID: PMC10045232 DOI: 10.1016/j.taap.2022.115877] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 12/23/2021] [Accepted: 01/05/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Volatile organic compounds (VOCs) are airborne toxicants abundant in outdoor and indoor air. High levels of VOCs are also present at various Superfund and other hazardous waste sites; however, little is known about the cardiovascular effects of VOCs. We hypothesized that ambient exposure to VOCs exacerbate cardiovascular disease (CVD) risk by depleting circulating angiogenic cells (CACs). APPROACH AND RESULTS In this cross-sectional study, we recruited 603 participants with low-to-high CVD risk and measured 15 subpopulations of CACs by flow cytometry and 16 urinary metabolites of 12 VOCs by LC/MS/MS. Associations between CAC and VOC metabolite levels were examined using generalized linear models in the total sample, and separately in non-smokers. In single pollutant models, metabolites of ethylbenzene/styrene and xylene, were negatively associated with CAC levels in both the total sample, and in non-smokers. The metabolite of acrylonitrile was negatively associated with CD45dim/CD146+/CD34+/AC133+ cells and CD45+/CD146+/AC133+, and the toluene metabolite with AC133+ cells. In analysis of non-smokers (n = 375), multipollutant models showed a negative association with metabolites of ethylbenzene/styrene, benzene, and xylene with CD45dim/CD146+/CD34+ cells, independent of other VOC metabolite levels. Cumulative VOC risk score showed a strong negative association with CD45dim/CD146+/CD34+ cells, suggesting that total VOC exposure has a cumulative effect on pro-angiogenic cells. We found a non-linear relationship for benzene, which showed an increase in CAC levels at low, but depletion at higher levels of exposure. Sex and race, hypertension, and diabetes significantly modified VOC associated CAC depletion. CONCLUSION Low-level ambient exposure to VOCs is associated with CAC depletion, which could compromise endothelial repair and angiogenesis, and exacerbate CVD risk.
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Peng W, Shi H, Li M, Li X, Liu T, Wang Y. Association of residential greenness with geriatric depression among the elderly covered by long-term care insurance in Shanghai. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:12054-12064. [PMID: 34561801 DOI: 10.1007/s11356-021-16585-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 09/13/2021] [Indexed: 05/22/2023]
Abstract
Residential greenness exposure has been linked to a number of physical and mental disorders. Nevertheless, evidence on the association between greenness and geriatric depression was limited and focused on developed countries. This study was aimed to investigate whether the relationship between residential greenness exposure and geriatric depression exists among the elderly with long-term care insurance (LTCI) in Shanghai, China. In 2018, a total of 1066 LTCI elderly from a cross-sectional survey completed a questionnaire in Shanghai. Residential greenness indicators, including normalized difference vegetation index (NDVI) and soil-adjusted vegetation index (SAVI), were calculated from the Landsat 8 imagery data in different buffers (100-m, 300-m, and 500-m). Mediation analysis by perceived social support was conducted to explore potential mechanisms underlying the associations. In the fully adjusted model, one IQR increase of NDVI and SAVI in the 300-m buffer size was associated with an 11.9% (PR: 0.881, 95% CI: 0.795, 0.977) and 14.7% (PR: 0.853, 95% CI: 0.766, 0.949) lower prevalence of geriatric depression, respectively. Stronger association was observed in the elderly with lower education level, living in non-central area, and lower family monthly income. Perceived social support significantly mediated 40.4% of the total effect for NDVI 300-m buffer and 40.3% for SAVI 300-m buffer to the greenness-depression association, respectively. Our results indicate the importance of residential greenness exposure to geriatric depression, especially for the elderly with lower education level, living in non-central area, and lower family monthly income. Perceived social support might mediate the association. Well-designed longitudinal studies are warranted to confirm our findings and investigate the underlying mechanisms.
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Affiliation(s)
- Wenjia Peng
- School of Public Health, Fudan University, Shanghai, People's Republic of China
| | - Hengyuan Shi
- Epidemiology and Health Statistics, School of Public Health, Bengbu Medical College, Bengbu, Anhui, People's Republic of China
| | - Mengying Li
- School of Public Health, Fudan University, Shanghai, People's Republic of China
| | - Xinghui Li
- School of Public Health, Fudan University, Shanghai, People's Republic of China
| | - Ting Liu
- Epidemiology and Health Statistics, School of Public Health, Bengbu Medical College, Bengbu, Anhui, People's Republic of China
| | - Ying Wang
- School of Public Health, Fudan University, Shanghai, People's Republic of China.
- School of Public Health/Key Lab of Health Technology Assessment, National Health and Family Planning Commission of the People's Republic of China, Fudan University, Shanghai, 200433, People's Republic of China.
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Lai KY, Kumari S, Gallacher J, Webster C, Sarkar C. Associations of residential walkability and greenness with arterial stiffness in the UK Biobank. ENVIRONMENT INTERNATIONAL 2022; 158:106960. [PMID: 34735956 DOI: 10.1016/j.envint.2021.106960] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 09/25/2021] [Accepted: 10/23/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Arterial stiffness is a key non-invasive marker of early vascular ageing, however, little is known of its associations with urban built environment. We examined the associations of objectively-measured residential walkability and greenness with arterial stiffness in a large UK-wide population cohort. METHODS We employed data from the baseline UK Biobank cohort comprising adult participants recruited over the period of 2006 to 2010. Residential walkability index, defined as a function of density (residential, retail and public transit), street-level design, and destination accessibility was measured using a 1-Km dwelling catchment, while greenness was modelled as the mean Normalized Difference Vegetation Index (NDVI) of 0.5-metre resolution assessed within a 0.5-Km catchment. Arterial stiffness index (ASI) was measured non-invasively from the pulse waveform. Linear regression models were developed to examine associations of walkability and greenness with arterial stiffness. Restricted cubic spline (RCS) models were developed to examine dose-response relationships. We also examined effect modifications by sex and age, as well as the interaction effect of greenness and walkability. RESULTS This cross-sectional study used a target sample of 169,704 UK Biobank participants aged ≥ 39 years. After full adjustments, in reference to the lowest walkability exposure quartile, those in the highest were associated with lower ASI (β = -0.083 m/s, 95% CI: -0.14 to -0.03, p = 0.005). Participants in the third and fourth NDVI greenness exposure quartiles were also associated with lower ASI (β = -0.074 m/s, -0.14 to -0.01, p < 0.020 for the third and β = -0.293 m/s, -0.36 to -0.23, p < 0.001 for the fourth quartiles in reference to the first). The inverse association between NDVI greenness and ASI was more pronounced among women (p < 0.001), older adults (p = 0.011) and among participants in the highest walkability quartile (p < 0.001). CONCLUSION Designing more walkable and greener residential environments can be a preventive intervention aimed at lowering the population distribution of vascular ageing and associated cardiovascular risks.
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Affiliation(s)
- Ka Yan Lai
- Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Knowles Building, Pokfulam Road, Pokfulam, Hong Kong, China
| | - Sarika Kumari
- Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Knowles Building, Pokfulam Road, Pokfulam, Hong Kong, China
| | - John Gallacher
- Department of Psychiatry, Oxford University, Warneford Hospital, Oxford OX3 7JX, United Kingdom
| | - Chris Webster
- Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Knowles Building, Pokfulam Road, Pokfulam, Hong Kong, China
| | - Chinmoy Sarkar
- Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Knowles Building, Pokfulam Road, Pokfulam, Hong Kong, China; School of Public Health, The University of Hong Kong, Patrick Manson Building, Sassoon Road, Pokfulam, Hong Kong, China.
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Jiang J, Mao S, Xie Y, Chen X, Abulaiti K, Liu M, Zheng J, Hu W, Hou Z, Chen L, Xiang H. Is residential greenness associated with dyslipidemia and lipid levels in Chinese rural-dwelling adults? The Henan rural cohort study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:5852-5862. [PMID: 34426868 DOI: 10.1007/s11356-021-16026-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 08/14/2021] [Indexed: 06/13/2023]
Abstract
Scarce epidemiologic research examined the associations between residential greenness and dyslipidemia or lipid levels in low/middle-income countries. Baseline statistics (2015-2017) of 39,259 rural-dwelling adults were obtained from a Chinese longitudinal study. The blood lipid level was measured utilizing an enzymatic assay method. According to the 2016 Chinese guidelines on dyslipidemia (revision), patients with dyslipidemia were defined. Participants' exposure to residential greenness was characterized by the satellite-based normalized difference vegetation index (NDVI). Mixed effects logistic regression and mixed effects linear regression were performed to assess the associations of residential greenness with dyslipidemia and lipid levels. The median (interquartile range, IQR) of 3-year average NDVI1000-m was 0.521 (0.089) units. Each IQR increase in NDVI1000-m was significantly linked with increased odds of hyperbetalipoproteinemia (OR = 1.33, 95%CI 1.21-1.46). The same increment in NDVI1000-m was associated with lower total cholesterol (TC) levels and increased low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) levels. For instance, the %changes in HDL-C levels was 0.71% (95%CI 0.17%-1.26%). The above relationships were partially mediated by reducing air pollution and lowering body mass index (BMI). Interaction effect analysis observed the greenness-lipid association was stronger in males than females (i.e., NDVI1000-m-TC association). Long-term exposure to residential greenness was associated with odds of dyslipidemia and lipid levels in Chinese rural-dwelling adults, particularly among males. Considering the cross-sectional study design, more longitudinal studies are needed to identify the causal associations.
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Affiliation(s)
- Jie Jiang
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan, Hubei, China
- Global Health Institute, Wuhan University, Wuhan, Hubei, China
| | - Shuyuan Mao
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan, Hubei, China
- Global Health Institute, Wuhan University, Wuhan, Hubei, China
| | - Yinyu Xie
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan, Hubei, China
- Global Health Institute, Wuhan University, Wuhan, Hubei, China
| | - Xingkai Chen
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan, Hubei, China
- Global Health Institute, Wuhan University, Wuhan, Hubei, China
| | - Kadila Abulaiti
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan, Hubei, China
- Global Health Institute, Wuhan University, Wuhan, Hubei, China
| | - Manqi Liu
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan, Hubei, China
- Global Health Institute, Wuhan University, Wuhan, Hubei, China
| | - Jingyang Zheng
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan, Hubei, China
- Global Health Institute, Wuhan University, Wuhan, Hubei, China
| | - Wenlong Hu
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan, Hubei, China
- Global Health Institute, Wuhan University, Wuhan, Hubei, China
| | - Zeyu Hou
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan, Hubei, China
- Global Health Institute, Wuhan University, Wuhan, Hubei, China
| | - Lifeng Chen
- Department of Laboratory Medicine, Wuhan Pulmonary Hospital, Wuhan, Hubei, China.
| | - Hao Xiang
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan, Hubei, China
- Global Health Institute, Wuhan University, Wuhan, Hubei, China
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Yang L, Chan KL, Yuen JWM, Wong FKY, Han L, Ho HC, Chang KKP, Ho YS, Siu JYM, Tian L, Wong MS. Effects of Urban Green Space on Cardiovascular and Respiratory Biomarkers in Chinese Adults: Panel Study Using Digital Tracking Devices. JMIR Cardio 2021; 5:e31316. [PMID: 34967754 PMCID: PMC8759022 DOI: 10.2196/31316] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 10/28/2021] [Accepted: 11/16/2021] [Indexed: 11/13/2022] Open
Abstract
Background The health benefits of urban green space have been widely reported in the literature; however, the biological mechanisms remain unexplored, and a causal relationship cannot be established between green space exposure and cardiorespiratory health. Objective Our aim was to conduct a panel study using personal tracking devices to continuously collect individual exposure data from healthy Chinese adults aged 50 to 64 years living in Hong Kong. Methods A panel of cardiorespiratory biomarkers was tested each week for a period of 5 consecutive weeks. Data on weekly exposure to green space, air pollution, and the physical activities of individual participants were collected by personal tracking devices. The effects of green space exposure measured by the normalized difference vegetation index (NDVI) at buffer zones of 100, 250, and 500 meters on a panel of cardiorespiratory biomarkers were estimated by a generalized linear mixed-effects model, with adjustment for confounding variables of sociodemographic characteristics, exposure to air pollutants and noise, exercise, and nutrient intake. Results A total of 39 participants (mean age 56.4 years, range 50-63 years) were recruited and followed up for 5 consecutive weeks. After adjustment for sex, income, occupation, physical activities, dietary intake, noise, and air pollution, significant negative associations with the NDVI for the 250-meter buffer zone were found in total cholesterol (–21.6% per IQR increase in NDVI, 95% CI –32.7% to –10.6%), low-density lipoprotein (–14.9%, 95% CI –23.4% to –6.4%), glucose (–11.2%, 95% CI –21.9% to –0.5%), and high-sensitivity C-reactive protein (–41.3%, 95% CI –81.7% to –0.9%). Similar effect estimates were found for the 100-meter and 250-meter buffer zones. After adjustment for multiple testing, the effect estimates of glucose and high-sensitivity C-reactive protein were no longer significant. Conclusions The health benefits of green space can be found in some metabolic and inflammatory biomarkers. Further studies are warranted to establish the causal relationship between green space and cardiorespiratory health.
