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Patrick K, Hekler EB, Estrin D, Mohr DC, Riper H, Crane D, Godino J, Riley WT. The Pace of Technologic Change: Implications for Digital Health Behavior Intervention Research. Am J Prev Med 2016; 51:816-824. [PMID: 27745681 DOI: 10.1016/j.amepre.2016.05.001] [Citation(s) in RCA: 94] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 05/02/2016] [Accepted: 05/02/2016] [Indexed: 01/01/2023]
Abstract
This paper addresses the rapid pace of change in the technologies that support digital interventions; the complexity of the health problems they aim to address; and the adaptation of scientific methods to accommodate the volume, velocity, and variety of data and interventions possible from these technologies. Information, communication, and computing technologies are now part of every societal domain and support essentially every facet of human activity. Ubiquitous computing, a vision articulated fewer than 30 years ago, has now arrived. Simultaneously, there is a global crisis in health through the combination of lifestyle and age-related chronic disease and multiple comorbidities. Computationally intensive health behavior interventions may be one of the most powerful methods to reduce the consequences of this crisis, but new methods are needed for health research and practice, and evidence is needed to support their widespread use. The challenges are many, including a reluctance to abandon timeworn theories and models of health behavior-and health interventions more broadly-that emerged in an era of self-reported data; medical models of prevention, diagnosis, and treatment; and scientific methods grounded in sparse and expensive data. There are also many challenges inherent in demonstrating that newer approaches are, indeed, effective. Potential solutions may be found in leveraging methods of research that have been shown to be successful in other domains, particularly engineering. A more "agile science" may be needed that streamlines the methods through which elements of health interventions are shown to work or not, and to more rapidly deploy and iteratively improve those that do. There is much to do to advance the issues discussed in this paper, and the papers in this theme issue. It remains an open question whether interventions based in these new models and methods are, in fact, equally if not more efficacious as what is available currently. Economic analyses of these new approaches are needed because assumptions of net worth compared to other approaches are just that, assumptions. Human-centered design research is needed to ensure that users ultimately benefit. Finally, a translational research agenda will be needed, as the status quo will likely be resistant to change.
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Affiliation(s)
- Kevin Patrick
- Center for Wireless and Population Health Systems, University of California, San Diego, La Jolla, California.
| | - Eric B Hekler
- School of Nutrition and Health Promotion, Arizona State University, Phoenix, Arizona
| | - Deborah Estrin
- Cornell NYC Tech, Department of Computer Science, Cornell University, New York, New York
| | - David C Mohr
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Heleen Riper
- Faculty of Behavioural and Movement Sciences, Section of Clinical Psychology, VU University Amsterdam, Amsterdam, the Netherlands
| | - David Crane
- Centre for Behaviour Change, University College London, London, United Kingdom
| | - Job Godino
- Center for Wireless and Population Health Systems, University of California, San Diego, La Jolla, California
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Duncan DT, Tamura K, Regan SD, Athens J, Elbel B, Meline J, Al-Ajlouni YA, Chaix B. Quantifying spatial misclassification in exposure to noise complaints among low-income housing residents across New York City neighborhoods: a Global Positioning System (GPS) study. Ann Epidemiol 2016; 27:67-75. [PMID: 28063754 DOI: 10.1016/j.annepidem.2016.09.017] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 09/11/2016] [Accepted: 09/21/2016] [Indexed: 11/29/2022]
Abstract
PURPOSE To examine if there was spatial misclassification in exposure to neighborhood noise complaints among a sample of low-income housing residents in New York City, comparing home-based spatial buffers and Global Positioning System (GPS) daily path buffers. METHODS Data came from the community-based NYC Low-Income Housing, Neighborhoods and Health Study, where GPS tracking of the sample was conducted for a week (analytic n = 102). We created a GPS daily path buffer (a buffering zone drawn around GPS tracks) of 200 m and 400 m. We also used home-based buffers of 200 m and 400 m. Using these "neighborhoods" (or exposure areas), we calculated neighborhood exposure to noisy events from 311 complaints data (analytic n = 143,967). Friedman tests (to compare overall differences in neighborhood definitions) were applied. RESULTS There were differences in neighborhood noise complaints according to the selected neighborhood definitions (P < .05). For example, the mean neighborhood noise complaint count was 1196 per square kilometer for the 400-m home-based and 812 per square kilometer for the 400-m activity space buffer, illustrating how neighborhood definition influences the estimates of exposure to neighborhood noise complaints. CONCLUSIONS These analyses suggest that, whenever appropriate, GPS neighborhood definitions can be used in spatial epidemiology research in spatially mobile populations to understand people's lived experience.
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Affiliation(s)
- Dustin T Duncan
- Department of Population Health, New York University School of Medicine, New York.
| | - Kosuke Tamura
- Department of Population Health, New York University School of Medicine, New York
| | - Seann D Regan
- Department of Population Health, New York University School of Medicine, New York
| | - Jessica Athens
- Department of Population Health, New York University School of Medicine, New York
| | - Brian Elbel
- Department of Population Health, New York University School of Medicine, New York; Wagner Graduate School of Public Service, New York University, New York
| | - Julie Meline
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, Paris, France; Inserm, UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
| | - Yazan A Al-Ajlouni
- Department of Population Health, New York University School of Medicine, New York
| | - Basile Chaix
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, Paris, France; Inserm, UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
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153
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Tabak R, Hipp JA, Dodson EA, Yang L, Adlakha D, Brownson RC. Exploring associations between perceived home and work neighborhood environments, diet behaviors, and obesity: Results from a survey of employed adults in Missouri. Prev Med Rep 2016; 4:591-596. [PMID: 27843759 PMCID: PMC5107640 DOI: 10.1016/j.pmedr.2016.10.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 10/20/2016] [Accepted: 10/23/2016] [Indexed: 10/26/2022] Open
Abstract
Dietary behaviors are associated with obesity, and may be influenced by the environment. The objective of the current work was to investigate whether perceptions of built environment factors related to eating in the residential neighborhood will have different, independent associations with BMI and dietary behaviors than perceived built environment factors in the worksite neighborhood. In 2012-2013, a cross-sectional telephone-survey of Missouri adults (n = 2015) assessed perceptions of home and workplace built environment factors related to eating, dietary behaviors, and height and weight. Logistic regression models explored associations between perceived neighborhood built environment variables, diet, and obesity. The only variable associated with any of the outcomes explored in the fully adjusted models was the home neighborhood composite scale. None of the work environment variables were significantly associated with any of the health/behavior outcomes after adjustment. Few associations were found after adjustment for personal and job-related characteristics, and none were identified with the workplace neighborhood environment. While few home environment associations were found after adjustment, and none were identified with the perceived workplace neighborhood environment, the current study adds to the limited literature looking at associations between the perceived neighborhood around the workplace neighborhood and the perceived neighborhood around the home and dietary behaviors and obesity in adults. Future studies are needed to determine whether relationships between these environments and behavior exist, and if so, if they are causal and warrant intervention attempts.
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Affiliation(s)
- Rachel Tabak
- Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, Campus Box 1196, One Brookings Drive, St. Louis, MO 63130, United States
| | - J Aaron Hipp
- Department of Parks, Recreation, and Tourism Management, Center for Geospatial Analytics, North Carolina State University, 5124 Jordan Hall, Campus Box 8004, Raleigh, NC 27695, United States
| | - Elizabeth A Dodson
- Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, Campus Box 1196, One Brookings Drive, St. Louis, MO 63130, United States
| | - Lin Yang
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1 Floor, 1090 Vienna, Austria
| | - Deepti Adlakha
- Center for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Ross C Brownson
- Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, Campus Box 1196, One Brookings Drive, St. Louis, MO 63130, United States; Department of Surgery and Alvin J. Siteman Cancer Center, Washington University School of Medicine, United States
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154
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Cebrecos A, Díez J, Gullón P, Bilal U, Franco M, Escobar F. Characterizing physical activity and food urban environments: a GIS-based multicomponent proposal. Int J Health Geogr 2016; 15:35. [PMID: 27716312 PMCID: PMC5050955 DOI: 10.1186/s12942-016-0065-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 09/28/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Healthier urban environments influence the distribution of cardiovascular risk factors. Our aim was to design and implement a multicomponent method based on Geographic Information Systems to characterize and evaluate environmental correlates of obesity: the food and the physical activity urban environments. METHODS Study location comprised a socio-demographically average urban area of 12 contiguous census sections (≈16,000 residents), in Madrid, Spain. We conducted on-field audits on all food stores and street segments. We designed a synthetic index integrating continuous measures of both environments, by kernel density analyses. Index ranges from 0 to 100 (least-most healthy). RESULTS We found a heterogeneous distribution with 75 and 50 % of the area scoring less than 36.8 and 25.5, respectively. Census sections of study area were categorized by Jenks intervals as high, medium-high, medium-low and low. 41.0 % of residents lived in an area with a low score, 23.6 % medium-low and 31.1 % medium-high and 4.2 % in a high. CONCLUSION The proposed synthetic index may be a relevant tool to inform urban health interventions, providing a feasible way to integrate different measures of barriers and facilitators of healthy urban environments in terms of food and physical activity.
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Affiliation(s)
- Alba Cebrecos
- Social and Cardiovascular Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain.,Department of Geology, Geography and Environmental Sciences, University of Alcalá, Calle Colegios 2, 28801, Alcalá de Henares, Madrid, Spain
| | - Julia Díez
- Social and Cardiovascular Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - Pedro Gullón
- Social and Cardiovascular Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain.,Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Madrid, Spain
| | - Usama Bilal
- Social and Cardiovascular Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Manuel Franco
- Social and Cardiovascular Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Francisco Escobar
- Social and Cardiovascular Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain. .,Department of Geology, Geography and Environmental Sciences, University of Alcalá, Calle Colegios 2, 28801, Alcalá de Henares, Madrid, Spain.
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155
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Tamayo A, Mujahid MS, Laraia B, Warton EM, Blanchard SD, Kelly M, Moffet HH, Adler N, Schillinger D, Karter AJ. Police-Recorded Crime and Perceived Stress among Patients with Type 2 Diabetes: the Diabetes Study of Northern California (DISTANCE). J Urban Health 2016; 93:745-757. [PMID: 27613180 PMCID: PMC5052144 DOI: 10.1007/s11524-016-0069-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
While stress has been linked to poor health outcomes, little is known about the impact of objective measures of neighborhood crime on stress in patients with chronic disease. Using the Kaiser Permanente Diabetes Study of Northern California (DISTANCE), we examined associations between police-recorded crime (2005-2007) and stress (Perceived Stress Scale-4) in four large Northern California cities (Oakland, Sacramento, San Francisco, and San Jose). We performed stratified analysis by gender and race/ethnicity using generalized linear regression models. In our study sample (n = 3188, mean age 59, range 30-77), 10 % reported high stress. In adjusted analyses, higher neighborhood all crimes rate was associated with modest increase in high stress for African-American (OR = 1.10; 95 % CI 1.02-1.22) and Latina women (OR = 1.36; 95 % CI 1.10-1.67) and property crime showed similar associations with stress for these groups of women. Visible crime was associated with stress only for Latina women (OR = 1.43; 95 % CI 1.14-1.78). We found no association between crime and stress among men or other racial/ethnic groups of women. High crime levels may disproportionately impact health among certain subpopulations. Studies using additional measures of stress are necessary to differentiate the health impact of crime-related stress from other forms of stressors among individuals living with diabetes.
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Affiliation(s)
- Aracely Tamayo
- School of Public Health, Division of Epidemiology, University of California Berkeley, 101 Haviland Hall, Berkeley, CA, 94720-7358, USA
| | - Mahasin S Mujahid
- School of Public Health, Division of Epidemiology, University of California Berkeley, 101 Haviland Hall, Berkeley, CA, 94720-7358, USA.
| | - Barbara Laraia
- Berkeley School of Public Health, Division of Public Health Nutrition, University of California, 207B University Hall, Berkeley, CA, 94720, USA
| | - E Margaret Warton
- Kaiser Permanente Division of Research, 2000 Broadway, Oakland, CA, 94612, USA
| | - Samuel D Blanchard
- Berkeley Department of Environmental Science, Policy and Management, University of California, 130 Mulford Hall, Berkeley, CA, 94720-3114, USA
| | - Maggi Kelly
- Berkeley Department of Environmental Science, Policy and Management, University of California, 130 Mulford Hall, Berkeley, CA, 94720-3114, USA
| | - Howard H Moffet
- Kaiser Permanente Division of Research, 2000 Broadway, Oakland, CA, 94612, USA
| | - Nancy Adler
- San Francisco Center for Health and Community, University of California, 3333 California St. Laurel Heights, San Francisco, CA, 94118, USA
| | - Dean Schillinger
- San Francisco Center for Vulnerable Populations at San Francisco General Hospital, University of California, 1001 Portero Ave, SFGH 10, San Francisco, CA, 94110, USA
| | - Andrew J Karter
- Kaiser Permanente Division of Research, 2000 Broadway, Oakland, CA, 94612, USA
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156
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Hammad SS, Berry DC. The Child Obesity Epidemic in Saudi Arabia: A Review of the Literature. J Transcult Nurs 2016; 28:505-515. [PMID: 27655934 DOI: 10.1177/1043659616668398] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
PURPOSE To examine prevalence, nutrition and activity, and overweight and obesity prevention and management in Saudi Arabia. DESIGN Using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis criteria, PubMed, Web of Science, PyschINFO, Global Health, Family Studies Worldwide, Middle Eastern Studies, and Sociological Abstracts was searched from January 1, 2003 to January 31, 2016. Inclusion criteria included peer-reviewed articles published in Arabic and English that focused on prevalence, overweight or obesity in children 2 to 20 years of age, body mass index percentile, and interventions. FINDINGS Three themes were identified: epidemiological features, where the eastern region had the highest prevalence of overweight and obesity, risk factors, which included higher parental education, and lifestyle factors, which included increased consumption of calorie-dense food and a sedentary lifestyle. CONCLUSION Childhood obesity is increasing in Saudi Arabia at an alarming rate. IMPLICATIONS FOR PRACTICE Practitioners need to consider the cultural influences of the increasing obesity epidemic in Saudi Arabia.
