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Chandrabose M, Rachele JN, Gunn L, Kavanagh A, Owen N, Turrell G, Giles-Corti B, Sugiyama T. Built environment and cardio-metabolic health: systematic review and meta-analysis of longitudinal studies. Obes Rev 2019; 20:41-54. [PMID: 30253075 DOI: 10.1111/obr.12759] [Citation(s) in RCA: 130] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 07/26/2018] [Accepted: 07/26/2018] [Indexed: 02/03/2023]
Abstract
Built environment attributes may be related to cardio-metabolic diseases (e.g. type 2 diabetes, heart disease and stroke) and their risk factors, potentially by influencing residents' physical activity. However, existing literature reviews on the built environment and health for the most part focus on obesity as the outcome and rely on cross-sectional studies. This systematic review synthesized current evidence on longitudinal relationships between built environment attributes and cardio-metabolic health outcomes among adults and on the potential mediating role of physical inactivity. By searching eight databases for peer-reviewed journal articles published in the English language between January 2000 and July 2016, the review identified 36 articles. A meta-analysis method, weighted Z-test, was used to quantify the strength of evidence by incorporating the methodological quality of the studies. We found strong evidence for longitudinal relationships of walkability with obesity, type 2 diabetes and hypertension outcomes in the expected direction. There was strong evidence for the impact of urban sprawl on obesity outcomes. The evidence on potential mediation by physical activity was inconclusive. Further longitudinal studies are warranted to examine which specific built environment attributes influence residents' cardio-metabolic health outcomes and how physical inactivity may be involved in these relationships.
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Affiliation(s)
- M Chandrabose
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - J N Rachele
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - L Gunn
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.,Centre for Urban Research, RMIT University, Melbourne, Victoria, Australia
| | - A Kavanagh
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - N Owen
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.,Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia.,Centre for Urban Transitions, Swinburne University of Technology, Melbourne, Victoria, Australia.,School of Public Health, The University of Queensland, Brisbane, Queensland, Australia.,Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia.,Institute for Resilient Regions, University of Southern Queensland, Springfield, Queensland, Australia
| | - G Turrell
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.,Centre for Urban Research, RMIT University, Melbourne, Victoria, Australia.,School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - B Giles-Corti
- Centre for Urban Research, RMIT University, Melbourne, Victoria, Australia
| | - T Sugiyama
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia.,Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia.,Centre for Urban Transitions, Swinburne University of Technology, Melbourne, Victoria, Australia
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102
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Assibey-Mensah V, Fabio A, Mendez DD, Lee PC, Roberts JM, Catov JM. Neighbourhood assets and early pregnancy cardiometabolic risk factors. Paediatr Perinat Epidemiol 2019; 33:79-87. [PMID: 30632180 PMCID: PMC6353674 DOI: 10.1111/ppe.12531] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 11/20/2018] [Accepted: 11/21/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Prepregnancy cardiometabolic risk factors are associated with increased risks of adverse pregnancy outcomes. Neighbourhood features may reflect prepregnancy exposures that contribute to poor cardiometabolic health before pregnancy and may contribute to racial disparities in pregnancy outcomes. METHODS Early pregnancy measurements from 1504 women enrolled in the Prenatal Exposures and Preeclampsia Prevention study were linked to a 2000 Census-based measure of neighbourhood socio-economic status and commercial data (food, alcohol, and retail density) during 1997-2001. Multilevel random-intercept linear regression was used to separately estimate the association between levels of neighbourhood assets (low, mid-low, mid-high, high) and C-reactive protein (CRP), systolic blood pressure (SBP), and body mass index (BMI) in cross-sectional analyses. Low neighbourhood assets have high-poverty/low-retail, whereas high neighbourhood assets have low-poverty/high-retail. Models were adjusted for individual-level factors (age and race), and we assessed effect modification by race. RESULTS Low compared with high neighbourhood assets were associated with higher BMI (β 1.95 kg/m2 , 95% CI 0.89, 3.00), after adjusting for individual-level covariates. After adjusting for BMI and other covariates, low compared with high assets were associated with higher CRP concentrations (β 0.20 ng/mL, 95% CI 0.01, 0.39). Neighbourhood assets were not associated with SBP. Race did not modify the association between neighbourhood assets and cardiometabolic risk factors. CONCLUSIONS Early pregnancy adiposity is related to neighbourhood features independent of individual factors. Further, inflammation beyond accounting for adiposity is related to neighbourhood features. Strategies that address neighbourhood assets during preconception and interconception may be promising approaches to improve prepregnancy health.
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Affiliation(s)
- Vanessa Assibey-Mensah
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh, School of Medicine, Pittsburgh, PA USA
- Magee-Womens Research Institute, University of Pittsburgh, Pittsburgh, PA USA
| | - Anthony Fabio
- Department of Epidemiology, University of Pittsburgh, Graduate School of Public Health Pittsburgh, PA USA
| | - Dara D. Mendez
- Department of Epidemiology, University of Pittsburgh, Graduate School of Public Health Pittsburgh, PA USA
- University of Pittsburgh, Graduate School of Public Health, Department of Behavioral and Community Health Sciences, Pittsburgh, PA USA
| | - Pei-Chen Lee
- Department of Epidemiology, University of Pittsburgh, Graduate School of Public Health Pittsburgh, PA USA
- Department of Health Care Management, College of Health Technology, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - James M. Roberts
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh, School of Medicine, Pittsburgh, PA USA
- Magee-Womens Research Institute, University of Pittsburgh, Pittsburgh, PA USA
- Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA USA
| | - Janet M. Catov
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh, School of Medicine, Pittsburgh, PA USA
- Magee-Womens Research Institute, University of Pittsburgh, Pittsburgh, PA USA
- Department of Epidemiology, University of Pittsburgh, Graduate School of Public Health Pittsburgh, PA USA
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103
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Hoenink JC, Lakerveld J, Rutter H, Compernolle S, De Bourdeaudhuij I, Bárdos H, Charreire H, Oppert JM, Mackenbach JD. The Moderating Role of Social Neighbourhood Factors in the Association between Features of the Physical Neighbourhood Environment and Weight Status. Obes Facts 2019; 12:14-24. [PMID: 30673683 PMCID: PMC6465716 DOI: 10.1159/000496118] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 12/09/2018] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND This paper investigated the independent and joint associations between aspects of the physical neighbourhood environment and social neighbourhood factors with BMI and overweight status in European adults. METHODS Data from 5,199 participants in the SPOTLIGHT survey were analysed. Participants reported on their height, weight and perceptions of the neighbourhood. Objectively measured aspects of the physical neighbourhood environment included: presence of recreational facilities, features of the active transportation environment, neighbourhood aesthetics and presence of different types of food outlets. Social factors included the self-reported variables social network, social cohesion, social trust and perceived crime and the census variable neighbourhood socioeconomic status. Outcome measures were BMI and overweight status. Main associations between physical and social factors and BMI/overweight status were analysed using multilevel regression analyses adjusted for confounders. Moderation analysis was conducted by adding the interaction terms between physical and social neighbourhood factors one by one to the multivariable models. Significant interaction terms were then stratified. RESULTS Significant associations with BMI/overweight status were found for features of the active transportation environment and all social factors, except perceived crime. Several significant interaction terms were detected, but no significant associations between the physical neighbourhood environment and BMI/overweight status were found after stratification. CONCLUSION We did not find consistent interactions between physical and social neighbourhood factors to explain BMI and overweight status.
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Affiliation(s)
- Jody C Hoenink
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU Medical Centre Amsterdam, Amsterdam, The Netherlands
| | - Jeroen Lakerveld
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU Medical Centre Amsterdam, Amsterdam, The Netherlands
| | - Harry Rutter
- Department of Social & Policy Sciences, University of Bath, Bath, United Kingdom
| | - Sofie Compernolle
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | | | - Helga Bárdos
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
| | - Helene Charreire
- Université Paris Est, LabUrba, UPEC, Créteil, France
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, Université Paris 13, Bobigny, France
| | - Jean Michel Oppert
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, Université Paris 13, Bobigny, France
- Sorbonne Université Institute of Cardiometabolism and Nutrition, Department of Nutrition, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Joreintje D Mackenbach
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU Medical Centre Amsterdam, Amsterdam, The Netherlands,
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104
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Johnson KA, Showell NN, Flessa S, Janssen M, Reid N, Cheskin LJ, Thornton RL. Do Neighborhoods Matter? A Systematic Review of Modifiable Risk Factors for Obesity among Low Socio-Economic Status Black and Hispanic Children. Child Obes 2018; 15:71-86. [PMID: 30565954 PMCID: PMC6386088 DOI: 10.1089/chi.2018.0044] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Childhood obesity increases the risk of obesity and harmful comorbidities later in life. It is influenced by characteristics of a child's neighborhood, particularly among underserved groups. Our objective was to systematically review the evidence relating neighborhood environment and obesity risk among urban, low socioeconomic status (SES) Black and Hispanic children. METHODS We included studies published from 1993 through early 2017 from PubMed, SCOPUS, Web of Science, and Sociological Abstracts databases investigating relationships between empirically measured neighborhood characteristics and obesity risk factors in the populations of interest. Databases were last searched on May 8, 2018. Initial analysis took place during 2014 and was completed during 2017. We extracted data on study population, design, and associations between neighborhood characteristics and obesity risk factors. RESULTS We identified 2011 unique studies; 24 were included. Few studies demonstrated consistent patterns of association. Most neighborhood characteristics were not examined across multiple studies. BMI may be related to living in a lower-income neighborhood or convenience store access. CONCLUSIONS This review found that the body of evidence relating neighborhood exposures and obesity risk factors among urban, low SES Black (also commonly referred to in the literature as "non-Hispanic Black" or African American) and Hispanic children is limited. Given the high risk of obesity and cardiovascular disease among these populations throughout the life course, research on neighborhood determinants of obesity should specifically include these populations, ensuring adequate power and methodological rigor to detect differences.
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Affiliation(s)
- Katherine Abowd Johnson
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Nakiya N. Showell
- Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD
| | - Sarah Flessa
- Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD
| | | | - Natalie Reid
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Lawrence J. Cheskin
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Global Obesity Prevention Center at Johns Hopkins, Baltimore, MD
| | - Rachel L.J. Thornton
- Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD
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105
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Hobbs M, Griffiths C, Green MA, Jordan H, Saunders J, Christensen A, McKenna J. Fast-food outlet availability and obesity: Considering variation by age and methodological diversity in 22,889 Yorkshire Health Study participants. Spat Spatiotemporal Epidemiol 2018; 28:43-53. [PMID: 30739654 DOI: 10.1016/j.sste.2018.11.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 09/17/2018] [Accepted: 11/03/2018] [Indexed: 01/09/2023]
Abstract
This study investigated if the relationship between residential fast-food outlet availability and obesity varied due to methodological diversity or by age. Cross-sectional data (n = 22,889) from the Yorkshire Health Study, England were used. Obesity was defined using self-reported height and weight (BMI ≥ 30). Food outlets ("fast-food", "large supermarkets", and "convenience or other food retail outlets") were mapped using Ordnance Survey Points of Interest (PoI) database. Logistic regression was used for all analyses. Methodological diversity included adjustment for other food outlets as covariates and continuous count vs. quartile. The association between residential fast-food outlets and obesity was inconsistent and effects remained substantively the same when considering methodological diversity. This study contributes to evidence by proposing the use of a more comprehensive conceptual model adjusting for wider markers of the food environment. This study offers tentative evidence that the association between fast-food outlets and obesity varies by age.
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Affiliation(s)
- M Hobbs
- Carnegie School of Sport, Leeds Beckett University, Leeds LS6 3QT, UK; GeoHealth Laboratory, Geospatial Research Institute, University of Canterbury, Ernest Rutherford Building, Christchurch, New Zealand.
| | - C Griffiths
- Carnegie School of Sport, Leeds Beckett University, Leeds LS6 3QT, UK
| | - M A Green
- School of Environmental Sciences, University of Liverpool, Liverpool, UK
| | - H Jordan
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - J Saunders
- Leeds Beckett University formerly Public Health Team, Rotherham Borough Council, UK
| | - A Christensen
- Carnegie School of Sport, Leeds Beckett University, Leeds LS6 3QT, UK
| | - J McKenna
- Carnegie School of Sport, Leeds Beckett University, Leeds LS6 3QT, UK
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106
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Williams AD, Shenassa E, Slopen N, Rossen L. Cardiometabolic Dysfunction Among U.S. Adolescents and Area-Level Poverty: Race/Ethnicity-Specific Associations. J Adolesc Health 2018; 63:546-553. [PMID: 30348278 PMCID: PMC6318802 DOI: 10.1016/j.jadohealth.2018.07.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 07/03/2018] [Accepted: 07/04/2018] [Indexed: 02/02/2023]
Abstract
PURPOSE To examine race/ethnicity-specific associations between area-level poverty and cardiometabolic dysfunction among U.S. adolescents. METHODS Data were from 10,415 adolescents aged 12-19 in the National Health and Nutrition Examination Survey (1999-2012), linked with census tract data on area-level poverty (the percent population living in poverty, grouped into race/ethnicity-specific quartiles). Cardiometabolic dysfunction was parameterized by summing z-scores of six cardiometabolic biomarkers, grouped into quintiles. Hierarchical ordinal models estimated overall and race/ethnicity specific associations. Posthoc analysis explored associations between area-level poverty and family poverty-to-income ratio. RESULTS Overall, compared to adolescents residing in areas with the lowest area-level poverty (i.e., first quartile), residents in third (OR 1.32, 95% CI 1.13, 1.53) and fourth (OR 1.27, 95% CI 1.08, 1.50) quartiles of area-level poverty experienced elevated odds of cardiometabolic dysfunction. Area-level poverty predicted cardiometabolic dysfunction between non-Hispanic white and Mexican American adolescents, but not between non-Hispanic black adolescents. CONCLUSIONS We found race/ethnicity-specific associations between area-level poverty and cardiometabolic dysfunction among U.S. adolescents, highlighting the moderating effect of race-ethnicity. Among non-Hispanic black adolescents, neither higher area-level nor family-level socioeconomic status is associated with cardiometabolic health, in contrast to non-Hispanic white adolescents. Similar associations among non-Hispanic white and Mexican American groups aligns with evidence of the Hispanic Paradox. Future studies of effect of area-level determinants of cardiometabolic dysfunction may consider race/ethnicity-specific associations.