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Affiliation(s)
- Lin Yang
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Ka Long Chan
- Department of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - John W M Yuen
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Frances K Y Wong
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Lefei Han
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong.,School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hung Chak Ho
- Department of Urban Planning and Design, The University of Hong Kong, Hong Kong, Hong Kong
| | - Katherine K P Chang
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Yuen Shan Ho
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Judy Yuen-Man Siu
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Linwei Tian
- School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong
| | - Man Sing Wong
- Department of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
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Dong X, Tu R, Zhang L, Abdulai T, Liu X, Li R, Hou J, Mao Z, Huo W, Zhai X, Guo Y, Chen G, Wang C. Residential greenness and atherosclerotic cardiovascular disease risk in a rural Chinese adult population. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2021; 222:112458. [PMID: 34217118 DOI: 10.1016/j.ecoenv.2021.112458] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 06/16/2021] [Accepted: 06/22/2021] [Indexed: 06/13/2023]
Abstract
Residential greenness may be beneficial for cardiovascular health, but the evidence is still scarce, especially in developing countries. This study aimed to assess the associations between exposure to residential greenness and 10-year atherosclerotic cardiovascular disease (ASCVD) risk in a large rural Chinese adult population. This was a cross-sectional study based on 31,162 participants aged 35-74 years with complete data on predictors of the 10-year ASCVD risk from the Henan Rural Cohort Study. The satellite-derived Normalized Difference Vegetation Index (NDVI) and Enhanced Vegetation Index (EVI) were used to quantify residential greenness in a buffer radius of 500 m, 1000 m, and 3000 m. The high 10-years ASCVD risk was defined as the estimated risk ≥10% based on prediction equations from the China-PAR Project for Chinese populations. Multivariable-adjusted logistic regression models were performed to estimate the associations of greenness exposures with high 10-year ASCVD risk, and mediation analyses were employed to the potential mediators. For per interquartile range (IQR) increase in NDVI500-m, NDVI1000-m, NDVI3000-m, EVI500-m, EVI1000-m, and EVI3000-m, the adjusted OR (95% CI) of high 10-years ASCVD risk was 0.828 (0.793-0.866), 0.850 (0.817-0.885), 0.823 (0.792-0.855), 0.848 (0.809-0.889), 0.863 (0.826-0.901), 0.843 (0.805-0.883), respectively. Strong associations of NDVI500-m and EVI500-m with high 10-years ASCVD risk were found among participants with lower education level and lower averaged monthly income. The associations of greenness exposures with high 10-year ASCVD risk were partially explained by particulate matter with an aerodynamic diameter ≤1 µm, BMI, and physical activity. Enhancing residential greenness exposure may be beneficial for reducing the high 10-year ASCVD risk in rural Chinese adults.
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Affiliation(s)
- Xiaokang Dong
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Runqi Tu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Lulu Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Tanko Abdulai
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Xiaotian Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Ruiying Li
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Jian Hou
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Zhenxing Mao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Wenqian Huo
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Xinxia Zhai
- Yima Center for Disease Control and Prevention, Sanmenxia City, Henan Province 472300, PR China
| | - Yuming Guo
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Gongbo Chen
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, PR China.
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China.
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Miguet M, Venetis S, Rukh G, Lind L, Schiöth HB. Time spent outdoors and risk of myocardial infarction and stroke in middle and old aged adults: Results from the UK Biobank prospective cohort. ENVIRONMENTAL RESEARCH 2021; 199:111350. [PMID: 34019889 DOI: 10.1016/j.envres.2021.111350] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 05/12/2021] [Accepted: 05/13/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Time spent outdoors has been previously related to several cardiovascular risk factors, implying that it may confer either beneficial or harmful effects on cardiovascular health. However, no large population-based studies have examined the relation between time spent outdoors and myocardial infarction and stroke. OBJECTIVES We aimed to investigate the longitudinal relation between time spent outdoors and myocardial infarction and stroke in large UK population-based cohort. METHODS A total of 446,648 participants from UK Biobank were included in the study of which 431,146 participants (56% females and 44% males with a mean age of 56.4 ± 8.1 years) were followed for a median time of 7 years. Time spent outdoors was self-reported and participants were stratified into quantiles (less than 1.5 [reference group]; 1.5 to 2.4; 2.5 to 3.5 and more than 3.5 h per day outdoors). Myocardial infarction and stroke events were either collected from hospital records and death registries or were self-reported by the participants. Cox proportional hazard regression was used for the analysis. In addition to age and sex, analyses were adjusted for potential demographic (TDI, ethnic background, current employment status), lifestyle (alcohol intake frequency, current tobacco use, sedentary time and moderate-to-vigorous physical activity), health related factors (BMI, systolic and diastolic blood pressure) and environmental indicators (NO2, NOx, PM10, PM2.5-10, PM2,5, noise pollution, % greenspace, % natural environment and % water). RESULTS A 20% increased risk for myocardial infarction incidence was observed among participants who reported spending more than 3.5 h/day outdoors (HR: 1.20, 95% CI: 1.06-1.36) compared to the reference group. A trend was also observed for stroke (HR: 1.14, 95% CI: 0.97-1.34). CONCLUSION Findings from the present study indicate that spending more than 3.5 h/day outdoors is a risk factor for myocardial infarction and stroke. Future research is needed to further understand the relation between time spent outdoors and cardiovascular disease.
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Affiliation(s)
- Maud Miguet
- Department of Neuroscience, Functional Pharmacology, Uppsala University, Uppsala, Sweden.
| | - Sotirios Venetis
- Department of Neuroscience, Functional Pharmacology, Uppsala University, Uppsala, Sweden
| | - Gull Rukh
- Department of Neuroscience, Functional Pharmacology, Uppsala University, Uppsala, Sweden
| | - Lars Lind
- Department of Medical Sciences, Cardiovascular Epidemiology, Uppsala University, Uppsala, Sweden
| | - Helgi B Schiöth
- Department of Neuroscience, Functional Pharmacology, Uppsala University, Uppsala, Sweden; Institute for Translational Medicine and Biotechnology, Sechenov First Moscow State Medical University, Moscow, Russia
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Social Determinants of Health and Cardiovascular Disease: Current State and Future Directions Towards Healthcare Equity. Curr Atheroscler Rep 2021; 23:55. [PMID: 34308497 DOI: 10.1007/s11883-021-00949-w] [Citation(s) in RCA: 67] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2021] [Indexed: 02/08/2023]
Abstract
PURPOSE OF REVIEW We sought to examine the role of social and environmental conditions that determine an individual's behaviors and risk of disease-collectively known as social determinants of health (SDOH)-in shaping cardiovascular (CV) health of the population and giving rise to disparities in risk factors, outcomes, and clinical care for cardiovascular disease (CVD), the leading cause of death in the United States (US). RECENT FINDINGS Traditional CV risk factors have been extensively targeted in existing CVD prevention and management paradigms, often with little attention to SDOH. Limited evidence suggests an association between individual SDOH (e.g., income, education) and CVD. However, inequities in CVD care, risk factors, and outcomes have not been studied using a broad SDOH framework. We examined existing evidence of the association between SDOH-organized into 6 domains, including economic stability, education, food, neighborhood and physical environment, healthcare system, and community and social context-and CVD. Greater social adversity, defined by adverse SDOH, was linked to higher burden of CVD risk factors and poor outcomes, such as stroke, myocardial infarction (MI), coronary heart disease, heart failure, and mortality. Conversely, favorable social conditions had protective effects on CVD. Upstream SDOH interact across domains to produce cumulative downstream effects on CV health, via multiple physiologic and behavioral pathways. SDOH are major drivers of sociodemographic disparities in CVD, with a disproportionate impact on socially disadvantaged populations. Efforts to achieve health equity should take into account the structural, institutional, and environmental barriers to optimum CV health in marginalized populations. In this review, we highlight major knowledge gaps for each SDOH domain and propose a set of actionable recommendations to inform CVD care, ensure equitable distribution of healthcare resources, and reduce observed disparities.
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Lee KS, Choi YJ, Cho JW, Moon SJ, Lim YH, Kim JI, Lee YA, Shin CH, Kim BN, Hong YC. Children's Greenness Exposure and IQ-Associated DNA Methylation: A Prospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7429. [PMID: 34299878 PMCID: PMC8304819 DOI: 10.3390/ijerph18147429] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 06/29/2021] [Accepted: 07/05/2021] [Indexed: 12/11/2022]
Abstract
Epigenetics is known to be involved in regulatory pathways through which greenness exposure influences child development and health. We aimed to investigate the associations between residential surrounding greenness and DNA methylation changes in children, and further assessed the association between DNA methylation and children's intelligence quotient (IQ) in a prospective cohort study. We identified cytosine-guanine dinucleotide sites (CpGs) associated with cognitive abilities from epigenome- and genome-wide association studies through a systematic literature review for candidate gene analysis. We estimated the residential surrounding greenness at age 2 using a geographic information system. DNA methylation was analyzed from whole blood using the HumanMethylationEPIC array in 59 children at age 2. We analyzed the association between greenness exposure and DNA methylation at age 2 at the selected CpGs using multivariable linear regression. We further investigated the relationship between DNA methylation and children's IQ. We identified 8743 CpGs associated with cognitive ability based on the literature review. Among these CpGs, we found that 25 CpGs were significantly associated with greenness exposure at age 2, including cg26269038 (Bonferroni-corrected p ≤ 0.05) located in the body of SLC6A3, which encodes a dopamine transporter. DNA methylation at cg26269038 at age 2 was significantly associated with children's performance IQ at age 6. Exposure to surrounding greenness was associated with cognitive ability-related DNA methylation changes, which was also associated with children's IQ. Further studies are warranted to clarify the epigenetic pathways linking greenness exposure and neurocognitive function.
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Affiliation(s)
- Kyung-Shin Lee
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul 03080, Korea; (K.-S.L.); (Y.-J.C.); (S.-J.M.); (Y.-H.L.)
- Environmental Health Center, Seoul National University College of Medicine, Seoul 03080, Korea
| | - Yoon-Jung Choi
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul 03080, Korea; (K.-S.L.); (Y.-J.C.); (S.-J.M.); (Y.-H.L.)
- Environmental Health Center, Seoul National University College of Medicine, Seoul 03080, Korea
| | - Jin-Woo Cho
- Department of Statistics, University of Pittsburgh, Pittsburgh, PA 15260, USA;
| | - Sung-Ji Moon
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul 03080, Korea; (K.-S.L.); (Y.-J.C.); (S.-J.M.); (Y.-H.L.)
| | - Youn-Hee Lim
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul 03080, Korea; (K.-S.L.); (Y.-J.C.); (S.-J.M.); (Y.-H.L.)
- Section of Environmental Health, Department of Public Health, University of Copenhagen, 1014 Copenhagen, Denmark
| | - Johanna-Inhyang Kim
- Department of Psychiatry, Hanyang University Medical Center, Seoul 04763, Korea;
| | - Young-Ah Lee
- Department of Pediatrics, Seoul National University Children’s Hospital, Seoul National University College of Medicine, Seoul 03080, Korea; (Y.-A.L.); (C.-H.S.)
| | - Choong-Ho Shin
- Department of Pediatrics, Seoul National University Children’s Hospital, Seoul National University College of Medicine, Seoul 03080, Korea; (Y.-A.L.); (C.-H.S.)
| | - Bung-Nyun Kim
- Division of Children and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Hospital, Seoul 03080, Korea
| | - Yun-Chul Hong
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul 03080, Korea; (K.-S.L.); (Y.-J.C.); (S.-J.M.); (Y.-H.L.)
- Environmental Health Center, Seoul National University College of Medicine, Seoul 03080, Korea
- Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul 03080, Korea
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Ciupa T, Suligowski R. Green-Blue Spaces and Population Density versus COVID-19 Cases and Deaths in Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6636. [PMID: 34203108 PMCID: PMC8296329 DOI: 10.3390/ijerph18126636] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/08/2021] [Accepted: 06/16/2021] [Indexed: 02/08/2023]
Abstract
In the last year, in connection with the COVID-19 pandemic caused by the SARS-CoV-2 coronavirus, scientific papers have appeared in which the authors are trying to identify factors (including environmental) favoring the spread of this disease. This paper presents the spatial differentiation in the total number of COVID-19 cases and deaths during the full year (March 2020-March 2021) of the SARS-CoV-2 pandemic in Poland versus green-blue spaces (green-i.a. forests, orchards, meadows and pastures, recreational and rest areas, biologically active arable land; blue-lakes and artificial water reservoirs, rivers, ecological areas and internal waters) and population density. The analysis covers 380 counties, including 66 cities. This study used daily reports on the progress of the pandemic in Poland published by the Ministry of Health of the Republic of Poland and unique, detailed data on 24 types of land use available in the Statistics Poland database. Statistical relationships were determined between the above-mentioned environmental variables and the variables characterizing COVID-19 (cases and deaths). Various basic types of regression models were analysed. The optimal model was selected, and the determination coefficient, significance level and the values of the parameters of these relationships, together with the estimation error, were calculated. The obtained results indicated that the higher the number of green-blue spaces in individual counties, the lower the total number of COVID-19 infections and deaths. These relationships were described by logarithmic and homographic models. In turn, an increase in the population density caused an increase in COVID-19 cases and deaths, according to the power model. These results can be used in the current analysis of the spread of the pandemic, including the location of potential outbreaks. In turn, the developed models can be used as a tool in forecasting the development of the pandemic and making decisions about the implementation of preventive measures.
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Affiliation(s)
| | - Roman Suligowski
- Department of Environmental Research and Geo-Information, Institute of Geography and Environmental Sciences, Jan Kochanowski University in Kielce, Uniwersytecka 7, 25-406 Kielce, Poland;
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Kua KP, Lee S. The influence of residential greenness on mortality in the Asia-Pacific region: a systematic review and meta-analysis. Perspect Public Health 2021; 141:342-353. [PMID: 34120524 DOI: 10.1177/17579139211011496] [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
AIMS To critically appraise the evidence of the impact of exposure to salutogenic green environment on mortality, which is an important endpoint in epidemiological and clinical studies. METHODS We searched for studies published and indexed in three databases (PubMed, AMED, and CINAHL Plus) from inception until 31 March 2020, complemented with a search of cited literature for articles describing the effects of greenness on mortality in Asia-Pacific region. Eligible articles were screened and data were extracted independently by two reviewers. A random-effects model was utilised to obtain pool hazard ratio (HR) and risk ratio of all-cause mortality outcome. RESULTS The search identified 3239 studies, of which 20 studies reporting 133,363 participants from longitudinal cohort studies and 202 million people from population-based prevalence studies were included in the review. The majority of the studies (60%) were conducted in high-income countries in Asia-Pacific. All participants of the longitudinal cohort studies were aged 60 years or older, whereas the prevalence studies involved people of all age groups. A significant protective association of green environment exposure with all-cause mortality was reported in 18 studies. Pooled results from five studies showed increased level of greenness exposure was associated with a significant decrease in all-cause mortality (pooled HR = 0.97; 95% confidence interval (CI) = 0.93 to 1.02; p < 0.01; I²= 87.8%). Meta-analysis of total number of deaths in different quartiles of green spaces noted decreased risks of mortality with all causes of death with increased surrounding greenness. CONCLUSIONS Some limited evidence suggests that populations exposed to the greener environment have a lower risk of mortality, implying the potential role of greenness in increasing longevity. Further studies with standardised design and outcome reporting should be conducted in low- and middle-income countries and in populations of low socioeconomic status to glean more generalisable and complete evidence for public health policy implications.
