Cause and context: place-based approaches to investigate how environments affect mental health

Brownfield land and health: A systematic review of the literature

BACKGROUND

Brownfield land is vacant or derelict land that was previously used for industrial or commercial purposes. Brownfield land is increasingly being targeted for housing development, however, depending on the previous use and remediation activity, it might pose potential risks to the health of residents on or in the vicinity of redeveloped sites. This systematic review of the literature synthesises the empirical evidence on the associations between brownfield land and health.

METHODS

We systematically searched EMBASE, MEDLINE, Global Health, Web of Science, Scopus and GreenFile using a study protocol registered on PROSPERO (CRD42022286826). The search strategy combined the keywords "brownfield" and its interchangeable terms such as "previously developed land", and any health outcomes such as "respiratory diseases" and "mortality". Publications identified from the search were screened for eligibility by two authors, and data were extracted from the selected articles. Study quality was assessed based on the Newcastle-Ottawa Scale.

RESULTS

Of the 1,987 records retrieved, 6 studies met the inclusion criteria; 3 ecological studies, 2 cross-sectional studies, and 1 longitudinal study. There was considerable heterogeneity in the exposure metrics and health outcomes assessed. All studies found significant positive associations between brownfield land proximity or density with at least one health relevant outcome, including poorer self-reported general health, increased mortality rates, increased birth defects, increased serum metal levels, and accelerated immune ageing.

CONCLUSIONS

Brownfield land may negatively affect the health of nearby residents. The epidemiological evidence on health effects associated with brownfield land in local communities, however, remains inconclusive and limited. Further studies are required to build the evidence base to inform future housing policies and urban planning.

Time-Varying Food Retail and Incident Disease in the Cardiovascular Health Study

INTRODUCTION

Natural experiments can strengthen evidence linking neighborhood food retail presence to dietary intake patterns and cardiometabolic health outcomes, yet sample size and follow-up duration are typically not extensive. To complement natural experiment evidence, longitudinal data were used to estimate the impacts of neighborhood food retail presence on incident disease.

METHODS

The Cardiovascular Health Study recruited adults aged 65+ years in 1989-1993. Analyses conducted in 2021-2022 included those in good baseline health, with addresses updated annually through the year of death (restricted to 91% who died during >2 decades of cohort follow-up). Baseline and annually updated presence of 2 combined food retail categories (supermarkets/produce markets and convenience/snack focused) was characterized using establishment-level data for 1-km and 5-km Euclidean buffers. Cox proportional hazards models estimated associations with time to each incident outcome (cardiovascular disease, diabetes), adjusting for individual and area-based confounders.

RESULTS

Among 2,939 participants, 36% with baseline supermarket/produce market presence within 1 km had excess incident cardiovascular disease (hazard ratio=1.12; 95% CI=1.01, 1.24); the association was attenuated and no longer statistically significant after adjustment for sociodemographic characteristics. Adjusted associations were robustly null for time-varying supermarket/produce market or convenience/fast food retail presence across analyses with outcomes of cardiovascular disease or diabetes incidence.

CONCLUSIONS

Food environment changes continue to be studied to provide an evidence base for policy decisions, and null findings in this longitudinal analysis add literature that casts doubt on the sufficiency of strategies targeting food retail presence alone of an elderly cohort for curtailing incident events of clinical importance.

The Evaluation of Conventional, Electric and Hybrid Electric Passenger Car Pass-By Noise Annoyance Using Psychoacoustical Properties

Road traffic noise is one of the most prominent sources of urban noise pollution. Recently, as a result of the electrification of vehicles, lower noise levels are expected in urban areas at speeds below 50 km/h. The commonly used physical descriptor, the A-weighted sound pressure level, does not sufficiently characterize the perceived annoyance of either combustion engine or electric passenger car pass-by noises. Psychoacoustical descriptors are advantageous for characterization purposes. The objective of this study was to evaluate the perceived annoyance caused by the noise from internal combustion engine, electric, and hybrid passenger cars using psychoacoustical properties. To achieve this objective, the following steps were conducted. First, the binaurally recorded sounds of 40 cars from different brands with different motorization were presented to the subjects who indicated the intensity of their perceived annoyance on a quasi-continuous scale. Second, the signal and psychoacoustical properties of the recorded sounds were analyzed. Third, a new annoyance index was developed, based on annoyance judgments and signal and psychoacoustical properties, to characterize the annoyance caused by pass-by noises. One of the novel aspects of this study is the consideration of not only the pass-by sounds of the internal combustion engine passenger cars, but also the pass-by sounds of hybrid and electric passenger cars. An acceleration from idle to a target speed of 50 km/h was selected as a traffic pass-by situation, which differs from those considered in previous studies. The results of the study show that psychoacoustical properties, such as loudness, tonality, roughness, and fluctuation strength, are very useful to characterize the annoyance perception, which is caused by single passenger car pass-by sounds in the above mentioned traffic situation. The developed index, which is a weighted combination of chosen psychoacoustical properties, can be very useful for traffic planning and traffic noise prevention measures.