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Affiliation(s)
- Andrew D. Williams
- Maternal and Child Health Program, Department of Family Science, University of Maryland College Park, College Park, Maryland
| | - Edmond Shenassa
- Maternal and Child Health Program, Department of Family Science, University of Maryland College Park, College Park, Maryland; Department of Epidemiology and Biostatistics, University of Maryland, College Park, Maryland; Department of Epidemiology and Biostatistics, School of Public Health, Brown University, Providence, Rhode Island; Department of Epidemiology and Biostatistics, School of Medicine, University of Maryland Baltimore, Baltimore, Maryland.
| | - Natalie Slopen
- Department of Epidemiology and Biostatistics, University of Maryland, College Park, Maryland
| | - Lauren Rossen
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland
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107
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Sarkar C, Webster C, Gallacher J. Are exposures to ready-to-eat food environments associated with type 2 diabetes? A cross-sectional study of 347 551 UK Biobank adult participants. Lancet Planet Health 2018; 2:e438-e450. [PMID: 30318101 DOI: 10.1016/s2542-5196(18)30208-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 07/23/2018] [Accepted: 09/14/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Rapid urbanisation and associated socioeconomic transformations have modified current lifestyles, shifting dietary preferences towards ready-to-eat, calorie-dense food of poor nutritional quality. The effect of ready-to-eat food environments that sell food for instant consumption on the risk of type 2 diabetes has received scant attention. We therefore aimed to examine the association between exposure to ready-to-eat food environments and type 2 diabetes in a large and diverse population sample. METHODS We conducted a cross-sectional study of adult male and female participants from the baseline phase of the UK Biobank cohort. Participants in this cohort were aged 37-73 years and resided in one of 21 cities in the UK. Ready-to-eat food environments, which we determined from a modelled and linked built environment database, were objectively measured within 1-km catchment areas of the residential streets of participants and were expressed as metrics of density and proximity to the participants' homes. We used logistic regression models to examine the associations between exposure to ready-to-eat food environments and the odds of type 2 diabetes, adjusting for individual covariates such as physical activity. As sensitivity analyses, we investigated the associations between the street distance to the nearest ready-to-eat food outlet and type 2 diabetes. We also tested post hoc for effect modification by sex, income, body-mass index, and location of the UK Biobank collection centre. FINDINGS Of 502 635 UK Biobank participants enrolled between March 13, 2006, and Oct 1, 2010, the sample analysed included 347 551 (69·1%) participants. The density of ready-to-eat food environments within a 1-km catchment area was associated with higher odds of type 2 diabetes for participants in the groups with highest exposure to restaurants and cafeterias (odss ratio 1·129, 95% CI 1·05-1·21; p=0·0007) and a composite measure of ready-to-eat outlet density (1·112, 1·02-1·21; p=0·0134) compared with those with no exposure. Exposure to hot and cold takeaways was only significantly associated with higher odds of type 2 diabetes at the second highest exposure category that we examined (1·076, 1·01-1·14; p=0·0171), representing a density of 0·75-2·15 units per km2. A protective effect with distance decay was observed: participants in the highest quintile of street distance to nearest ready-to-eat food outlet reported lower odds of type 2 diabetes than those in the lowest quintile (0·842, 0·78-0·91; p<0·0001 for restaurants and cafeterias; and 0·913, 0·85-0·98; p=0·0173 for hot and cold takeaways). These effects were most pronounced in overweight participants (p=0·0329), but there was no evidence of interaction by sex, income, or UK Biobank collection centre. INTERPRETATION Access to ready-to-eat food environments was positively associated with type 2 diabetes. Top-down policies aimed at minimising unhealthy food access could potentially reduce unhealthy consumption and risks of chronic diseases. Further long-term studies are needed to effectively guide such interventions. FUNDING University of Hong Kong, UK Biobank, and UK Economic & Social Research Council.
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Affiliation(s)
- Chinmoy Sarkar
- Healthy High Density Cities Lab, HKUrbanLab, University of Hong Kong, Hong Kong Special Administrative Region, China.
| | - Chris Webster
- Healthy High Density Cities Lab, HKUrbanLab, University of Hong Kong, Hong Kong Special Administrative Region, China
| | - John Gallacher
- Department of Psychiatry, Oxford University, Warneford Hospital, Oxford, UK
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108
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Wang J, Kwan MP. An Analytical Framework for Integrating the Spatiotemporal Dynamics of Environmental Context and Individual Mobility in Exposure Assessment: A Study on the Relationship between Food Environment Exposures and Body Weight. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E2022. [PMID: 30223592 PMCID: PMC6163926 DOI: 10.3390/ijerph15092022] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 09/11/2018] [Accepted: 09/13/2018] [Indexed: 12/19/2022]
Abstract
In past studies, individual environmental exposures were largely measured in a static manner. In this study, we develop and implement an analytical framework that dynamically represents environmental context (the environmental context cube) and effectively integrates individual daily movement (individual space-time tunnel) for accurately deriving individual environmental exposures (the environmental context exposure index). The framework is applied to examine the relationship between food environment exposures and the overweight status of 46 participants using data collected with global positioning systems (GPS) in Columbus, Ohio, and binary logistic regression models. The results indicate that the proposed framework generates more reliable measurements of individual food environment exposures when compared to other widely used methods. Taking into account the complex spatial and temporal dynamics of individual environmental exposures, the proposed framework also helps to mitigate the uncertain geographic context problem (UGCoP). It can be used in other environmental health studies concerning environmental influences on a wide range of health behaviors and outcomes.
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Affiliation(s)
- Jue Wang
- Department of Geography and Geographic Information Science, Natural History Building, 1301 W Green Street University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA.
| | - Mei-Po Kwan
- Department of Geography and Geographic Information Science, Natural History Building, 1301 W Green Street University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA.
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109
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Mooney SJ, Lemaitre RN, Siscovick DS, Hurvitz P, Goh CE, Kaufman TK, Zulaika G, Sheehan DM, Sotoodehnia N, Lovasi GS. Neighborhood food environment, dietary fatty acid biomarkers, and cardiac arrest risk. Health Place 2018; 53:128-134. [PMID: 30121010 PMCID: PMC6245544 DOI: 10.1016/j.healthplace.2018.08.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Revised: 07/19/2018] [Accepted: 08/03/2018] [Indexed: 12/21/2022]
Abstract
We explored links between food environments, dietary intake biomarkers, and sudden cardiac arrest in a population-based longitudinal study using cases and controls accruing between 1990 and 2010 in King County, WA. Surprisingly, presence of more unhealthy food sources near home was associated with a lower 18:1 trans-fatty acid concentration (-0.05% per standard deviation higher count of unhealthy food sources, 95% Confidence Interval [CI]: 0.01, 0.09). However, presence of more unhealthy food sources was associated with higher odds of cardiac arrest (Odds Ratio [OR]: 2.29, 95% CI: 1.19, 4.41 per standard deviation in unhealthy food outlets). While unhealthy food outlets were associated with higher cardiac arrest risk, circulating 18:1 trans fats did not explain the association.
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Affiliation(s)
- Stephen J Mooney
- Harborview Injury Prevention & Research Center, University of Washington, 401 Broadway, 4th Floor, Seattle, WA 98122, USA.
| | - Rozenn N Lemaitre
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
| | | | - Philip Hurvitz
- Department of Urban Design & Planning, College of Built Environments, University of Washington, Seattle, WA, USA
| | - Charlene E Goh
- Department of Epidemiology, Columbia University, New York, NY, USA
| | - Tanya K Kaufman
- New York City Department of Health and Mental Hygiene, New York, NY, USA
| | - Garazi Zulaika
- Department of Epidemiology, Columbia University, New York, NY, USA
| | - Daniel M Sheehan
- Department of Epidemiology, Columbia University, New York, NY, USA
| | - Nona Sotoodehnia
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Gina S Lovasi
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
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Schoner J, Chapman J, Fox EH, Iroz-Elardo N, Brookes A, MacLeod KE, Frank LD. Bringing health into transportation and land use scenario planning: Creating a National Public Health Assessment Model (N-PHAM). JOURNAL OF TRANSPORT & HEALTH 2018; 10:401-418. [PMID: 35350107 PMCID: PMC8958996 DOI: 10.1016/j.jth.2018.04.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
There is mounting evidence linking land development and transportation investments to physical activity with resulting implications for chronic disease prevention. Links between the physical environment and health have traditionally focused on harmful exposures such as air pollution, noise, and traffic injury. Given limited funds and competition for how and where investments are made, there is a need to prioritize and target resources to maximize health benefits that can include activity related chronic disease prevention. The ability to apply this evidence to decision making has been limited by the complexity and inconsistency of research methods, and lack of a direct connection with the planning contexts in which decisions are made. Scenario planning tools provide a method to apply evidence with spatial planning decisions at a range of geographic scales. The US Environmental Protection Agency commissioned the development of a National Public Health Assessment Model (N-PHAM). This project utilized built and natural environment data at the block-group level and large population surveys to model the relationships of the environment with several health outcomes for a range of age and income groups. N-PHAM is the first health assessment tool that can connect to multiple existing scenario planning platforms utilizing nationally available data and can be consistently applied nationally. Such tools can empower communities to choose investments that have the greatest potential to improve public health and quality of life, reduce health care costs, and address environmental justice related disparities.
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Affiliation(s)
- Jessica Schoner
- Urban Design 4 Health Inc., 353 Rockingham St., Rochester, NY 14620, USA
| | - Jim Chapman
- Urban Design 4 Health Inc., 353 Rockingham St., Rochester, NY 14620, USA
| | - Eric H Fox
- Urban Design 4 Health Inc., 353 Rockingham St., Rochester, NY 14620, USA
| | - Nicole Iroz-Elardo
- Urban Design 4 Health Inc., 353 Rockingham St., Rochester, NY 14620, USA
| | - Allen Brookes
- US Environmental Protection Agency, 200 S.W. 35th Street, Corvallis, OR 97333-4902, USA
| | - Kara E MacLeod
- Fielding School of Public Health, University of California, Los Angeles, Life Sciences Building, Office 5127, Los Angeles, CA 90095, USA
| | - Lawrence D Frank
- University of British Columbia Schools of Population & Public Health & Community & Regional Planning, 2206 East Mall, Vancouver, BC, Canada V6T 1Z3
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111
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Mayne SL, Moore KA, Powell-Wiley TM, Evenson KR, Block R, Kershaw KN. Longitudinal Associations of Neighborhood Crime and Perceived Safety With Blood Pressure: The Multi-Ethnic Study of Atherosclerosis (MESA). Am J Hypertens 2018; 31:1024-1032. [PMID: 29897398 PMCID: PMC6077783 DOI: 10.1093/ajh/hpy066] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 04/06/2018] [Accepted: 04/18/2018] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND High neighborhood crime and low perceptions of safety may influence blood pressure (BP) through chronic stress. Few studies have examined these associations using longitudinal data. METHODS We used longitudinal data from 528 participants of the Multi-Ethnic Study of Atherosclerosis (aged 45-84, nonhypertensive at baseline) who lived in Chicago, Illinois. We examined associations of changes in individual-level perceived safety, aggregated neighborhood-level perceived safety, and past-year rates of police-recorded crime in a 1, ½, or ¼ mile buffer per 1,000 population with changes in systolic and diastolic BPs using fixed-effects linear regression. BP was measured five times between 2000 and 2012 and was adjusted for antihypertensive medication use (+10 mm Hg added to systolic and +5 mm Hg added to diastolic BP for participants on medication). Models were adjusted for time-varying sociodemographic and health-related characteristics and neighborhood socioeconomic status. We assessed differences by sex. RESULTS A standard deviation increase in individual-level perceived safety was associated with a 1.54 mm Hg reduction in systolic BP overall (95% confidence interval [CI]: 0.25, 2.83), and with a 1.24 mm Hg reduction in diastolic BP among women only (95% CI: 0.37, 2.12) in adjusted models. Increased neighborhood-level safety was not associated with BP change. An increase in police-recorded crime was associated with a reduction in systolic and diastolic BPs among women only, but results were sensitive to neighborhood buffer size. CONCLUSIONS Results suggest individual perception of neighborhood safety may be particularly salient for systolic BP reduction relative to more objective neighborhood exposures.
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Affiliation(s)
- Stephanie L Mayne
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Kari A Moore
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Tiffany M Powell-Wiley
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Kelly R Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Richard Block
- Department of Sociology, Loyola University, Chicago, IL, USA
| | - Kiarri N Kershaw
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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112
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Laatikainen TE, Hasanzadeh K, Kyttä M. Capturing exposure in environmental health research: challenges and opportunities of different activity space models. Int J Health Geogr 2018; 17:29. [PMID: 30055616 PMCID: PMC6064075 DOI: 10.1186/s12942-018-0149-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 07/18/2018] [Indexed: 11/18/2022] Open
Abstract
Background The built environment health promotion has attracted notable attention across a wide spectrum of health-related research over the past decade. However, the results about the contextual effects on health and PA are highly heterogeneous. The discrepancies between the results can potentially be partly explained by the diverse use of different spatial units of analysis in assessing individuals’ exposure to various environment characteristics. This study investigated whether different residential and activity space units of analysis yield distinct results regarding the association between the built environment and health. In addition, this study examines the challenges and opportunities of the different spatial units of analysis for environmental health-related research. Methods Two common residential units of analysis and two novel activity space models were used to examine older adults’ wellbeing in relation to the built environment features in the Helsinki Metropolitan Area, Finland. An administrative unit, 500 m residential buffer, home range model and individualized residential exposure model were used to assess the associations between the built environment and wellbeing of respondent’s (n = 844). Results All four different spatial units of analysis yield distinct results regarding the associations between the built environment characteristics and wellbeing. A positive association between green space and health was found only when exposure was assessed with individualized residential exposure model. Walkability index and the length of pedestrian and bicycle roads were found to positively correlate with perceived wellbeing measures only with a home range model. Additionally, all units of analysis differed from each other in terms of size, shape, and how they capture different contextual measures. Conclusions The results show that different spatial units of analysis result in considerably different measurements of built environment. In turn, the differences derived from the use of different spatial units seem to considerably affect the associations between environment characteristics and wellbeing measures. Although it is not easy to argue about the correctness of these measurements, what is evident is that they can reveal different wellbeing outcomes. While some methods are especially usable to determine the availability of environmental opportunities that promote active travel and the related health outcomes, others can provide us with insight into the mechanisms how the actual exposure to green structure can enhance wellbeing.