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Affiliation(s)
- K P Kua
- Puchong Health Clinic, Petaling District Health Office, Ministry of Health Malaysia, Petaling, Selangor, Malaysia
| | - Swh Lee
- School of Pharmacy, Monash University, Subang Jaya, Selangor, Malaysia; Asian Centre for Evidence Synthesis in Population, Implementation, and Clinical Outcomes (PICO), Health and Well-Being Cluster, Global Asia in the 21st Century (GA21) Platform, Monash University, Subang Jaya, Selangor, Malaysia; Gerontechnology Laboratory, Global Asia in the 21st Century (GA21) Platform, Monash University, Subang Jaya, Selangor, Malaysia; Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Selangor, Malaysia
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71
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De Petris S, Squillacioti G, Bono R, Borgogno-Mondino E. Geomatics and epidemiology: Associating oxidative stress and greenness in urban areas. ENVIRONMENTAL RESEARCH 2021; 197:110999. [PMID: 33713710 DOI: 10.1016/j.envres.2021.110999] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 03/01/2021] [Accepted: 03/05/2021] [Indexed: 06/12/2023]
Abstract
Green spaces may benefit human health mainly by mitigating noise and air pollution, promoting physical or social activities and improving mental health. Based on the influence that green space exposure seems to exert on Public Health and using a multidisciplinary approach, we investigated, the association between oxidative stress (OS) and green exposure in children. Overall, 207 subjects (10-13 yrs) living in Torino (NW- Italy) were involved in this study. Each participant provided a urinary sample, used to quantify a reliable OS biomarker (15-F2t-IsoP), and their residence addresses, used for geocoding. Green exposure was characterised by calculating i) the Soil Adjusted Vegetation Index (SAVI) within fixed buffers around each participant's home, using remotely-sensed data; ii) Tree Map accounting for evergreen/broadleaf species; iii) The percentage of green cover (PGC). Significant negative correlation (Pearson's r = -0.758, p < 0.001) between PGC and 15-F2t-IsoP was found. Greater SAVI was associated with lower OS (Pearson's r = -0.717, p < 0.001). Noticeably, evergreens seemed to determine a significant OS reduction compared to broadleaves (slope = -0.12 and -0.02, respectively; Warton-test F = 12.48, p = 0.0011). Finally, a spatial distribution of 15-F2t-IsoP estimates map, overlying with 2011 Census Data on same-aged dwellers of Torino, was generated. Predictive models accounting for green spaces influence on OS can be useful tool derived from geomatic employ in the Public Health field. Future developments of such a multidisciplinary approach should be considered in urban planning and policy-makers decisions to better define priority zones to requalify in urban settings.
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Affiliation(s)
- Samuele De Petris
- Department of Agriculture, Forest and Food Sciences, University of Torino, 10095, Grugliasco (TO), Italy.
| | - Giulia Squillacioti
- Department of Public Health and Pediatrics, University of Torino, 10121, Torino, Italy.
| | - Roberto Bono
- Department of Public Health and Pediatrics, University of Torino, 10121, Torino, Italy.
| | - Enrico Borgogno-Mondino
- Department of Agriculture, Forest and Food Sciences, University of Torino, 10095, Grugliasco (TO), Italy.
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Silva JP, Singh A, Oldenburg B, Gunathunga W, Alagiyawanna AMAAP, Mavoa S. Associations between residential greenness and self-reported heart disease in Sri Lankan men: A cross-sectional study. PLoS One 2021; 16:e0252382. [PMID: 34048455 PMCID: PMC8162690 DOI: 10.1371/journal.pone.0252382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 05/15/2021] [Indexed: 11/28/2022] Open
Abstract
Cardiovascular diseases (CVDs) are major contributors to morbidity and mortality in lower-middle-income countries (LMICs). Features of the natural environment, such as greenness, are a potential, modifiable determinant of CVD, yet there is a lack of evidence, particularly in LMICs. Our study investigated associations between residential greenness, measured using the Normalized Difference Vegetation Index (NDVI), and self-reported heart disease in 5268 Sri Lankan men aged 34 to 55 years. Multivariable logistic regression models were fitted to examine associations between mean NDVI within 100 m, 400 m, 800 m, 1600 m, and 2000 m of the residential address, adjusting for age, marital status, income, education, alcohol consumption, smoking and road length. Fully adjusted models showed that a 0.1 increase in mean NDVI was associated with lower odds of heart disease when using the 400 m (OR: 0.80; 95% CI: 0.64, 1.00), 800 m (OR: 0.85; 95% CI: 0.63, 1.14), and 2000 m (OR: 0.74; 95% CI: 0.48, 1.13) buffers. Further research in different contexts, and with improved outcome measures, is needed to confirm relationships between residential greenness and heart disease in rural areas and in LMICs.
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Affiliation(s)
- J. Padmaka Silva
- Office of the Regional Director of Health Services, Monaragala, Sri Lanka
- Melbourne School of Population & Global Health, The University of Melbourne, Melbourne, Australia
| | - Ankur Singh
- Melbourne School of Population & Global Health, The University of Melbourne, Melbourne, Australia
| | - Brian Oldenburg
- Melbourne School of Population & Global Health, The University of Melbourne, Melbourne, Australia
| | - Wasantha Gunathunga
- Department of Community Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | | | - Suzanne Mavoa
- Melbourne School of Population & Global Health, The University of Melbourne, Melbourne, Australia
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Dong X, Liu X, Zhang L, Li R, Tu R, Hou J, Mao Z, Huo W, Guo Y, Li S, Chen G, Wang C. Residential greenness associated with lower serum uric acid levels and hyperuricemia prevalence in a large Chinese rural population. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 770:145300. [PMID: 33517006 DOI: 10.1016/j.scitotenv.2021.145300] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 01/16/2021] [Accepted: 01/16/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND The association between residential greenness and hyperuricemia remains unclear, especially in developing countries. The current study aimed to explore the associations between residential greenness and both serum uric acid (SUA) levels and hyperuricemia in a Chinese rural population and to examine potential pathways of these associations. METHODS In this cross-sectional study, 38,721 rural residents were recruited from the baseline survey of the Henan Rural Cohort study in 2015-2017. Two satellite-derived vegetation indices, i.e., the normalized difference vegetation index (NDVI) and the enhanced vegetation index (EVI), were used to estimate residential greenness. Air pollution was determined by two proxies: particulate matter with aerodynamic diameter ≤ 2.5 μm (PM2.5) and nitrogen dioxide (NO2). Hyperuricemia was defined as SUA levels of >417 μmol/L and > 357 μmol/L for men and women, respectively. Multivariable-adjusted linear regression and logistic regression models were applied to investigate the associations of greenness with SUA and hyperuricemia, and mediation analyses were used to explore possible mechanisms underlying the associations. RESULTS An interquartile range (IQR) increase in both EVI and NDVI in the 500 m buffer was significantly associated with reductions in SUA levels of -7.23 μmol/L (95% confidence interval (CI): -8.96, -5.50) and -4.38 μmol/L (95% CI: -5.93, -2.83), respectively. The same increases in EVI500-m and NDVI500-m were associated with 13.8% (95% CI: 5.8%, 21.2%) and 13.0% (95% CI: 5.6%, 19.8%) lower hyperuricemia prevalence, respectively. These associations were stronger in older people (age ≥ 65), men or participants with higher averaged monthly income. The associations were partly mediated by physical activity and BMI, while no mediation effect was observed for air pollution. CONCLUSIONS Higher levels of residential greenness were significantly associated with lower SUA levels and hyperuricemia prevalence in the Chinese rural population. BMI and physical activity may play important mediating roles in the associations.
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Affiliation(s)
- Xiaokang Dong
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Xiaotian Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Lulu Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Ruiying Li
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Runqi Tu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Jian Hou
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Zhenxing Mao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Wenqian Huo
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Yuming Guo
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Gongbo Chen
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, PR China.
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China.
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Tvina A, Visser A, Walker SL, Tsaih SW, Zhou Y, Beyer K, Palatnik A. Residential proximity to tree canopy and preterm birth in Black women. Am J Obstet Gynecol MFM 2021; 3:100391. [PMID: 33984532 DOI: 10.1016/j.ajogmf.2021.100391] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 04/29/2021] [Accepted: 05/03/2021] [Indexed: 01/26/2023]
Abstract
BACKGROUND There are marked racial disparities in obstetrical outcomes, with the incidence of preterm birth being the highest among non-Hispanic Black women. The presence of green space, such as forests and parks, is now widely viewed as a health-promoting characteristic of residential environments. OBJECTIVE This study aimed to examine the association between the proximity of tree canopies to a prenatal residential address and the rates of preterm birth among non-Hispanic Black women in Milwaukee, Wisconsin. STUDY DESIGN This was a retrospective, case-control study utilizing hospital pregnancy records of self-identified non-Hispanic Black women. The addresses of the women, who delivered from 2011 to 2019, were geocoded to characterize the percentage of tree canopy surrounding the prenatal address using the National Land Cover Database. Circular residential buffers of 100, 150, 250, and 500 m were used to assess the exposure to tree canopy coverage in proximity to a prenatal address. Univariable and multivariable analyses were conducted to determine whether tree canopy percentage at 4 different proximity buffers, examined both in means and quartiles, was associated with preterm birth (birth at <37 weeks' gestation). RESULTS Of the 2771 non-Hispanic Black women included in the study, 333 (12.0%) experienced preterm births. Less tree canopy coverage was significantly (P < .05) associated with preterm birth, irrespective of whether the coverage was quantified as a mean or by quartile. In the unadjusted and adjusted models, which adjusted for sociodemographic and clinical risk factors for preterm birth, a 10% increase in tree canopy coverage was associated with lower odds of preterm birth at all 4 buffers examined. When examining the green space by quartile, higher quartiles were associated with lower odds of preterm birth at the 100-, 150-, and 250 m buffers, but not at the 500 m buffer. CONCLUSION A higher percentage of tree canopy coverage in close proximity to the prenatal residential address is associated with lower odds of preterm birth among non-Hispanic Black women. These findings suggest that access to neighborhood green space is an important factor associated with preterm birth.
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Affiliation(s)
- Alina Tvina
- Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, WI (Dr Tvina, MS Visser, and Dr Palatnik)
| | - Anna Visser
- Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, WI (Dr Tvina, MS Visser, and Dr Palatnik)
| | - Shannon L Walker
- Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, WI (Ms Walker and Dr Palatnik); Institute of Health and Equity, Department of Public and Community Health, Medical College of Wisconsin, Milwaukee, WI (Ms Walker and Drs Zhou and Beyer)
| | - Shirng-Wern Tsaih
- Genomic Sciences and Precision Medicine Center, Medical College of Wisconsin, Milwaukee, WI (Dr Tsaih)
| | - Yuhong Zhou
- Institute of Health and Equity, Department of Public and Community Health, Medical College of Wisconsin, Milwaukee, WI (Ms Walker and Drs Zhou and Beyer)
| | - Kirsten Beyer
- Institute of Health and Equity, Department of Public and Community Health, Medical College of Wisconsin, Milwaukee, WI (Ms Walker and Drs Zhou and Beyer)
| | - Anna Palatnik
- Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, WI (Dr Tvina, MS Visser, and Dr Palatnik); Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, WI (Ms Walker and Dr Palatnik).
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Iyer HS, James P, Valeri L, Bajunirwe F, Nankya-Mutyoba J, Njelekela M, Chiwanga F, Sewram V, Ajayi I, Adebamowo C, Dalal S, Reid TG, Rebbeck TR, Adami HO, Holmes MD. Neighborhood greenness and burden of non-communicable diseases in Sub-Saharan Africa: A multi-country cross-sectional study. ENVIRONMENTAL RESEARCH 2021; 196:110397. [PMID: 33130166 PMCID: PMC8085185 DOI: 10.1016/j.envres.2020.110397] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 10/15/2020] [Accepted: 10/23/2020] [Indexed: 05/04/2023]
Abstract
Population growth, demographic transitions and urbanization in sub-Saharan Africa (SSA) will increase non-communicable disease (NCD) burden. We studied the association between neighborhood greenness and NCDs in a multi-country cross-sectional study. Among 1178 participants, in adjusted models, a 0.11 unit NDVI increase was associated with lower BMI (β: -1.01, 95% CI: -1.35, -0.67), and lower odds of overweight/obesity (aOR: 0.73, 95% CI: 0.62, 0.85), diabetes (aOR: 0.77, 95% CI: 0.62, 0.96), and having ≥3 allostatic load components compared to none (aOR: 0.66, 95% CI: 0.52, 0.85). Except for diabetes, these remained statistically significant after Bonferroni correction. We observed no association between NDVI and hypertension or cholesterol. Our findings are consistent with health benefits of neighborhood greenness reported in other countries, suggesting greening strategies could be considered as part of broader public health interventions for NCDs.