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Affiliation(s)
- Sama S Hammad
- 1 The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Diane C Berry
- 1 The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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157
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Carroll SJ, Paquet C, Howard NJ, Coffee NT, Taylor AW, Niyonsenga T, Daniel M. Local descriptive norms for overweight/obesity and physical inactivity, features of the built environment, and 10-year change in glycosylated haemoglobin in an Australian population-based biomedical cohort. Soc Sci Med 2016; 166:233-243. [PMID: 27591806 DOI: 10.1016/j.socscimed.2016.08.031] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 08/17/2016] [Accepted: 08/19/2016] [Indexed: 01/17/2023]
Abstract
Descriptive norms vary between places. Spatial variation in health-related descriptive norms may predict individual-level health outcomes. Such relationships have rarely been investigated. This study assessed 10-year change in glycosylated haemoglobin (HbA1c) in relation to local descriptive norms for overweight/obesity (n = 1890) and physical inactivity (n = 1906) in models accounting for features of the built environment. HbA1c was measured three times over 10 years for a population-based biomedical cohort of adults in Adelaide, South Australia. Environmental exposures were expressed for cohort participants using 1600 m road-network buffers centred on participants' residential address. Local descriptive norms (prevalence of overweight/obesity [body mass index ≥25 kg/m(2)] and of physical inactivity [<150 min/week]) were aggregated from responses to a separate geocoded population survey. Built environment measures were public open space (POS) availability (proportion of buffer area) and walkability. Separate sets of multilevel models analysed different predictors of 10-year change in HbA1c. Each model featured one local descriptive norm and one built environment variable with area-level education and individual-level covariates (age, sex, employment status, education, marital status, and smoking status). Interactions between local descriptive norms and built environment measures were assessed. HbA1c increased over time. POS availability and local descriptive norms for overweight/obesity and physical inactivity were each associated with greater rates of HbA1c increase. Greater walkability was associated with a reduced rate of HbA1c increase, and reduced the influence of the overweight/obesity norm on the rate of increase in HbA1c. Local descriptive health-related norms and features of the built environment predict 10-year change in HbA1c. The impact of local descriptive norms can vary according to built environment features. Little researched thus far, local descriptive norms may play an important role in the evolution of HbA1c and thus cardiometabolic risk, over time. Further empirical research on local descriptive norms is necessary to understand how residential environments shape chronic disease risk.
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Affiliation(s)
- Suzanne J Carroll
- Spatial Epidemiology and Evaluation Research Group, Centre for Population Health Research, School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia.
| | - Catherine Paquet
- Spatial Epidemiology and Evaluation Research Group, Centre for Population Health Research, School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia; Research Centre of the Douglas Mental Health University Institute, Verdun, Québec, Canada.
| | - Natasha J Howard
- Spatial Epidemiology and Evaluation Research Group, Centre for Population Health Research, School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia.
| | - Neil T Coffee
- Spatial Epidemiology and Evaluation Research Group, Centre for Population Health Research, School of Health Sciences, University of South Australia, 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, Centre for Population Health Research, School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia.
| | - Mark Daniel
- Spatial Epidemiology and Evaluation Research Group, Centre for Population Health Research, School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia; Department of Medicine, The University of Melbourne, St. Vincent's Hospital, Melbourne, Victoria, Australia; South Australian Health & Medical Research Institute, Adelaide, South Australia, Australia.
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158
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Costa S, Adams J, Phillips V, Benjamin Neelon SE. The relationship between childcare and adiposity, body mass and obesity-related risk factors: protocol for a systematic review of longitudinal studies. Syst Rev 2016; 5:141. [PMID: 27535547 PMCID: PMC4989341 DOI: 10.1186/s13643-016-0312-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 08/02/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The rising prevalence of obesity, particularly in childhood, is a global public health emergency. There is some evidence that exposure to non-parental childcare before age 6 years is associated with subsequent development of obesity and obesity-related behaviours such as physical activity, sedentary behaviour, sleep, diet and stress, although these findings are inconsistent. It is possible that the relationship between early childcare and later obesity and obesity-related behaviours depends on characteristics of childcare exposure such as type (i.e. informal versus formal care), duration (i.e. number of years spent in childcare), intensity (e.g. number of hours per week) and timing (i.e. age of onset of childcare) of care received. The relationship may also be moderated by socio-demographic characteristics of children and their families. We will conduct a systematic review exploring longitudinal associations between childcare (type, duration, intensity and timing) and measures of adiposity and body mass, physical activity, sedentary behaviour, sleep, diet and stress. We will also assess whether these relationships vary by socio-demographic factors. METHODS We will include studies that explore longitudinal associations between childcare attendance in children aged <6 years not in primary school at first assessment and body weight, adiposity, physical activity, diet, sleep and stress. We will limit studies to those involving middle- and high-income countries. Two independent reviewers will screen search results in two stages: (1) title and abstract and (2) and full text. One reviewer will extract relevant data and a second will verify this information. We will assess risk of bias of included studies using an adaption of the United States Department of Agriculture National Evidence Library Bias Assessment Tool. We will tabulate and summarise results narratively. We may conduct meta-analysis if at least five studies report comparable data. DISCUSSION To our knowledge, this will be the first systematic review to summarise the existing evidence on longitudinal associations between childcare and adiposity, body mass and obesity-related risk factors. The results will be of relevance to other researchers, childcare practitioners and policy makers. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42015027233.
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Affiliation(s)
- Silvia Costa
- UKCRC Centre for Diet and Activity Research, Medical Research Council Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ UK
| | - Jean Adams
- UKCRC Centre for Diet and Activity Research, Medical Research Council Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ UK
| | - Veronica Phillips
- Medical Library, School of Clinical Medicine, University of Cambridge, Box 111, Cambridge Biomedical Campus, Cambridge, CB2 0SP UK
| | - Sara E Benjamin Neelon
- UKCRC Centre for Diet and Activity Research, Medical Research Council Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ UK
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, 624 N Broadway, Baltimore, MD 21205 USA
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159
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Florian J, Roy NMSO, Quintiliani LM, Truong V, Feng Y, Bloch PP, Russinova ZL, Lasser KE. Using Photovoice and Asset Mapping to Inform a Community-Based Diabetes Intervention, Boston, Massachusetts, 2015. Prev Chronic Dis 2016; 13:E107. [PMID: 27513998 PMCID: PMC4993113 DOI: 10.5888/pcd13.160160] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Introduction Diabetes self-management takes place within a complex social and environmental context. This study’s objective was to examine the perceived and actual presence of community assets that may aid in diabetes control. Methods We conducted one 6-hour photovoice session with 11 adults with poorly controlled diabetes in Boston, Massachusetts. Participants were recruited from census tracts with high numbers of people with poorly controlled diabetes (diabetes “hot spots”). We coded the discussions and identified relevant themes. We further explored themes related to the built environment through community asset mapping. Through walking surveys, we evaluated 5 diabetes hot spots related to physical activity resources, walking environment, and availability of food choices in restaurants and food stores. Results Community themes from the photovoice session were access to healthy food, restaurants, and prepared foods; food assistance programs; exercise facilities; and church. Asset mapping identified 114 community assets including 22 food stores, 22 restaurants, and 5 exercise facilities. Each diabetes hot spot contained at least 1 food store with 5 to 9 varieties of fruits and vegetables. Only 1 of the exercise facilities had signage regarding hours or services. Memberships ranged from free to $9.95 per month. Overall, these findings were inconsistent with participants’ reports in the photovoice group. Conclusion We identified a mismatch between perceptions of community assets and built environment and the objective reality of that environment. Incorporating photovoice and community asset mapping into a community-based diabetes intervention may bring awareness to underused neighborhood resources that can help people control their diabetes.
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Affiliation(s)
- Jana Florian
- Boston Medical Center, Section of General Internal Medicine, 801 Massachusetts Ave, Crosstown No. 2094, Boston, MA 02119.
| | - Nicole M St Omer Roy
- Boston Medical Center, Section of General Internal Medicine, Boston University School of Medicine, Boston, Massachusetts
| | - Lisa M Quintiliani
- Boston Medical Center, Section of General Internal Medicine, Boston, Massachusetts
| | - Ve Truong
- Boston Medical Center, Section of General Internal Medicine, Boston, Massachusetts
| | - Yi Feng
- Boston Medical Center, Section of General Internal Medicine, Boston University School of Medicine, Boston, Massachusetts
| | - Philippe P Bloch
- Boston University, Center for Psychiatric Rehabilitation, Boston, Massachusetts
| | - Zlatka L Russinova
- Boston University, Center for Psychiatric Rehabilitation, Boston, Massachusetts
| | - Karen E Lasser
- Boston Medical Center, Section of General Internal Medicine, Boston, Massachusetts
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160
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Zijlema WL, Smidt N, Klijs B, Morley DW, Gulliver J, de Hoogh K, Scholtens S, Rosmalen JGM, Stolk RP. The LifeLines Cohort Study: a resource providing new opportunities for environmental epidemiology. ACTA ACUST UNITED AC 2016; 74:32. [PMID: 27482379 PMCID: PMC4968004 DOI: 10.1186/s13690-016-0144-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 05/23/2016] [Indexed: 12/19/2022]
Abstract
BACKGROUND Lifelines is a prospective population-based cohort study investigating the biological, behavioral and environmental determinants of healthy ageing among 167,729 participants from the North East region of the Netherlands. The collection and geocoding of (history of) home and work addresses allows linkage of individual-level health data to detailed exposure data. We describe the reasons for choosing particular assessments of environmental exposures in LifeLines and consider the implications for future investigations. METHODS Exposure to ambient air pollution and road traffic noise was estimated using harmonized models. Data on noise annoyance, perceived exposure to electromagnetic fields, perceived living environment, and neighborhood characteristics were collected with questionnaires. A comprehensive medical assessment and questionnaires were completed in order to assess determinants of health and well-being. Blood and urine samples were collected from all participants and genome wide association data are available for a subsample of 15,638 participants. RESULTS Mean age was 45 years (standard deviation (SD) 13 years), and 59 % were female. Median levels of NO2 and PM10 were 15.7 (interquartile range (IQR) 4.9) μg/m(3) and 24.0 (IQR 0.6) μg/m(3) respectively. Median levels of daytime road traffic noise were 54.0 (IQR 4.2) dB(A). CONCLUSIONS The combination of harmonized environmental exposures and extensive assessment of health outcomes in LifeLines offers great opportunities for environmental epidemiology. LifeLines aims to be a resource for the international scientific community.
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Affiliation(s)
- Wilma L Zijlema
- Department of Epidemiology, University Medical Center Groningen, HPC CC72, University of Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands
| | - Nynke Smidt
- Department of Epidemiology, University Medical Center Groningen, HPC CC72, University of Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands
| | - Bart Klijs
- Department of Epidemiology, University Medical Center Groningen, HPC CC72, University of Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands
| | - David W Morley
- Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, Imperial College London, London, UK
| | - John Gulliver
- Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, Imperial College London, London, UK
| | - Kees de Hoogh
- Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, Imperial College London, London, UK ; Swiss Tropical and Public Health Institute, Basel, Switzerland ; University of Basel, Basel, Switzerland
| | | | - Judith G M Rosmalen
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Ronald P Stolk
- Department of Epidemiology, University Medical Center Groningen, HPC CC72, University of Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands ; LifeLines Cohort Study, Groningen, The Netherlands
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161
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Brown SC, Lombard J, Wang K, Byrne MM, Toro M, Plater-Zyberk E, Feaster DJ, Kardys J, Nardi MI, Perez-Gomez G, Pantin HM, Szapocznik J. Neighborhood Greenness and Chronic Health Conditions in Medicare Beneficiaries. Am J Prev Med 2016; 51:78-89. [PMID: 27061891 DOI: 10.1016/j.amepre.2016.02.008] [Citation(s) in RCA: 102] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2015] [Revised: 01/11/2016] [Accepted: 02/04/2016] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Prior studies suggest that exposure to the natural environment may impact health. The present study examines the association between objective measures of block-level greenness (vegetative presence) and chronic medical conditions, including cardiometabolic conditions, in a large population-based sample of Medicare beneficiaries in Miami-Dade County, Florida. METHODS The sample included 249,405 Medicare beneficiaries aged ≥65 years whose location (ZIP+4) within Miami-Dade County, Florida, did not change, from 2010 to 2011. Data were obtained in 2013 and multilevel analyses conducted in 2014 to examine relationships between greenness, measured by mean Normalized Difference Vegetation Index from satellite imagery at the Census block level, and chronic health conditions in 2011, adjusting for neighborhood median household income, individual age, gender, race, and ethnicity. RESULTS Higher greenness was significantly associated with better health, adjusting for covariates: An increase in mean block-level Normalized Difference Vegetation Index from 1 SD less to 1 SD more than the mean was associated with 49 fewer chronic conditions per 1,000 individuals, which is approximately similar to a reduction in age of the overall study population by 3 years. This same level of increase in mean Normalized Difference Vegetation Index was associated with a reduced risk of diabetes by 14%, hypertension by 13%, and hyperlipidemia by 10%. Planned post-hoc analyses revealed stronger and more consistently positive relationships between greenness and health in lower- than higher-income neighborhoods. CONCLUSIONS Greenness or vegetative presence may be effective in promoting health in older populations, particularly in poor neighborhoods, possibly due to increased time outdoors, physical activity, or stress mitigation.