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Affiliation(s)
- Tiina E Laatikainen
- Department of Built Environment, Aalto University, PO Box 14100, 00076, Aalto, Finland.
| | - Kamyar Hasanzadeh
- Department of Built Environment, Aalto University, PO Box 14100, 00076, Aalto, Finland
| | - Marketta Kyttä
- Department of Built Environment, Aalto University, PO Box 14100, 00076, Aalto, Finland
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113
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Nathan A, Villanueva K, Rozek J, Davern M, Gunn L, Trapp G, Boulangé C, Christian H. The Role of the Built Environment on Health Across the Life Course: A Call for CollaborACTION. Am J Health Promot 2018; 32:1460-1468. [DOI: 10.1177/0890117118779463a] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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114
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Bravo MA, Anthopolos R, Kimbro RT, Miranda ML. Residential Racial Isolation and Spatial Patterning of Type 2 Diabetes Mellitus in Durham, North Carolina. Am J Epidemiol 2018; 187:1467-1476. [PMID: 29762649 DOI: 10.1093/aje/kwy026] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Accepted: 02/01/2018] [Indexed: 12/17/2022] Open
Abstract
Neighborhood characteristics such as racial segregation may be associated with type 2 diabetes mellitus, but studies have not examined these relationships using spatial models appropriate for geographically patterned health outcomes. We constructed a local, spatial index of racial isolation (RI) for black residents in a defined area, measuring the extent to which they are exposed only to one another, to estimate associations of diabetes with RI and examine how RI relates to spatial patterning in diabetes. We obtained electronic health records from 2007-2011 from the Duke Medicine Enterprise Data Warehouse. Patient data were linked to RI based on census block of residence. We used aspatial and spatial Bayesian models to assess spatial variation in diabetes and relationships with RI. Compared with spatial models with patient age and sex, residual geographic heterogeneity in diabetes in spatial models that also included RI was 29% and 24% lower for non-Hispanic white and black residents, respectively. A 0.20-unit increase in RI was associated with an increased risk of diabetes for white (risk ratio = 1.24, 95% credible interval: 1.17, 1.31) and black (risk ratio = 1.07, 95% credible interval: 1.05, 1.10) residents. Improved understanding of neighborhood characteristics associated with diabetes can inform development of policy interventions.
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Affiliation(s)
| | - Rebecca Anthopolos
- Children’s Environmental Health Initiative, Rice University, Houston, Texas
| | | | - Marie Lynn Miranda
- Department of Statistics, Rice University, Houston, Texas
- Children’s Environmental Health Initiative, Rice University, Houston, Texas
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115
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Echoes from Gaea, Poseidon, Hephaestus, and Prometheus: environmental risk factors for high blood pressure. J Hum Hypertens 2018; 32:594-607. [PMID: 29899375 DOI: 10.1038/s41371-018-0078-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 05/01/2018] [Indexed: 12/14/2022]
Abstract
High blood pressure (BP) affects over one billion people and is the leading risk factor for global mortality. While many lifestyle and genetic risk factors are well-accepted to increase BP, the role of the external environment is typically overlooked. Mounting evidence now supports that numerous environmental factors can promote an elevation in BP. Broadly speaking these include aspects of the natural environment (e.g., cold temperatures, higher altitude, and winter season), natural disasters (e.g., earthquakes, volcanic eruptions), and man-made exposures (e.g., noise, air pollutants, and toxins/chemicals). This is important for health care providers to recognize as one (or several) of these environmental factors could be playing a clinically meaningful role in elevating BP or disrupting hypertension control among their patients. At the population level, certain environmental exposures may even be contributing to the growing pandemic of hypertension. Here we provide an updated review of the literature linking environment exposures with high BP and outline practical recommendations for clinicians.
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116
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Jiang L, Chang J, Beals J, Bullock A, Manson SM. Neighborhood characteristics and lifestyle intervention outcomes: Results from the Special Diabetes Program for Indians. Prev Med 2018; 111:216-224. [PMID: 29534990 PMCID: PMC5930056 DOI: 10.1016/j.ypmed.2018.03.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 03/02/2018] [Accepted: 03/09/2018] [Indexed: 10/17/2022]
Abstract
Growing evidence reveals various neighborhood conditions are associated with the risk of developing type 2 diabetes. It is unknown, however, whether the effectiveness of diabetes prevention interventions is also influenced by neighborhood characteristics. The purpose of the current study is to examine the impact of neighborhood characteristics on the outcomes of a lifestyle intervention to prevent diabetes in American Indians and Alaska Natives (AI/ANs). Year 2000 US Census Tract data were linked with those from the Special Diabetes Program for Indians Diabetes Prevention Program (SDPI-DP), an evidence-based lifestyle intervention implemented in 36 AI/AN grantee sites across the US. A total of 3394 participants started the intervention between 01/01/2006 and 07/31/2009 and were followed by 07/31/2016. In 2016-2017, data analyses were conducted to evaluate the relationships of neighborhood characteristics with intervention outcomes, controlling for individual level socioeconomic status. AI/ANs from sites located in neighborhoods with higher median household income had 38% lower risk of developing diabetes than those from sites with lower neighborhood income (adjusted hazard ratio = 0.65, 95% CI: 0.47-0.90). Further, those from sites with higher neighborhood concentrations of AI/ANs achieved less BMI reduction and physical activity increase. Meanwhile, participants from sites with higher neighborhood level of vehicle occupancy made more improvement in BMI and diet. Lifestyle intervention effectiveness was not optimal when the intervention was implemented at sites with disadvantaged neighborhood characteristics. Meaningful improvements in socioeconomic and other neighborhood disadvantages of vulnerable populations could be important in stemming the global epidemic of diabetes.
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Affiliation(s)
- Luohua Jiang
- Department of Epidemiology, School of Medicine, University of California Irvine, California, United States.
| | - Jenny Chang
- Department of Epidemiology, School of Medicine, University of California Irvine, California, United States
| | - Janette Beals
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Ann Bullock
- Division of Diabetes Treatment and Prevention, Indian Health Service, Rockville, MD, United States
| | - Spero M Manson
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
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117
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Kim Y, Austin SB, Subramanian SV, Kawachi I. The Cardiometabolic Burden of Self-Perceived Obesity: A Multilevel Analysis of a Nationally Representative Sample of Korean Adults. Sci Rep 2018; 8:7901. [PMID: 29784967 PMCID: PMC5962568 DOI: 10.1038/s41598-018-26192-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Accepted: 05/02/2018] [Indexed: 01/25/2023] Open
Abstract
Emerging evidence has shown that self-perception of overweight/obese status is associated with unfavorable cardiometabolic outcomes, above and beyond actual body weight. Given the lack of research among Asian populations, we examined the association between weight perception and metabolic syndrome (MetS) and cardiometabolic risks among Koreans. Data from the 2010–2015 Korea National Health and Nutrition Examination Survey, including women (N = 12,181) and men (N = 9,448) aged 19–65 years, were analyzed. Weight status perception was measured by participants’ self-evaluation of their body size (“very/slightly obese,” “normal,” and “very/slightly thin”). Overall, 23.2% of women and 28.7% of men had MetS. Our cross-sectional multilevel logistic analyses showed a significant positive association between self-perceived obesity (vs. perceived normal weight) and MetS, independent of BMI and sociodemographic/behavioral/medical conditions, with a stronger association detected among men (OR = 1.38, p < 0.05) than women (OR = 1.22, p < 0.05), confirmed by a statistically significant interaction. Additionally, perceived obesity was associated with high blood pressure (OR = 1.27, p < 0.05) and high triglycerides (OR = 1.38, p < 0.05) among men and low high-density lipoprotein cholesterol (OR = 1.15, p < 0.05) among women. While further prospective research is needed, our findings suggest that perception of being obese may be an unfavorable indicator of cardiometabolic health among Koreans regardless of actual body weight.
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Affiliation(s)
- Yongjoo Kim
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
| | - S Bryn Austin
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.,Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - S V Subramanian
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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118
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Carroll SJ, Niyonsenga T, Coffee NT, Taylor AW, Daniel M. Associations between local descriptive norms for overweight/obesity and insufficient fruit intake, individual-level diet, and 10-year change in body mass index and glycosylated haemoglobin in an Australian cohort. Int J Behav Nutr Phys Act 2018; 15:44. [PMID: 29776358 PMCID: PMC5960151 DOI: 10.1186/s12966-018-0675-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 05/06/2018] [Indexed: 01/09/2023] Open
Abstract
Background Descriptive norms (what other people do) relate to individual-level dietary behaviour and health outcome including overweight and obesity. Descriptive norms vary across residential areas but the impact of spatial variation in norms on individual-level diet and health is poorly understood. This study assessed spatial associations between local descriptive norms for overweight/obesity and insufficient fruit intake (spatially-specific local prevalence), and individual-level dietary intakes (fruit, vegetable and sugary drinks) and 10-year change in body mass index (BMI) and glycosylated haemoglobin (HbA1c). Methods HbA1c and BMI were clinically measured three times over 10 years for a population-based adult cohort (n = 4056) in Adelaide, South Australia. Local descriptive norms for both overweight/obesity and insufficient fruit intake specific to each cohort participant were calculated as the prevalence of these factors, constructed from geocoded population surveillance data aggregated for 1600 m road-network buffers centred on cohort participants’ residential addresses. Latent growth models estimated the effect of local descriptive norms on dietary behaviours and change in HbA1c and BMI, accounting for spatial clustering and covariates (individual-level age, sex, smoking status, employment and education, and area-level median household income). Results Local descriptive overweight/obesity norms were associated with individual-level fruit intake (inversely) and sugary drink consumption (positively), and worsening HbA1c and BMI. Spatially-specific local norms for insufficient fruit intake were associated with individual-level fruit intake (inversely) and sugary drink consumption (positively) and worsening HbA1c but not change in BMI. Individual-level fruit and vegetable intakes were not associated with change in HbA1c or BMI. Sugary drink consumption was also not associated with change in HbA1c but rather with increasing BMI. Conclusion Adverse local descriptive norms for overweight/obesity and insufficient fruit intake are associated with unhealthful dietary intakes and worsening HbA1c and BMI. As such, spatial variation in lifestyle-related norms is an important consideration relevant to the design of population health interventions. Adverse local norms influence health behaviours and outcomes and stand to inhibit the effectiveness of traditional intervention efforts not spatially tailored to local population characteristics. Spatially targeted social de-normalisation strategies for regions with high levels of unhealthful norms may hold promise in concert with individual, environmental and policy intervention approaches.
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Affiliation(s)
- Suzanne J Carroll
- Centre for Research and Action in Public Health, Health Research Institute, University of Canberra, Bruce, ACT, Australia.
| | - Theo Niyonsenga
- Centre for Research and Action in Public Health, Health Research Institute, University of Canberra, Bruce, ACT, Australia.,Spatial Epidemiology & Evaluation Research Group, School of Health Sciences and Centre for Population Health Research, University of South Australia, Adelaide, Australia
| | - Neil T Coffee
- Centre for Research and Action in Public Health, Health Research Institute, University of Canberra, Bruce, ACT, Australia.,Spatial Epidemiology & Evaluation Research Group, School of Health Sciences and Centre for Population Health Research, University of South Australia, Adelaide, Australia
| | - Anne W Taylor
- Discipline of Medicine, The University of Adelaide, Adelaide, SA, Australia
| | - Mark Daniel
- Centre for Research and Action in Public Health, Health Research Institute, University of Canberra, Bruce, ACT, Australia.,Spatial Epidemiology & Evaluation Research Group, School of Health Sciences and Centre for Population Health Research, University of South Australia, Adelaide, Australia.,Department of Medicine, The University of Melbourne, St Vincent's Hospital, Melbourne, VIC, Australia
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119
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Zhou X, Li D. Quantifying multi-dimensional attributes of human activities at various geographic scales based on smartphone tracking. Int J Health Geogr 2018; 17:11. [PMID: 29743069 PMCID: PMC5941789 DOI: 10.1186/s12942-018-0130-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 04/20/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Advancement in location-aware technologies, and information and communication technology in the past decades has furthered our knowledge of the interaction between human activities and the built environment. An increasing number of studies have collected data regarding individual activities to better understand how the environment shapes human behavior. Despite this growing interest, some challenges exist in collecting and processing individual's activity data, e.g., capturing people's precise environmental contexts and analyzing data at multiple spatial scales. METHODS In this study, we propose and implement an innovative system that integrates smartphone-based step tracking with an app and the sequential tile scan techniques to collect and process activity data. We apply the OpenStreetMap tile system to aggregate positioning points at various scales. We also propose duration, step and probability surfaces to quantify the multi-dimensional attributes of activities. RESULTS Results show that, by running the app in the background, smartphones can measure multi-dimensional attributes of human activities, including space, duration, step, and location uncertainty at various spatial scales. By coordinating Global Positioning System (GPS) sensor with accelerometer sensor, this app can save battery which otherwise would be drained by GPS sensor quickly. Based on a test dataset, we were able to detect the recreational center and sports center as the space where the user was most active, among other places visited. CONCLUSION The methods provide techniques to address key issues in analyzing human activity data. The system can support future studies on behavioral and health consequences related to individual's environmental exposure.
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Affiliation(s)
- Xiaolu Zhou
- Department of Geology and Geography, Georgia Southern University, 68 Georgia Ave, Herty Bldg 0201, Statesboro, GA, 30460, USA. .,Yunnan University of Finance and Economics, Longquan Road 237, Kunming, 650221, Yunnan, China.
| | - Dongying Li
- Department of Landscape Architecture and Urban Planning, Texas A&M University, College Station, TX, 77843, USA
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120
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Johnson DA, Hirsch JA, Moore KA, Redline S, Diez Roux AV. Associations Between the Built Environment and Objective Measures of Sleep: The Multi-Ethnic Study of Atherosclerosis. Am J Epidemiol 2018; 187:941-950. [PMID: 29547912 PMCID: PMC5928457 DOI: 10.1093/aje/kwx302] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 05/10/2017] [Accepted: 06/20/2017] [Indexed: 12/26/2022] Open
Abstract
Although dense neighborhood built environments support increased physical activity and lower obesity, these features may also disturb sleep. Therefore, we sought to understand the association between the built environment and objectively measured sleep. From 2010 to 2013, we analyzed data from examination 5 of the Multi-Ethnic Study of Atherosclerosis, a diverse population from 6 US cities. We fit multilevel models that assessed the association between the built environment (Street Smart Walk Score, social engagement destinations, street intersections, and population density) and sleep duration or efficiency from 1-week wrist actigraphy in 1,889 individuals. After adjustment for covariates, a 1-standard-deviation increase in Street Smart Walk Score was associated with 23% higher odds of short sleep duration (≤6 hours; odds ratio = 1.2, 95% confidence interval: 1.0, 1.4), as well as shorter average sleep duration (mean difference = -8.1 minutes, 95% confidence interval: -12.1, -4.2). Results were consistent across other built environment measures. Associations were attenuated after adjustment for survey-based measure of neighborhood noise. Dense neighborhood development may have multiple health consequence. In promoting denser neighborhoods to increase walkability, it is important to also implement strategies that reduce the adverse impacts of this development on sleep, such as noise reductions efforts.