A Systematic Review of Studies Describing the Effectiveness, Acceptability, and Potential Harms of Place-Based Interventions to Address Loneliness and Mental Health Problems

Given the links between the built environment and loneliness, there is interest in using place-based approaches (addressing built environment characteristics and related socio-spatial factors) in local communities to tackle loneliness and mental health problems. However, few studies have described the effectiveness, acceptability, or potential harms of such interventions. This review aimed to synthesize the literature describing local community-based interventions that target place-based factors to address loneliness and mental health problems, informing the development of future public health approaches. We searched PsycINFO, Medline, and Embase using a structured search strategy to identify English-language studies evaluating the effectiveness, acceptability, and potential harms of place-based community interventions in addressing loneliness and mental health problems, both in general and clinical populations. Seven studies met the inclusion criteria, classified as evaluating provision of community facilities (such as clubhouses), active engagement in local green spaces, and housing regeneration. None were randomised trials. Quantitative and qualitative findings suggested promising effects and/or acceptability of six interventions, with minimal potential harms. There is a clear need for randomised trials or quasi-experimental studies of place-based interventions to describe their effectiveness in addressing loneliness and mental health problems, as well as complementary qualitative work investigating acceptability. This will inform future policy development.

Are Rurality, Area Deprivation, Access to Outside Space, and Green Space Associated with Mental Health during the COVID-19 Pandemic? A Cross Sectional Study (CHARIS-E)

The study investigated if rurality, area deprivation, access to outside space (Study 1), and frequency of visiting and duration in green space (Study 2) are associated with mental health during the COVID-19 pandemic and examined if individual demographics (age, gender, COVID-19 shielding status) and illness beliefs have a direct association with mental health during the COVID-19 pandemic. A serial, weekly, nationally representative, cross-sectional, observational study of randomly selected adults was conducted in Scotland during June and July 2020. If available, validated instruments were used to measure psychological distress, individual demographics, illness beliefs, and the following characteristics: Rurality, area deprivation, access to residential outside space, frequency of visiting, and duration in green space. Simple linear regressions followed by examination of moderation effect were conducted. There were 2969 participants in Study 1, of which 1765 (59.6%) were female, 349 (11.9%) were in the shielding category, and the median age was 54 years. There were 502 participants in Study 2, of which 295 (58.60%) were female, 58 (11.6%) were in shielding category, and the median age was 53 years. Direct effects showed that psychological distress was worse if participants reported the following: Urban, in a deprived area, no access to or sharing residential outside space, fewer visits to green space (environment), younger, female, in the shielding category (demographics), worse illness (COVID-19) representations, and greater threat perception (illness beliefs). Moderation analyses showed that environmental factors amplified the direct effects of the individual factors on psychological distress. This study offers pointers for public health and for environmental planning, design, and management, including housing design and public open space provision and regulation.

How Do Urban Environments Affect Young People's Mental Health? A Novel Conceptual Framework to Bridge Public Health, Planning, and Neurourbanism

Childhood and adolescence are crucial periods for mental and social development. Currently, mental illness among young people is a global epidemic, and rates of disorders such as depression and anxiety are rising. Urban living, compared with rural living, is linked with a higher risk of serious mental illness, which is important because the world is urbanizing faster than ever before. Urban environments and their landscapes, designs, and features influence mental health and well-being. However, no conceptual frameworks to date have detailed the effect of urban environments on young people's mental health, and few studies have considered the growing role of digital and social media in this relationship, leading to calls for the development of holistic approaches to describe this relationship. This article synthesizes existing knowledge on urban places (both built and natural environments) and mental health in the public health and urban planning literature and examines the emerging field of neurourbanism (a multidisciplinary study of the effect of urban environments on mental health and brain activity) to enhance current practice and research. We developed 2 novel conceptual frameworks (1 research-oriented, 1 practice-oriented), adapted from Bronfenbrenner's socioecological model, that focus on the relationship between urban environments and young people's mental health. We added a digital and social media contextual level to the socioecological model, and we applied a multilayer concept to highlight potential cross-field interactions and collaborations. The proposed frameworks can help to guide future practice and research in this area.

Impact of Built Environments on Body Weight (the Moving to Health Study): Protocol for a Retrospective Longitudinal Observational Study

BACKGROUND

Studies assessing the impact of built environments on body weight are often limited by modest power to detect residential effects that are small for individuals but may nonetheless comprise large attributable risks.

OBJECTIVE

We used data extracted from electronic health records to construct a large retrospective cohort of patients. This cohort will be used to explore both the impact of moving between environments and the long-term impact of changing neighborhood environments.

METHODS

We identified members with at least 12 months of Kaiser Permanente Washington (KPWA) membership and at least one weight measurement in their records during a period between January 2005 and April 2017 in which they lived in King County, Washington. Information on member demographics, address history, diagnoses, and clinical visits data (including weight) was extracted. This paper describes the characteristics of the adult (aged 18-89 years) cohort constructed from these data.