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Affiliation(s)
- Scott C Brown
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida; University of Miami School of Architecture, Coral Gables, Florida.
| | - Joanna Lombard
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida; University of Miami School of Architecture, Coral Gables, Florida
| | - Kefeng Wang
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - Margaret M Byrne
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - Matthew Toro
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - Elizabeth Plater-Zyberk
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida; University of Miami School of Architecture, Coral Gables, Florida
| | - Daniel J Feaster
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - Jack Kardys
- Miami-Dade County Department of Parks, Recreation and Open Spaces, Miami, Florida
| | - Maria I Nardi
- Miami-Dade County Department of Parks, Recreation and Open Spaces, Miami, Florida
| | - Gianna Perez-Gomez
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - Hilda M Pantin
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - José Szapocznik
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida; University of Miami School of Architecture, Coral Gables, Florida
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Perchoux C, Chaix B, Brondeel R, Kestens Y. Residential buffer, perceived neighborhood, and individual activity space: New refinements in the definition of exposure areas – The RECORD Cohort Study. Health Place 2016; 40:116-22. [DOI: 10.1016/j.healthplace.2016.05.004] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Revised: 04/22/2016] [Accepted: 05/03/2016] [Indexed: 10/21/2022]
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163
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Sadler RC, Clark AF, Wilk P, O'Connor C, Gilliland JA. Using GPS and activity tracking to reveal the influence of adolescents' food environment exposure on junk food purchasing. Canadian Journal of Public Health 2016; 107:5346. [PMID: 27281521 DOI: 10.17269/cjph.107.5346] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 03/17/2016] [Accepted: 03/06/2016] [Indexed: 11/17/2022]
Abstract
OBJECTIVES This study examines the influence of adolescents' exposure to unhealthy food outlets on junk food purchasing during trips between home and school, with particular attention to how exposure and purchasing differ according to child's biological sex, mode of transportation, and direction to or from school. METHODS Between 2010 and 2013, students (n = 654) aged 9-13 years from 25 schools in London and Middlesex County, ON, completed a socio-demographic survey and an activity diary (to identify food purchases), and were observed via a global positioning system for 2 weeks (to track routes for trips to/from school). Spatial data on routes and purchase data were integrated with a validated food outlet database in a geographic information system, and exposure was measured as the minutes a child spent within 50 m of an unhealthy food outlet (i.e., fast food restaurants, variety stores). For trips involving junk food exposure (n = 4588), multilevel logistic regression was used to assess the relationship between exposure and purchasing. RESULTS Multilevel analyses indicated that adolescents' duration of exposure to unhealthy food outlets between home and school had a significant effect on the likelihood of junk food purchasing. This relationship remained significant when the data were stratified by sex (female/male), trip direction (to/from school) and travel mode (active/car), with the exception of adolescents who travelled by bus. CONCLUSION Policies and programs that mitigate the concentration of unhealthy food outlets close to schools are critical for encouraging healthy eating behaviours among children and reducing diet-related health issues such as obesity.
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164
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Jiang B, Li B, Wang Y, Han B, Wang N, Li Q, Yang W, Huang G, Wang J, Chen Y, Chen Y, Zhu C, Lin D, Lu Y. The nine-year changes of the incidence and characteristics of metabolic syndrome in China: longitudinal comparisons of the two cross-sectional surveys in a newly formed urban community. Cardiovasc Diabetol 2016; 15:84. [PMID: 27255215 PMCID: PMC4891912 DOI: 10.1186/s12933-016-0402-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Accepted: 05/24/2016] [Indexed: 01/07/2023] Open
Abstract
Background To assess the 9-year changes of the incidence and characteristics of metabolic syndrome (MetS) in Chinese community under the background of dramatically changed environment. Methods Two cross-sectional surveys of the general population were carried out in 2005 and 2014 in Dengmin and Hongnan villages of Fengcheng community, a newly formed urban community from rural area 10 years ago. All permanent adult residents aged 18–80 without active malignant tumors and pregnancy were invited to attend the study. They participated in clinical examinations for anthropometric and blood pressure measurements. Fasting blood samples were drawn for analysis of lipids and glucose. Presence of MetS was defined based on the IDF/AHA harmonized criteria. MetS z-score was calculated to evaluate the degree of total metabolic disorder. Results A total of 1042 subjects in 2005 and 1053 subjects in 2014 were included in the final analysis. The participants were stratified by gender. The incidence of MetS was higher in 2014 than 2005 in both genders (female, 48.28 vs 31.61 %; male, 41.12 vs 26.30 %; p value, both <0.001). Of the five MetS components, the FBG and TG levels were higher in 2014 than 2005 in both gender, however, the SBP and DBP values were even lower in 2014 than 2005. The differences of FBG, blood pressure and lipid levels between 2005 and 2014 still exist after ruling out recognized diabetic, hypertensive and dyslipidemic subjects, individually. In MetS subjects, MetS z-score showed the whole metabolic profile get worse in 2014 than 2005 in both sex (female, 1.97 ± 2.53 vs 1.74 ± 2.29; male, 2.51 ± 2.79 vs 1.01 ± 2.38. both P < 0.001). Using 3 abnormal components as a combination, we found the frequency of different kinds of combination also changed in MetS subjects. In female, the combination of WC + BP + HDL disorder decreased from 29.7 % (2005) to 11.0 % (2014) and WC + FBG + BP disorder became the most popular phenotype (18.8 %) in 2014. Conclusions The dramatically changed environments have extensive influence on metabolic parameters of local residents. More targeted measures need to be taken to meet the serious challenges of metabolic diseases. Trial registration ChiCTR-ECS-14005052, http://www.chictr.org, Survey on Prevalence in East China for Metabolic Diseases and Risk Factors (SPECT-China) Electronic supplementary material The online version of this article (doi:10.1186/s12933-016-0402-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Boren Jiang
- Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, 200011, China
| | - Bin Li
- Fengcheng Hospital, Fengxian District, Shanghai, China
| | - Yongbin Wang
- Fengcheng Hospital, Fengxian District, Shanghai, China
| | - Bing Han
- Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, 200011, China
| | - Ningjian Wang
- Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, 200011, China
| | - Qin Li
- Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, 200011, China
| | - Weihong Yang
- Fengcheng Hospital, Fengxian District, Shanghai, China
| | - Guolan Huang
- Fengcheng Hospital, Fengxian District, Shanghai, China
| | - Jinhua Wang
- Fengcheng Hospital, Fengxian District, Shanghai, China
| | - Yi Chen
- Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, 200011, China
| | - Yingchao Chen
- Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, 200011, China
| | - Chunfang Zhu
- Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, 200011, China
| | - Dongping Lin
- Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, 200011, China
| | - Yingli Lu
- Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, 200011, China.
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Kaiser P, Diez Roux AV, Mujahid M, Carnethon M, Bertoni A, Adar SD, Shea S, McClelland R, Lisabeth L. Neighborhood Environments and Incident Hypertension in the Multi-Ethnic Study of Atherosclerosis. Am J Epidemiol 2016; 183:988-97. [PMID: 27188946 DOI: 10.1093/aje/kwv296] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 10/20/2015] [Indexed: 12/13/2022] Open
Abstract
We examined relationships between neighborhood physical and social environments and incidence of hypertension in a cohort of 3,382 adults at 6 sites in the United States over 10 years of follow-up (2000-2011), using data from the Multi-Ethnic Study of Atherosclerosis. The sample was aged 45-84 years (mean = 59 years) and free of clinical cardiovascular disease and hypertension at baseline. Of the participants, 51% were female, 44% white, 23% Hispanic, 21% black, and 13% Chinese-American; 39% of participants developed hypertension during an average of 7.2 years of follow-up. Cox models were used to estimate associations of time-varying cumulative average neighborhood features (survey-based healthy food availability, walking environment, social cohesion, safety, and geographic information system-based density of favorable food stores and recreational resources) with incident hypertension. After adjustment for individual and neighborhood-level covariates, a 1-standard-deviation increase in healthy food availability was associated with a 12% lower rate of hypertension (hazard ratio = 0.88, 95% confidence interval: 0.82, 0.95). Other neighborhood features were not related to incidence of hypertension. The neighborhood food environment is related to the risk of hypertension.
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166
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Smith KR, Hanson HA, Brown BB, Zick CD, Kowaleski-Jones L, Fan JX. Movers and stayers: how residential selection contributes to the association between female body mass index and neighborhood characteristics. Int J Obes (Lond) 2016; 40:1384-91. [PMID: 27133620 PMCID: PMC5014692 DOI: 10.1038/ijo.2016.78] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2015] [Revised: 02/01/2016] [Accepted: 03/06/2016] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES To examine how a woman's current body mass index (BMI) is associated with nonrandom residential migration that is based on the average BMI of her origin and destination neighborhoods. SUBJECTS/METHODS Among women having at least two children, all birth certificates from Salt Lake county from 1989 to 2010 (n=34 010) were used to obtain prepregnancy weights before the first and second births, residential location and sociodemographic information. Census data were used for measures of walkability of neighborhoods. RESULTS After adjustments for age, education, race/ethnicity and marital status, obese women living in the leanest neighborhoods are found to be three times more likely (odds ratio (OR)=3.03, 95% confidence interval (CI) 2.06-4.47) to move to the heaviest neighborhoods relative to women with healthy weight (BMI between 18 and 25 kg m(-2)). Conversely, obese women in the heaviest neighborhoods are 60% less likely (OR=0.39, 95% CI 0.22-0.69) to move to the leanest neighborhoods relative to healthy weight women. Indicators of relatively greater walkability (older housing, greater proportion of residents who walk to work) and higher median family income characterize leaner neighborhoods. CONCLUSIONS The findings are consistent with the hypothesis that nonrandom selection into and out of neighborhoods accounts for some of the association between BMI and neighborhood characteristics.
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Affiliation(s)
- K R Smith
- Department of Family and Consumer Studies, University of Utah, Salt Lake City, UT, USA
| | - H A Hanson
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT, USA
| | - B B Brown
- Department of Family and Consumer Studies, University of Utah, Salt Lake City, UT, USA
| | - C D Zick
- Department of Family and Consumer Studies, University of Utah, Salt Lake City, UT, USA
| | - L Kowaleski-Jones
- Department of Family and Consumer Studies, University of Utah, Salt Lake City, UT, USA
| | - J X Fan
- Department of Family and Consumer Studies, University of Utah, Salt Lake City, UT, USA
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167
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Braun LM, Rodríguez DA, Evenson KR, Hirsch JA, Moore KA, Diez Roux AV. Walkability and cardiometabolic risk factors: Cross-sectional and longitudinal associations from the Multi-Ethnic Study of Atherosclerosis. Health Place 2016; 39:9-17. [PMID: 26922513 PMCID: PMC5015685 DOI: 10.1016/j.healthplace.2016.02.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2015] [Revised: 02/01/2016] [Accepted: 02/11/2016] [Indexed: 12/28/2022]
Abstract
We used data from 3227 older adults in the Multi-Ethnic Study of Atherosclerosis (2004-2012) to explore cross-sectional and longitudinal associations between walkability and cardiometabolic risk factors. In cross-sectional analyses, linear regression was used to estimate associations of Street Smart Walk Score® with glucose, triglycerides, HDL and LDL cholesterol, systolic and diastolic blood pressure, and waist circumference, while logistic regression was used to estimate associations with odds of metabolic syndrome. Econometric fixed effects models were used to estimate longitudinal associations of changes in walkability with changes in each risk factor among participants who moved residential locations between 2004 and 2012 (n=583). Most cross-sectional and longitudinal associations were small and statistically non-significant. We found limited evidence that higher walkability was cross-sectionally associated with lower blood pressure but that increases in walkability were associated with increases in triglycerides and blood pressure over time. Further research over longer time periods is needed to understand the potential for built environment interventions to improve cardiometabolic health.
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Affiliation(s)
- Lindsay M Braun
- Department of City and Regional Planning, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
| | - Daniel A Rodríguez
- Department of City and Regional Planning, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Kelly R Evenson
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Jana A Hirsch
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Kari A Moore
- Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States
| | - Ana V Diez Roux
- Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States
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168
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Alvarado SE. Neighborhood disadvantage and obesity across childhood and adolescence: Evidence from the NLSY children and young adults cohort (1986-2010). SOCIAL SCIENCE RESEARCH 2016; 57:80-98. [PMID: 26973033 DOI: 10.1016/j.ssresearch.2016.01.008] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Revised: 01/15/2016] [Accepted: 01/22/2016] [Indexed: 05/21/2023]
Abstract
Previous research suggests that youth who grow up in socioeconomically disadvantaged neighborhoods face higher odds of becoming obese. Neighborhood effects scholars, meanwhile, have suggested that contextual influences may increase in strength as children age. This is the first study to examine whether developmental epochs moderate the effect of neighborhood disadvantage on obesity over time. I use thirteen waves of new restricted and geo-coded data on children ages 2-18 from the National Longitudinal Survey of Youth, Children and Young Adults. Bivariate and pooled logistic regression results suggest that neighborhood disadvantage has a stronger impact on adolescents' likelihood of becoming obese. Fixed effects models reveal that after adjusting for observed and unobserved confounders, adolescents continue to face higher odds of becoming obese due to the conditions associated with living in disadvantaged neighborhoods. Moreover, as research on adults suggests, girls experience larger impacts of neighborhood disadvantage than boys.