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Affiliation(s)
- Dayna A Johnson
- Division of Sleep and Circadian Disorders, Harvard Medical School and Brigham and Women’s Hospital, Boston, Massachusetts
| | - Jana A Hirsch
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Kari A Moore
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Harvard Medical School and Brigham and Women’s Hospital, Boston, Massachusetts
| | - Ana V Diez Roux
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
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121
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Sarkar C, Webster C, Gallacher J. Neighbourhood walkability and incidence of hypertension: Findings from the study of 429,334 UK Biobank participants. Int J Hyg Environ Health 2018; 221:458-468. [PMID: 29398408 DOI: 10.1016/j.ijheh.2018.01.009] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2017] [Revised: 01/04/2018] [Accepted: 01/17/2018] [Indexed: 01/28/2023]
Abstract
BACKGROUND With an estimated one billion hypertension cases worldwide, the role of the built environment in its prevention and control is still uncertain. The present study aims to examine the associations between neighbourhood walkability and hypertension in a large and diverse population-based cohort. MATERIALS AND METHODS We examined the association between neighbourhood walkability and blood pressure outcomes for N = 429,334 participants drawn from the UK Biobank and aged 38-73 years. Neighbourhood walkability was objectively modelled from detailed building footprint-level data within multi-scale functional neighbourhoods (1.0-, 1.5- and 2.0-kilometer street catchments of geocoded dwelling). A series of linear and modified Poisson regression models were employed to examine the association between walkability and outcomes of diastolic blood pressure (DBP in mmHg), systolic blood pressure (SBP in mmHg) and prevalent hypertension adjusting for socio-demographic, lifestyle and related physical environmental covariates. We also examined the relationship between walkability and change in blood pressure for a sub-sample of participants with follow-up data and tested for interaction effects of age, sex, employment status, neighbourhood SES, residential density and green exposure. RESULTS Neighbourhood walkability within one-kilometer street catchment was beneficially associated with all the three blood pressure outcomes, independent of all other factors. Each interquartile increment in walkability was associated with the lower blood pressure outcomes of DBP (β = -0.358, 95% CI: -0.42, -0.29 mmHg), SBP (β = -0.833, 95% CI: -0.95, -0.72 mmHg) as well as reduced hypertension risk (RR = 0.970, 95% CI: 0.96, 0.98). The results remained consistent across spatial and temporal scales and were sensitive to sub-groups, with pronounced protective effects among female participants, those aged between 50 and 60 years, in employment, residing in deprived, high density and greener areas. CONCLUSION This large population-based cohort found evidence of protective association between neighbourhood walkability and blood pressure outcomes. Given the enduring public health impact of community design on individual behaviour and lifestyle, of particular interest, are the targetted upstream-level interventions in city design aimed at optimizing walkability. Further long term studies are required to assess its sustained effects upon hypertension prevention and control.
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Affiliation(s)
- Chinmoy Sarkar
- Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Knowles Building, Pokfulam Road, Hong Kong, Hong Kong Special Administrative Region, China.
| | - Chris Webster
- Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Knowles Building, Pokfulam Road, Hong Kong, Hong Kong Special Administrative Region, China
| | - John Gallacher
- Department of Psychiatry, Oxford University, Warneford Hospital, Oxford OX3 7JX, United Kingdom
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122
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Tabaei BP, Rundle AG, Wu WY, Horowitz CR, Mayer V, Sheehan DM, Chamany S. Associations of Residential Socioeconomic, Food, and Built Environments With Glycemic Control in Persons With Diabetes in New York City From 2007-2013. Am J Epidemiol 2018; 187:736-745. [PMID: 29020137 DOI: 10.1093/aje/kwx300] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 08/04/2017] [Indexed: 12/13/2022] Open
Abstract
In the present study, we examined the longitudinal associations between residential environmental factors and glycemic control in 182,756 adults with diabetes in New York City from 2007 to 2013. Glycemic control was defined as a hemoglobin A1c (HbA1c) level less than 7%. We constructed residential-level measures and performed principle component analysis to formulate a residential composite score. On the basis of this score, we divided residential areas into quintiles, with the lowest and highest quintiles reflecting the least and most advantaged residential environments, respectively. Several residential-level environmental characteristics, including more advantaged socioeconomic conditions, greater ratio of healthy food outlets to unhealthy food outlets, and residential walkability were associated with increased glycemic control. Individuals who lived continuously in the most advantaged residential areas took less time to achieve glycemic control compared with the individuals who lived continuously in the least advantaged residential areas (9.9 vs. 11.5 months). Moving from less advantaged residential areas to more advantaged residential areas was related to improved diabetes control (decrease in HbA1c = 0.40%, 95% confidence interval: 0.22, 0.55), whereas moving from more advantaged residential areas to less advantaged residential areas was related to worsening diabetes control (increase in HbA1c = 0.33%, 95% confidence interval: 0.24, 0.44). These results show that residential areas with greater resources to support healthy food and residential walkability are associated with improved glycemic control in persons with diabetes.
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Affiliation(s)
- Bahman P Tabaei
- Division of Prevention and Primary Care, New York City Department of Health and Mental Hygiene, Queens, New York
| | - Andrew G Rundle
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Winfred Y Wu
- Division of Prevention and Primary Care, New York City Department of Health and Mental Hygiene, Queens, New York
| | - Carol R Horowitz
- Department of Population Health Science and Policy, Division of General Internal Medicine, Icahn School of Medicine at Mt. Sinai, New York, New York
| | - Victoria Mayer
- Department of Population Health Science and Policy, Division of General Internal Medicine, Icahn School of Medicine at Mt. Sinai, New York, New York
| | - Daniel M Sheehan
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Shadi Chamany
- Division of Prevention and Primary Care, New York City Department of Health and Mental Hygiene, Queens, New York
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123
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Zenk SN, Tarlov E, Powell LM, Wing C, Matthews SA, Slater S, Gordon HS, Berbaum M, Fitzgibbon ML. Weight and Veterans' Environments Study (WAVES) I and II: Rationale, Methods, and Cohort Characteristics. Am J Health Promot 2018; 32:779-794. [PMID: 29214851 PMCID: PMC5876028 DOI: 10.1177/0890117117694448] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
PURPOSE To present the rationale, methods, and cohort characteristics for 2 complementary "big data" studies of residential environment contributions to body weight, metabolic risk, and weight management program participation and effectiveness. DESIGN Retrospective cohort. SETTING Continental United States. PARTICIPANTS A total of 3 261 115 veterans who received Department of Veterans Affairs (VA) health care in 2009 to 2014, including 169 910 weight management program participants and a propensity score-derived comparison group. INTERVENTION The VA MOVE! weight management program, an evidence-based lifestyle intervention. MEASURES Body mass index, metabolic risk measures, and MOVE! participation; residential environmental attributes (eg, food outlet availability and walkability); and MOVE! program characteristics. ANALYSIS Descriptive statistics presented on cohort characteristics and environments where they live. RESULTS Forty-four percent of men and 42.8% of women were obese, whereas 4.9% of men and 9.9% of women engaged in MOVE!. About half of the cohort had at least 1 supermarket within 1 mile of their home, whereas they averaged close to 4 convenience stores (3.6 for men, 3.9 for women) and 8 fast-food restaurants (7.9 for men, 8.2 for women). Forty-one percent of men and 38.6% of women did not have a park, and 35.5% of men and 31.3% of women did not have a commercial fitness facility within 1 mile. CONCLUSION Drawing on a large nationwide cohort residing in diverse environments, these studies are poised to significantly inform policy and weight management program design.
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Affiliation(s)
- Shannon N Zenk
- 1 Department of Health Systems Science, University of Illinois at Chicago College of Nursing, Chicago, IL, USA
| | - Elizabeth Tarlov
- 1 Department of Health Systems Science, University of Illinois at Chicago College of Nursing, Chicago, IL, USA
- 2 Center of Innovation for Complex Chronic Healthcare (CINCCH), Hines VA Hospital, Hines, IL, USA
| | - Lisa M Powell
- 3 Health Policy and Administration Division, University of Illinois at Chicago School of Public Health, Chicago, IL, USA
- 4 Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
| | - Coady Wing
- 5 Indiana University-Bloomington School of Public and Environmental Affairs, Bloomington, IN, USA
| | - Stephen A Matthews
- 6 Department of Sociology, Anthropology, and Demography, Pennsylvania State University, University Park, PA, USA
| | - Sandy Slater
- 3 Health Policy and Administration Division, University of Illinois at Chicago School of Public Health, Chicago, IL, USA
- 4 Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
| | - Howard S Gordon
- 7 Jesse Brown VA Medical Center, Chicago, IL, USA
- 8 Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Michael Berbaum
- 4 Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
| | - Marian L Fitzgibbon
- 3 Health Policy and Administration Division, University of Illinois at Chicago School of Public Health, Chicago, IL, USA
- 4 Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
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Perceived Environmental Factors Associated with Obesity in Libyan Men and Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15020301. [PMID: 29425161 PMCID: PMC5858370 DOI: 10.3390/ijerph15020301] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 01/29/2018] [Accepted: 02/06/2018] [Indexed: 11/17/2022]
Abstract
Background: There is a lack of research pertaining to the links between built environment attributes and obesity in adults in the Eastern Mediterranean Region. In the Libyan context, no previous studies have been conducted to investigate this relationship. Therefore, the aim of this study was to examine associations between perceived neighbourhood built environmental attributes and obesity among Libyan men and women. The prevalence of overweight and obesity was also assessed. Methods: A cross-sectional study design was used for the population-based survey in Benghazi, Libya. A multi-stage cluster sampling technique was used to select Libyan adults from the Benghazi electoral register. The Physical Activity Neighbourhood Environment Scale (PANES) was used to measure participants’ perception of neighbourhood environmental factors. Using the Tanita BC-601 Segmental Body Composition Monitor and a portable stadiometer, anthropometric measurements were taken at a mutually agreeable place by qualified nurses. Results: Four hundred and one Libyan adults were recruited (78% response rate). Participants were aged 20–65 years, 63% were female, and all had lived in Benghazi for over 10 years. The prevalence of obesity and overweight was 42.4% and 32.9% respectively. A significant association was found between BMI and 6 neighbourhood environment attributes, specifically: street connectivity, unsafe environment and committing crimes at night, and neighbourhood aesthetics. For men only, these were: access to public transport, access to recreational facilities, and unsafe environment and committing crimes during the day. The attribute ‘residential density zones’ was only significant for women. Conclusions: The study suggests that Libyan people are at risk of living in neighbourhoods with unsupportive environmental features of physical activity, which are likely to promote obesity of both genders. The findings of this study could inform Libyan health policies about interventions in the obesogenic environments that might slow the obesity epidemic and contain the public health crisis. This study suggests that further research is needed, within the Libyan context, to explore the impact of the neighbourhood environment attributes on contributing to increased obesity.
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Barber S, Diez Roux AV, Cardoso L, Santos S, Toste V, James S, Barreto S, Schmidt M, Giatti L, Chor D. At the intersection of place, race, and health in Brazil: Residential segregation and cardio-metabolic risk factors in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Soc Sci Med 2018; 199:67-76. [DOI: 10.1016/j.socscimed.2017.05.047] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 05/20/2017] [Accepted: 05/23/2017] [Indexed: 10/19/2022]
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Letarte L, Lebel A, Waygood E, Tchernof A, Biertho L. Longitudinal designs to study neighbourhood effects on the development of obesity: a scoping review protocol. BMJ Open 2018; 8:e017704. [PMID: 29371268 PMCID: PMC5786143 DOI: 10.1136/bmjopen-2017-017704] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 09/07/2017] [Accepted: 11/03/2017] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION The prevalence of obesity has increased significantly in the last three decades and became an important public health concern. Evidence of weight status variability at the neighbourhood level has led researchers to look more precisely at the characteristics of local geographic areas that might influence energy balance related behaviours, giving rise to the field of the 'neighbourhood effect' in public health research. Among an abundant literature about neighbourhood effects and obesity, we propose a protocol for a scoping review that will aim at determining how temporal measurements of residential neighbourhood exposure, individual covariates and weight outcome are integrated in longitudinal designs. METHODS AND ANALYSIS A list of relevant citations will be obtained through a comprehensive systematic database search in Pubmed, Web of Science and Embase. The search strategy will be designed using a broad definition of neighbourhood to take into account the heterogeneity of this concept in research. Two investigators will screen titles, abstracts and entire publications using predetermined eligibility criteria yielding a list of selected publications. Data from the publications included in the scoping review will be charted according to bibliographic information, study population, exposure, outcomes and results. DISCUSSION AND CONCLUSION To our knowledge, our protocol will yield the first scoping review regarding longitudinal designs of neighbourhood effect on obesity. Describing how longitudinal designs include temporal measurements of exposure, covariates and outcome is a necessary step in the quest to determine if or which contextual characteristics are likely to be involved in the development of obesity. Such information would bring new knowledge to complement current aetiological investigations and would contribute to enhancing resource allocation strategies for stakeholders in developing relevant interventions to prevent obesity and its negative impacts.