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Affiliation(s)
- Hari S Iyer
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, USA.
| | - Peter James
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, USA
| | - Linda Valeri
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, USA
| | - Francis Bajunirwe
- Department of Community Health, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Joan Nankya-Mutyoba
- Department of Epidemiology & Biostatistics, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Marina Njelekela
- Department of Physiology, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania; Department of Internal Medicine, Muhimbili National Hospital, Dar Es Salaam, Tanzania; Deloitte Consulting Limited, Dar Es Salaam, Tanzania
| | - Faraja Chiwanga
- Department of Internal Medicine, Muhimbili National Hospital, Dar Es Salaam, Tanzania
| | - Vikash Sewram
- African Cancer Institute, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - IkeOluwapo Ajayi
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Clement Adebamowo
- Institute of Human Virology, Abuja, Nigeria; Greenebaum Comprehensive Cancer Center and Institute of Human Virology, University of Maryland School of Medicine, Baltimore, USA
| | - Shona Dalal
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, USA
| | - Todd G Reid
- Media Lab and Connection Science, Massachusetts Institute of Technology, Boston, USA; Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, USA
| | - Timothy R Rebbeck
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, USA
| | - Hans-Olov Adami
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, USA; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Clinical Effectiveness Research Group, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Michelle D Holmes
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, USA; Channing Division of Network Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, USA
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Astell-Burt T, Feng X. Urban green space, tree canopy and prevention of cardiometabolic diseases: a multilevel longitudinal study of 46 786 Australians. Int J Epidemiol 2021; 49:926-933. [PMID: 31722373 PMCID: PMC7394941 DOI: 10.1093/ije/dyz239] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2019] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Cross-sectional studies suggest that more green space may lower the odds of prevalent diabetes, hypertension and cardiovascular diseases (CVD) in cities. We assess if these results are replicable for tree canopy exposure and then extend the study longitudinally to examine incident cardiometabolic outcomes. METHODS The study was set in the Australian cities of Sydney, Wollongong and Newcastle. Total green space and tree canopy as percentages of landcover within 1.6 km (1 mile) from home were linked to a residentially stable sample of 46 786 participants in the Sax Institute's 45 and Up Study (baseline 2006-09; follow-up 2012-15). Separate multilevel models were used to investigate whether the odds of prevalent and incident doctor-diagnosed diabetes, hypertension and CVD were associated with total green space and tree canopy provision, adjusting for age, sex, income, education, employment and couple status. RESULTS Lower odds of prevalent diabetes were observed with 1% increases in total green space [odds ratio (OR) 0.993, 95% confidence interval (CI) 0.988 to 0.998] and tree canopy (0.984, 0.978 to 0.989). Lower odds of prevalent CVD were found with a 1% increase in tree canopy only (0.996, 0.993 to 0.999). Lower odds of incident diabetes (0.988, 0.981 to 0.994), hypertension (0.993, 0.989 to 0.997) and CVD (0.993, 0.988 to 0.998) were associated with a 1% increase in tree canopy, but not total green space. At ≥30% compared with 0-9% tree canopy, there were lower odds of incident diabetes (0.687, 0.547 to 0.855), hypertension (0.828, 0.719 to 0.952) and CVD (0.782, 0.652 to 0.935). However, ≥30% compared with 0-4% total green space was associated with lower odds of prevalent diabetes only (0.695, 0.512 to 0.962). CONCLUSIONS Restoring local tree canopy in neighbourhoods may help to prevent the incidence of cardiometabolic diseases.
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Affiliation(s)
- Thomas Astell-Burt
- Population Wellbeing and Environment Research Lab (PowerLab), School of Health and Society, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia
| | - Xiaoqi Feng
- School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
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Kwan SC, Ismail R, Ismail NH, Mohamed N. An ecological study of the relationship between urban built environment and cardiovascular hospital admissions (2004-2016) in an Asian developing country. Soc Sci Med 2021; 276:113868. [PMID: 33799201 DOI: 10.1016/j.socscimed.2021.113868] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 01/08/2021] [Accepted: 03/16/2021] [Indexed: 11/26/2022]
Abstract
This study aims to evaluate the relationship between urban built environment and hospital admissions from cardiovascular diseases in Kuala Lumpur, Malaysia. Hospital admission data from 2004 to 2016 for cardiovascular diseases were used with patient residential postcodes as the unit of analysis. Data was split into 2004-2009 (12,551 cases) and 2010-2016 (17,154 cases) periods corresponding to land use data. We used generalized linear mixed model to analyse population density, property value, entropy index, and the kernel density (800 m) of specific land use, bus and rail stations, and road junctions, with time period and postcodes as the random effects to generate incidence rate ratios (IRRs). Results indicated that entropy index and recreational area density were associated with fewer hypertensive disease and ischemic heart disease hospital admissions (IRR range: 0.49-0.68, 95%CI: 0.27, 0.97). Population density and property value were associated with fewer cerebrovascular disease hospital admissions (IRR range: 0.29-0.34, 95%CI: 0.11, 0.75). Contrarily, density of road junctions was associated with 2.5-6.3 times more hospital admissions for cardiovascular disease hospital admissions (IRR range: 2.53-6.34, 95%CI: 1.07,17.91). There were no significant association between hospital admission and density of residential area, undeveloped land, rail and bus stations. The shapes of relationships for all attributes were non-linear, and changed markedly at the third quartile except for recreational area density. The findings suggest that land use attributes have some protective effects on the cardiovascular disease admission cases as compared to the transport attributes. These findings have important merits for integrating health into urban planning.
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Affiliation(s)
- Soo Chen Kwan
- Center for Southeast Asian Studies (CSEAS), Kyoto University, Kyoto, Japan; Center for Toxicology and Health Risk Studies (CORE), Faculty of Health Sciences, National University of Malaysia, Malaysia.
| | - Rohaida Ismail
- Environmental Health Research Centre, Institute for Medical Research, Ministry of Health Malaysia, Malaysia
| | | | - Norlen Mohamed
- Disease Control Division, Ministry of Health Malaysia, Malaysia
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Green Space and Health Equity: A Systematic Review on the Potential of Green Space to Reduce Health Disparities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052563. [PMID: 33806546 PMCID: PMC7967323 DOI: 10.3390/ijerph18052563] [Citation(s) in RCA: 134] [Impact Index Per Article: 44.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 02/25/2021] [Accepted: 02/26/2021] [Indexed: 02/07/2023]
Abstract
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.
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79
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Bikomeye JC, Rublee CS, Beyer KMM. Positive Externalities of Climate Change Mitigation and Adaptation for Human Health: A Review and Conceptual Framework for Public Health Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2481. [PMID: 33802347 PMCID: PMC7967605 DOI: 10.3390/ijerph18052481] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 02/24/2021] [Accepted: 02/26/2021] [Indexed: 12/17/2022]
Abstract
Anthropogenic climate change is adversely impacting people and contributing to suffering and increased costs from climate-related diseases and injuries. In responding to this urgent and growing public health crisis, mitigation strategies are in place to reduce future greenhouse gas emissions (GHGE) while adaptation strategies exist to reduce and/or alleviate the adverse effects of climate change by increasing systems' resilience to future impacts. While these strategies have numerous positive benefits on climate change itself, they also often have other positive externalities or health co-benefits. This knowledge can be harnessed to promote and improve global public health, particularly for the most vulnerable populations. Previous conceptual models in mitigation and adaptation studies such as the shared socioeconomic pathways (SSPs) considered health in the thinking, but health outcomes were not their primary intention. Additionally, existing guidance documents such as the World Health Organization (WHO) Guidance for Climate Resilient and Environmentally Sustainable Health Care Facilities is designed primarily for public health professionals or healthcare managers in hospital settings with a primary focus on resilience. However, a detailed cross sectoral and multidisciplinary conceptual framework, which links mitigation and adaptation strategies with health outcomes as a primary end point, has not yet been developed to guide research in this area. In this paper, we briefly summarize the burden of climate change on global public health, describe important mitigation and adaptation strategies, and present key health benefits by giving context specific examples from high, middle, and low-income settings. We then provide a conceptual framework to inform future global public health research and preparedness across sectors and disciplines and outline key stakeholders recommendations in promoting climate resilient systems and advancing health equity.
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Affiliation(s)
- Jean C. Bikomeye
- PhD Program in Public and Community Health, Institute for Health and Equity, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA;
| | - Caitlin S. Rublee
- Department of Emergency Medicine, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA;
| | - Kirsten M. M. Beyer
- PhD Program in Public and Community Health, Institute for Health and Equity, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA;
- Division of Epidemiology, Institute for Health and Equity, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA
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80
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Riggs DW, Yeager R, Conklin DJ, DeJarnett N, Keith RJ, DeFilippis AP, Rai SN, Bhatnagar A. Residential proximity to greenness mitigates the hemodynamic effects of ambient air pollution. Am J Physiol Heart Circ Physiol 2021; 320:H1102-H1111. [PMID: 33416460 PMCID: PMC8294702 DOI: 10.1152/ajpheart.00689.2020] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 01/05/2021] [Accepted: 01/06/2021] [Indexed: 02/07/2023]
Abstract
Residential proximity to greenness is associated with a lower risk of cardiovascular disease (CVD) and all-cause mortality. However, it is unclear whether the beneficial effects of greenness are linked to a reduction in the effects of ambient air pollutants. We measured arterial stiffness in 73 participants with moderate to high CVD risk. Average levels of ambient PM2.5 and ozone were calculated from local monitoring stations. Residential greenness was estimated using satellite-derived normalized difference vegetation index (NDVI) for a 200-m and 1-km radius around each participant's home. Participants were 51% female, average age of 52 yr, and 79% had diagnosed hypertension. In multiple linear regression models, residential NDVI was negatively associated with augmentation index (-3.8% per 0.1 NDVI). Ambient levels of PM2.5 [per interquartile range (IQR) of 6.9 μg/m3] were positively associated with augmentation pressure (3.1 mmHg), pulse pressure (5.9 mmHg), and aortic systolic pressure (8.1 mmHg). Ozone (per IQR of 0.03 ppm) was positively associated with augmentation index (5.5%), augmentation pressure (3.1 mmHg), and aortic systolic pressure (10 mmHg). In areas of low greenness, both PM2.5 and ozone were positively associated with pulse pressure. Additionally, ozone was positively associated with augmentation pressure and systolic blood pressure. However, in areas of high greenness, there was no significant association between indices of arterial stiffness with either PM2.5 or ozone. Residential proximity to greenness is associated with lower values of arterial stiffness. Residential greenness may mitigate the adverse effects of PM2.5 and ozone on arterial stiffness.NEW & NOTEWORTHY Previous studies have linked proximity to green spaces with lower cardiovascular disease risk. However, the mechanisms underlying the salutary effects of green areas are not known. In our study of participants at risk of cardiovascular disease, we found that arterial stiffness was positively associated with short-term exposure to PM2.5, PM10, and ozone and inversely associated with greenness. The association between pollution and arterial stiffness was attenuated in areas of high greenness, suggesting that living green neighborhoods can lessen the adverse cardiovascular effects of air pollution.
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Affiliation(s)
- Daniel W Riggs
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky
- Department of Epidemiology and Population Health, University of Louisville, Louisville, Kentucky
| | - Ray Yeager
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky
- Department of Environmental and Occupational Health Sciences, University of Louisville, Louisville, Kentucky
| | - Daniel J Conklin
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky
| | - Natasha DeJarnett
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky
| | - Rachel J Keith
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky
| | - Andrew P DeFilippis
- Division of Cardiovascular Medicine, Department of Medicine, University of Louisville, Louisville, Kentucky
| | - Shesh N Rai
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky
- Department of Bioinformatics and Biostatistics, University of Louisville, Louisville, Kentucky
- Biostatistics and Bioinformatics Facility, James Graham Brown Cancer Center, University of Louisville, Louisville, Kentucky
| | - Aruni Bhatnagar
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky
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Neighborhood Characteristics and Cardiovascular Biomarkers in Middle-Aged and Older Adults: the Baltimore Memory Study. J Urban Health 2021; 98:130-142. [PMID: 33420552 PMCID: PMC7873131 DOI: 10.1007/s11524-020-00499-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Neighborhood greenness has been linked to better cardiovascular health, but little is known about its association with biomarkers related to cardiovascular risk. Adverse neighborhood conditions, such as disorder and socioeconomic disadvantage, are associated with higher cardiovascular biomarker levels, but these relationships may differ in neighborhoods with more greenness. This study evaluated cross-sectional associations of validated measures of neighborhood greenness, disorder, and socioeconomic disadvantage with cardiovascular biomarkers in middle-aged and older adults living in Baltimore City. The sample included 500 adults, aged 57-79 years, enrolled in the Baltimore Memory Study and living in Baltimore City during 2009-2010. Multi-level log-gamma regressions examined associations between the three neighborhood characteristics and seven cardiovascular biomarkers. Models additionally evaluated the effect modification by neighborhood greenness on associations of neighborhood disorder and socioeconomic disadvantage with the biomarkers. Adjusting for covariates and neighborhood greenness, greater neighborhood disorder was associated with higher C-reactive protein (exp β = 1.21, SE = 0.11, p = 0.035) and serum amyloid A (exp β = 1.28, SE = 0.12, p = 0.008), while greater neighborhood socioeconomic disadvantage was associated with higher tumor necrosis factor alpha (exp β = 1.24, SE = 0.12, p = 0.019). Higher neighborhood greenness was associated with lower soluble vascular cell adhesion molecule-1, accounting for disorder (exp β = 0.70, SE = 0.10, p = 0.010) and socioeconomic disadvantage (exp β = 0.73, SE = 0.10, p = 0.025). There was no evidence of effect modification among neighborhood characteristics. The findings suggest that neighborhood effects on cardiovascular health may be mediated through cardiovascular biomarker levels, and that socioeconomic disadvantage, disorder, and greenness may each be important features of neighborhoods.