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169
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Williams J, Townsend N, Duncan G, Drewnowski A. Participant Experience Using GPS Devices in a Food Environment and Nutrition Study. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2016. [DOI: 10.1080/19320248.2015.1112754] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Julianne Williams
- British Heart Foundation Centre on Population Approaches for NCD-Prevention, Nuffield Department of Population Health, University of Oxford, Oxford, England
| | - Nick Townsend
- British Heart Foundation Centre on Population Approaches for NCD-Prevention, Nuffield Department of Population Health, University of Oxford, Oxford, England
| | - Glen Duncan
- Epidemiology & Nutritional Sciences, University of Washington, Seattle, Washington, USA
| | - Adam Drewnowski
- Epidemiology & Nutritional Sciences, University of Washington, Seattle, Washington, USA
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170
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Hirsch JA, Meyer KA, Peterson M, Rodriguez DA, Song Y, Peng K, Huh J, Gordon-Larsen P. Obtaining Longitudinal Built Environment Data Retrospectively across 25 years in Four US Cities. Front Public Health 2016; 4:65. [PMID: 27148512 PMCID: PMC4835448 DOI: 10.3389/fpubh.2016.00065] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Accepted: 03/27/2016] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Neighborhood transportation infrastructure and public recreational facilities are theorized to improve the activity, weight, and cardiometabolic profiles of individuals living in close proximity to these resources. However, owing to data limitations, there has not been adequate study of the influence of timing and placement of new infrastructure on health over time. METHODS This protocol details methods of the four cities study to perform retrospective field audits in order to capitalize on existing longitudinal health data from the coronary artery risk development in young adults (CARDIA) study. We developed and verified measures of recreation facilities (trails, parks) and transportation infrastructure (bus, light rail, bicycle parking, bicycle paths) in Birmingham, AL; Chicago, IL; Minneapolis, MN; and Oakland, CA (USA). We identify introductions, renovations, and closures between 1985 and 2010 to develop measures of facility and infrastructure change. Ultimately, these data were linked to CARDIA sites' respondents' geographic locations over the 25-year study period to examine associations with health behaviors and outcomes. RESULTS Data available for retrospective audits was inconsistent by city, primarily due to record-keeping differences. We found large increases in bicycle infrastructure, with the exception of Birmingham, AL, USA. Excluding the addition of a new rail line in Minneapolis, MN, USA, few changes occurred in bus service, rail, and parks. CONCLUSION Our method represents innovation toward the collection of retrospective neighborhood data for use in longitudinal analyses. The data produced give insight into the way neighborhood infrastructure has changed over time and the potential relationship between these changes and health behaviors.
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Affiliation(s)
- Jana A. Hirsch
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Katie A. Meyer
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Marc Peterson
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Daniel A. Rodriguez
- Department of City and Regional Planning, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Yan Song
- Department of City and Regional Planning, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Ke Peng
- Department of City and Regional Planning, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jun Huh
- Department of City and Regional Planning, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Penny Gordon-Larsen
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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171
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Tamayo A, Karter AJ, Mujahid MS, Warton EM, Moffet HH, Adler N, Schillinger D, Hendrickson O'Connell B, Laraia B. Associations of perceived neighborhood safety and crime with cardiometabolic risk factors among a population with type 2 diabetes. Health Place 2016; 39:116-21. [PMID: 27060870 DOI: 10.1016/j.healthplace.2016.03.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 02/18/2016] [Accepted: 03/24/2016] [Indexed: 11/18/2022]
Abstract
Little is known about how neighborhood crime may relate to health in diabetes patients. We examined associations between individuals' perceptions of neighborhood safety or violent crime and stress, physical activity, body mass index (BMI) or hemoglobin A1c (HbA1c) in a sample (n=721) of adults (mean age:63) with diabetes. Self-reported neighborhood safety, violent crime, physical activity, and stress were collected and linked to clinical measures of BMI and HbA1c. Approximately 54% and 15% of patients reported neighborhood safety concerns and violent crimes, respectively. Any neighborhood safety concerns (β=1.14, 95% C.I. 0.04-2.24) and violent crime (β=2.04, 95% C.I. 0.34-3.73) were associated with BMI in adjusted analysis. Any violent crime was associated with class II-III obesity (BMI≥35) (OR=1.34, 95% C.I.: 1.02, 1.75). There were no significant associations between neighborhood safety concerns or violent crime with stress, physical activity, or HbA1c. Neighborhood safety is associated with BMI and obesity. Further studies, including longitudinal designs, are needed to study how people with diabetes may be influenced by a sense of poor personal safety in their neighborhoods.
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Affiliation(s)
- Aracely Tamayo
- University of California, Berkeley School of Public Health, Division of Epidemiology, 101 Haviland Hall Berkeley, CA 94720-7358, United States.
| | - Andrew J Karter
- Kaiser Permanente, Division of Research Oakland, CA, United States
| | - Mahasin S Mujahid
- UC Berkeley, School of Public Health, Division of Epidemiology Berkeley, CA, United States
| | | | - Howard H Moffet
- Kaiser Permanente, Division of Research Oakland, CA, United States
| | - Nancy Adler
- University of California, San Francisco, Center for Health and Community San Francisco, CA, United States
| | - Dean Schillinger
- San Francisco General Hospital, University of California, San Francisco, Division of General Internal Medicine, Center for Vulnerable Populations San Francisco, CA, United States
| | | | - Barbara Laraia
- UC Berkeley SPH, Community Health and Human Development Berkeley, CA, United States
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172
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Gao M, Ahern J, Koshland CP. Perceived built environment and health-related quality of life in four types of neighborhoods in Xi'an, China. Health Place 2016; 39:110-5. [PMID: 27055241 DOI: 10.1016/j.healthplace.2016.03.008] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Revised: 03/09/2016] [Accepted: 03/24/2016] [Indexed: 11/29/2022]
Abstract
Development in Chinese cities is resulting in a diversity of urban environments that may influence health. In a cross-sectional study of 1608 adults in 20 neighborhoods of Xi'an, China, we examined perceptions of neighborhoods using the NEWS-A survey and health-related quality of life (HRQOL) from the SF-12 across four types of neighborhoods: old/planned, old/unplanned, new/high density, and new/low density. Increased accessibility was significantly associated with both higher mental (range: 3.13-5.53 points) and physical (range: 2.06-3.54 points) well-being for all types of neighborhoods. In the new neighborhoods, increased perceived diversity, safety, and esthetics were significantly associated with higher physical and mental well-being. This study can help inform urban planning priorities to improve quality of life as Chinese cities develop.
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Affiliation(s)
- Meiling Gao
- Berkeley Energy and Climate Institute, University of California, Berkeley, 4th Floor, 488 Sutardja Dai Hall, Berkeley, CA 94720, USA.
| | - Jennifer Ahern
- Division of Epidemiology, School of Public Health, University of California, Berkeley, 285 University Hall, Berkeley, CA 94720, USA.
| | - Catherine P Koshland
- Environmental Health Sciences Division, School of Public Health, University of California, Berkeley, 50 University Hall #7360, Berkeley, CA 94720, USA.
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O'Donoghue G, Perchoux C, Mensah K, Lakerveld J, van der Ploeg H, Bernaards C, Chastin SFM, Simon C, O'Gorman D, Nazare JA. A systematic review of correlates of sedentary behaviour in adults aged 18-65 years: a socio-ecological approach. BMC Public Health 2016; 16:163. [PMID: 26887323 PMCID: PMC4756464 DOI: 10.1186/s12889-016-2841-3] [Citation(s) in RCA: 263] [Impact Index Per Article: 32.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 02/05/2016] [Indexed: 11/10/2022] Open
Abstract
Background Recent research shows that sedentary behaviour is associated with adverse cardio-metabolic consequences even among those considered sufficiently physically active. In order to successfully develop interventions to address this unhealthy behaviour, factors that influence sedentariness need to be identified and fully understood. The aim of this review is to identify individual, social, environmental, and policy-related determinants or correlates of sedentary behaviours among adults aged 18–65 years. Methods PubMed, Embase, CINAHL, PsycINFO and Web of Science were searched for articles published between January 2000 and September 2015. The search strategy was based on four key elements and their synonyms: (a) sedentary behaviour (b) correlates (c) types of sedentary behaviours (d) types of correlates. Articles were included if information relating to sedentary behaviour in adults (18–65 years) was reported. Studies on samples selected by disease were excluded. The full protocol is available from PROSPERO (PROSPERO 2014:CRD42014009823). Results 74 original studies were identified out of 4041: 71 observational, two qualitative and one experimental study. Sedentary behaviour was primarily measured as self-reported screen leisure time and total sitting time. In 15 studies, objectively measured total sedentary time was reported: accelerometry (n = 14) and heart rate (n = 1). Individual level factors such as age, physical activity levels, body mass index, socio-economic status and mood were all significantly correlated with sedentariness. A trend towards increased amounts of leisure screen time was identified in those married or cohabiting while having children resulted in less total sitting time. Several environmental correlates were identified including proximity of green space, neighbourhood walkability and safety and weather. Conclusions Results provide further evidence relating to several already recognised individual level factors and preliminary evidence relating to social and environmental factors that should be further investigated. Most studies relied upon cross-sectional design limiting causal inference and the heterogeneity of the sedentary measures prevented direct comparison of findings. Future research necessitates longitudinal study designs, exploration of policy-related factors, further exploration of environmental factors, analysis of inter-relationships between identified factors and better classification of sedentary behaviour domains. Electronic supplementary material The online version of this article (doi:10.1186/s12889-016-2841-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Grainne O'Donoghue
- Centre for Preventive Medicine, School of Health & Human Performance, Dublin City University, Dublin 9, Republic of Ireland.
| | - Camille Perchoux
- CarMeN Laboratory, INSERM U1060, Lyon 1 University, CRNH-Rhône-Alpes, CENS, Lyon, France.
| | - Keitly Mensah
- CarMeN Laboratory, INSERM U1060, Lyon 1 University, CRNH-Rhône-Alpes, CENS, Lyon, France.
| | - Jeroen Lakerveld
- EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, Netherlands.
| | - Hidde van der Ploeg
- EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, Netherlands.
| | | | - Sebastien F M Chastin
- Institute of Applied Health Research, School of Health and Life Science, Glasgow Caledonian University, Glasgow, UK.
| | - Chantal Simon
- CarMeN Laboratory, INSERM U1060, Lyon 1 University, CRNH-Rhône-Alpes, CENS, Lyon, France.
| | - Donal O'Gorman
- Centre for Preventive Medicine, School of Health & Human Performance, Dublin City University, Dublin 9, Republic of Ireland.
| | - Julie-Anne Nazare
- CarMeN Laboratory, INSERM U1060, Lyon 1 University, CRNH-Rhône-Alpes, CENS, Lyon, France.
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174
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Bélanger D, Abdous B, Valois P, Gosselin P, Sidi EAL. A multilevel analysis to explain self-reported adverse health effects and adaptation to urban heat: a cross-sectional survey in the deprived areas of 9 Canadian cities. BMC Public Health 2016; 16:144. [PMID: 26872840 PMCID: PMC4751716 DOI: 10.1186/s12889-016-2749-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Accepted: 01/19/2016] [Indexed: 11/10/2022] Open
Abstract
Background This study identifies the characteristics and perceptions related to the individual, the dwelling and the neighbourhood of residence associated with the prevalence of self-reported adverse health impacts and an adaptation index when it is very hot and humid in summer in the most disadvantaged sectors of the nine most populous cities of Québec, Canada, in 2011. Methods The study uses a cross-sectional design and a stratified representative sample; 3485 people (individual-level) were interviewed in their residence. They lived in 1647 buildings (building-level) in 87 most materially and socially disadvantaged census dissemination areas (DA-level). Multilevel analysis was used to perform 3-level models nested one in the other to examine individual impacts as well as the adaptation index. Results For the prevalence of impacts, which is 46 %, the logistic model includes 13 individual-level indicators (including air conditioning and the adaptation index) and 1 building-level indicator. For the adaptation index, with values ranging from -3 to +3, the linear model has 10 individual-level indicators, 1 building-level indicator and 2 DA-level indicators. Of all these indicators, 9 were associated to the prevalence of impacts only and 8 to the adaptation index only. Conclusion This 3-level analysis shows the differential importance of the characteristics of residents, buildings and their surroundings on self-reported adverse health impacts and on adaptation (other than air conditioning) under hot and humid summer conditions. It also identifies indicators specific to impacts or adaptation. People with negative health impacts from heat rely more on adaptation strategies while low physical activity and good dwelling/building insulation lead to lower adaptation. Better neighbourhood walkability favors adaptations other than air conditioning. Thus, adaptation to heat in these neighbourhoods seems reactive rather than preventive. These first multi-level insights pave the way for the development of a theoretical framework of the process from heat exposure to impacts and adaptation for research, surveillance and public health interventions at all relevant levels. Electronic supplementary material The online version of this article (doi:10.1186/s12889-016-2749-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Diane Bélanger
- Institut national de la recherche scientifique (INRS) Centre Eau Terre Environnement, 490, rue de la Couronne, Québec, Québec, G1K 9A9, Canada.,Centre de recherche du Centre hospitalier universitaire (CHU) de Québec, 2705, boulevard Laurier, Québec, Québec, G1V 4G2, Canada
| | - Belkacem Abdous
- Centre de recherche du Centre hospitalier universitaire (CHU) de Québec, 2705, boulevard Laurier, Québec, Québec, G1V 4G2, Canada.,Université Laval, 2325 rue de l'Université, Québec, Québec, G1V 0A6, Canada
| | - Pierre Valois
- Université Laval, 2325 rue de l'Université, Québec, Québec, G1V 0A6, Canada
| | - Pierre Gosselin
- Institut national de la recherche scientifique (INRS) Centre Eau Terre Environnement, 490, rue de la Couronne, Québec, Québec, G1K 9A9, Canada. .,Centre de recherche du Centre hospitalier universitaire (CHU) de Québec, 2705, boulevard Laurier, Québec, Québec, G1V 4G2, Canada. .,Institut national de santé publique du Québec (INSPQ), 945, avenue Wolfe, Québec, Québec, G1V 5B3, Canada. .,Ouranos, 550, Sherbrooke Ouest, Tour Ouest, 19e étage, Montréal, Québec, H3A 1B9, Canada.