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Affiliation(s)
- Laurence Letarte
- Graduate School of Land Management and Regional Planning, Laval University, Québec, Canada
- Québec Heart and Lung Institute, Québec, Canada
| | - Alexandre Lebel
- Graduate School of Land Management and Regional Planning, Laval University, Québec, Canada
- Québec Heart and Lung Institute, Québec, Canada
| | - E.O.D Waygood
- Graduate School of Land Management and Regional Planning, Laval University, Québec, Canada
| | - André Tchernof
- Québec Heart and Lung Institute, Québec, Canada
- School of Nutrition, Laval University, Québec, Canada
| | - Laurent Biertho
- Québec Heart and Lung Institute, Québec, Canada
- Department of Surgery, Laval University, Québec, Canada
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Conroy SM, Shariff-Marco S, Yang J, Hertz A, Cockburn M, Shvetsov YB, Clarke CA, Abright CL, Haiman CA, Le Marchand L, Kolonel LN, Monroe KR, Wilkens LR, Gomez SL, Cheng I. Characterizing the neighborhood obesogenic environment in the Multiethnic Cohort: a multi-level infrastructure for cancer health disparities research. Cancer Causes Control 2018; 29:167-183. [PMID: 29222610 PMCID: PMC5806518 DOI: 10.1007/s10552-017-0980-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 11/06/2017] [Indexed: 01/09/2023]
Abstract
PURPOSE We characterized the neighborhood obesogenic environment in the Multiethnic Cohort (MEC) by examining the associations of obesity with attributes of the social and built environment, establishing a multi-level infrastructure for future cancer research. METHODS For 102,906 African American, Japanese American, Latino, and white MEC participants residing predominately in Los Angeles County, baseline residential addresses (1993-1996) were linked to census and geospatial data, capturing neighborhood socioeconomic status (nSES), population density, commuting, food outlets, amenities, walkability, and traffic density. We examined neighborhood attributes and obesity (body mass index ≥ 30 kg/m2) associations using multinomial logistic regression, adjusting for individual-level (e.g., demographics, physical activity, and diet) and neighborhood-level factors. RESULTS NSES was associated with obesity among African Americans, Latinos, and whites (p-trend ≤ 0.02), with twofold higher odds (adjusted odds ratios, 95% confidence intervals) for living in the lowest versus highest quintile among African American women (2.07, 1.62-2.65), white men (2.11, 1.29-3.44), and white women (2.50, 1.73-3.61). Lower density of businesses among African American and white women and lower traffic density among white men were also associated with obesity (p-trends ≤ 0.02). CONCLUSIONS Our study highlights differential impacts of neighborhood factors across racial/ethnic groups and establishes the foundation for multi-level studies of the neighborhood context and obesity-related cancers.
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Affiliation(s)
- Shannon M Conroy
- Department of Epidemiology and Biostatistics, University of California, San Francisco, School of Medicine, San Francisco, CA, USA
| | | | - Juan Yang
- Cancer Prevention Institute of California, Fremont, CA, USA
| | - Andrew Hertz
- Cancer Prevention Institute of California, Fremont, CA, USA
| | - Myles Cockburn
- Colorado School of Public Health, University of Colorado, Denver, CO, USA
| | | | | | - Cheryl L Abright
- University of Hawaii at Manoa School of Nursing and Dental Hygiene, Honolulu, HI, USA
| | | | | | | | | | | | - Scarlett Lin Gomez
- Department of Epidemiology and Biostatistics, University of California, San Francisco, School of Medicine, San Francisco, CA, USA
- Cancer Prevention Institute of California, Fremont, CA, USA
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, USA
| | - Iona Cheng
- Department of Epidemiology and Biostatistics, University of California, San Francisco, School of Medicine, San Francisco, CA, USA.
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Gunn LD, Mavoa S, Boulangé C, Hooper P, Kavanagh A, Giles-Corti B. Designing healthy communities: creating evidence on metrics for built environment features associated with walkable neighbourhood activity centres. Int J Behav Nutr Phys Act 2017; 14:164. [PMID: 29202849 PMCID: PMC5716232 DOI: 10.1186/s12966-017-0621-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 11/22/2017] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Evidence-based metrics are needed to inform urban policy to create healthy walkable communities. Most active living research has developed metrics of the environment around residential addresses, ignoring other important walking locations. Therefore, this study examined: metrics for built environment features surrounding local shopping centres, (known in Melbourne, Australia as neighbourhood activity centres (NACs) which are typically anchored by a supermarket); the association between NACs and transport walking; and, policy compliance for supermarket provision. METHODS In this observational study, cluster analysis was used to categorize 534 NACs in Melbourne, Australia by their built environment features. The NACS were linked to eligible Victorian Integrated Survey of Travel Activity 2009-2010 (VISTA) survey participants (n=19,984). Adjusted multilevel logistic regressions estimated associations between each cluster typology and two outcomes of daily walking: any transport walking; and, any 'neighbourhood' transport walking. Distance between residential dwellings and closest NAC was assessed to evaluate compliance with local planning policy on supermarket locations. RESULTS Metrics for 19 built environment features were estimated and three NAC clusters associated with walkability were identified. NACs with significantly higher street connectivity (mean:161, SD:20), destination diversity (mean:16, SD:0.4); and net residential density (mean:77, SD:65) were interpreted as being 'highly walkable' when compared with 'low walkable' NACs, which had lower street connectivity (mean:57, SD:15); destination diversity (mean:11, SD:3); and net residential density (mean:10, SD:3). The odds of any daily transport walking was 5.85 times higher (95% CI: 4.22, 8.11), and for any 'neighborhood' transport walking 8.66 (95% CI: 5.89, 12.72) times higher, for residents whose closest NAC was highly walkable compared with those living near low walkable NACs. Only highly walkable NACs met the policy requirement that residents live within 1km of a local supermarket. CONCLUSIONS Built environment features surrounding NACs must reach certain levels to encourage walking and deliver walkable communities. Research and metrics about the type and quantity of built environment features around both walking trip origins and destinations is needed to inform urban planning policies and urban design guidelines.
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Affiliation(s)
- Lucy Dubrelle Gunn
- Healthy Liveable Cities Group, Centre for Urban Research, College for Design and Social Context, Royal Melbourne Institute of Technology, Melbourne, Victoria, 3010, Australia.
| | - Suzanne Mavoa
- Noncommunicable Disease Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Claire Boulangé
- Healthy Liveable Cities Group, Centre for Urban Research, College for Design and Social Context, Royal Melbourne Institute of Technology, Melbourne, Victoria, 3010, Australia
| | - Paula Hooper
- Centre for the Built Environment and Health, School of Earth and Environment and School of Sports Science, Exercise & Health, University of Western Australia, Perth, Western Australia, Australia
| | - Anne Kavanagh
- Gender and Women's Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Billie Giles-Corti
- Healthy Liveable Cities Group, Centre for Urban Research, College for Design and Social Context, Royal Melbourne Institute of Technology, Melbourne, Victoria, 3010, Australia
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Lucumi DI, Schulz AJ, Roux AVD, Grogan-Kaylor A. Income inequality and high blood pressure in Colombia: a multilevel analysis. CAD SAUDE PUBLICA 2017; 33:e00172316. [DOI: 10.1590/0102-311x00172316] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 03/08/2017] [Indexed: 11/21/2022] Open
Abstract
The objective of this research was to examine the association between income inequality and high blood pressure in Colombia. Using a nationally representative Colombian sample of adults, and data from departments and municipalities, we fit sex-stratified linear and logistic multilevel models with blood pressure as a continuous and binary variable, respectively. In adjusted models, women living in departments with the highest quintile of income inequality in 1997 had higher systolic blood pressure than their counterparts living in the lowest quintile of income inequality (mean difference 4.42mmHg; 95%CI: 1.46, 7.39). Women living in departments that were at the fourth and fifth quintile of income inequality in 1994 were more likely to have hypertension than those living in departments at the first quintile in the same year (OR: 1.56 and 1.48, respectively). For men, no associations of income inequality with either systolic blood pressure or hypertension were observed. Our findings are consistent with the hypothesis that income inequality is associated with increased risk of high blood pressure for women. Future studies to analyze pathways linking income inequality to high blood pressure in Colombia are needed.
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Sarkar C, Webster C, Gallacher J. Association between adiposity outcomes and residential density: a full-data, cross-sectional analysis of 419 562 UK Biobank adult participants. Lancet Planet Health 2017; 1:e277-e288. [PMID: 29851626 DOI: 10.1016/s2542-5196(17)30119-5] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 08/23/2017] [Accepted: 09/18/2017] [Indexed: 05/10/2023]
Abstract
BACKGROUND Obesity is a major health issue and an important public health target for urban design. However, the evidence for identifying the optimum residential density in relation to obesity has been far from compelling. We examined the association of obesity with residential density in a large and diverse population sample drawn from the UK Biobank to identify healthy-weight-sustaining density environments. METHODS For this full-data, cross-sectional analysis, we used UK Biobank data for adult men and women aged 37-73 years from 22 cities across the UK. Baseline examinations were done between 2006 and 2010. Residential unit density was objectively assessed within a 1 km street catchment of a participant's residence. Other activity-influencing built environment factors were measured in terms of density of retail, public transport, and street-level movement density, which were modelled from network analyses of through movement of street links within the defined catchment. We regressed adiposity indicators of body-mass index (BMI; kg/m2), waist circumference (cm), whole body fat (kg), and obesity (WHO criteria of BMI ≥30 kg/m2) on residential density (units per km2), adjusting for activity-influencing built environment factors and individual covariates. We also investigated effect modification by age, sex, employment status, and physical activity. We used a series of linear continuous and logistic regression models and non-linear restricted cubic spline models as appropriate. FINDINGS Of 502 649 adults in the prospective cohort, 419 562 (83·5%) participants across 22 UK Biobank assessment centres met baseline data requirements and were included in the analytic sample. The fitted restricted cubic spline adiposity-residential density dose-response curve identified a turning point at a residential density of 1800 residential units per km2. Below a residential density of 1800 units per km2, an increment of 1000 units per km2 was positively related with adiposity, being associated with higher BMI (β 0·19 kg/m2, 95% CI 0·14 to 0·24), waist circumference (β 0·41 cm, 0·28 to 0·54), and whole body fat (β 0·40 kg, 0·30 to 0·50), and with increased odds of obesity (odds ratio [OR] 1·10, 1·07 to 1·14). Beyond 1800 units per km2, residential density had a protective effect on adiposity and was associated with lower BMI (β -0·22 kg/m2, -0·25 to -0·20), waist circumference (β -0·54 cm, -0·61 to -0·48), and whole body fat (β -0·38 kg, -0·43 to -0·33), and with decreased odds of obesity (OR 0·91, 0·90 to 0·93). Subgroup analyses identified more pronounced protective effects of residential density among individuals who were younger, female, in employment, and accumulating higher levels of physical activity, except in the case of whole body fat, for which the protective effects were stronger in men. INTERPRETATION Housing-level policy related to the optimisation of healthy density in cities might be a potential upstream-level public health intervention towards the minimisation and offsetting of obesity; however, further research based on accumulated prospective data is necessary for evidencing specific pathways. The findings might mean that governments, such as the UK Government, who are attempting to prevent suburban densification by, for example, prohibiting the subdivision of single lot housing and the conversion of domestic gardens to housing lots, will potentially have the effect of inhibiting the conversion of suburbs into more healthy places to live. FUNDING University of Hong Kong, UK Biobank, and UK Economic & Social Research Council.
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Affiliation(s)
- Chinmoy Sarkar
- Healthy High Density Cities Lab, HKUrbanLab, University of Hong Kong, Hong Kong Special Administrative Region, China.
| | - Chris Webster
- Healthy High Density Cities Lab, HKUrbanLab, University of Hong Kong, Hong Kong Special Administrative Region, China
| | - John Gallacher
- Healthy High Density Cities Lab, HKUrbanLab, University of Hong Kong, Hong Kong Special Administrative Region, China; Department of Psychiatry, Oxford University, Warneford Hospital, Oxford, UK
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Carroll SJ, Niyonsenga T, Coffee NT, Taylor AW, Daniel M. Does Physical Activity Mediate the Associations Between Local-Area Descriptive Norms, Built Environment Walkability, and Glycosylated Hemoglobin? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14090953. [PMID: 28832552 PMCID: PMC5615490 DOI: 10.3390/ijerph14090953] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 08/15/2017] [Accepted: 08/21/2017] [Indexed: 02/08/2023]
Abstract
Associations between local-area residential features and glycosylated hemoglobin (HbA1c) may be mediated by individual-level health behaviors. Such indirect effects have rarely been tested. This study assessed whether individual-level self-reported physical activity mediated the influence of local-area descriptive norms and objectively expressed walkability on 10-year change in HbA1c. HbA1c was assessed three times for adults in a 10-year population-based biomedical cohort (n = 4056). Local-area norms specific to each participant were calculated, aggregating responses from a separate statewide surveillance survey for 1600 m road-network buffers centered on participant addresses (local prevalence of overweight/obesity (body mass index ≥25 kg/m²) and physical inactivity (<150 min/week)). Separate latent growth models estimated direct and indirect (through physical activity) effects of local-area exposures on change in HbA1c, accounting for spatial clustering and covariates (individual-level age, sex, smoking status, marital status, employment and education, and area-level median household income). HbA1c worsened over time. Local-area norms directly and indirectly predicted worsening HbA1c trajectories. Walkability was directly and indirectly protective of worsening HbA1c. Local-area descriptive norms and walkability influence cardiometabolic risk trajectory through individual-level physical activity. Efforts to reduce population cardiometabolic risk should consider the extent of local-area unhealthful behavioral norms and walkability in tailoring strategies to improve physical activity.
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Affiliation(s)
- Suzanne J Carroll
- Centre for Research and Action in Public Health, Health Research Institute, University of Canberra, University Drive, Bruce 2617, Australia.
- Spatial Epidemiology & Evaluation Research Group, School of Health Sciences and Centre for Population Health Research, University of South Australia, North Terrace, Adelaide 5001, Australia.
| | - Theo Niyonsenga
- Centre for Research and Action in Public Health, Health Research Institute, University of Canberra, University Drive, Bruce 2617, Australia.
- Spatial Epidemiology & Evaluation Research Group, School of Health Sciences and Centre for Population Health Research, University of South Australia, North Terrace, Adelaide 5001, Australia.
| | - Neil T Coffee
- Centre for Research and Action in Public Health, Health Research Institute, University of Canberra, University Drive, Bruce 2617, Australia.
- Spatial Epidemiology & Evaluation Research Group, School of Health Sciences and Centre for Population Health Research, University of South Australia, North Terrace, Adelaide 5001, Australia.
| | - Anne W Taylor
- Discipline of Medicine, University of Adelaide, North Terrace, Adelaide 5005, Australia.
| | - Mark Daniel
- Centre for Research and Action in Public Health, Health Research Institute, University of Canberra, University Drive, Bruce 2617, Australia.
- Spatial Epidemiology & Evaluation Research Group, School of Health Sciences and Centre for Population Health Research, University of South Australia, North Terrace, Adelaide 5001, Australia.
- Department of Medicine, University of Melbourne, St Vincent's Hospital, Parkville, Melbourne 3010, Australia.