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Voss S, Schneider A, Huth C, Wolf K, Markevych I, Schwettmann L, Rathmann W, Peters A, Breitner S. ENVINT-D-20-01309: Long-term exposure to air pollution, road traffic noise, residential greenness, and prevalent and incident metabolic syndrome: Results from the population-based KORA F4/FF4 cohort in Augsburg, Germany. ENVIRONMENT INTERNATIONAL 2021; 147:106364. [PMID: 33421766 DOI: 10.1016/j.envint.2020.106364] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 11/12/2020] [Accepted: 12/21/2020] [Indexed: 05/28/2023]
Abstract
BACKGROUND A growing number of epidemiological studies show associations between environmental factors and impaired cardiometabolic health. However, evidence is scarce concerning these risk factors and their impact on metabolic syndrome (MetS). This analysis aims to investigate associations between long-term exposure to air pollution, road traffic noise, residential greenness, and MetS. METHODS We used data of the first (F4, 2006-2008) and second (FF4, 2013-2014) follow-up of the population-based KORA S4 survey in the region of Augsburg, Germany, to investigate associations between exposures and MetS prevalence at F4 (N = 2883) and MetS incidence at FF4 (N = 1192; average follow-up: 6.5 years). Residential long-term exposures to air pollution - including particulate matter (PM) with a diameter < 10 µm (PM10), PM < 2.5 µm (PM2.5), PM between 2.5 and 10 µm (PMcoarse), absorbance of PM2.5 (PM2.5abs), particle number concentration (PNC), nitrogen dioxide (NO2), ozone (O3) - and road traffic noise were modeled by land-use regression models and noise maps. For greenness, the Normalized Difference Vegetation Index (NDVI) was obtained. We estimated Odds Ratios (OR) for single and multi-exposure models using logistic regression and generalized estimating equations adjusted for confounders. Joint Odds Ratios were calculated based on the Cumulative Risk Index. Effect modifiers were examined with interaction terms. RESULTS We found positive associations between prevalent MetS and interquartile range (IQR) increases in PM10 (OR: 1.15; 95% confidence interval [95% CI]: 1.02, 1.29), PM2.5 (OR: 1.14; 95% CI: 1.02, 1.28), PMcoarse (OR: 1.14; 95% CI: 1.02, 1.27), and PM2.5abs (OR: 1.17; 95% CI: 1.03, 1.32). Results further showed negative, but non-significant associations between exposure to greenness and prevalent and incident MetS. No effects were seen for exposure to road traffic noise. Joint Odds Ratios from multi-exposure models were higher than ORs from models with only one exposure.
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Affiliation(s)
- Stephan Voss
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, LMU Munich, Munich, Germany; Pettenkofer School of Public Health, Munich, Germany; Institute of Epidemiology, Helmholtz Zentrum München GmbH - German Research Center for Environmental Health, Neuherberg, Germany.
| | - Alexandra Schneider
- Institute of Epidemiology, Helmholtz Zentrum München GmbH - German Research Center for Environmental Health, Neuherberg, Germany
| | - Cornelia Huth
- Institute of Epidemiology, Helmholtz Zentrum München GmbH - German Research Center for Environmental Health, Neuherberg, Germany
| | - Kathrin Wolf
- Institute of Epidemiology, Helmholtz Zentrum München GmbH - German Research Center for Environmental Health, Neuherberg, Germany
| | - Iana Markevych
- Institute of Epidemiology, Helmholtz Zentrum München GmbH - German Research Center for Environmental Health, Neuherberg, Germany; Institute and Clinic for Occupational, Social and Environmental Medicine, LMU Munich, Munich, Germany; Institute of Psychology, Jagiellonian University, Cracow, Poland
| | - Lars Schwettmann
- Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Institute of Health Economics and Health Care Management, Neuherberg, Germany
| | - Wolfgang Rathmann
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Duesseldorf, Germany
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München GmbH - German Research Center for Environmental Health, Neuherberg, Germany
| | - Susanne Breitner
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, LMU Munich, Munich, Germany; Institute of Epidemiology, Helmholtz Zentrum München GmbH - German Research Center for Environmental Health, Neuherberg, Germany
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83
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Xie Y, He W, Zhang X, Cui J, Tian X, Chen J, Zhang K, Li S, Di N, Xiang H, Wang H, Chen G, Guo Y. Association of air pollution and greenness with carotid plaque: A prospective cohort study in China. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 273:116514. [PMID: 33486240 DOI: 10.1016/j.envpol.2021.116514] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 01/11/2021] [Accepted: 01/12/2021] [Indexed: 06/12/2023]
Abstract
Previous studies indicated that exposure to air pollution was associated with the progress of atherosclerosis, but evidence is very limited in China and even in the world. This study aims to assess the associations of long-term exposures to air pollution and greenness with the occurrence of carotid plaque. Participants of this cohort study were urban residents and office workers who visited Hebei General Hospital for routine physical examination annually from September 2016 through to December 2018. Eligible participants were people diagnosed the absence of carotid plaque clinically at their first hospital visit and were followed up at their second or third hospital visit. Exposure to particulate matter with aerodynamic diameter less than 2.5 μm (PM2.5), nitrogen dioxide (NO2) and ozone (O3) were estimated using an inverse distance weighted (IDW) method. The level of greenness was assessed using the Normalized Difference Vegetation Index (NDVI) and Enhanced Vegetation Index (EVI). The associations were evaluated using Cox proportional hazards regression models. Among 4,137 participants, 575 showed the occurrence of carotid plaque during the follow-up period. After controlling for potential confounders, the hazard ratios (HRs) and 95% confidence intervals (95%CIs) of carotid plaque associated with per interquartile range (IQR) increase in PM2.5, NO2, and O3 were 1.78 (1.55, 2.03), 1.32 (1.14, 1.53) and 1.99 (1.71, 2.31), respectively. Increased EVI and NDVI were significantly associated with lower risk of carotid plaque [HR (and 95%CI): 0.84 (0.77, 0.93) and 0.87 (0.80, 0.94)]. PM2.5 significantly mediated 80.47% or 93.00% of the estimated association between EVI or NDVI and carotid plaque. In light of the significant associations between air pollution, greenness and carotid plaque in this study, continued efforts are needed to curb air pollution and plan more green space considering their effects on vascular disease.
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Affiliation(s)
- Yinyu Xie
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan, Hubei, China; Global Health Institute, Wuhan University, Wuhan, Hubei, China
| | - Weiliang He
- Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Xiaoling Zhang
- Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Jian Cui
- Department of General Surgery, Beijing Hospital, Beijing, China; National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Xiaochao Tian
- Department of Cardiology, Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Jiang Chen
- School of Remote Sensing and Information Engineering, Wuhan University, Wuhan, Hubei, China
| | - Kaihua Zhang
- Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei, China; Hebei Medical University, Shijiazhuang, Hebei, China
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Niu Di
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan, Hubei, China; Global Health Institute, Wuhan University, Wuhan, Hubei, China
| | - Hao Xiang
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan, Hubei, China; Global Health Institute, Wuhan University, Wuhan, Hubei, China
| | - Hebo Wang
- Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei, China; Hebei Medical University, Shijiazhuang, Hebei, China
| | - Gongbo Chen
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan, Hubei, China; Global Health Institute, Wuhan University, Wuhan, Hubei, China.
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Poulsen MN, Schwartz BS, Nordberg C, DeWalle J, Pollak J, Imperatore G, Mercado CI, Siegel KR, Hirsch AG. Association of Greenness with Blood Pressure among Individuals with Type 2 Diabetes across Rural to Urban Community Types in Pennsylvania, USA. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020614. [PMID: 33450813 PMCID: PMC7828293 DOI: 10.3390/ijerph18020614] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 01/05/2021] [Accepted: 01/08/2021] [Indexed: 01/25/2023]
Abstract
Greenness may impact blood pressure (BP), though evidence is limited among individuals with type 2 diabetes (T2D), for whom BP management is critical. We evaluated associations of residential greenness with BP among individuals with T2D in geographically diverse communities in Pennsylvania. To address variation in greenness type, we evaluated modification of associations by percent forest. We obtained systolic (SBP) and diastolic (DBP) BP measurements from medical records of 9593 individuals following diabetes diagnosis. Proximate greenness was estimated within 1250-m buffers surrounding individuals’ residences using the normalized difference vegetation index (NDVI) prior to blood pressure measurement. Percent forest was calculated using the U.S. National Land Cover Database. Linear mixed models with robust standard errors accounted for spatial clustering; models were stratified by community type (townships/boroughs/cities). In townships, the greenest communities, an interquartile range increase in NDVI was associated with reductions in SBP of 0.87 mmHg (95% CI: −1.43, −0.30) and in DBP of 0.41 mmHg (95% CI: −0.78, −0.05). No significant associations were observed in boroughs or cities. Evidence for modification by percent forest was weak. Findings suggest a threshold effect whereby high greenness may be necessary to influence BP in this population and support a slight beneficial impact of greenness on cardiovascular disease risk.
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Affiliation(s)
- Melissa N. Poulsen
- Department of Population Health Sciences, Geisinger, Danville, PA 17822, USA; (B.S.S.); (C.N.); (J.D.); (A.G.H.)
- Correspondence:
| | - Brian S. Schwartz
- Department of Population Health Sciences, Geisinger, Danville, PA 17822, USA; (B.S.S.); (C.N.); (J.D.); (A.G.H.)
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA;
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
| | - Cara Nordberg
- Department of Population Health Sciences, Geisinger, Danville, PA 17822, USA; (B.S.S.); (C.N.); (J.D.); (A.G.H.)
| | - Joseph DeWalle
- Department of Population Health Sciences, Geisinger, Danville, PA 17822, USA; (B.S.S.); (C.N.); (J.D.); (A.G.H.)
| | - Jonathan Pollak
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA;
| | - Giuseppina Imperatore
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA; (G.I.); (C.I.M.); (K.R.S.)
| | - Carla I. Mercado
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA; (G.I.); (C.I.M.); (K.R.S.)
| | - Karen R. Siegel
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA; (G.I.); (C.I.M.); (K.R.S.)
| | - Annemarie G. Hirsch
- Department of Population Health Sciences, Geisinger, Danville, PA 17822, USA; (B.S.S.); (C.N.); (J.D.); (A.G.H.)
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O'Toole TE, Amraotkar AA, DeFilippis AP, Rai SN, Keith RJ, Baba SP, Lorkiewicz P, Crandell CE, Pariser GL, Wingard CJ, Pope Iii CA, Bhatnagar A. Protocol to assess the efficacy of carnosine supplementation in mitigating the adverse cardiovascular responses to particulate matter (PM) exposure: the Nucleophilic Defense Against PM Toxicity (NEAT) trial. BMJ Open 2020; 10:e039118. [PMID: 33372072 PMCID: PMC7772308 DOI: 10.1136/bmjopen-2020-039118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Exposure to airborne particulate matter (PM) is associated with cardiovascular disease. These outcomes are believed to originate from pulmonary oxidative stress and the systemic delivery of oxidised biomolecules (eg, aldehydes) generated in the lungs. Carnosine is an endogenous di-peptide (β-alanine-L-histidine) which promotes physiological homeostasis in part by conjugating to and neutralising toxic aldehydes. We hypothesise that an increase of endogenous carnosine by dietary supplementation would mitigate the adverse cardiovascular outcomes associated with PM exposure in humans. METHODS AND ANALYSIS To test this, we designed the Nucleophilic Defense Against PM Toxicity trial. This trial will enroll 240 participants over 2 years and determine if carnosine supplementation mitigates the adverse effects of PM inhalation. The participants will have low levels of endogenous carnosine to facilitate identification of supplementation-specific outcomes. At enrollment, we will measure several indices of inflammation, preclinical cardiovascular disease and physical function. Participants will be randomly allocated to carnosine or placebo groups and instructed to take their oral supplement for 12 weeks with two return clinical visits and repeated assessments during times of peak PM exposure (June-September) in Louisville, Kentucky, USA. Statistical modelling approaches will be used to assess the efficacy of carnosine supplementation in mitigating adverse outcomes. ETHICS AND DISSEMINATION This study protocol has been approved by the Institutional Review Board at the University of Louisville. Results from this study will be disseminated at scientific conferences and in peer-reviewed publications.Trial registration: NCT03314987; Pre-results.
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Affiliation(s)
- Timothy E O'Toole
- Division of Environmental Medicine, Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky, USA
| | - Alok A Amraotkar
- Division of Environmental Medicine, Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky, USA
- Division of Cardiovascular Medicine, University of Louisville, Louisville, Kentucky, USA
| | | | - Shesh N Rai
- Department of Biostatistics and Bioinfomatics, University of Louisville, Louisville, Kentucky, USA
| | - Rachel J Keith
- Division of Environmental Medicine, Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky, USA
| | - Shahid P Baba
- Division of Environmental Medicine, Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky, USA
| | - Pawel Lorkiewicz
- Division of Environmental Medicine, Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky, USA
- Department of Chemistry, University of Louisville, Louisville, KY, USA
| | - Catherine E Crandell
- Department of Physical Therapy, Bellarmine University, Louisville, Kentucky, USA
| | - Gina L Pariser
- Department of Physical Therapy, Bellarmine University, Louisville, Kentucky, USA
| | | | - C Arden Pope Iii
- Department of Economics, Brigham Young University, Provo, Utah, USA
| | - Aruni Bhatnagar
- Division of Environmental Medicine, Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky, USA
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Di N, Li S, Xiang H, Xie Y, Mao Z, Hou J, Liu X, Huo W, Yang B, Dong G, Wang C, Chen G, Guo Y. Associations of Residential Greenness with Depression and Anxiety in Rural Chinese Adults. Innovation (N Y) 2020; 1:100054. [PMID: 34557719 PMCID: PMC8454668 DOI: 10.1016/j.xinn.2020.100054] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 10/29/2020] [Indexed: 12/27/2022] Open
Abstract
Background Depression and anxiety are top contributors to non-fatal health loss globally. Several studies have indicated the association between residential greenness and mental health. Method The participants (n = 27,366) were recruited from four counties in Henan Province, China during 2015–2017. Symptoms of depression and anxiety were evaluated using the Patient Health Questionnaire-2 (PHQ-2) and the Generalized Anxiety Disorder-2 (GAD-2) in the baseline survey. The level of residential greenness during the 3-year period before the baseline survey was assessed using the Moderate Resolution Imaging Spectroradiometer (MODIS) Normalized Difference Vegetation Index (NDVI) and Enhanced Vegetation Index (EVI). The mixed-effect linear regression model was applied to examine the associations of residential greenness with depression and anxiety. Results The results of adjusted models showed that the score of PHQ-2 (Δscore and 95% confidence interval [CI]) decreased by −0.024 (−0.041, −0.006) and −0.022 (−0.038, −0.004) with an interquartile range (IQR) increase in NDVI and EVI within a 1,000-m buffer radius, respectively. The score of GAD-2 (Δscore and 95% CI) decreased by −0.024 (−0.040, −0.006) and −0.028 (−0.044, −0.011), in relation to an IQR increase in NDVI and EVI within a 1,000-m buffer radius, respectively. Conclusions A higher level of residential greenness was significantly associated with lower risk of depression and anxiety in rural areas of Henan Province. Improving residential greenness accessibility may help to promote the mental health of rural populations. Mental disorders, particularly depression and anxiety, have become one of the most serious public health issues globally. Symptoms of depression and anxiety and level of residential greenness were investigated for 27,366 participants from the Henan Rural Cohort. The mixed effect linear regression model was used to examine the associations between level of residential greenness and depression and anxiety in rural areas of Henan Province, China. Higher residential greenness was significantly associated with lower risks of depression and anxiety. Stronger effects of residential greenness were observed in males and in those with higher income and education level.