| | - Elhadji A Laouan Sidi
- Centre de recherche du Centre hospitalier universitaire (CHU) de Québec, 2705, boulevard Laurier, Québec, Québec, G1V 4G2, Canada
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175
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Barber S, Hickson DA, Kawachi I, Subramanian SV, Earls F. Double-jeopardy: The joint impact of neighborhood disadvantage and low social cohesion on cumulative risk of disease among African American men and women in the Jackson Heart Study. Soc Sci Med 2016; 153:107-15. [PMID: 26894941 DOI: 10.1016/j.socscimed.2016.02.001] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 10/12/2015] [Accepted: 02/01/2016] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Few studies have examined the joint impact of neighborhood disadvantage and low social cohesion on health. Moreover, no study has considered the joint impact of these factors on a cumulative disease risk profile among a large sample of African American adults. Using data from the Jackson Heart Study, we examined the extent to which social cohesion modifies the relationship between neighborhood disadvantage and cumulative biological risk (CBR)-a measure of accumulated risk across multiple physiological systems. METHODS Our analysis included 4408 African American women and men ages 21-85 residing in the Jackson, MS Metropolitan Area. We measured neighborhood disadvantage using a composite score of socioeconomic indicators from the 2000 US Census and social cohesion was assessed using a 5-item validated scale. Standardized z-scores of biomarkers representing cardiovascular, metabolic, inflammatory, and neuroendocrine systems were combined to create a CBR score. We used two-level linear regression models with random intercepts adjusting for socio-demographic and behavioral covariates in the analysis. A three-way interaction term was included to examine whether the relationship between neighborhood disadvantage and CBR differed by levels of social cohesion and gender. RESULTS The interaction between neighborhood disadvantage, social cohesion and gender was statistically significant (p = 0.05) such that the association between living in a disadvantaged neighborhood and CBR was strongest for men living in neighborhoods with low levels of social cohesion (B = 0.63, SE: 0.32). In gender-specific models, we found a statistically significant interaction between neighborhood disadvantage and social cohesion for men (p = 0.05) but not for women (p = 0.50). CONCLUSION Neighborhoods characterized by high levels of economic disadvantage and low levels of social cohesion contribute to higher cumulative risk of disease among African American men. This suggests that they may face a unique set of challenges that put them at greater risk in these settings.
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Affiliation(s)
- Sharrelle Barber
- Harvard T.H. Chan School of Public Health, Department of Social and Behavioral Sciences, 677 Huntington Avenue, 7th Floor, Boston, MA 02115, United States.
| | - DeMarc A Hickson
- University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216-4505, United States; My Brother's Keeper, Inc., Rigeland, MS, United States
| | - Ichiro Kawachi
- Harvard T.H. Chan School of Public Health, Department of Social and Behavioral Sciences, 677 Huntington Avenue, 7th Floor, Boston, MA 02115, United States
| | - S V Subramanian
- Harvard T.H. Chan School of Public Health, Department of Social and Behavioral Sciences, 677 Huntington Avenue, 7th Floor, Boston, MA 02115, United States
| | - Felton Earls
- Harvard T.H. Chan School of Public Health, Department of Social and Behavioral Sciences, 677 Huntington Avenue, 7th Floor, Boston, MA 02115, United States
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176
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Suglia SF, Shelton RC, Hsiao A, Wang YC, Rundle A, Link BG. Why the Neighborhood Social Environment Is Critical in Obesity Prevention. J Urban Health 2016; 93:206-12. [PMID: 26780582 PMCID: PMC4794461 DOI: 10.1007/s11524-015-0017-6] [Citation(s) in RCA: 125] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The continuing obesity epidemic in the USA calls for the examination of antecedents to the well-known risk factors of physical activity and diet. The neighborhood built environment has been extensively studied in relation to obesity noting an increased risk of development and prevalence of obesity in relation to numerous built environment characteristics (lack of green spaces, higher number of fast food restaurants, low walkability indices). The neighborhood social environment, however, has been less extensively studied but is perhaps an equally important component of the neighborhood environment. The neighborhood social environment, particularly constructs of social capital, collective efficacy, and crime, is associated with obesity among both adults and children. Several studies have identified physical activity as a potential pathway of the neighborhood social environment and obesity association. Further work on social networks and norms and residential segregation, as well as the examination of dietary behaviors and mental health as potential mediating pathways, is necessary. Given the existing evidence, intervening on the neighborhood social environment may prove to be an effective target for the prevention on obesity. Intervention studies that promote healthy behaviors and prevent obesity while addressing aspects of the neighborhood social environment are necessary to better identify targets for obesity prevention.
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Affiliation(s)
- Shakira F Suglia
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th St., New York, NY, 10032, USA.
| | - Rachel C Shelton
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Amber Hsiao
- Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Y Claire Wang
- Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Andrew Rundle
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th St., New York, NY, 10032, USA
| | - Bruce G Link
- University of California Riverside, 900 University Avenue, Riverside, CA, 92521, USA
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177
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Glass TA, Bilal U. Are neighborhoods causal? Complications arising from the 'stickiness' of ZNA. Soc Sci Med 2016; 166:244-253. [PMID: 26830654 DOI: 10.1016/j.socscimed.2016.01.001] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Revised: 12/23/2015] [Accepted: 01/03/2016] [Indexed: 02/06/2023]
Abstract
Are neighborhoods causal? The answer remains elusive. Armed with new multilevel methods, enthusiasm for neighborhoods research surged at the turn of the century. However, a wave of skepticism has arisen based on the difficulty of drawing causal inferences from observational studies in which selection to neighborhoods is non-random. Researchers have sought answers from experimental and quasi-experimental studies of movers vs. stayers. We develop two related concepts in this essay in the hopes of shedding light on this problem. First, the inceptive environment into which persons are born (which we term ZNA for Zip code Nativity Area) exerts a potentially powerful causal impact on health. Detecting that causal effect is challenging for reasons similar that obtain in other fields (including genetics). Second, we explicate the problem of neighborhood 'stickiness' in terms of the persistence of neighborhood treatment assignment, and argue that under-appreciation of stickiness has led to systematic bias in causal estimates of neighborhoods proportional to the degree of stickiness. In sticky contexts, failure to account for the lasting influences of ZNA by adjusting for intermediate individual socioeconomic and health variables on the causal pathway can result in neighborhood effects estimates that are biased toward the null. We follow with an example drawn from evidence of neighborhood 'stickiness' and obesity. The stickiness of ZNA cautions us that experimental evidence may be insufficient or misleading as a solution to causal inference problems in neighborhood research.
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Affiliation(s)
- Thomas A Glass
- Johns Hopkins Bloomberg School of Public Health, United States.
| | - Usama Bilal
- Johns Hopkins Bloomberg School of Public Health, United States; Social and Cardiovascular Research Group, School of Medicine, University of Alcala, Madrid, Spain
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178
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Hirsch JA, Winters M, Ashe MC, Clarke P, McKay H. Destinations That Older Adults Experience Within Their GPS Activity Spaces Relation to Objectively Measured Physical Activity. ENVIRONMENT AND BEHAVIOR 2016; 48:55-77. [PMID: 26783370 PMCID: PMC4714356 DOI: 10.1177/0013916515607312] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Identifying the relevant geography is an ongoing obstacle to effectively evaluate the influence of neighborhood built environment on physical activity. We characterized density and diversity of destinations that 77 older adults experienced within individually representative GPS activity spaces and traditional residential buffers and assessed their associations with accelerometry-measured physical activity. Traditional residential buffers had lower destination density and diversity than activity spaces. Activity spaces based only on pedestrian and bicycling trips had higher destination densities than all-mode activity spaces. Regardless of neighborhood definition, adjusted associations between destinations and physical activity generally failed to reach statistical significance. However, within pedestrian and bicycling-based activity spaces each additional destination type was associated with 243.3 more steps/day (95% confidence interval (CI) 36.0, 450.7). Traditional buffers may not accurately portray the geographic space or neighborhood resources experienced by older adults. Pedestrian and bicycling activity spaces elucidate the importance of destinations for facilitating active transportation.
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Affiliation(s)
- Jana A. Hirsch
- Research completed at: Centre for Hip Health and Mobility and Department of Medicine, University of British Columbia, 2635 Laurel Street, Vancouver, British Columbia, Canada, V5Z 1M9. Present location: Carolina Population Center, University of North Carolina at Chapel Hill, 206 West Franklin St, Chapel Hill, NC 27516 USA
| | - Meghan Winters
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, British Columbia V5A 1S6, Canada
| | - Maureen C. Ashe
- Centre for Hip Health and Mobility and Department of Family Practice, University of British Columbia, 2635 Laurel Street, Vancouver, British Columbia V5Z 1M9, Canada
| | - Philippa Clarke
- Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI 48104 USA
| | - Heather McKay
- Centre for Hip Health and Mobility and Department of Family Practice, University of British Columbia, 2635 Laurel Street, Vancouver, British Columbia V5Z 1M9, Canada
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179
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Glonti K, Mackenbach JD, Ng J, Lakerveld J, Oppert JM, Bárdos H, McKee M, Rutter H. Psychosocial environment: definitions, measures and associations with weight status--a systematic review. Obes Rev 2016; 17 Suppl 1:81-95. [PMID: 26879116 DOI: 10.1111/obr.12383] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 12/17/2015] [Accepted: 12/18/2015] [Indexed: 11/30/2022]
Abstract
Socio-ecological models suggest that many elements of the social environment act as upstream determinants of obesity. This systematic review examined definitions, measures and strength of associations between the psychosocial environment and adult weight status. Studies were included if they were conducted on adults, the outcome was weight status, carried out in any developed country and investigated at least one psychosocial environmental construct. Six databases for primary studies were searched: EMBASE, MEDLINE, PsycINFO, Scopus, Web of Science and the Cochrane Library. We restricted our search to studies published in English between January 1995 and February 2015. An adapted 'Quality Assessment Tool for Quantitative Studies' was used to evaluate risk of bias of included studies. Out of 14,784 screened records, 42 articles were assessed using full text. A total of 19 studies were included. The strongest associations with weight status were found for social capital and collective efficacy, although few studies found significant associations. There was heterogeneity in the definitions and metrics of psychosocial environmental constructs. There is limited evidence that greater social capital and collective efficacy are associated with healthier weight status. The research conducted to date has not robustly identified relations. We highlight challenges to undertaking research and establishing causality in this field and provide recommendations for further research.
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Affiliation(s)
- K Glonti
- ECOHOST - The Centre for Health and Social Change, London School of Hygiene and Tropical Medicine, London, UK
| | - J D Mackenbach
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - J Ng
- Department of Service Planning and Care Integration, Sengkang Health, Singapore
| | - J Lakerveld
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - J-M 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 Universités, Université Pierre et Marie Curie, Université Paris 06; Institute of Cardiometabolism and Nutrition, Department of Nutrition, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - H Bárdos
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
| | - M McKee
- ECOHOST - The Centre for Health and Social Change, London School of Hygiene and Tropical Medicine, London, UK
| | - H Rutter
- ECOHOST - The Centre for Health and Social Change, London School of Hygiene and Tropical Medicine, London, UK
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180
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Mackenbach JD, Lakerveld J, Van Lenthe FJ, Teixeira PJ, Compernolle S, De Bourdeaudhuij I, Charreire H, Oppert JM, Bárdos H, Glonti K, Rutter H, McKee M, Nijpels G, Brug J. Interactions of individual perceived barriers and neighbourhood destinations with obesity-related behaviours in Europe. Obes Rev 2016; 17 Suppl 1:68-80. [PMID: 26879115 DOI: 10.1111/obr.12374] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 12/15/2015] [Indexed: 12/01/2022]
Abstract
Perceived barriers towards physical activity and healthy eating as well as local availability of opportunities (destinations in the neighbourhood) are important determinants of obesity-related behaviours in adults. Little is known, however, about how these factors interact with the behaviours. Data were analysed from 5,205 participants of the SPOTLIGHT survey, conducted in 60 neighbourhoods in urban regions of five different countries across Europe. A virtual audit was conducted to collect data on the presence of destinations in each neighbourhood. Direct associations of, and interactions between, the number of individual perceived barriers and presence of destinations with obesity-related behaviours (physical activity and dietary behaviours) were analysed using multilevel regression analyses, adjusted for key covariates. Perceiving more individual barriers towards physical activity and healthy eating was associated with lower odds of physical activity and healthy eating. The presence of destinations such as bicycle lanes, parks and supermarkets was associated with higher levels of physical activity and healthier dietary behaviours. Analyses of additive interaction terms suggested that the interaction of destinations and barriers was competitive, such that the presence of destinations influenced obesity-related behaviours most among those perceiving more barriers. These explorative findings emphasize the interest and importance of combining objective (e.g. virtual neighbourhood audit) methods and subjective (e.g. individual perceived barriers collected in a survey) to better understand how the characteristics of the residential built environment can shape obesity-related behaviours depending on individual characteristics.