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Sarkar C. Residential greenness and adiposity: Findings from the UK Biobank. ENVIRONMENT INTERNATIONAL 2017; 106:1-10. [PMID: 28551493 DOI: 10.1016/j.envint.2017.05.016] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 04/23/2017] [Accepted: 05/17/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND With the rapid urbanization and prevailing obesity pandemic, the role of residential green exposures in obesity prevention has gained renewed focus. The study investigated the effects of residential green exposures on adiposity using a large and diverse population sample drawn from the UK Biobank. MATERIALS AND METHODS This was a population based cross-sectional study of 333,183 participants aged 38-73years with individual-level data on residential greenness and built environment exposures. Residential greenness was assessed through 0.50-metre resolution normalized difference vegetation index (NDVI) derived from spectral reflectance measurements in remotely sensed colour infrared data and measured around geocoded participants' dwelling. A series of continuous and binary outcome models examined the associations between residential greenness and markers of adiposity, expressed as body-mass index (BMI) in kg/m2, waist circumference (WC) in cm, whole body fat (WBF) in kg and obesity (BMI≥30kg/m2) after adjusting for other activity-influencing built environment and individual-level confounders. Sensitivity analyses involved studying effect modification by gender, age, urbanicity and SES as well as examining relationships between residential greenness and active travel behaviour. RESULTS Residential greenness was independently and consistently associated with lower adiposity, the association being robust to adjustments. An interquartile increment in NDVI greenness was associated with lower BMI (βBMI=-0.123kg/m2, 95% CI: -0.14, -0.10kg/m2), WC (βWC=-0.551cm, 95% CI: -0.61, -0.50cm), and WBF (βWBF=-0.138kg, 95% CI: -0.18, -0.10kg) as well as a reduced relative risk of obesity (RR=0.968, 95% CI: 0.96, 0.98). Residential greenness was beneficially related with active travel, being associated with higher odds of using active mode for non-work travel (OR=1.093, 95% CI: 1.08, 1.11) as well as doing >30min walking (OR=1.039, 95% CI: 1.03, 1.05). CONCLUSION Residing in greener areas was associated with healthy weight outcomes possibly through a physical activity-related mechanism. Green allocation and design may act as upstream-level public health interventions ameliorating the negative health externalities of obesogenic urban environments. Further prospective studies are needed to identify potential causal pathways and thereby effectively guide such interventions.
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Affiliation(s)
- Chinmoy Sarkar
- Healthy High Density Cities Lab, HKUrbanLab, University of Hong Kong, Knowles Building, Pokfulam Road, Hong Kong.
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Costa S, Adams J, Gonzalez-Nahm S, Benjamin Neelon SE. Childcare in Infancy and Later Obesity: a Narrative Review of Longitudinal Studies. CURRENT PEDIATRICS REPORTS 2017; 5:118-131. [PMID: 28845369 PMCID: PMC5550538 DOI: 10.1007/s40124-017-0134-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
PURPOSE OF REVIEW The purpose of this review was to summarize the current literature on the longitudinal relationship between non-parental childcare during infancy and later obesity. RECENT FINDINGS Eleven studies met the inclusion criteria, comprising 74 associations relevant to the review. Studies were highly heterogeneous in terms of defining childcare, categorizing different types of childcare, assessing obesity, and age at measurement of outcome and exposure. Most of the associations were either non-significant (42 associations, 57%) or showed a significant association between increased exposure to childcare and greater obesity (30 associations, 41%). There were very few examples of associations indicating that childcare was associated with lower obesity. SUMMARY There is limited research on the longitudinal relationship between childcare in infancy and later obesity. Existing studies showed mixed results, similar to recent reviews reporting on cross-sectional studies and older ages. The different definitions of childcare and wide variety of measures of exposure make comparisons between studies challenging.
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Affiliation(s)
- Silvia Costa
- UKCRC Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Jean Adams
- UKCRC Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Sarah Gonzalez-Nahm
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD USA
| | - Sara E Benjamin Neelon
- UKCRC Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD USA
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Wörn J, Ellwardt L, Aartsen M, Huisman M. Cognitive functioning among Dutch older adults: Do neighborhood socioeconomic status and urbanity matter? Soc Sci Med 2017. [PMID: 28647643 DOI: 10.1016/j.socscimed.2017.05.052] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Positive associations of neighborhood socioeconomic characteristics and older adults' cognitive functioning have been demonstrated in previous studies, but overall results have been mixed and evidence from European countries and particularly the Netherlands is scarce. We investigated the effects of socioeconomic status (SES) and urbanity of neighborhoods on four domains of cognitive functioning in a sample of 985 Dutch older adults aged 65-88 years from the Longitudinal Aging Study Amsterdam. Besides cross-sectional level differences in general cognitive functioning, processing speed, problem solving and memory, we examined cognitive decline over a period of six years. Growth models in a multilevel framework were used to simultaneously assess levels and decline of cognitive functioning. In models not adjusting for individual SES, we found some evidence of higher levels of cognitive functioning in neighborhoods with a higher SES. In the same models, urbanity generally showed positive or inversely U-shaped associations with levels of cognitive functioning. Overall, effects of neighborhood urbanity remained significant when adjusting for individual SES. In contrast, level differences by neighborhood SES were largely explained by the respondents' individual SES. This suggests that neighborhood SES does not influence levels of cognitive functioning beyond the fact that individuals with a similar SES tend to self-select into neighborhoods with a corresponding SES. No evidence of systematically faster decline in neighborhoods with lower SES or lower degrees of urbanity was found. The findings suggest that neighborhood SES has no independent effect on older adults cognitive functioning in the Netherlands. Furthermore, the study reveals that neighborhood urbanity should be considered a determinant of cognitive functioning. This finding is in line with theoretical approaches that assume beneficial effects of exposure to complex environments on cognitive functioning. We encourage further investigations into the effect of urbanity in other contexts before drawing firm conclusions.
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Affiliation(s)
- Jonathan Wörn
- University of Cologne, Research Training Group SOCLIFE, Albertus-Magnus-Platz, 50923 Cologne, Germany; University of Cologne, Institute of Sociology and Social Psychology, Albertus-Magnus-Platz, 50923 Cologne, Germany.
| | - Lea Ellwardt
- University of Cologne, Institute of Sociology and Social Psychology, Albertus-Magnus-Platz, 50923 Cologne, Germany.
| | - Marja Aartsen
- Oslo and Akershus University College of Applied Sciences, Norwegian Social Research, P.O. Box 4 St. Olavs Plass, 0130 Oslo, Norway.
| | - Martijn Huisman
- VU University Amsterdam, Medical Center, Department of Epidemiology and Biostatistics, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands; VU University Amsterdam, Department of Sociology, De Boelelaan 1081, 1081 HV Amsterdam, The Netherlands.
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135
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GPS or travel diary: Comparing spatial and temporal characteristics of visits to fast food restaurants and supermarkets. PLoS One 2017; 12:e0174859. [PMID: 28388619 PMCID: PMC5384745 DOI: 10.1371/journal.pone.0174859] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 03/16/2017] [Indexed: 01/19/2023] Open
Abstract
To assess differences between GPS and self-reported measures of location, we examined visits to fast food restaurants and supermarkets using a spatiotemporal framework. Data came from 446 participants who responded to a survey, filled out travel diaries of places visited, and wore a GPS receiver for seven consecutive days. Provided by Public Health Seattle King County, addresses from food permit data were matched to King County tax assessor parcels in a GIS. A three-step process was used to verify travel-diary reported visits using GPS records: (1) GPS records were temporally matched if their timestamps were within the time window created by the arrival and departure times reported in the travel diary; (2) the temporally matched GPS records were then spatially matched if they were located in a food establishment parcel of the same type reported in the diary; (3) the travel diary visit was then GPS-sensed if the name of food establishment in the parcel matched the one reported in the travel diary. To account for errors in reporting arrival and departure times, GPS records were temporally matched to three time windows: the exact time, +/- 10 minutes, and +/- 30 minutes. One third of the participants reported 273 visits to fast food restaurants; 88% reported 1,102 visits to supermarkets. Of these, 77.3 percent of the fast food and 78.6 percent supermarket visits were GPS-sensed using the +/-10-minute time window. At this time window, the mean travel-diary reported fast food visit duration was 14.5 minutes (SD 20.2), 1.7 minutes longer than the GPS-sensed visit. For supermarkets, the reported visit duration was 23.7 minutes (SD 18.9), 3.4 minutes longer than the GPS-sensed visit. Travel diaries provide reasonably accurate information on the locations and brand names of fast food restaurants and supermarkets participants report visiting.
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136
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Are buffers around home representative of physical activity spaces among adults? Health Place 2017; 45:181-188. [PMID: 28391129 DOI: 10.1016/j.healthplace.2017.03.013] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 02/13/2017] [Accepted: 03/23/2017] [Indexed: 11/20/2022]
Abstract
Residential buffers are frequently used to assess built environment characteristics relevant to physical activity (PA), yet little is known about how well they represent the spatial areas in which individuals undertake PA. We used System for Observing Play and Recreation in Communities data for 217 adults from five US states who wore an accelerometer and a GPS for three weeks to create newly defined PA-specific activity spaces. These PA spaces were based on PA occurring in bouts of ≥10min and were defined as 1) the single minimum convex polygon (MCP) containing all of a participant's PA bout minutes and 2) the combination of many MCPs constructed using each PA bout independently. Participants spent a large proportion of their PA bout time outside of 0.5, 1, and 5 mile residential buffers, and these residential buffers were a poor approximation of the spatial areas in which PA bouts occurred. The newly proposed GPS-based PA spaces can be used in future studies in place of the more general concept of activity space to better approximate built environments experienced during PA.
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137
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Conroy SM, Clarke CA, Yang J, Shariff-Marco S, Shvetsov YB, Park SY, Albright CL, Hertz A, Monroe KR, Kolonel LN, Marchand LL, Wilkens LR, Gomez SL, Cheng I. Contextual Impact of Neighborhood Obesogenic Factors on Postmenopausal Breast Cancer: The Multiethnic Cohort. Cancer Epidemiol Biomarkers Prev 2017; 26:480-489. [PMID: 28143808 PMCID: PMC5380519 DOI: 10.1158/1055-9965.epi-16-0941] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Revised: 01/25/2017] [Accepted: 01/27/2017] [Indexed: 12/13/2022] Open
Abstract
Background: While obesity is well-understood to increase breast cancer risk, the role of the neighborhood obesogenic environment, encompassing social and built environment attributes that influence body size, is poorly understood.Methods: Using principal components factor analysis, five composite factors [neighborhood socioeconomic status (nSES), urban, mixed-land development, unhealthy food environment, parks] on the basis of geospatial data were developed to characterize the obesogenic environment for 48,247 postmenopausal women in the Multiethnic Cohort, residing predominately in Los Angeles County. We used Cox proportional hazards regression to examine the association between neighborhood obesogenic factors and breast cancer risk (n = 2,341 cases after 17 years of follow-up), adjusting for body mass index (BMI), weight gain since age 21, education, established risk factors, other neighborhood factors, and clustering by block group.Results: Lower nSES was associated with lower breast cancer risk [quintile 1 vs. 5: HR, 0.79; 95% confidence interval (CI), 0.66-0.95], with a more pronounced association observed in Latinos (quintile 1 vs. 5: HR, 0.60; 95% CI, 0.43-0.85). More urban environments were associated with lower breast cancer risk in Japanese Americans (quintile 5 vs. 1: HR, 0.49; 95% CI, 0.26-0.90), and lower mixed-land development was associated with higher breast cancer risk in Latinos (quintile 1 vs. 5: HR, 1.46; 95% CI, 1.10-1.93).Conclusions: Obesogenic neighborhood environment factors, especially nSES, urbanicity, and mixed-land development, were differentially and independently associated with breast cancer risk in this multiethnic population.Impact: These findings highlight the need for additional studies of the driving contextual aspects of nSES that influence breast cancer risk. Cancer Epidemiol Biomarkers Prev; 26(4); 480-9. ©2017 AACRSee all the articles in this CEBP Focus section, "Geospatial Approaches to Cancer Control and Population Sciences."
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Affiliation(s)
| | - Christina A Clarke
- Cancer Prevention Institute of California, Fremont, California
- Stanford Cancer Institute, Stanford, California
- Stanford University School of Medicine, Stanford, California
| | - Juan Yang
- Cancer Prevention Institute of California, Fremont, California
| | - Salma Shariff-Marco
- Cancer Prevention Institute of California, Fremont, California
- Stanford Cancer Institute, Stanford, California
- Stanford University School of Medicine, Stanford, California
| | | | - Song-Yi Park
- University of Hawaii Cancer Center, Honolulu, Hawaii
| | - Cheryl L Albright
- University of Hawaii at Manoa School of Nursing and Dental Hygiene, Honolulu, Hawaii
| | - Andrew Hertz
- Cancer Prevention Institute of California, Fremont, California
| | | | | | | | | | - Scarlett Lin Gomez
- Cancer Prevention Institute of California, Fremont, California
- Stanford Cancer Institute, Stanford, California
- Stanford University School of Medicine, Stanford, California
| | - Iona Cheng
- Cancer Prevention Institute of California, Fremont, California.
- Stanford Cancer Institute, Stanford, California
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138
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Lilly CL, Umer A, Cottrell L, Pyles L, Neal W. Examination of cardiovascular risk factors and rurality in Appalachian children. Rural Remote Health 2017; 17:4200. [PMID: 28320207 DOI: 10.22605/rrh4200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTOIN The prevalence of childhood cardiovascular disease (CVD) risk factors often increases in more rural geographic regions in the USA. However, research on the topic often has conflicting results. Researchers note differences in definitions of rurality and other factors that would lead to differences in inference, including appropriate use of statistical clustering analysis, representative data, and inclusion of individual-level covariates. The present study's objective was to examine CVD risk factors during childhood by geographic distribution in the US Appalachian region as a first step towards understanding the health disparities in this area. METHODS Rurality and CVD risk factors (including blood pressure, body-mass index (BMI), and cholesterol) were examined in a large, representative sample of fifth-grade students (<i>N=</i>73 014) from an Appalachian state in the USA. A six-category Rural-Urban Continuum Codes classification system was used to define rurality regions. Mixed modeling analysis was used to appropriately cluster individuals within 725 unique zip codes in each of these six regions, and allowed for including several individual-level socioeconomic factors as covariates. RESULTS Rural areas had better outcomes for certain CVD risk factors (lowest low-density lipoprotein cholesterol (LDL-C), and blood pressure (BP) and highest high-density lipoprotein cholesterol (HDL-C)) whereas mid-sized metro and town areas presented with the worst CVD risk factors (highest BMI% above ideal, mean diastolic BP, LDL-C, total cholesterol, triglyceride levels and lowest HDL-C) outcomes in children and adolescence in this Appalachian state. CONCLUSIONS Counter to the study hypothesis, mid-sized metro areas presented with the worst CVD risk factors outcomes in children and adolescence in the Appalachian state. This data contradicts previous literature suggesting a straightforward link between rurality and cardiovascular risk factors. Future research should include a longitudinal design and explore some of the mechanisms between cardiovascular risk factors and rurality.