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Affiliation(s)
- Niu Di
- Global Health Institute; Department of Global Health, School of Health Sciences, Wuhan University, Wuhan 430071, Hubei, China
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Hao Xiang
- Global Health Institute; Department of Global Health, School of Health Sciences, Wuhan University, Wuhan 430071, Hubei, China
| | - Yinyu Xie
- Global Health Institute; Department of Global Health, School of Health Sciences, Wuhan University, Wuhan 430071, Hubei, China
| | - Zhenxing Mao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou 450001, Henan, China
| | - Jian Hou
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou 450001, Henan, China
| | - Xiaotian Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou 450001, Henan, China
| | - Wenqian Huo
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou 450001, Henan, China
| | - Boyi Yang
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment; Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2 Road, Yuexiu District, Guangzhou 510080, Guangdong, China
| | - Guanghui Dong
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment; Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2 Road, Yuexiu District, Guangzhou 510080, Guangdong, China
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou 450001, Henan, China
| | - Gongbo Chen
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment; Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2 Road, Yuexiu District, Guangzhou 510080, Guangdong, China
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
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Fan J, Guo Y, Cao Z, Cong S, Wang N, Lin H, Wang C, Bao H, Lv X, Wang B, Gao Y, Chen Y, Yang T, Wang L, Wang C, Ruan Z, Fang L. Neighborhood greenness associated with chronic obstructive pulmonary disease: A nationwide cross-sectional study in China. ENVIRONMENT INTERNATIONAL 2020; 144:106042. [PMID: 32827808 DOI: 10.1016/j.envint.2020.106042] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 07/17/2020] [Accepted: 08/05/2020] [Indexed: 06/11/2023]
Abstract
Differential findings have been reported on the association between neighborhood greenness and chronic obstructive pulmonary disease (COPD). The underlying reasons might be the different types of vegetation and the diagnosis methods used in different studies. In this nationwide cross-sectional study in China, we examined the linkage between neighborhood greenness and COPD prevalence among 66,752 adults aged 40 years and above. Neighborhood greenness was estimated using the normalized difference vegetation index (NDVI) based on satellite imagery within buffers of 100, 300, 500, 1000, 2000, 3000 and 5000 m of residential community of the participants. COPD was defined according to the 2017 Global Initiative for Chronic Obstructive Lung Disease lung function criteria. A two-level logistic regression model was applied to estimate the associations. Finally, 9134 adults were classified as COPD. We observed significant positive associations between neighborhood greenness and COPD prevalence. The odds ratio for each interquartile range increase in NDVI within 100 m buffer was 1.08 (95% CI: 1.01, 1.15) after adjustment for potential confounders. Consistent associations were observed across all other NDVI buffer sizes. Stratified analyses revealed that younger adults (40-65 years) and urban residents might be the vulnerable subpopulations. Further regional analyses found that residents from the Northeastern and Northern China were more likely to have this association. Our results indicated that neighborhood greenness might be one risk factor of COPD prevalence. Our study have important public health implications for allocating the surrounding green spaces among living areas, especially for those with respiratory illness; however, the findings and the underlying mechanisms warrant further examinations in longitudinal settings.
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Affiliation(s)
- Jing Fan
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yawei Guo
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Zheng Cao
- School of Geographical Sciences, Guangzhou University, Guangzhou, China
| | - Shu Cong
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ning Wang
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Heling Bao
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China; Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Xueli Lv
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Baohua Wang
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yi Gao
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yahong Chen
- Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, China
| | - Ting Yang
- Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Linhong Wang
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Chen Wang
- Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zengliang Ruan
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.
| | - Liwen Fang
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
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88
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O’Toole TE, Li X, Riggs DW, Hoetker DJ, Yeager R, Lorkiewicz P, Baba SP, Cooper NG, Bhatnagar A. Urinary levels of the acrolein conjugates of carnosine are associated with inhaled toxicants. Inhal Toxicol 2020; 32:468-476. [PMID: 33179563 PMCID: PMC7875462 DOI: 10.1080/08958378.2020.1845257] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 10/26/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The inhalation of air-borne toxicants is associated with adverse health outcomes which can be somewhat mitigated by enhancing endogenous anti-oxidant capacity. Carnosine is a naturally occurring dipeptide (β-alanine-L-histidine), present in high abundance in skeletal and cardiac muscle. This multi-functional dipeptide has anti-oxidant properties, can buffer intracellular pH, chelate metals, and sequester aldehydes such as acrolein. Due to these chemical properties, carnosine may be protective against inhaled pollutants which can contain metals and aldehydes and can stimulate the generation of electrophiles in exposed tissues. Thus, assessment of carnosine levels, or levels of its acrolein conjugates (carnosine-propanal and carnosine-propanol) may inform on level of exposure and risk assessment. METHODS We used established mass spectroscopy methods to measure levels of urinary carnosine (n = 605) and its conjugates with acrolein (n = 561) in a subset of participants in the Louisville Healthy Heart Study (mean age = 51 ± 10; 52% male). We then determined associations between these measures and air pollution exposure and smoking behavior using statistical modeling approaches. RESULTS We found that higher levels of non-conjugated carnosine, carnosine-propanal, and carnosine-propanol were significantly associated with males (p < 0.02) and those of Caucasian ethnicity (p < 0.02). Levels of carnosine-propanol were significantly higher in never-smokers (p = 0.001) but lower in current smokers (p = 0.037). This conjugate also demonstrated a negative association with mean-daily particulate air pollution (PM2.5) levels (p = 0.01). CONCLUSIONS These findings suggest that urinary levels of carnosine-propanol may inform as to risk from inhaled pollutants.
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Affiliation(s)
- Timothy E. O’Toole
- Department of Medicine, University of Louisville, Louisville, Kentucky, United States of America
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky, United States of America
| | - Xiaohong Li
- Department of Anatomical Sciences and Neurobiology, University of Louisville, Louisville, Kentucky, United States of America
| | - Daniel W. Riggs
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky, United States of America
- KBRIN Bioinformatics Core, University of Louisville, Louisville, Kentucky, United States of America
| | - David J. Hoetker
- Department of Medicine, University of Louisville, Louisville, Kentucky, United States of America
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky, United States of America
| | - Ray Yeager
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky, United States of America
- Department of Environmental and Occupational Health Sciences, University of Louisville, Louisville, Kentucky, United States of America
| | - Pawel Lorkiewicz
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky, United States of America
- Department of Chemistry, University of Louisville, Louisville, Kentucky, United States of America
| | - Shahid P. Baba
- Department of Medicine, University of Louisville, Louisville, Kentucky, United States of America
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky, United States of America
| | - Nigel G.F. Cooper
- Department of Anatomical Sciences and Neurobiology, University of Louisville, Louisville, Kentucky, United States of America
| | - Aruni Bhatnagar
- Department of Medicine, University of Louisville, Louisville, Kentucky, United States of America
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky, United States of America
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Hautekiet P, Nawrot TS, Demarest S, Van der Heyden J, Van Overmeire I, De Clercq EM, Saenen ND. Environmental exposures and health behavior in association with mental health: a study design. Arch Public Health 2020; 78:105. [PMID: 33093954 PMCID: PMC7576706 DOI: 10.1186/s13690-020-00477-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 09/22/2020] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Air pollution, green space and smoking are known to affect human health. However, less is known about their underlying biological mechanisms. One of these mechanisms could be biological aging. In this study, we explore the mediation of biomarkers of exposure and biological aging to explain the associations between environmental exposures, health behavior and mental health. METHODS The study population of this cross-sectional study (n = 1168) is a subsample of the Belgian 2018 Health Interview Survey (BHIS). Mental health indicators including psychological and severe psychological distress, life satisfaction, vitality, eating disorders, suicidal ideation, subjective health and depressive and anxiety disorders, demographics and health behavior such as smoking are derived from the BHIS. Urine and blood samples are collected to measure respectively the biomarkers of exposure (urinary black carbon (BC) and (hydroxy)cotinine) and the biomarkers of biological aging (mitochondrial DNA content (mtDNAc) and telomere length (TL)). Recent and chronic exposure (μg/m3) to nitrogen dioxide (NO2), particulate matter ≤2.5 μm (PM2.5) and ≤ 10 μm (PM10) and BC at the participants' residence are modelled using a high resolution spatial temporal interpolation model. Residential green space is defined in buffers of different size (50 m - 5000 m) using land cover data in ArcGIS 10 software. For the statistical analysis multivariate linear and logistic regressions as well as mediation analyses are used taking into account a priori selected covariates and confounders. RESULTS As this study combined data of BHIS and laboratory analyses, not all data is available for all participants. Therefore, data analyses will be conducted on different subsets. Data on air pollution and green space exposure is available for all BHIS participants. Questions on smoking and mental health were answered by respectively 7829 and 7213 BHIS participants. For biomarker assessment, (hydroxy) cotinine, urinary BC and the biomarkers of biological aging are measured for respectively 1130, 1120 and 985 participants. CONCLUSION By use of personal markers of air pollution and smoking, as well as biological aging, we will gain knowledge about the association between environmental exposures, health behavior, and the mental health status. The results of the study can provide insights on the health of the Belgian population, making it a nationwide interesting study.
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Affiliation(s)
- Pauline Hautekiet
- Sciensano, Brussels, Belgium
- Centre for Environmental Sciences, Hasselt University, Agoralaan gebouw D, BE-3590 Hasselt, Belgium
| | - Tim S. Nawrot
- Centre for Environmental Sciences, Hasselt University, Agoralaan gebouw D, BE-3590 Hasselt, Belgium
- Centre for Environment and Health, Leuven University, Leuven, Belgium
| | | | | | | | | | - Nelly D. Saenen
- Sciensano, Brussels, Belgium
- Centre for Environmental Sciences, Hasselt University, Agoralaan gebouw D, BE-3590 Hasselt, Belgium
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90
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Conlon KC, Mallen E, Gronlund CJ, Berrocal VJ, Larsen L, O’Neill MS. Mapping Human Vulnerability to Extreme Heat: A Critical Assessment of Heat Vulnerability Indices Created Using Principal Components Analysis. ENVIRONMENTAL HEALTH PERSPECTIVES 2020; 128:97001. [PMID: 32875815 PMCID: PMC7466325 DOI: 10.1289/ehp4030] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
BACKGROUND Extreme heat poses current and future risks to human health. Heat vulnerability indices (HVIs), commonly developed using principal components analysis (PCA), are mapped to identify populations vulnerable to extreme heat. Few studies critically assess implications of analytic choices made when employing this methodology for fine-scale vulnerability mapping. OBJECTIVE We investigated sensitivity of HVIs created by applying PCA to input variables and whether training input variables on heat-health data produced HVIs with similar spatial vulnerability patterns for Detroit, Michigan, USA. METHODS We acquired 2010 Census tract and block group level data, land cover data, daily ambient apparent temperature, and all-cause mortality during May-September, 2000-2009. We used PCA to construct HVIs using: a) "unsupervised"-PCA applied to variables selected a priori as risk factors for heat-related health outcomes; b) "supervised"-PCA applied only to variables significantly correlated with proportion of all-cause mortality occurring on extreme heat days (i.e., days with 2-d mean apparent temperature above month-specific 95th percentiles). RESULTS Unsupervised and supervised HVIs yielded differing spatial vulnerability patterns, depending on selected land cover input variables. Supervised PCA explained 62% of variance in the input variables and was applied on half the variables used in the unsupervised method. Census tract-level supervised HVI values were positively associated with increased proportion of mortality occurring on extreme heat days; supervised PCA could not be applied to block group data. Unsupervised HVI values were not associated with extreme heat mortality for either tracts or block groups. DISCUSSION HVIs calculated using PCA are sensitive to input data and scale. Supervised HVIs may provide marginally more specific indicators of heat vulnerability than unsupervised HVIs. PCA-derived HVIs address correlation among vulnerability indicators, although the resulting output requires careful contextual interpretation beyond generating epidemiological research questions. Methods with reliably stable outputs should be leveraged for prioritizing heat interventions. https://doi.org/10.1289/EHP4030.