RESULTS

We identified 229,755 adults representing nearly 1.2 million person-years of follow-up. The mean age at baseline was 45 years, and 58.0% (133,326/229,755) were female. Nearly one-fourth of people (55,150/229,755) moved within King County at least once during the follow-up, representing 84,698 total moves. Members tended to move to new neighborhoods matching their origin neighborhoods on residential density and property values.

CONCLUSIONS

Data were available in the KPWA database to construct a very large cohort based in King County, Washington. Future analyses will directly examine associations between neighborhood conditions and longitudinal changes in body weight and diabetes as well as other health conditions.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/16787.

Pathways and contingencies linking road traffic noise to annoyance, noise sensitivity, and mental Ill-Health

CONTEXT

Traffic noise may contribute to depression and anxiety through higher noise annoyance (NA). However, little is known about noise sensitivity (NS) and mental health status as contextual factors.

OBJECTIVE

We tested three hypotheses: (1) Traffic noise is associated with mental ill-health through higher NA; (2) Mental ill-health and NS moderate the association between traffic noise and NA; and (3) NS moderates the indirect effect of traffic noise on mental ill-health.

SUBJECTS AND METHODS

We used a convenience sample of 437 undergraduate students from the Medical University in Plovdiv, Bulgaria (mean age 21 years; 35% male). Residential road traffic noise (LAeq; day equivalent noise level) was calculated using a land use regression model. Depression and anxiety symptoms were measured with the Patient Health Questionnaire 9-item (PHQ-9) and the Generalized Anxiety Disorder 7-item (GAD-7) scale, respectively. NA was measured using a 5-point verbal scale. The Noise Sensitivity Scale Short Form (NSS-SF) was used to measure NS. To investigate how these variables intertwine, we conducted mediation, moderation and moderated mediation analyses.

RESULTS

LAeq was indirectly associated with higher PHQ-9/GAD-7 scores through higher NA, but only in the low NS group. The relationship between LAeq and NA was stronger in students reporting depression/anxiety. While high NS was associated with high NA even at low noise levels, LAeq contributed to NA only in students low on NS.

CONCLUSIONS

We found complex conditional relationships between traffic noise, annoyance and mental ill-health. Understanding respective vulnerability profiles within the community could aid noise policy and increase efficacy of interventions.

Road Traffic Noise Exposure and Depression/Anxiety: An Updated Systematic Review and Meta-Analysis

Unlike other World Health Organization evidence reviews, the systematic review on mental disorders could not provide a quantitative estimate of the effect of environmental noise. With that in mind, we aimed to update it with additional studies published through to 18 August 2019 in order to allow for a formal meta-analysis of the association of residential road traffic noise with anxiety and depression. The quality effects and random effects estimators were used for meta-analysis and the robustness of findings was tested in several sensitivity analyses. Ten studies were included in the qualitative synthesis, from which we extracted 15 estimates for depression (n = 1,201,168) and five for anxiety (n = 372,079). Almost all studies were cross-sectional and the risk of bias in them was generally high. We found 4% (95% CI: -3%, 11%) higher odds of depression and 12% (95% CI: -4%, 30%) of anxiety associated with a 10 dB(A) increase in day-evening-night noise level (Lden). Both models suffered from moderate heterogeneity (55% and 54%), but there was evidence of publication bias only in the depression model. These findings were robust with no evidence of study-level moderators. A sensitivity analysis on an alternative set of categorically-reported estimates supported a linear relationship between Lden and depression. Taking into account an overall quality assessment for the included studies, we conclude that there is evidence of "very low" quality that increasing exposure to road traffic noise may be associated with depression and anxiety.

Comparisons of depression, anxiety, well-being, and perceptions of the built environment amongst adults seeking social, intermediate and market-rent accommodation in the former London Olympic Athletes' Village

The Examining Neighbourhood Activities in Built Living Environments in London (ENABLE London) study provides a unique opportunity to examine differences in mental health and well-being amongst adults seeking social, intermediate (affordable rent), and market-rent housing in a purpose built neighbourhood (East Village, the former London 2012 Olympic Athletes' Village), specifically designed to encourage positive health behaviours. Multi-level logistic regression models examined baseline differences in levels of depression, anxiety and well-being across the housing groups. Compared with the intermediate group, those seeking social housing were more likely to be depressed, anxious and had poorer well-being after adjustment for demographic and health status variables. Further adjustments for neighbourhood perceptions suggest that compared with the intermediate group, perceived neighbourhood characteristics may be an important determinant of depression amongst those seeking social housing, and lower levels of happiness the previous day amongst those seeking market-rent housing. These findings add to the extensive literature on inequalities in health, and provide a strong basis for future longitudinal work that will examine change in depression, anxiety and well-being after moving into East Village, where those seeking social housing potentially have the most to gain.