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Affiliation(s)
| | - Amna Umer
- West Virginia University, Morgantown, West Virginia, USA.
| | | | - Lee Pyles
- West Virginia University, Morgantown, West Virginia, USA.
| | - William Neal
- West Virginia University, Morgantown, West Virginia, USA.
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139
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Stankov I, Howard NJ, Daniel M, Cargo M. Policy, Research and Residents' Perspectives on Built Environments Implicated in Heart Disease: A Concept Mapping Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:E170. [PMID: 28208786 PMCID: PMC5334724 DOI: 10.3390/ijerph14020170] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 02/06/2017] [Indexed: 01/24/2023]
Abstract
An underrepresentation of stakeholder perspectives within urban health research arguably limits our understanding of what is a multi-dimensional and complex relationship between the built environment and health. By engaging a wide range of stakeholders using a participatory concept mapping approach, this study aimed to achieve a more holistic and nuanced understanding of the built environments shaping disease risk, specifically cardiometabolic risk (CMR). Moreover, this study aimed to ascertain the importance and changeability of identified environments through government action. Through the concept mapping process, community members, researchers, government and non-government stakeholders collectively identified eleven clusters encompassing 102 built environmental domains related to CMR, a number of which are underrepresented within the literature. Among the identified built environments, open space, public transportation and pedestrian environments were highlighted as key targets for policy intervention. Whilst there was substantive convergence in stakeholder groups' perspectives concerning the built environment and CMR, there were disparities in the level of importance government stakeholders and community members respectively assigned to pedestrian environments and street connectivity. These findings support the role of participatory methods in strengthening how urban health issues are understood and in affording novel insights into points of action for public health and policy intervention.
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Affiliation(s)
- Ivana Stankov
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA 19104, USA.
- Centre for Population Health Research, School of Health Sciences, University of South Australia, Adelaide, SA 5001, Australia.
| | - Natasha J Howard
- Centre for Population Health Research, School of Health Sciences, University of South Australia, Adelaide, SA 5001, Australia.
| | - Mark Daniel
- Centre for Population Health Research, School of Health Sciences, University of South Australia, Adelaide, SA 5001, Australia.
- South Australian Health and Medical Research Institute, Adelaide, SA 5001, Australia.
| | - Margaret Cargo
- Centre for Population Health Research, School of Health Sciences, University of South Australia, Adelaide, SA 5001, Australia.
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140
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Carroll SJ, Paquet C, Howard NJ, Coffee NT, Adams RJ, Taylor AW, Niyonsenga T, Daniel M. Local descriptive body weight and dietary norms, food availability, and 10-year change in glycosylated haemoglobin in an Australian population-based biomedical cohort. BMC Public Health 2017; 17:149. [PMID: 28148239 PMCID: PMC5289014 DOI: 10.1186/s12889-017-4068-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 01/24/2017] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Individual-level health outcomes are shaped by environmental risk conditions. Norms figure prominently in socio-behavioural theories yet spatial variations in health-related norms have rarely been investigated as environmental risk conditions. This study assessed: 1) the contributions of local descriptive norms for overweight/obesity and dietary behaviour to 10-year change in glycosylated haemoglobin (HbA1c), accounting for food resource availability; and 2) whether associations between local descriptive norms and HbA1c were moderated by food resource availability. METHODS HbA1c, representing cardiometabolic risk, was measured three times over 10 years for a population-based biomedical cohort of adults in Adelaide, South Australia. Residential environmental exposures were defined using 1600 m participant-centred road-network buffers. Local descriptive norms for overweight/obesity and insufficient fruit intake (proportion of residents with BMI ≥ 25 kg/m2 [n = 1890] or fruit intake of <2 serves/day [n = 1945], respectively) were aggregated from responses to a separate geocoded population survey. Fast-food and healthful food resource availability (counts) were extracted from a retail database. Separate sets of multilevel models included different predictors, one local descriptive norm and either fast-food or healthful food resource availability, with area-level education and individual-level covariates (age, sex, employment status, education, marital status, and smoking status). Interactions between local descriptive norms and food resource availability were tested. RESULTS HbA1c concentration rose over time. Local descriptive norms for overweight/obesity and insufficient fruit intake predicted greater rates of increase in HbA1c. Neither fast-food nor healthful food resource availability were associated with change in HbA1c. Greater healthful food resource availability reduced the rate of increase in HbA1c concentration attributed to the overweight/obesity norm. CONCLUSIONS Local descriptive health-related norms, not food resource availability, predicted 10-year change in HbA1c. Null findings for food resource availability may reflect a sufficiency or minimum threshold level of resources such that availability poses no barrier to obtaining healthful or unhealthful foods for this region. However, the influence of local descriptive norms varied according to food resource availability in effects on HbA1c. Local descriptive health-related norms have received little attention thus far but are important influences on individual cardiometabolic risk. Further research is needed to explore how local descriptive norms contribute to chronic disease risk and outcomes.
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Affiliation(s)
- Suzanne J. Carroll
- Spatial Epidemiology and Evaluation Research Group, School of Health Sciences and Centre for Population Health Research, University of South Australia, IPC CWE-48, GPO Box 2471, Adelaide, South Australia 5001 Australia
| | - Catherine Paquet
- Spatial Epidemiology and Evaluation Research Group, School of Health Sciences and Centre for Population Health Research, University of South Australia, IPC CWE-48, GPO Box 2471, Adelaide, South Australia 5001 Australia
- Research Centre of the Douglas Mental Health University Institute, Verdun, Québec Canada
| | - Natasha J. Howard
- Spatial Epidemiology and Evaluation Research Group, School of Health Sciences and Centre for Population Health Research, University of South Australia, IPC CWE-48, GPO Box 2471, Adelaide, South Australia 5001 Australia
| | - Neil T. Coffee
- Spatial Epidemiology and Evaluation Research Group, School of Health Sciences and Centre for Population Health Research, University of South Australia, IPC CWE-48, GPO Box 2471, Adelaide, South Australia 5001 Australia
| | - Robert J. Adams
- Discipline of Medicine, The University of Adelaide, Adelaide, South Australia Australia
| | - Anne W. Taylor
- Discipline of Medicine, The University of Adelaide, Adelaide, South Australia Australia
| | - Theo Niyonsenga
- Spatial Epidemiology and Evaluation Research Group, School of Health Sciences and Centre for Population Health Research, University of South Australia, IPC CWE-48, GPO Box 2471, Adelaide, South Australia 5001 Australia
| | - Mark Daniel
- Spatial Epidemiology and Evaluation Research Group, School of Health Sciences and Centre for Population Health Research, University of South Australia, IPC CWE-48, GPO Box 2471, Adelaide, South Australia 5001 Australia
- Department of Medicine, The University of Melbourne, St. Vincent’s Hospital, Melbourne, VIC Australia
- South Australian Health & Medical Research Institute, Adelaide, South Australia Australia
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141
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Sarkar C, Webster C. Healthy Cities of Tomorrow: the Case for Large Scale Built Environment-Health Studies. J Urban Health 2017; 94:4-19. [PMID: 28116584 PMCID: PMC5359177 DOI: 10.1007/s11524-016-0122-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- Chinmoy Sarkar
- Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Knowles Building, Pokfulam Road, Pok Fu Lam, Hong Kong.
| | - Chris Webster
- Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Knowles Building, Pokfulam Road, Pok Fu Lam, Hong Kong.,Department of Land Economy, Cambridge University, 19 Silver Street, Cambridge, CB3 9EP, UK
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142
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Association of environmental indicators with teen alcohol use and problem behavior: Teens' observations vs. objectively-measured indicators. Health Place 2017; 43:151-157. [PMID: 28061392 DOI: 10.1016/j.healthplace.2016.12.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 12/09/2016] [Accepted: 12/12/2016] [Indexed: 11/20/2022]
Abstract
Most prior studies use objectively measured data (e.g., census-based indicators) to assess contextual risks. However, teens' observations might be more important for their risk behavior. OBJECTIVES 1) determine relationships between observed and objective indicators of contextual risks 2) determine relations of observed and objective indicators with teen alcohol use and problem behavior. Teens aged 14-16 (N=170) carried GPS-enabled smartphones for one month, with locations documented. Ecological momentary assessment (EMA) measured teens' observations via texts regarding risk behaviors and environmental observations. Objective indicators of alcohol outlets and disorganization were spatially joined to EMAs based on teens' location at the time of the texts. Observed and objective disorganization, and objective indicators of alcohol outlets were related to alcohol use. Observed disorganization was related to problem behavior, while objective indicators were unrelated. Findings suggest the importance of considering teens' observations of contextual risk for understanding influences on risk behavior and suggest future directions for research and prevention strategies.
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143
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Lakerveld J, Mackenbach J. The Upstream Determinants of Adult Obesity. Obes Facts 2017; 10:216-222. [PMID: 28564658 PMCID: PMC5644962 DOI: 10.1159/000471489] [Citation(s) in RCA: 93] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 03/09/2017] [Indexed: 01/11/2023] Open
Abstract
Over-consumption of high-energy foods and a lack of physical activity are the main behavioural risk factors for people to develop obesity. These behaviours are influenced by a range of individual-level factors which are nested within contexts that contain influencing characteristics further upstream. In this paper, we define these upstream determinants. We also provide a historical background, summarise the current evidence base regarding these determinants across various types of environments and put them in perspective.
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Affiliation(s)
- Jeroen Lakerveld
- *Dr. Jeroen Lakerveld, Department of Epidemiology and Biostatistics, VU Medical Center, De Boelelaan 1089a, 1081 HV Amsterdam, The Netherlands,
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144
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Simonelli G, Dudley KA, Weng J, Gallo LC, Perreira K, Shah NA, Alcantara C, Zee PC, Ramos AR, Llabre MM, Sotres-Alvarez D, Wang R, Patel SR. Neighborhood Factors as Predictors of Poor Sleep in the Sueño Ancillary Study of the Hispanic Community Health Study/Study of Latinos. Sleep 2017; 40:2661544. [PMID: 28364454 PMCID: PMC5804993 DOI: 10.1093/sleep/zsw025] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Study Objectives To evaluate whether an adverse neighborhood environment has higher prevalence of poor sleep in a US Hispanic/Latino population. Methods A cross-sectional analysis was performed in 2156 US Hispanic/Latino participants aged 18-64 years from the Sueño ancillary study of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Participants completed surveys of neighborhood environment including perceived safety, violence and noise, the Insomnia Severity Index (ISI), and 7 days of wrist actigraphy. Results In age and sex-adjusted analyses, short sleep, low sleep efficiency, and late sleep midpoint were all more prevalent among those living in an unsafe neighborhood. After adjustment for background, site, nativity, income, employment, depressive symptoms, and sleep apnea, the absolute risk of sleeping <6 hours was 7.7 (95% CI [0.9, 14.6]) percentage points greater in those living in an unsafe compared to a safe neighborhood. There were no differences in the prevalence of insomnia by level of safety or violence. Insomnia was more prevalent among those living in a noisy neighborhood. In adjusted analysis, the absolute risk of insomnia was 4.4 (95% CI [0.4, 8.4]) percentage points greater in those living in noisy compared to non-noisy neighborhoods. Conclusion Using validated measures of sleep duration and insomnia, we have demonstrated the existence of a higher prevalence of short sleep and insomnia by adverse neighborhood factors. An adverse neighborhood environment is an established risk factor for a variety of poor health outcomes. Our findings suggest negative effects on sleep may represent one pathway by which neighborhood environment influences health.
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Affiliation(s)
- Guido Simonelli
- Behavioral Biology Branch, Walter Reed Army Institute of Research, Silver Spring, MD
| | - Katherine A Dudley
- Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA
| | - Jia Weng
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA
| | - Linda C Gallo
- Department of Psychology San Diego State University, San Diego, CA
| | - Krista Perreira
- Department of Public Policy, University of North Carolina, Chapel Hill, NC
| | - Neomi A Shah
- Division of Pulmonary, Critical Care and Sleep, Icahn School of Medicine at Mount Sinai, New York, NY
| | | | - Phyllis C Zee
- Center for Circadian and Sleep Medicine, Northwestern University Feinberg School of Medicine, Evanston, IL
| | - Alberto R Ramos
- Department of Neurology, University of Miami, Miller School of Medicine, Miami, FL
| | - Maria M Llabre
- Department of Psychology, University of Miami, Coral Gables, FL
| | - Daniela Sotres-Alvarez
- Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
| | - Rui Wang
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA
| | - Sanjay R Patel
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA
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145
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Riva M, Larsen CVL, Bjerregaard P. Association between individual-level and community-level socio-economic status and blood pressure among Inuit in Greenland. Int J Circumpolar Health 2016; 75:32757. [PMID: 27938632 PMCID: PMC5148804 DOI: 10.3402/ijch.v75.32757] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 10/19/2016] [Accepted: 10/19/2016] [Indexed: 11/29/2022] Open
Abstract
Background Despite abundant evidence that socio-economic status (SES) is a fundamental determinant of health, there is a dearth of research examining association between SES, measured at the individual and community levels, and cardiovascular risk factors and morbidity among indigenous populations. Objectives To examine the influence of individual-level and community-level SES on systolic and diastolic blood pressure among Greenlandic Inuit. Methods Multilevel analysis of cross-sectional data from the Inuit Health in Transition – Greenland Survey, to which 3,108 Greenlandic Inuit aged 18 years and older participated. Blood pressure is measured using an automatic device, according to standardized protocol. Individual SES is measured by education. Community socio-economic conditions are measured using combined information on average disposable household income and settlement type. Results Education was not significantly associated with blood pressure. There was an inverse U-shape association between community socio-economic conditions and blood pressure with significantly lower SBP and DBP among participants living in remote traditional villages characterized by lower average disposable household income and in affluent more urbanized towns. Sex-stratified analyses demonstrate the salience of community conditions for men. Conclusions The association observed between blood pressure and community-level socio-economic conditions suggests that public health and social policies, programmes and interventions aiming to improve living conditions might improve cardiovascular health in Greenland. Studies are required to further examine social gradients in cardiovascular risk factors and morbidity among indigenous populations using different measures of SES.