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Affiliation(s)
- Kathryn C. Conlon
- University of Michigan School of Public Health, Ann Arbor, Michigan, USA
- School of Medicine, University of California Davis, Davis, California, USA
| | - Evan Mallen
- University of Michigan Taubman College of Architecture and Urban Planning, Ann Arbor, Michigan, USA
- Georgia Institute of Technology School of City and Regional Planning, Atlanta, Georgia, USA
| | - Carina J. Gronlund
- University of Michigan School of Public Health, Ann Arbor, Michigan, USA
- University of Michigan Institute for Social Research, Ann Arbor, Michigan, USA
| | - Veronica J. Berrocal
- School of Information and Computer Science, University of California Irvine, Irvine, California, USA
| | - Larissa Larsen
- University of Michigan Taubman College of Architecture and Urban Planning, Ann Arbor, Michigan, USA
| | - Marie S. O’Neill
- University of Michigan School of Public Health, Ann Arbor, Michigan, USA
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91
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Earth Observation Data Supporting Non-Communicable Disease Research: A Review. REMOTE SENSING 2020. [DOI: 10.3390/rs12162541] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
A disease is non-communicable when it is not transferred from one person to another. Typical examples include all types of cancer, diabetes, stroke, or allergies, as well as mental diseases. Non-communicable diseases have at least two things in common—environmental impact and chronicity. These diseases are often associated with reduced quality of life, a higher rate of premature deaths, and negative impacts on a countries’ economy due to healthcare costs and missing work force. Additionally, they affect the individual’s immune system, which increases susceptibility toward communicable diseases, such as the flu or other viral and bacterial infections. Thus, mitigating the effects of non-communicable diseases is one of the most pressing issues of modern medicine, healthcare, and governments in general. Apart from the predisposition toward such diseases (the genome), their occurrence is associated with environmental parameters that people are exposed to (the exposome). Exposure to stressors such as bad air or water quality, noise, extreme heat, or an overall unnatural surrounding all impact the susceptibility to non-communicable diseases. In the identification of such environmental parameters, geoinformation products derived from Earth Observation data acquired by satellites play an increasingly important role. In this paper, we present a review on the joint use of Earth Observation data and public health data for research on non-communicable diseases. We analyzed 146 articles from peer-reviewed journals (Impact Factor ≥ 2) from all over the world that included Earth Observation data and public health data for their assessments. Our results show that this field of synergistic geohealth analyses is still relatively young, with most studies published within the last five years and within national boundaries. While the contribution of Earth Observation, and especially remote sensing-derived geoinformation products on land surface dynamics is on the rise, there is still a huge potential for transdisciplinary integration into studies. We see the necessity for future research and advocate for the increased incorporation of thematically profound remote sensing products with high spatial and temporal resolution into the mapping of exposomes and thus the vulnerability and resilience assessment of a population regarding non-communicable diseases.
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92
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Liu L, Zhu A, Shu C, Zeng Y, Ji JS. Gene-Environment Interaction of FOXO and Residential Greenness on Mortality Among Older Adults. Rejuvenation Res 2020; 24:49-61. [PMID: 32364002 DOI: 10.1089/rej.2019.2301] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Residential greenness is an important environmental factor that is strongly associated with mortality. To our knowledge, there was no previous study on the gene-environment interaction analysis between residential greenness and forkhead box O (FOXO) gene, a candidate longevity gene. Our sample consisted of 3179 participants aged 65 and older from the Chinese Longitudinal Healthy Longevity Survey. Residential greenness was measured by satellite-derived normalized difference vegetation index (NDVI) using a 500-m radius around each residential location. Contemporaneous NDVI, cumulative NDVI, and changes in NDVI over time were calculated. We used Cox-proportional hazard regression models to assess the main effect and gene-environment interaction effect of FOXO single nucleotide polymorphism (SNP) and residential greenness on mortality. We found that participants carrying two minor alleles of the three studied FOXO3A SNPs had lower mortality risk than those without minor allele (hazard ratio [HR]: 0.803 95% confidence interval [CI]: 0.654-0.987 for rs4946936, HR: 0.807 95% CI: 0.669-0.974 for rs2802292, HR: 0.803 95% CI: 0.666-0.968 for rs2253310). We found no difference in mortality among the genotypes of the other three FOXO1A SNPs (rs17630266, rs2755213, or rs2755209). Higher contemporaneous NDVI was associated with lower mortality risk (HR: 0.887 95% CI: 0.863-0.911 for 0.1-U of NDVI). The protective effect of both contemporaneous NDVI and cumulative NDVI was stronger for two minor allele carriers compared with zero minor allele carriers of the three FOXO3A SNPs. Compared with the zero minor allele genotype of the three FOXO3A SNPs, the protective effect on the mortality risk of minor allele homozygotes also increased with the increasing NDVI level at percentile 25, 50, and 75 (interaction term coefficient p < 0.05). We found gene-environment interaction between FOXO and residential greenness on mortality in this population study. A higher level of greenness may interact with FOXO pathways.
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Affiliation(s)
- Linxin Liu
- Environmental Research Center, Duke Kunshan University, Kunshan, China
| | - Anna Zhu
- Environmental Research Center, Duke Kunshan University, Kunshan, China
| | - Chang Shu
- School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Yi Zeng
- Center for the Study of Aging and Human Development, Duke Medical School, Durham, North Carolina, USA.,Center for Healthy Aging and Development Studies, National School of Development, Peking University, Beijing, China
| | - John S Ji
- Environmental Research Center, Duke Kunshan University, Kunshan, China.,Nicholas School of the Environment, Duke University, Durham, North Carolina, USA
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93
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Aerts R, Nemery B, Bauwelinck M, Trabelsi S, Deboosere P, Van Nieuwenhuyse A, Nawrot TS, Casas L. Residential green space, air pollution, socioeconomic deprivation and cardiovascular medication sales in Belgium: A nationwide ecological study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 712:136426. [PMID: 31945528 DOI: 10.1016/j.scitotenv.2019.136426] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 12/04/2019] [Accepted: 12/29/2019] [Indexed: 05/17/2023]
Abstract
Green space may improve cardiovascular (CV) health, for example by promoting physical activity and by reducing air pollution, noise and heat. Socioeconomic and environmental factors may modify the health effects of green space. We examined the association between residential green space and reimbursed CV medication sales in Belgium between 2006 and 2014, adjusting for socioeconomic deprivation and air pollution. We analyzed data for 11,575 census tracts using structural equation models for the entire country and for the administrative regions. Latent variables for green space, air pollution and socioeconomic deprivation were used as predictors of CV medication sales and were estimated from the number of patches of forest, census tract relative forest cover and relative forest cover within a 600 m buffer around the census tract; annual mean concentrations of PM2.5, BC and NO2; and percentages of inhabitants that were foreign-born from lower- and mid-income countries, unemployed or had no higher education. A direct association between socioeconomic deprivation and CV medication sales [parameter estimate (95% CI): 0.26 (0.25; 0.28)] and inverse associations between CV medication sales and green space [-0.71 (-0.80; -0.61)] and air pollution [-1.62 (-1.69; -0.61)] were observed. In the regional models, the association between green space and CV medication sales was stronger in the region with relatively low green space cover (Flemish Region, standardized estimate -0.16) than in the region with high green space cover (Walloon Region, -0.10). In the highly urbanized Brussels Capital Region the association tended towards the null. In all regions, the associations between CV medication sales and socioeconomic deprivation were direct and more prominent. Our results suggest that there may be an inverse association between green space and CV medication sales, but socioeconomic deprivation was always the strongest predictor of CV medication sales.
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Affiliation(s)
- Raf Aerts
- Risk and Health Impact Assessment, Sciensano (Belgian Institute of Health), Juliette Wytsmanstraat 14, BE-1050 Brussels, Belgium; Division Ecology, Evolution and Biodiversity Conservation, University of Leuven (KU Leuven), Kasteelpark Arenberg 31-2435, BE-3001 Leuven, Belgium; Center for Environmental Sciences, University of Hasselt, Agoralaan D, BE-3590 Diepenbeek, Hasselt, Belgium; Division Forest, Nature and Landscape, University of Leuven, Celestijnenlaan 200E-2411, BE-3001 Leuven, Belgium.
| | - Benoit Nemery
- Center for Environment and Health, Department of Public Health and Primary Care, University of Leuven, Herestraat 49-706, BE-3000 Leuven, Belgium.
| | - Mariska Bauwelinck
- Interface Demography, Department of Sociology, Vrije Universiteit Brussel, Pleinlaan 5, BE-1050 Brussels, Belgium.
| | - Sonia Trabelsi
- Louvain Institute of Data Analysis and Modeling in Economics and Statistics, UCLouvain, Voie du Roman Pays, 34 bte L1.03.01, BE-1348 Louvain-la-Neuve, Belgium.
| | - Patrick Deboosere
- Interface Demography, Department of Sociology, Vrije Universiteit Brussel, Pleinlaan 5, BE-1050 Brussels, Belgium.
| | - An Van Nieuwenhuyse
- Risk and Health Impact Assessment, Sciensano (Belgian Institute of Health), Juliette Wytsmanstraat 14, BE-1050 Brussels, Belgium; Center for Environment and Health, Department of Public Health and Primary Care, University of Leuven, Herestraat 49-706, BE-3000 Leuven, Belgium.
| | - Tim S Nawrot
- Center for Environmental Sciences, University of Hasselt, Agoralaan D, BE-3590 Diepenbeek, Hasselt, Belgium; Center for Environment and Health, Department of Public Health and Primary Care, University of Leuven, Herestraat 49-706, BE-3000 Leuven, Belgium
| | - Lidia Casas
- Center for Environment and Health, Department of Public Health and Primary Care, University of Leuven, Herestraat 49-706, BE-3000 Leuven, Belgium; Epidemiology and Social Medicine, University of Antwerp, Universiteitsplein 1-R.232, BE-2610 Wilrijk, Antwerp, Belgium.
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94
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Yeager R, Riggs DW, DeJarnett N, Srivastava S, Lorkiewicz P, Xie Z, Krivokhizhina T, Keith RJ, Srivastava S, Browning MHEM, Zafar N, Krishnasamy S, DeFilippis A, Turner J, Rai SN, Bhatnagar A. Association between residential greenness and exposure to volatile organic compounds. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 707:135435. [PMID: 31865083 PMCID: PMC7294698 DOI: 10.1016/j.scitotenv.2019.135435] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 11/06/2019] [Accepted: 11/07/2019] [Indexed: 05/28/2023]
Abstract
Residential proximity to vegetation and plants is associated with many health benefits, including reduced risk of cardiovascular disease, diabetes and mental stress. Although the mechanisms by which proximity to greenness affects health remain unclear, plants have been shown to remove particulate air pollution. However, the association between residential-area vegetation and exposure to volatile organic chemicals (VOCs) has not been investigated. We recruited a cohort of 213 non-smoking individuals and estimated peak, cumulative, and contemporaneous greenery using satellite-derived normalized difference vegetation index (NDVI) near their residence. We found that the urinary metabolites of exposure to VOCs - acrolein, acrylamide, acrylonitrile, benzene, 1-bromopropane, propylene oxide were inversely associated (7-31% lower) with 0.1 higher peak NDVI values within 100 m radius of the participants' home. These associations were significant at radii ranging from 25 to 300 m. Strongest associations were observed within a 200 m radius, where VOC metabolites were 22% lower per 0.1 unit higher NDVI. Of the 18 measured urinary metabolites, 7 were positively associated with variation of greenness within a 200 m radius of homes. The percent of tree canopy and street trees around participants' residence were less strongly associated with metabolite levels. The associations between urinary VOC metabolites and residential NDVI values were stronger in winter than in summer, and in participants who were more educated, White, and those who lived close to areas of high traffic. These findings suggest high levels of residential greenness are associated with lower VOC exposure, particularly in winter.
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Affiliation(s)
- Ray Yeager
- Christina Lee Brown Envirome Institute, University of Louisville, 302 E Muhammad Ali Blvd., Louisville, KY 40202, United States; Superfund Research Center, University of Louisville, 302 E Muhammad Ali Blvd., Louisville, KY 40202, United States; Department of Environmental and Occupational Health Sciences, University of Louisville, 485 E Gray St., Louisville, KY 40202, United States; Diabetes and Obesity Center, University of Louisville, 580 S. Preston St., Louisville, KY 40202, United States
| | - Daniel W Riggs
- Christina Lee Brown Envirome Institute, University of Louisville, 302 E Muhammad Ali Blvd., Louisville, KY 40202, United States; Superfund Research Center, University of Louisville, 302 E Muhammad Ali Blvd., Louisville, KY 40202, United States; Diabetes and Obesity Center, University of Louisville, 580 S. Preston St., Louisville, KY 40202, United States; Department of Bioinformatics and Biostatistics, University of Louisville, 485 E Gray St., Louisville, KY 40202, United States
| | - Natasha DeJarnett
- Department of Environmental and Occupational Health Sciences, University of Louisville, 485 E Gray St., Louisville, KY 40202, United States; Diabetes and Obesity Center, University of Louisville, 580 S. Preston St., Louisville, KY 40202, United States
| | - Shweta Srivastava
- Christina Lee Brown Envirome Institute, University of Louisville, 302 E Muhammad Ali Blvd., Louisville, KY 40202, United States; Superfund Research Center, University of Louisville, 302 E Muhammad Ali Blvd., Louisville, KY 40202, United States; Diabetes and Obesity Center, University of Louisville, 580 S. Preston St., Louisville, KY 40202, United States
| | - Pawel Lorkiewicz
- Christina Lee Brown Envirome Institute, University of Louisville, 302 E Muhammad Ali Blvd., Louisville, KY 40202, United States; Superfund Research Center, University of Louisville, 302 E Muhammad Ali Blvd., Louisville, KY 40202, United States; Diabetes and Obesity Center, University of Louisville, 580 S. Preston St., Louisville, KY 40202, United States
| | - Zhengzhi Xie
- Christina Lee Brown Envirome Institute, University of Louisville, 302 E Muhammad Ali Blvd., Louisville, KY 40202, United States; Superfund Research Center, University of Louisville, 302 E Muhammad Ali Blvd., Louisville, KY 40202, United States; Diabetes and Obesity Center, University of Louisville, 580 S. Preston St., Louisville, KY 40202, United States
| | - Tatiana Krivokhizhina
- Christina Lee Brown Envirome Institute, University of Louisville, 302 E Muhammad Ali Blvd., Louisville, KY 40202, United States; Superfund Research Center, University of Louisville, 302 E Muhammad Ali Blvd., Louisville, KY 40202, United States; Diabetes and Obesity Center, University of Louisville, 580 S. Preston St., Louisville, KY 40202, United States
| | - Rachel J Keith
- Christina Lee Brown Envirome Institute, University of Louisville, 302 E Muhammad Ali Blvd., Louisville, KY 40202, United States; Superfund Research Center, University of Louisville, 302 E Muhammad Ali Blvd., Louisville, KY 40202, United States; Diabetes and Obesity Center, University of Louisville, 580 S. Preston St., Louisville, KY 40202, United States
| | - Sanjay Srivastava
- Christina Lee Brown Envirome Institute, University of Louisville, 302 E Muhammad Ali Blvd., Louisville, KY 40202, United States; Superfund Research Center, University of Louisville, 302 E Muhammad Ali Blvd., Louisville, KY 40202, United States; Diabetes and Obesity Center, University of Louisville, 580 S. Preston St., Louisville, KY 40202, United States
| | - Matthew H E M Browning
- Department of Recreation, Sport and Tourism, University of Illinois Urbana-Champaign, 104 George Huff Hall, 1206 S 4th St., Champaign, IL 1820, United States
| | - Nagma Zafar
- Diabetes and Obesity Center, University of Louisville, 580 S. Preston St., Louisville, KY 40202, United States; Department of Pediatrics, University of Louisville, 411 E Chestnut St., Louisville KY, 40202, United States
| | - Sathya Krishnasamy
- Division of Endocrinology, Metabolism & Diabetes, University of Louisville, 550 South Jackson Street, Louisville, KY 40202, United States
| | - Andrew DeFilippis
- Christina Lee Brown Envirome Institute, University of Louisville, 302 E Muhammad Ali Blvd., Louisville, KY 40202, United States; Division of Cardiovascular Medicine, University of Louisville, 401 E. Chestnut St., Louisville, KY 40202, United States
| | - Jay Turner
- Department of Energy, Environmental and Chemical Engineering, Washington University in St. Louis, Campus Box 1100, 1 Brookings Drive, St. Louis, MO 63130, United States
| | - Shesh N Rai
- Department of Bioinformatics and Biostatistics, University of Louisville, 485 E Gray St., Louisville, KY 40202, United States; Department of Recreation, Sport and Tourism, University of Illinois Urbana-Champaign, 104 George Huff Hall, 1206 S 4th St., Champaign, IL 1820, United States; Biostatistics and Bioinformatics Shared Facility, James Graham Brown Cancer Center, University of Louisville, 529 S Jackson St., Louisville, KY 40202, United States
| | - Aruni Bhatnagar
- Christina Lee Brown Envirome Institute, University of Louisville, 302 E Muhammad Ali Blvd., Louisville, KY 40202, United States; Superfund Research Center, University of Louisville, 302 E Muhammad Ali Blvd., Louisville, KY 40202, United States; Diabetes and Obesity Center, University of Louisville, 580 S. Preston St., Louisville, KY 40202, United States.