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Affiliation(s)
- J D Mackenbach
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - J Lakerveld
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - F J Van Lenthe
- Department of Public Health, Erasmus Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - P J Teixeira
- Centre for Interdisciplinary Study of Human Performance (CIPER), Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal
| | - S Compernolle
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - I De Bourdeaudhuij
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - H Charreire
- Equipe de Recherche en Epidámiologie Nutritionnelle (EREN), Centre de Recherche en Epidámiologie et Statistiques, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, Université Paris 13, Bobigny, France.,Paris Est University, Lab-Urba, UPEC, Urban School of Paris, Créteil, France
| | - J-M Oppert
- Equipe de Recherche en Epidámiologie Nutritionnelle (EREN), Centre de Recherche en Epidámiologie et Statistiques, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, Université Paris 13, Bobigny, France.,Sorbonne Universités, Université Pierre et Marie Curie, Université Paris 06; Institute of Cardiometabolism and Nutrition, Department of Nutrition, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - H Bárdos
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
| | - K Glonti
- ECOHOST - The Centre for Health and Social Change, London School of Hygiene and Tropical Medicine, London, UK
| | - H Rutter
- ECOHOST - The Centre for Health and Social Change, London School of Hygiene and Tropical Medicine, London, UK
| | - M McKee
- ECOHOST - The Centre for Health and Social Change, London School of Hygiene and Tropical Medicine, London, UK
| | - G Nijpels
- Department of General Practice and Elderly Care, EMGO Institute for Health and Care Research, VU Medical Center Amsterdam, Amsterdam, The Netherlands
| | - J Brug
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
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Assessing opportunities for physical activity in the built environment of children: interrelation between kernel density and neighborhood scale. Int J Health Geogr 2015; 14:35. [PMID: 26694651 PMCID: PMC4689060 DOI: 10.1186/s12942-015-0027-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 12/01/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Built environment studies provide broad evidence that urban characteristics influence physical activity (PA). However, findings are still difficult to compare, due to inconsistent measures assessing urban point characteristics and varying definitions of spatial scale. Both were found to influence the strength of the association between the built environment and PA. METHODS We simultaneously evaluated the effect of kernel approaches and network-distances to investigate the association between urban characteristics and physical activity depending on spatial scale and intensity measure. We assessed urban measures of point characteristics such as intersections, public transit stations, and public open spaces in ego-centered network-dependent neighborhoods based on geographical data of one German study region of the IDEFICS study. We calculated point intensities using the simple intensity and kernel approaches based on fixed bandwidths, cross-validated bandwidths including isotropic and anisotropic kernel functions and considering adaptive bandwidths that adjust for residential density. We distinguished six network-distances from 500 m up to 2 km to calculate each intensity measure. A log-gamma regression model was used to investigate the effect of each urban measure on moderate-to-vigorous physical activity (MVPA) of 400 2- to 9.9-year old children who participated in the IDEFICS study. Models were stratified by sex and age groups, i.e. pre-school children (2 to <6 years) and school children (6-9.9 years), and were adjusted for age, body mass index (BMI), education and safety concerns of parents, season and valid weartime of accelerometers. RESULTS Association between intensity measures and MVPA strongly differed by network-distance, with stronger effects found for larger network-distances. Simple intensity revealed smaller effect estimates and smaller goodness-of-fit compared to kernel approaches. Smallest variation in effect estimates over network-distances was found for kernel intensity measures based on isotropic and anisotropic cross-validated bandwidth selection. CONCLUSION We found a strong variation in the association between the built environment and PA of children based on the choice of intensity measure and network-distance. Kernel intensity measures provided stable results over various scales and improved the assessment compared to the simple intensity measure. Considering different spatial scales and kernel intensity methods might reduce methodological limitations in assessing opportunities for PA in the built environment.
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182
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Implications of supermarket access, neighbourhood walkability and poverty rates for diabetes risk in an employee population. Public Health Nutr 2015; 19:2040-8. [PMID: 26638995 DOI: 10.1017/s1368980015003328] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Diabetes is a growing public health problem, and the environment in which people live and work may affect diabetes risk. The goal of the present study was to examine the association between multiple aspects of environment and diabetes risk in an employee population. DESIGN This was a retrospective cross-sectional analysis. Home environment variables were derived using employees' zip code. Descriptive statistics were run on all individual- and zip-code-level variables, stratified by diabetes risk and worksite. A multivariable logistic regression analysis was then conducted to determine the strongest associations with diabetes risk. SETTING Data were collected from employee health fairs in a Midwestern health system, 2009-2012. SUBJECTS The data set contains 25 227 unique individuals across four years of data. From this group, using an individual's first entry into the database, 15 522 individuals had complete data for analysis. RESULTS The prevalence of high diabetes risk in this population was 2·3 %. There was significant variability in individual- and zip-code-level variables across worksites. From the multivariable analysis, living in a zip code with higher percentage of poverty and higher walk score was positively associated with high diabetes risk, while living in a zip code with higher supermarket density was associated with a reduction in high diabetes risk. CONCLUSIONS Our study underscores the important relationship between poverty, home neighbourhood environment and diabetes risk, even in a relatively healthy employed population, and suggests a role for the employer in promoting health.
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183
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Zijlema WL, Klijs B, Stolk RP, Rosmalen JGM. (Un)Healthy in the City: Respiratory, Cardiometabolic and Mental Health Associated with Urbanity. PLoS One 2015; 10:e0143910. [PMID: 26630577 PMCID: PMC4667966 DOI: 10.1371/journal.pone.0143910] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Accepted: 11/11/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Research has shown that health differences exist between urban and rural areas. Most studies conducted, however, have focused on single health outcomes and have not assessed to what extent the association of urbanity with health is explained by population composition or socioeconomic status of the area. Our aim is to investigate associations of urbanity with four different health outcomes (i.e. lung function, metabolic syndrome, depression and anxiety) and to assess whether these associations are independent of residents' characteristics and area socioeconomic status. METHODS Our study population consisted of 74,733 individuals (42% males, mean age 43.8) who were part of the baseline sample of the LifeLines Cohort Study. Health outcomes were objectively measured with spirometry, a physical examination, laboratory blood analyses, and a psychiatric interview. Using multilevel linear and logistic regression models, associations of urbanity with lung function, and prevalence of metabolic syndrome, major depressive disorder and generalized anxiety disorder were assessed. All models were sequentially adjusted for age, sex, highest education, household equivalent income, smoking, physical activity, and mean neighborhood income. RESULTS As compared with individuals living in rural areas, those in semi-urban or urban areas had a poorer lung function (β -1.62, 95% CI -2.07;-1.16), and higher prevalence of major depressive disorder (OR 1.65, 95% CI 1.35;2.00), and generalized anxiety disorder (OR 1.58, 95% CI 1.35;1.84). Prevalence of metabolic syndrome, however, was lower in urban areas (OR 0.51, 95% CI 0.44;0.59). These associations were only partly explained by differences in residents' demographic, socioeconomic and lifestyle characteristics and socioeconomic status of the areas. CONCLUSIONS Our results suggest a differential health impact of urbanity according to type of disease. Living in an urban environment appears to be beneficial for cardiometabolic health but to have a detrimental impact on respiratory function and mental health. Future research should investigate which underlying mechanisms explain the differential health impact of urbanity.
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Affiliation(s)
- Wilma L. Zijlema
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, The Netherlands
- * E-mail:
| | - Bart Klijs
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, The Netherlands
| | - Ronald P. Stolk
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, The Netherlands
| | - Judith G. M. Rosmalen
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, The Netherlands
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184
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Sadler RC, Gilliland JA. Comparing children's GPS tracks with geospatial proxies for exposure to junk food. Spat Spatiotemporal Epidemiol 2015; 14-15:55-61. [PMID: 26530823 DOI: 10.1016/j.sste.2015.09.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Revised: 07/30/2015] [Accepted: 09/23/2015] [Indexed: 11/28/2022]
Abstract
Various geospatial techniques have been employed to estimate children's exposure to environmental cardiometabolic risk factors, including junk food. But many studies uncritically rely on exposure proxies which differ greatly from actual exposure. Misrepresentation of exposure by researchers could lead to poor decisions and ineffective policymaking. This study conducts a GIS-based analysis of GPS tracks--'activity spaces'--and 21 proxies for activity spaces (e.g. buffers, container approaches) for a sample of 526 children (ages 9-14) in London, Ontario, Canada. These measures are combined with a validated food environment database (including fast food and convenience stores) to create a series of junk food exposure estimates and quantify the errors resulting from use of different proxy methods. Results indicate that exposure proxies consistently underestimate exposure to junk foods by as much as 68%. This underestimation is important to policy development because children are exposed to more junk food than estimated using typical methods.
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Affiliation(s)
- Richard C Sadler
- Department of Family Medicine, Michigan State University, 200 E 1st St, Flint, MI 48502, United States.
| | - Jason A Gilliland
- Department of Geography, Faculty of Health Sciences, and Department of Paediatrics, University of Western Ontario, 1151 Richmond St, London, ON N6A 5C2, Canada.
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185
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Barber S, Hickson DA, Kawachi I, Subramanian SV, Earls F. Neighborhood Disadvantage and Cumulative Biological Risk Among a Socioeconomically Diverse Sample of African American Adults: An Examination in the Jackson Heart Study. J Racial Ethn Health Disparities 2015; 3:444-56. [PMID: 27294737 DOI: 10.1007/s40615-015-0157-0] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 08/05/2015] [Accepted: 08/07/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Neighborhoods characterized by disadvantage influence multiple risk factors for chronic disease and are considered potential drivers of racial and ethnic health inequities in the USA. The objective of the present study was to examine the relationship between neighborhood disadvantage and cumulative biological risk (CBR) and the extent to which the association differs by individual income and education among a large, socioeconomically diverse sample of African American adults. METHODS Data from the baseline examination of the Jackson Heart Study (2000-2004) were used for the analyses. The sample consisted of African American adults ages 21-85 with complete, geocoded data on CBR biomarkers and behavioral covariates (n = 4410). Neighborhood disadvantage was measured using a composite score of socioeconomic indicators from the 2000 US Census. Eight biomarkers representing cardiovascular, metabolic, inflammatory, and neuroendocrine systems were used to create a CBR score. We fit two-level linear regression models with random intercepts and included cross-level interaction terms between neighborhood disadvantage and individual socioeconomic status (SES). RESULTS Living in a disadvantaged neighborhood was associated with greater CBR after covariate adjustment (B = 0.18, standard error (SE) 0.07, p < 0.05). Interactions showed a weaker association for individuals with ≤high school education but were not statistically significant. CONCLUSION Disadvantaged neighborhoods contribute to poor health among African American adults via cumulative biological risk. Policies directly addressing the socioeconomic conditions of these environments should be considered as viable options to reduce disease risk in this group and mitigate racial/ethnic health inequities.
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Affiliation(s)
- Sharrelle Barber
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, 7th Floor, Boston, MA, 02115, USA. .,Department of Epidemiology and Biostatistics, School of Public Health, Drexel University, Nesbit Hall, 5th Floor; 3215 Market St., Philadelphia, PA, 19104, USA.
| | - DeMarc A Hickson
- University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216-4505, USA.,My Brother's Keeper, Inc., 710 Avignon Drive, Ridgeland, MS, 39157, USA
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, 7th Floor, Boston, MA, 02115, USA
| | - S V Subramanian
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, 7th Floor, Boston, MA, 02115, USA
| | - Felton Earls
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, 7th Floor, Boston, MA, 02115, USA
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186
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Christine PJ, Auchincloss AH, Bertoni AG, Carnethon MR, Sánchez BN, Moore K, Adar SD, Horwich TB, Watson KE, Diez Roux AV. Longitudinal Associations Between Neighborhood Physical and Social Environments and Incident Type 2 Diabetes Mellitus: The Multi-Ethnic Study of Atherosclerosis (MESA). JAMA Intern Med 2015; 175:1311-20. [PMID: 26121402 PMCID: PMC4799846 DOI: 10.1001/jamainternmed.2015.2691] [Citation(s) in RCA: 215] [Impact Index Per Article: 23.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
IMPORTANCE Neighborhood environments may influence the risk for developing type 2 diabetes mellitus (T2DM), but, to our knowledge, no longitudinal study has evaluated specific neighborhood exposures. OBJECTIVE To determine whether long-term exposures to neighborhood physical and social environments, including the availability of healthy food and physical activity resources and levels of social cohesion and safety, are associated with incident T2DM during a 10-year period. DESIGN, SETTING, AND PARTICIPANTS We used data from the Multi-Ethnic Study of Atherosclerosis, a population-based cohort study of adults aged 45 to 84 years at baseline (July 17, 2000, through August 29, 2002). A total of 5124 participants free of T2DM at baseline underwent 5 clinical follow-up examinations from July 17, 2000, through February 4, 2012. Time-varying measurements of neighborhood healthy food and physical activity resources and social environments were linked to individual participant addresses. Neighborhood environments were measured using geographic information system (GIS)- and survey-based methods and combined into a summary score. We estimated hazard ratios (HRs) of incident T2DM associated with cumulative exposure to neighborhood resources using Cox proportional hazards regression models adjusted for age, sex, income, educational level, race/ethnicity, alcohol use, and cigarette smoking. Data were analyzed from December 15, 2013, through September 22, 2014. MAIN OUTCOMES AND MEASURES Incident T2DM defined as a fasting glucose level of at least 126 mg/dL or use of insulin or oral antihyperglycemics. RESULTS During a median follow-up of 8.9 years (37,394 person-years), 616 of 5124 participants (12.0%) developed T2DM (crude incidence rate, 16.47 [95% CI, 15.22-17.83] per 1000 person-years). In adjusted models, a lower risk for developing T2DM was associated with greater cumulative exposure to indicators of neighborhood healthy food (12%; HR per interquartile range [IQR] increase in summary score, 0.88 [95% CI, 0.79-0.98]) and physical activity resources (21%; HR per IQR increase in summary score, 0.79 [95% CI, 0.71-0.88]), with associations driven primarily by the survey exposure measures. Neighborhood social environment was not associated with incident T2DM (HR per IQR increase in summary score, 0.96 [95% CI, 0.88-1.07]). CONCLUSIONS AND RELEVANCE Long-term exposure to residential environments with greater resources to support physical activity and, to a lesser extent, healthy diets was associated with a lower incidence of T2DM, although results varied by measurement method. Modifying neighborhood environments may represent a complementary, population-based approach to prevention of T2DM, although further intervention studies are needed.