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Affiliation(s)
- Mylène Riva
- Institute for Health and Social Policy and Department of Geography, McGill University, Montreal, Canada;
| | - Christina Viskum Lytken Larsen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.,Greenland Centre for Health Research, University of Greenland, Nuuk, Greenland
| | - Peter Bjerregaard
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.,Greenland Centre for Health Research, University of Greenland, Nuuk, Greenland
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Braun LM, Rodriguez DA, Song Y, Meyer KA, Lewis CE, Reis JP, Gordon-Larsen P. Changes in walking, body mass index, and cardiometabolic risk factors following residential relocation: Longitudinal results from the CARDIA study. JOURNAL OF TRANSPORT & HEALTH 2016; 3:426-439. [PMID: 28163997 PMCID: PMC5282825 DOI: 10.1016/j.jth.2016.08.006] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND While many studies have found the built environment to be associated with walking, most have used cross-sectional research designs and few have examined more distal cardiometabolic outcomes. This study contributes longitudinal evidence based on changes in walking, body mass index (BMI), and cardiometabolic risk following residential relocation. METHODS We examined 1,079 participants in the CARDIA study who moved residential locations between 2000 and 2006 (ages 32-46 in 2000, 49% white/51% black, 55% female). We created a walkability index from measures of population density, street connectivity, and food and physical activity resources, measured at participants' pre- and post-move residential locations. Outcomes measured before and after the move included walking, BMI, waist circumference, blood pressure, insulin resistance, triglycerides, cholesterol, atherogenic dyslipidemia, and C-reactive protein. Fixed effects (FE) models were used to estimate associations between within-person change in walkability and within-person change in each outcome. These estimates were compared to those from random effects (RE) models to assess the implications of unmeasured confounding. RESULTS In FE models, a one-SD increase in walkability was associated with a 0.81 mmHg decrease in systolic blood pressure [95% CI: (-1.55, -0.07)] and a 7.36 percent increase in C-reactive protein [95% CI: (0.60, 14.57)]. Although several significant associations were observed in the RE models, Hausman tests suggested that these estimates were biased for most outcomes. RE estimates were most commonly biased away from the null or in the opposite direction of effect as the FE estimates. CONCLUSIONS Greater walkability was associated with lower blood pressure and higher C-reactive protein in FE models, potentially reflecting competing health risks and benefits in dense, walkable environments. RE models tended to overstate or otherwise misrepresent the relationship between walkability and health. Approaches that base estimates on variation between individuals may be subject to bias from unmeasured confounding, such as residential self-selection.
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Affiliation(s)
- Lindsay M. Braun
- Department of City and Regional Planning, University of North Carolina at Chapel Hill
| | - Daniel A. Rodriguez
- Department of City and Regional Planning, University of California, Berkeley
| | - Yan Song
- Department of City and Regional Planning, University of North Carolina at Chapel Hill
| | - Katie A. Meyer
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill
| | - Cora E. Lewis
- Division of Preventive Medicine, Department of Medicine , University of Alabama at Birmingham
| | - Jared P. Reis
- National Heart, Lung, and Blood Institute, Prevention and Population Sciences Program
| | - Penny Gordon-Larsen
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill
- Carolina Population Center, University of North Carolina at Chapel Hill
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147
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Barber S, Hickson DA, Wang X, Sims M, Nelson C, Diez-Roux AV. Neighborhood Disadvantage, Poor Social Conditions, and Cardiovascular Disease Incidence Among African American Adults in the Jackson Heart Study. Am J Public Health 2016; 106:2219-2226. [PMID: 27736207 PMCID: PMC5105010 DOI: 10.2105/ajph.2016.303471] [Citation(s) in RCA: 86] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2016] [Indexed: 01/31/2023]
Abstract
OBJECTIVES To examine the impact of neighborhood conditions resulting from racial residential segregation on cardiovascular disease (CVD) risk in a socioeconomically diverse African American sample. METHODS The study included 4096 African American women (n = 2652) and men (n = 1444) aged 21 to 93 years from the Jackson Heart Study (Jackson, Mississippi; 2000-2011). We assessed neighborhood disadvantage with a composite measure of 8 indicators from the 2000 US Census. We assessed neighborhood-level social conditions, including social cohesion, violence, and disorder, with self-reported, validated scales. RESULTS Among African American women, each standard deviation increase in neighborhood disadvantage was associated with a 25% increased risk of CVD after covariate adjustment (hazard ratio = 1.25; 95% confidence interval = 1.05, 1.49). Risk also increased as levels of neighborhood violence and physical disorder increased after covariate adjustment. We observed no statistically significant associations among African American men in adjusted models. CONCLUSIONS Worse neighborhood economic and social conditions may contribute to increased risk of CVD among African American women. Policies directly addressing these issues may alleviate the burden of CVD in this group.
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Affiliation(s)
- Sharrelle Barber
- Sharrelle Barber, Xu Wang, and Ana V. Diez-Roux are with Drexel University School of Public Health, Department of Epidemiology and Biostatistics, and Center for Integrative Approaches to Health Disparities, Philadelphia, PA. DeMarc A. Hickson and Mario Sims are with University of Mississippi Medical Center, Jackson. Cheryl Nelson is with National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
| | - DeMarc A Hickson
- Sharrelle Barber, Xu Wang, and Ana V. Diez-Roux are with Drexel University School of Public Health, Department of Epidemiology and Biostatistics, and Center for Integrative Approaches to Health Disparities, Philadelphia, PA. DeMarc A. Hickson and Mario Sims are with University of Mississippi Medical Center, Jackson. Cheryl Nelson is with National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Xu Wang
- Sharrelle Barber, Xu Wang, and Ana V. Diez-Roux are with Drexel University School of Public Health, Department of Epidemiology and Biostatistics, and Center for Integrative Approaches to Health Disparities, Philadelphia, PA. DeMarc A. Hickson and Mario Sims are with University of Mississippi Medical Center, Jackson. Cheryl Nelson is with National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Mario Sims
- Sharrelle Barber, Xu Wang, and Ana V. Diez-Roux are with Drexel University School of Public Health, Department of Epidemiology and Biostatistics, and Center for Integrative Approaches to Health Disparities, Philadelphia, PA. DeMarc A. Hickson and Mario Sims are with University of Mississippi Medical Center, Jackson. Cheryl Nelson is with National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Cheryl Nelson
- Sharrelle Barber, Xu Wang, and Ana V. Diez-Roux are with Drexel University School of Public Health, Department of Epidemiology and Biostatistics, and Center for Integrative Approaches to Health Disparities, Philadelphia, PA. DeMarc A. Hickson and Mario Sims are with University of Mississippi Medical Center, Jackson. Cheryl Nelson is with National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Ana V Diez-Roux
- Sharrelle Barber, Xu Wang, and Ana V. Diez-Roux are with Drexel University School of Public Health, Department of Epidemiology and Biostatistics, and Center for Integrative Approaches to Health Disparities, Philadelphia, PA. DeMarc A. Hickson and Mario Sims are with University of Mississippi Medical Center, Jackson. Cheryl Nelson is with National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
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148
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Malambo P, Kengne AP, De Villiers A, Lambert EV, Puoane T. Built Environment, Selected Risk Factors and Major Cardiovascular Disease Outcomes: A Systematic Review. PLoS One 2016; 11:e0166846. [PMID: 27880835 PMCID: PMC5120821 DOI: 10.1371/journal.pone.0166846] [Citation(s) in RCA: 163] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 11/05/2016] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Built environment attributes have been linked to cardiovascular disease (CVD) risk. Therefore, identifying built environment attributes that are associated with CVD risk is relevant for facilitating effective public health interventions. OBJECTIVE To conduct a systematic review of literature to examine the influence of built environmental attributes on CVD risks. DATA SOURCE Multiple database searches including Science direct, CINAHL, Masterfile Premier, EBSCO and manual scan of reference lists were conducted. INCLUSION CRITERIA Studies published in English between 2005 and April 2015 were included if they assessed one or more of the neighborhood environmental attributes in relation with any major CVD outcomes and selected risk factors among adults. DATA EXTRACTION Author(s), country/city, sex, age, sample size, study design, tool used to measure neighborhood environment, exposure and outcome assessments and associations were extracted from eligible studies. RESULTS Eighteen studies met the inclusion criteria. Most studies used both cross-sectional design and Geographic Information System (GIS) to assess the neighborhood environmental attributes. Neighborhood environmental attributes were significantly associated with CVD risk and CVD outcomes in the expected direction. Residential density, safety from traffic, recreation facilities, street connectivity and high walkable environment were associated with physical activity. High walkable environment, fast food restaurants, supermarket/grocery stores were associated with blood pressure, body mass index, diabetes mellitus and metabolic syndrome. High density traffic, road proximity and fast food restaurants were associated with CVDs outcomes. CONCLUSION This study confirms the relationship between neighborhood environment attributes and CVDs and risk factors. Prevention programs should account for neighborhood environmental attributes in the communities where people live.
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Affiliation(s)
- Pasmore Malambo
- University of Western Cape, School of Public Health, Robert Sobukwe Rd, Bellville, Cape Town, 7535, South Africa
- * E-mail:
| | - Andre P. Kengne
- Non-communicable disease Unit, South African Medical Research Council, Francie van Zijl Drive, Parowvallei, P.O. Box 19070, 7505 Tygerberg, Cape Town, South Africa
| | - Anniza De Villiers
- Non-communicable disease Unit, South African Medical Research Council, Francie van Zijl Drive, Parowvallei, P.O. Box 19070, 7505 Tygerberg, Cape Town, South Africa
| | - Estelle V. Lambert
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Boundary Road, Newlands, 7700, Cape Town, South Africa
| | - Thandi Puoane
- University of Western Cape, School of Public Health, Robert Sobukwe Rd, Bellville, Cape Town, 7535, South Africa
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149
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Drewnowski A, Aggarwal A, Tang W, Hurvitz PM, Scully J, Stewart O, Moudon AV. Obesity, diet quality, physical activity, and the built environment: the need for behavioral pathways. BMC Public Health 2016; 16:1153. [PMID: 27832766 PMCID: PMC5105275 DOI: 10.1186/s12889-016-3798-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 11/01/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The built environment (BE) is said to influence local obesity rates. Few studies have explored causal pathways between home-neighborhood BE variables and health outcomes such as obesity. Such pathways are likely to involve both physical activity and diet. METHODS The Seattle Obesity Study (SOS II) was a longitudinal cohort of 440 adult residents of King Co, WA. Home addresses were geocoded. Home-neighborhood BE measures were framed as counts and densities of food sources and physical activity locations. Tax parcel property values were obtained from County tax assessor. Healthy Eating Index (HEI 2010) scores were constructed using data from food frequency questionnaires. Physical activity (PA) was obtained by self-report. Weights and heights were measured at baseline and following 12 months' exposure. Multivariable regressions examined the associations among BE measures at baseline, health behaviors (HEI-2010 and physical activity) at baseline, and health outcome both cross-sectionally and longitudinally. RESULTS None of the conventional neighborhood BE metrics were associated either with diet quality, or with meeting PA guidelines. Only higher property values did predict better diets and more physical activity. Better diets and more physical activity were associated with lower obesity prevalence at baseline and 12 mo, but did not predict weight change. CONCLUSION Any links between the BE and health outcomes critically depend on establishing appropriate behavioral pathways. In this study, home-centric BE measures, were not related to physical activity or to diet. Further studies will need to consider a broader range of BE attributes that may be related to diets and health.
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Affiliation(s)
- Adam Drewnowski
- Center for Public Health Nutrition, 1107 NE 45th St, University of Washington, Seattle, WA, 98105, USA. .,University of Washington, Box 353410, Seattle, WA, 98195, USA.
| | - Anju Aggarwal
- Center for Public Health Nutrition, 1107 NE 45th St, University of Washington, Seattle, WA, 98105, USA
| | - Wesley Tang
- Center for Public Health Nutrition, 1107 NE 45th St, University of Washington, Seattle, WA, 98105, USA
| | - Philip M Hurvitz
- Urban Form Lab, 1107 NE 45th St, University of Washington, Seattle, WA, 98105, USA
| | - Jason Scully
- Urban Form Lab, 1107 NE 45th St, University of Washington, Seattle, WA, 98105, USA
| | - Orion Stewart
- Urban Form Lab, 1107 NE 45th St, University of Washington, Seattle, WA, 98105, USA
| | - Anne Vernez Moudon
- Urban Form Lab, 1107 NE 45th St, University of Washington, Seattle, WA, 98105, USA
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150
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James P, Jankowska M, Marx C, Hart JE, Berrigan D, Kerr J, Hurvitz PM, Hipp JA, Laden F. "Spatial Energetics": Integrating Data From GPS, Accelerometry, and GIS to Address Obesity and Inactivity. Am J Prev Med 2016; 51:792-800. [PMID: 27528538 PMCID: PMC5067207 DOI: 10.1016/j.amepre.2016.06.006] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 05/05/2016] [Accepted: 06/04/2016] [Indexed: 01/23/2023]
Abstract
To address the current obesity and inactivity epidemics, public health researchers have attempted to identify spatial factors that influence physical inactivity and obesity. Technologic and methodologic developments have led to a revolutionary ability to examine dynamic, high-resolution measures of temporally matched location and behavior data through GPS, accelerometry, and GIS. These advances allow the investigation of spatial energetics, high-spatiotemporal resolution data on location and time-matched energetics, to examine how environmental characteristics, space, and time are linked to activity-related health behaviors with far more robust and detailed data than in previous work. Although the transdisciplinary field of spatial energetics demonstrates promise to provide novel insights on how individuals and populations interact with their environment, there remain significant conceptual, technical, analytical, and ethical challenges stemming from the complex data streams that spatial energetics research generates. First, it is essential to better understand what spatial energetics data represent, the relevant spatial context of analysis for these data, and if spatial energetics can establish causality for development of spatially relevant interventions. Second, there are significant technical problems for analysis of voluminous and complex data that may require development of spatially aware scalable computational infrastructures. Third, the field must come to agreement on appropriate statistical methodologies to account for multiple observations per person. Finally, these challenges must be considered within the context of maintaining participant privacy and security. This article describes gaps in current practice and understanding and suggests solutions to move this promising area of research forward.
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Affiliation(s)
- Peter James
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
| | | | - Christine Marx
- Division of Public Health Sciences, Washington University School of Medicine, St. Louis, Missouri
| | - Jaime E Hart
- Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - David Berrigan
- Health Behaviors Research Branch, Behavioral Research Program, National Cancer Institute, Bethesda, Maryland
| | - Jacqueline Kerr
- Department of Family Medicine and Public Health, University of California, San Diego, San Diego, California; Psychology Department, Graduate School of Public Health, San Diego State University, San Diego, California
| | | | - J Aaron Hipp
- Department of Parks, Recreation, and Tourism Management, North Carolina State University, Raleigh, North Carolina
| | - Francine Laden
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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