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Atti Le giornate della ricerca scientificae delle esperienze professionali dei giovani: Società Italiana di Igiene, Medicina Preventiva e Sanità Pubblica (SItI) Roma 20-21 dicembre 2019. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2020; 60:E1-E85. [PMID: 32258536 PMCID: PMC7105054 DOI: 10.15167/2421-4248/jpmh2019.60.4s3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Yang BY, Liu KK, Markevych I, Knibbs LD, Bloom MS, Dharmage SC, Lin S, Morawska L, Heinrich J, Jalaludin B, Gao M, Guo Y, Zhou Y, Huang WZ, Yu HY, Zeng XW, Hu LW, Hu Q, Dong GH. Association between residential greenness and metabolic syndrome in Chinese adults. ENVIRONMENT INTERNATIONAL 2020; 135:105388. [PMID: 31837524 DOI: 10.1016/j.envint.2019.105388] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 11/28/2019] [Accepted: 12/02/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Residing in greener areas has several health benefits, but no study to date has examined the effects of greenness on metabolic syndrome (MetS). We aimed to assess associations between residential greenness and MetS prevalence in China, and to explore whether air pollution and physical activity mediated any observed associations. METHODS We analyzed data from 15,477 adults who participated in the 33 Communities Chinese Health Study during 2009. We defined MetS according to standard guidelines for Chinese populations. Residential greenness was estimated using the Normalized Difference Vegetation Index (NDVI), the Soil Adjusted Vegetation Index (SAVI), and the Vegetation Continuous Field (VCF). We used generalized linear mixed models to assess the associations between greenness and MetS, and mediation analyses to explore potential mechanisms underlying the associations. RESULTS Higher greenness levels were associated with lower odds of MetS [e.g., for every interquartile range increase of NDVI500-m, SAVI500-m, and VCF500-m, the adjusted odds ratio of MetS was 0.81 (95% confidence interval: 0.70-0.93), 0.80 (95% confidence interval: 0.69-0.93), and 0.91 (95% confidence interval: 0.83-1.00), respectively]. The direction and the magnitude of the associations persisted in several sensitivity analyses. Stratified analyses showed that age and household income modified the associations, with greater effect estimates observed in participants younger than 65 years old or those with higher household income. Particulate matter with an aerodynamic diameter ≤10 μm, nitrogen dioxide, and ozone mediated 2.1-20.3% of the associations between greenness and MetS; no evidence of mediation was observed for physical activity. CONCLUSIONS Our findings suggest a beneficial association for residential greenness and MetS in Chinese urban dwellers, especially for participants younger than 65 years old and those with higher household income. Particulate matter with an aerodynamic diameter ≤10 μm, nitrogen dioxide and ozone, but not physical activity, may only partially mediate the association.
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Affiliation(s)
- Bo-Yi Yang
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Kang-Kang Liu
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Iana Markevych
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstraße 1, 80336 Munich, Germany; Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany
| | - Luke D Knibbs
- School of Public Health, The University of Queensland, Herston, Queensland 4006, Australia
| | - Michael S Bloom
- Departments of Environmental Health Sciences and Epidemiology and Biostatics, University at Albany, State University of New York, Rensselaer, NY 12144, USA
| | - Shaymali C Dharmage
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population & Global Health, The University of Melbourne, Melbourne, VIC 3010, Australia; Murdoch Children Research Institute, Melbourne, VIC 3010, Australia
| | - Shao Lin
- Departments of Environmental Health Sciences and Epidemiology and Biostatics, University at Albany, State University of New York, Rensselaer, NY 12144, USA
| | - Lidia Morawska
- International Laboratory for Air Quality and Health, Queensland University of Technology (QUT), GPO Box 2434, Brisbane, Queensland 4001, Australia
| | - Joachim Heinrich
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstraße 1, 80336 Munich, Germany; Comprehensive Pneumology Center Munich, German Center for Lung Research, Ziemssenstraße 1, 80336 Munich, Germany
| | - Bin Jalaludin
- Centre for Air Quality and Health Research and Evaluation, Glebe, NSW 2037, Australia; Population Health, South Western Sydney Local Health District, Liverpool, NSW 2170, Australia; Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia; School of Public Health and Community Medicine, The University of New South Wales, Kensington, NSW 2052, Australia
| | - Meng Gao
- Department of Geography, Hong Kong Baptist University, Hong Kong Special Administrative Region
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Yang Zhou
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Wen-Zhong Huang
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Hong-Yao Yu
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Xiao-Wen Zeng
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Li-Wen Hu
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Qiang Hu
- Department of Pediatric Surgery, Weifang People's Hospital, Weifang 261041, China.
| | - Guang-Hui Dong
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
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Zhu A, Yan L, Shu C, Zeng Y, Ji JS. APOE ε4 Modifies Effect of Residential Greenness on Cognitive Function among Older Adults: A Longitudinal Analysis in China. Sci Rep 2020; 10:82. [PMID: 31919381 PMCID: PMC6952401 DOI: 10.1038/s41598-019-57082-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 12/09/2019] [Indexed: 12/20/2022] Open
Abstract
We tested whether the protective effects of residential greenness on cognitive function differ by APOE ε4 status by using the Chinese Longitudinal Healthy Longevity Survey (CLHLS). We calculated Normalized Difference Vegetation Index (NDVI) using 500 m radii around residential addresses to measure greenness, and the Mini-Mental State Examination (MMSE) to assess cognitive function. We dichotomized the participants into APOE non-ε4 carriers, and APOE ε4 carriers. We applied the generalized estimating equations (GEE) to examine the association between baseline annual average NDVI, APOE ε4 carrier status, and cognitive impairment. Among 6,994 participants, 19.30% were APOE ε4 carriers. Compared to APOE ε4 non-carriers, the APOE ε4 carriers had a 15% higher odds of cognitive impairment (OR: 1.15, 95% CI: 1.05, 1.26). There was an age difference; the protective effect of residential greenness (the highest vs. lowest quartile) on cognitive impairment was observed among the non-ε4 carriers (OR: 0.83, 95% CI: 0.72, 0.95), but not among the ε4 carriers (OR: 1.00, 95% CI: 0.74, 1.34). However, the interaction term between annual average NDVI and APOE ε4 status was not significant (OR: 1.04, 95% CI: 0.97, 1.11). The protective effects of residential greenness on cognitive function differed by APOE ε4 status, which elucidated possible gene-environment interaction mechanisms in which residential greenness may benefit health.
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Affiliation(s)
- Anna Zhu
- Environmental Research Center, Duke Kunshan University, Kunshan, China
| | - Lijing Yan
- Global Health Research Center, Duke Kunshan University, Kunshan, China
| | - Chang Shu
- School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Yi Zeng
- Center for the Study of Aging and Human Development, Duke Medical School, Durham, NC, USA
- Center for Healthy Aging and Development Studies, National School of Development, Peking University, Beijing, China
| | - John S Ji
- Environmental Research Center, Duke Kunshan University, Kunshan, China.
- Nicholas School of the Environment, Duke University, Durham, NC, USA.
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98
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Labib SM, Lindley S, Huck JJ. Spatial dimensions of the influence of urban green-blue spaces on human health: A systematic review. ENVIRONMENTAL RESEARCH 2020; 180:108869. [PMID: 31722804 DOI: 10.1016/j.envres.2019.108869] [Citation(s) in RCA: 147] [Impact Index Per Article: 36.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Revised: 10/25/2019] [Accepted: 10/28/2019] [Indexed: 05/20/2023]
Abstract
BACKGROUND There is an increasing volume of literature investigating the links between urban environments and human health, much of which involves spatial conceptualisations and research designs involving various aspects of geographical information science. Despite intensifying research interest, there has been little systematic investigation of pragmatic methodological concerns, such as how studies are realised in terms of the types of data that are gathered and the analytical techniques that are applied, both of which have the potential to impact results. The aim of this systematic review is, therefore, to understand how spatial scale, datasets, methods, and analytics are currently applied in studies investigating the relationship between green and blue spaces and human health in urban areas. METHOD We systematically reviewed 93 articles following PRISMA protocol, extracted information regarding different spatial dimensions, and synthesised them in relation to various health indicators. RESULTS AND DISCUSSION We found a preponderance of the use of neighbourhood-scale in these studies, and a majority of the studies utilised land-use and vegetation indices gleaned from moderate resolution satellite imagery. We also observed the frequent adoption of fixed spatial units for measuring exposure to green and blue spaces based on physical proximity, typically ranging between 30 and 5000 m. The conceptual frameworks of the studies (e.g., the focus on physical vs. mental health or the definition of exposure to green space) were found to have an influence on the strength of association between exposure and health outcomes. Additionally, the strength and significance of associations also varied by study design, something which has not been considered systematically. CONCLUSION On the basis of our findings, we propose a set of recommendations for standardised protocols and methods for the evaluation of the impact of green-blue spaces on health. Our analysis suggests that future studies should consider conducting analyses at finer spatial scales and employing multiple exposure assessment methods to achieve a comprehensive and comparable evaluation of the association between greenspace and health along multiple pathways.
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Affiliation(s)
- S M Labib
- Department of Geography, School of Environment, Education and Development (SEED), University of Manchester, Arthur Lewis Building (1st Floor), Oxford Road, Manchester, M13 9PL, UK.
| | - Sarah Lindley
- Department of Geography, School of Environment, Education and Development (SEED), University of Manchester, Arthur Lewis Building (1st Floor), Oxford Road, Manchester, M13 9PL, UK.
| | - Jonny J Huck
- Department of Geography, School of Environment, Education and Development (SEED), University of Manchester, Arthur Lewis Building (1st Floor), Oxford Road, Manchester, M13 9PL, UK.
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Wiley ER, Seabrook JA, Gilliland JA, Anderson KK, Stranges S. Green space and substance use and addiction: A new frontier. Addict Behav 2020; 100:106155. [PMID: 31640883 DOI: 10.1016/j.addbeh.2019.106155] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 10/01/2019] [Accepted: 10/03/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Evan R Wiley
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Jamie A Seabrook
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; School of Food and Nutritional Sciences, Brescia University College, London, Ontario, Canada; Department of Paediatrics, Western University, London, Ontario, Canada; Children's Health Research Institute, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada; Human Environments Analysis Laboratory, London, Ontario, Canada
| | - Jason A Gilliland
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Department of Geography, Western University, London, Ontario, Canada; Department of Paediatrics, Western University, London, Ontario, Canada; School of Health Studies, Western University, London, Ontario, Canada; Children's Health Research Institute, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada; Human Environments Analysis Laboratory, London, Ontario, Canada
| | - Kelly K Anderson
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada; Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Saverio Stranges
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg.
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Billings ME, Hale L, Johnson DA. Physical and Social Environment Relationship With Sleep Health and Disorders. Chest 2019; 157:1304-1312. [PMID: 31870910 DOI: 10.1016/j.chest.2019.12.002] [Citation(s) in RCA: 110] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 11/11/2019] [Accepted: 12/09/2019] [Indexed: 12/14/2022] Open
Abstract
Sleep health is a multidimensional construct that includes adequate duration, quality, and appropriately timed sleep that may be influenced by environmental factors. In this review, we focus on how an individual's living and sleeping environment, both the surrounding neighborhood physical and social features and the atmosphere around them, may impact their sleep health. We explore the associations of the physical environment (urban density, recreational facilities, green space, mixed land use, and healthy food stores), neighborhood deprivation (disadvantage and disorder), and the social environment (social cohesion, safety, and stigma) with sleep in both adult and pediatric populations. We investigate how physical and social environmental features may lead to alterations in the timing, duration, and quality of sleep and contribute to the most prevalent sleep disorders: insomnia, sleep apnea, and circadian rhythm disorders. We also review how ambient factors such as artificial light, environmental noise, and air pollution may contribute to sleep pathology. We have included key studies and recent emerging data regarding how the differential distribution of environmental factors that may affect sleep health may contribute to sleep health disparities.
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Affiliation(s)
- Martha E Billings
- Division of Pulmonary, Critical Care & Sleep Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, WA.
| | - Lauren Hale
- Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY
| | - Dayna A Johnson
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
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