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Affiliation(s)
- Paul J Christine
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor
| | - Amy H Auchincloss
- Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, Pennsylvania
| | - Alain G Bertoni
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Mercedes R Carnethon
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Brisa N Sánchez
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor
| | - Kari Moore
- Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, Pennsylvania
| | - Sara D Adar
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor
| | - Tamara B Horwich
- Department of Medicine and Cardiology, David Geffen School of Medicine, University of California, Los Angeles
| | - Karol E Watson
- Department of Medicine and Cardiology, David Geffen School of Medicine, University of California, Los Angeles
| | - Ana V Diez Roux
- Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, Pennsylvania
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187
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Simonelli G, Patel SR, Rodríguez-Espínola S, Pérez-Chada D, Salvia A, Cardinali DP, Vigo DE. The impact of home safety on sleep in a Latin American country. Sleep Health 2015; 1:98-103. [PMID: 29073385 DOI: 10.1016/j.sleh.2015.02.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Revised: 02/13/2015] [Accepted: 02/16/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVES We sought to assess the impact of feelings of safety in one's neighborhood and home on sleep quality and sleep duration. DESIGN The design is a cross-sectional survey using face-to-face interviews, as part of the Argentine Social Debt Observatory assessment. SETTING The setting is a nationwide data from Argentina. PARTICIPANTS There are 5636 participants aged 18 years and older. INTERVENTION (IF ANY) N/A. MEASUREMENTS The relationships between both subjective sleep quality and self-reported sleep duration, categorized as short (<7 hours), normal (7-8 hours), and long (>8 hours) with safety in one's neighborhood and one's home, were analyzed. Age, sex, obesity, neighborhood socioeconomic status, and education were included as covariates. RESULTS Feeling unsafe in one's home was strongly associated with poorer sleep quality and with short sleep duration. Feeling unsafe in one's neighborhood was initially associated with reduced sleep quality but was no longer significant after controlling for home safety. In contrast, we found no correlation between safety measures and long sleep. In analyses stratified by sex, feeling unsafe in one's home was associated with poor sleep quality in women but not in men. CONCLUSIONS Our findings suggest that safety in the home has an important effect on both sleep quality and duration, particularly among women. In contrast, after accounting for safety in the home, neighborhood safety does not impact sleep. Further research is warranted to identify mechanisms underlying the sex differences in susceptibility to poor sleep quality and shorter sleep duration, as well as to assess whether interventions addressing safety in the home can be used to improve sleep and overall health.
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Affiliation(s)
- Guido Simonelli
- Applied Neuroscience Laboratory, Institute for Biomedical Research (BIOMED), School of Medical Sciences, Pontifical Catholic University of Argentina, and the National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina; Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA
| | - Sanjay R Patel
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA; Division of Pulmonary, Critical Care and Sleep Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Solange Rodríguez-Espínola
- Observatorio de la Deuda Social Argentina, Pontificia Universidad Católica Argentina, Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina
| | - Daniel Pérez-Chada
- Pulmonary Division, Department of Internal Medicine, Hospital Universitario Austral, Buenos Aires, Argentina
| | - Agustín Salvia
- Observatorio de la Deuda Social Argentina, Pontificia Universidad Católica Argentina, Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina
| | - Daniel P Cardinali
- Applied Neuroscience Laboratory, Institute for Biomedical Research (BIOMED), School of Medical Sciences, Pontifical Catholic University of Argentina, and the National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| | - Daniel E Vigo
- Applied Neuroscience Laboratory, Institute for Biomedical Research (BIOMED), School of Medical Sciences, Pontifical Catholic University of Argentina, and the National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina.
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188
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Interactive and independent associations between the socioeconomic and objective built environment on the neighbourhood level and individual health: a systematic review of multilevel studies. PLoS One 2015; 10:e0123456. [PMID: 25849569 PMCID: PMC4388459 DOI: 10.1371/journal.pone.0123456] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Accepted: 03/03/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The research question how contextual factors of neighbourhood environments influence individual health has gained increasing attention in public health research. Both socioeconomic neighbourhood characteristics and factors of the built environment play an important role for health and health-related behaviours. However, their reciprocal relationships have not been systematically reviewed so far. This systematic review aims to identify studies applying a multilevel modelling approach which consider both neighbourhood socioeconomic position (SEP) and factors of the objective built environment simultaneously in order to disentangle their independent and interactive effects on individual health. METHODS The three databases PubMed, PsycINFO, and Web of Science were systematically searched with terms for title and abstract screening. Grey literature was not included. Observational studies from USA, Canada, Australia, New Zealand, and Western European countries were considered which analysed simultaneously factors of neighbourhood SEP and the objective built environment with a multilevel modelling approach. Adjustment for individual SEP was a further inclusion criterion. RESULTS Thirty-three studies were included in qualitative synthesis. Twenty-two studies showed an independent association between characteristics of neighbourhood SEP or the built environment and individual health outcomes or health-related behaviours. Twenty-one studies found cross-level or within-level interactions either between neighbourhood SEP and the built environment, or between neighbourhood SEP or the built environment and individual characteristics, such as sex, individual SEP or ethnicity. Due to the large variation of study design and heterogeneous reporting of results the identification of consistent findings was problematic and made quantitative analysis not possible. CONCLUSIONS There is a need for studies considering multiple neighbourhood dimensions and applying multilevel modelling in order to clarify their causal relationship towards individual health. Especially, more studies using comparable characteristics of neighbourhood SEP and the objective built environment and analysing interactive effects are necessary to disentangle health impacts and identify vulnerable neighbourhoods and population groups.
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189
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Dubé L, Labban A, Moubarac JC, Heslop G, Ma Y, Paquet C. A nutrition/health mindset on commercial Big Data and drivers of food demand in modern and traditional systems. Ann N Y Acad Sci 2015; 1331:278-295. [PMID: 25514866 DOI: 10.1111/nyas.12595] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Building greater reciprocity between traditional and modern food systems and better convergence of human and economic development outcomes may enable the production and consumption of accessible, affordable, and appealing nutritious food for all. Information being key to such transformations, this roadmap paper offers a strategy that capitalizes on Big Data and advanced analytics, setting the foundation for an integrative intersectoral knowledge platform to better inform and monitor behavioral change and ecosystem transformation. Building upon the four P's of marketing (product, price, promotion, placement), we examine digital commercial marketing data through the lenses of the four A's of food security (availability, accessibility, affordability, appeal) using advanced consumer choice analytics for archetypal traditional (fresh fruits and vegetables) and modern (soft drinks) product categories. We demonstrate that business practices typically associated with the latter also have an important, if not more important, impact on purchases of the former category. Implications and limitations of the approach are discussed.
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Affiliation(s)
- Laurette Dubé
- Desautels Faculty of Management, McGill University, Montréal, Québec, Canada.,McGill Centre for the Convergence of Health and Economics (MCCHE), McGill University, Montréal, Québec, Canada
| | - Alice Labban
- Desautels Faculty of Management, McGill University, Montréal, Québec, Canada
| | | | - Gabriela Heslop
- McGill Centre for the Convergence of Health and Economics (MCCHE), McGill University, Montréal, Québec, Canada
| | - Yu Ma
- Department of Marketing, Business Economics, and Law, Alberta School of Business, University of Alberta, Edmonton, Alberta, Canada
| | - Catherine Paquet
- School of Population Health, University of South Australia, Adelaide, Australia.,Douglas Hospital Research Center, Douglas Mental Health University Institute, Montréal, Québec, Canada
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190
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Does location matter? A proposed methodology to evaluate neighbourhood effects on cardiac arrest survival and bystander CPR. CAN J EMERG MED 2015; 17:286-94. [DOI: 10.1017/cem.2014.40] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractBackgroundTraditional variables used to explain survival following out-of-hospital cardiac arrest (OHCA) account for only 72% of survival, suggesting that other unknown factors may influence outcomes. Research on other diseases suggests that neighbourhood factors may partly determine health outcomes. Yet, this approach has rarely been used for OHCA. This work outlines a methodology to investigate multiple neighbourhood factors as determinants of OHCA outcomes.MethodsA retrospective, observational cohort study design will be used. All adult non-emergency medical service witnessed OHCAs of cardiac etiology within the city of Toronto between 2006 and 2010 will be included. Event details will be extracted from the Toronto site of the Resuscitation Outcomes Consortium Epistry—Cardiac Arrest, an existing population-based dataset of consecutive OHCA patients. Geographic information systems technology will be used to assign patients to census tracts. Neighbourhood variables to be explored include the Ontario Marginalization Index (deprivation, dependency, ethnicity, and instability), crime rate, and density of family physicians. Hierarchical logistic regression analysis will be used to explore the association between neighbourhood characteristics and 1) survival-to-hospital discharge, 2) return-of-spontaneous circulation at hospital arrival, and 3) provision of bystander cardiopulmonary resuscitation (CPR). Receiver operating characteristics curves will evaluate each model’s ability to discriminate between those with and without each outcome.DiscussionThis study will determine the role of neighbourhood characteristics in OHCA and their association with clinical outcomes. The results can be used as the basis to focus on specific neighbourhoods for facilitating educational interventions, CPR awareness programs, and higher utilization of automatic defibrillation devices.
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191
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Wedick NM, Ma Y, Olendzki BC, Procter-Gray E, Cheng J, Kane KJ, Ockene IS, Pagoto SL, Land TG, Li W. Access to healthy food stores modifies effect of a dietary intervention. Am J Prev Med 2015; 48:309-17. [PMID: 25300734 PMCID: PMC4339420 DOI: 10.1016/j.amepre.2014.08.020] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Revised: 08/08/2014] [Accepted: 08/20/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Recent evidence suggests that opening a grocery store in a food desert does not translate to better diet quality among community residents. PURPOSE This study evaluated the influence of proximity to a healthy food store on the effect of a dietary behavioral intervention on diet among obese adults randomized to either a high fiber or American Heart Association diet intervention. METHODS Participants were recruited from Worcester County, Massachusetts, between June 2009 and January 2012. Dietary data were collected via 24-hour recalls at baseline and 3, 6, and 12 months post-intervention. Based on in-store inspection data, a store was considered as having adequate availability of healthy foods if it had at least one item available in each of 20 healthy food categories. Linear models evaluated maximum change in dietary outcomes in relation to road distance from residence to the nearest June healthy food store. The analysis was conducted in January to June 2014. RESULTS On average, participants (N=204) were aged 52 years, BMI=34.9, and included 72% women and 89% non-Hispanic whites. Shorter distance to a healthy food store was associated with greater improvements in consumption of fiber (b=-1.07 g/day per mile, p<0.01) and fruits and vegetables (b=-0.19 servings/day per mile, p=0.03) with and without covariate adjustment. CONCLUSIONS The effectiveness of dietary interventions is significantly influenced by the presence of a supportive community nutrition environment. Considering the nationwide efforts on promotion of healthy eating, the value of improving community access to healthy foods should not be underestimated. CLINICAL TRIAL REGISTRATION NUMBER NCT00911885.
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Affiliation(s)
- Nicole M Wedick
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester
| | - Yunsheng Ma
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester
| | - Barbara C Olendzki
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester
| | - Elizabeth Procter-Gray
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester
| | - Jie Cheng
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester
| | - Kevin J Kane
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester
| | - Ira S Ockene
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester
| | - Sherry L Pagoto
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester
| | - Thomas G Land
- Massachusetts Department of Public Health, Boston, Massachusetts
| | - Wenjun Li
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester.
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192
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Stewart T, Duncan S, Chaix B, Kestens Y, Schipperijn J, Schofield G. A novel assessment of adolescent mobility: a pilot study. Int J Behav Nutr Phys Act 2015; 12:18. [PMID: 25885927 PMCID: PMC4336506 DOI: 10.1186/s12966-015-0176-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Accepted: 01/29/2015] [Indexed: 12/17/2022] Open
Abstract
Background The accurate measurement of daily mobility and travel to destinations beyond the residential neighbourhood has been identified as an important but almost systematically overlooked factor when investigating the relationship between exposure to the built environment and physical activity. The recent development of VERITAS – a web-based application nested within a computer-assisted personal interview – allows researchers to assess daily mobility, travel to regular destinations, and perceived neighbourhood boundaries using interactive mapping technology. The aims of this pilot study were to (1) demonstrate the feasibility and functionality of using VERITAS in an adolescent sample, and (2) compare urban form characteristics and geometric features of the perceived neighbourhood with traditional neighbourhood delimitations. Methods Data were collected and analysed for twenty-eight participants (14 male, 15.9 ± 1.48 years) in 2013. Participants underwent anthropometric assessment before completing a custom-designed VERITAS protocol under the supervision of trained interview technicians. Regularly visited destinations, school travel routes, transportation modes, travel companions, and perceived neighbourhood boundaries were assessed. Data were imported into ArcGIS and street network distances between the home and each geolocated destination were generated. Convex hull activity spaces were derived from destinations. Urban form variables and geometric characteristics were compared between the perceived neighbourhood, existing meshblocks, 1 mile Euclidean buffers, and 1 km network buffers. Results In total, 529 destinations were geolocated, 58% of which were outside the perceived neighbourhood boundary. Active travel was inversely associated with distance to destinations (r = −.43, p < .05) and traveling with adults (r = −.68, p < .01). Urban form and geometric characteristics of the perceived neighbourhood were different from those in other neighbourhood delimitations. Conclusions This study demonstrates the feasibility of using VERITAS to assess mobility within adolescent populations. Our results also illustrate the potential novelty and use of user-defined spaces, and highlight the limitations of relying on restricted definitions of place (i.e., administrative or residential-focused neighbourhoods) when assessing environmental exposure.
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Affiliation(s)
- Tom Stewart
- Human Potential Centre, Auckland University of Technology, Private Bag 92006, Auckland, 1142, Auckland, New Zealand.
| | - Scott Duncan
- Human Potential Centre, Auckland University of Technology, Private Bag 92006, Auckland, 1142, Auckland, New Zealand.
| | | | - Yan Kestens
- CRCHUM, Department of social and preventive medicine, Université de Montréal, Montreal, Canada.
| | - Jasper Schipperijn
- Research Unit for Active Living, Department of Sport Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
| | - Grant Schofield
- Human Potential Centre, Auckland University of Technology, Private Bag 92006, Auckland, 1142, Auckland, New Zealand.
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193
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Abstract
A growing body of research has examined whether racial/ethnic residential segregation contributes to health disparities, but recent findings in the literature, particularly with respect to cardiovascular disease (CVD) risk, have not been summarized. This review provides an overview of findings from studies of racial/ethnic residential segregation of non-Hispanic blacks and Hispanics with CVD risk published between January 2011 and July 2014. The majority of studies of black segregation showed higher segregation was related to higher CVD risk, although relationships were less clear for certain outcomes. Relationships among Hispanics were more mixed and appeared to vary widely by factors such as gender, country of origin, racial identity, and acculturation. Implications for research on racial/ethnic disparities in CVD and lingering gaps in the literature are discussed as well.
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194
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Barrington WE, Beresford SAA, Koepsell TD, Duncan GE, Moudon AV. Worksite neighborhood and obesogenic behaviors: findings among employees in the Promoting Activity and Changes in Eating (PACE) trial. Am J Prev Med 2015; 48:31-41. [PMID: 25442234 PMCID: PMC4418796 DOI: 10.1016/j.amepre.2014.08.025] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Revised: 07/22/2014] [Accepted: 08/19/2014] [Indexed: 11/18/2022]
Abstract
BACKGROUND Understanding mechanisms linking neighborhood context to health behaviors may provide targets for increasing lifestyle intervention effectiveness. Although associations between home neighborhood and obesogenic behaviors have been studied, less is known about the role of worksite neighborhood. PURPOSE To evaluate associations between worksite neighborhood context at baseline (2006) and change in obesogenic behaviors of adult employees at follow-up (2007-2009) in a worksite randomized trial to prevent weight gain. METHODS Worksite property values were used as an indicator of worksite neighborhood SES (NSES). Worksite neighborhood built environment attributes associated with walkability were evaluated as explanatory factors in relationships among worksite NSES, diet, and physical activity behaviors of employees. Behavioral data were collected at baseline (2005-2007) and follow-up (2007-2009). Multilevel linear and logistic models were constructed adjusting for covariates and accounting for clustering within worksites. Product-of-coefficients methods were used to assess mediation. Analyses were performed after study completion (2011-2012). RESULTS Higher worksite NSES was associated with more walking (OR=1.16, 95% CI=1.03, 1.30, p=0.01). Higher density of residential units surrounding worksites was associated with more walking and eating five or more daily servings of fruits and vegetables, independent of worksite NSES. Residential density partially explained relationships among worksite NSES, fruit and vegetable consumption, and walking. CONCLUSIONS Worksite neighborhood context may influence employees' obesogenic behaviors. Furthermore, residential density around worksites could be an indicator of access to dietary and physical activity-related infrastructure in urban areas. This may be important given the popularity of worksites as venues for obesity prevention efforts.
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Affiliation(s)
- Wendy E Barrington
- School of Nursing, University of Washington, Seattle, Washington; School of Public Health, University of Washington, Seattle, Washington.
| | - Shirley A A Beresford
- School of Public Health, University of Washington, Seattle, Washington; Fred Hutchinson Cancer Research Center, Division of Public Health Sciences, Seattle, Washington
| | - Thomas D Koepsell
- School of Public Health, University of Washington, Seattle, Washington
| | - Glen E Duncan
- School of Public Health, University of Washington, Seattle, Washington
| | - Anne Vernez Moudon
- School of Public Health, University of Washington, Seattle, Washington; College of Built Environments, University of Washington, Seattle, Washington
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195
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Urban environments and obesity in southeast Asia: a systematic review, meta-analysis and meta-regression. PLoS One 2014; 9:e113547. [PMID: 25426942 PMCID: PMC4245122 DOI: 10.1371/journal.pone.0113547] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Accepted: 10/29/2014] [Indexed: 01/21/2023] Open
Abstract
Many environmental factors contribute to the rise in prevalence of obesity in populations but one key driver is urbanization. Countries in Southeast (SE) Asia have undergone rapid changes in urbanization in recent decades. The aim of this study is to provide a systematic review of studies exploring the relationship between living in an urban or rural environment (urbanicity) and obesity in Southeast Asia. In particular, the review will investigate whether the associations are uniform across countries and ages, and by sex. The literature search was conducted up to June 2014 using five databases: EMBASE, PubMed, GlobalHealth, DigitalJournal and Open Grey. Forty-five articles representing eight of the eleven countries in SE Asia were included in the review. The review found a consistent positive association between urbanicity and obesity in countries of Southeast Asia, in all age groups and both genders. Regional differences between the associations are partly explained by gross national income (GNI). In countries with lower GNI per capita, the association between urbanicity and obesity was greater. Such findings have implications for policy makers. They imply that population level interventions need to be country or region specific, tailored to suit the current stage of economic development. In addition, less developed countries might be more vulnerable to the negative health impact of urbanization than more developed countries.
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196
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Measuring food availability and accessibility among adolescents: Moving beyond the neighbourhood boundary. Soc Sci Med 2014; 133:322-30. [PMID: 25619139 DOI: 10.1016/j.socscimed.2014.11.019] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Geographic methods have provided insight about food location availability and accessibility in understanding neighbourhood variations in health. However, quantifying exposure to food locations within a pre-defined range of an individual's residence ignores locations outside of the residential neighbourhood encountered in daily life. Global positioning system (GPS) data enables exploration of multiple contextual influences on health. This study defines place in relation to behaviour, employing GPS data to 1) describe adolescent food environments within and outside of the residential buffer, 2) quantify actual food location visits, and 3) explore associations between availability and accessibility of food locations and dietary intake. Adolescents (N = 380; ages 12-16), wore GPS loggers for up to seven days. Availability and accessibility of food locations were defined by counts and distances to food locations within a 15-min walk (1 km) of home, as well as within 50 m of an adolescent's GPS track. We compared the proportion of food locations within the residential buffer to the proportion outside but within the GPS buffer. These proportions were compared to counts and distances to food locations actually visited. We explored associations between food location availability and accessibility with dietary intake variables. Food location availability and accessibility was greater and visits occurred more commonly outside of the residential buffer than within it. Food location availability and accessibility was greater for urban than suburban and rural adolescents. There were no associations between home-based measures of availability and accessibility and dietary intake and only one for GPS-based measures, with greater distance to convenience stores associated with greater fruit and vegetable consumption. This study provides important descriptive information about adolescent exposure to food locations. Findings confirm that traditional home-based approaches overestimate the importance of the neighbourhood food environment, but provide only modest evidence of linkages between the food environment beyond the residential neighbourhood boundary and dietary intake.
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197
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Ortiz-Hernández L, Janssen I. Social disorder, physical activity and adiposity in Mexican adults: Evidence from a longitudinal study. Health Place 2014; 30:13-9. [DOI: 10.1016/j.healthplace.2014.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Revised: 07/29/2014] [Accepted: 08/01/2014] [Indexed: 10/24/2022]
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198
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Crawford TW, Jilcott Pitts SB, McGuirt JT, Keyserling TC, Ammerman AS. Conceptualizing and comparing neighborhood and activity space measures for food environment research. Health Place 2014; 30:215-25. [PMID: 25306420 PMCID: PMC4253906 DOI: 10.1016/j.healthplace.2014.09.007] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Revised: 09/04/2014] [Accepted: 09/09/2014] [Indexed: 10/24/2022]
Abstract
Greater accessibility to geospatial technologies has led to a surge of spatialized public health research, much of which has focused on food environments. The purpose of this study was to analyze differing spatial measures of exposure to supermarkets and farmers׳ markets among women of reproductive age in eastern North Carolina. Exposure measures were derived using participant-defined neighborhoods, investigator-defined road network neighborhoods, and activity spaces incorporating participants׳ time space behaviors. Results showed that mean area for participant-defined neighborhoods (0.04 sq. miles) was much smaller than 2.0 mile road network neighborhoods (3.11 sq. miles) and activity spaces (26.36 sq. miles), and that activity spaces provided the greatest market exposure. The traditional residential neighborhood concept may not be particularly relevant for all places. Time-space approaches capturing activity space may be more relevant, particularly if integrated with mixed methods strategies.
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Affiliation(s)
- Thomas W Crawford
- Banpu Endowed Chair, 3694 West Pine Mall, Center for Sustainability, Saint Louis University, St. Louis, MO 63108, United States.
| | - Stephanie B Jilcott Pitts
- East Carolina University, Department of Public Health, 600 Moye Blvd, MS 660, Greenville, NC 27834, United States.
| | - Jared T McGuirt
- University of North Carolina at Chapel Hill, Department of Nutrition Chapel Hill, NC 27599, United States.
| | - Thomas C Keyserling
- Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, United States.
| | - Alice S Ammerman
- Department of Nutrition, Gillings School of Global Public Health Director, Center for Health Promotion, Disease Prevention University of North Carolina at Chapel Hill, CB# 7426, Chapel Hill, NC 27599-7426, United States.
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199
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Arora NK, Pillai R, Dasgupta R, Garg PR. Whole-of-society monitoring framework for sugar, salt, and fat consumption and noncommunicable diseases in India. Ann N Y Acad Sci 2014; 1331:157-173. [PMID: 25335459 DOI: 10.1111/nyas.12555] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
India has experienced a rising prevalence of cardiometabolic risk factors in the past 15 years: the prevalence of diabetes has increased from 5.9% to 9.1%, hypertension from 17.2% to 29.2%, and obesity from 4% to 15%. The increase is among all socioeconomic groups and in urban and rural populations, though the quantum of change varies. A concomitant increase in per capita consumption of sugar from 22 to 55.3 g/day and total fat from 21.2 to 54 g/day was observed, with significant differences between states of high and low human development index (HDI). Per capita consumption of sugar, salt, and fat is consistently and significantly associated with overweight and obesity but variably associated with the occurrence of hypertension and diabetes. Market research shows that approximately 50-60% of total salt, sugar, and fat in Indian markets is procured by bulk purchasers, generally for manufacturing processed food items. This sector of the Indian economy is among the fastest growing, with several policy incentives. It is not clear from most of the data sets whether available information on per capita sugar, salt, and fat consumption has considered the contribution of processed and ready-to-eat food items. The unprecedented changes of rapid urbanization, mechanization, and globalization demand close monitoring of social, developmental, and economic determinants. This paper provides pieces of evidence to justify a whole-of-society (WoS) framework for monitoring the inputs, processes, and behavioral components of the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Disease and Stroke (NPCDCS) in India.
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Affiliation(s)
- Narendra K Arora
- Clinical Epidemiology, The INCLEN Trust International, New Delhi, India
| | - Rakesh Pillai
- Clinical Epidemiology, The INCLEN Trust International, New Delhi, India
| | - Rajib Dasgupta
- Centre of Social Medicine & Community Health, Jawaharlal Nehru University, New Delhi, India
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200
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Hirsch JA, Moore KA, Clarke PJ, Rodriguez DA, Evenson KR, Brines SJ, Zagorski MA, Diez Roux AV. Changes in the built environment and changes in the amount of walking over time: longitudinal results from the multi-ethnic study of atherosclerosis. Am J Epidemiol 2014; 180:799-809. [PMID: 25234431 DOI: 10.1093/aje/kwu218] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Lack of longitudinal research hinders causal inference on the association between the built environment and walking. In the present study, we used data from 6,027 adults in the Multi-Ethnic Study of Atherosclerosis who were 45-84 years of age at baseline to investigate the association of neighborhood built environment with trends in the amount of walking between 2000 and 2012. Walking for transportation and walking for leisure were assessed at baseline and at 3 follow-up visits (median follow-up = 9.15 years). Time-varying built environment measures (measures of population density, land use, number of destinations, bus access, and street connectivity) were created using geographic information systems. We used linear mixed models to estimate the associations between baseline levels of and a change in each built environment feature and a change in the frequency of walking. After adjustment for potential confounders, we found that higher baseline levels of population density, area zoned for retail, social destinations, walking destinations, and street connectivity were associated with greater increases in walking for transportation over time. Higher baseline levels of land zoned for residential use and distance to buses were associated with less pronounced increases (or decreases) in walking for transportation over time. Increases in the number of social destinations, the number of walking destinations, and street connectivity over time were associated with greater increases in walking for transportation. Higher baseline levels of both land zoned for retail and walking destinations were associated with greater increases in leisure walking, but no changes in built environment features were associated with leisure walking. The creation of mixed-use, dense developments may encourage adults to incorporate walking for transportation into their everyday lives.
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