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van Velzen M, de Graaf-Waar HI, Ubert T, van der Willigen RF, Muilwijk L, Schmitt MA, Scheper MC, van Meeteren NLU. 21st century (clinical) decision support in nursing and allied healthcare. Developing a learning health system: a reasoned design of a theoretical framework. BMC Med Inform Decis Mak 2023; 23:279. [PMID: 38053104 PMCID: PMC10699040 DOI: 10.1186/s12911-023-02372-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 11/09/2023] [Indexed: 12/07/2023] Open
Abstract
In this paper, we present a framework for developing a Learning Health System (LHS) to provide means to a computerized clinical decision support system for allied healthcare and/or nursing professionals. LHSs are well suited to transform healthcare systems in a mission-oriented approach, and is being adopted by an increasing number of countries. Our theoretical framework provides a blueprint for organizing such a transformation with help of evidence based state of the art methodologies and techniques to eventually optimize personalized health and healthcare. Learning via health information technologies using LHS enables users to learn both individually and collectively, and independent of their location. These developments demand healthcare innovations beyond a disease focused orientation since clinical decision making in allied healthcare and nursing is mainly based on aspects of individuals' functioning, wellbeing and (dis)abilities. Developing LHSs depends heavily on intertwined social and technological innovation, and research and development. Crucial factors may be the transformation of the Internet of Things into the Internet of FAIR data & services. However, Electronic Health Record (EHR) data is in up to 80% unstructured including free text narratives and stored in various inaccessible data warehouses. Enabling the use of data as a driver for learning is challenged by interoperability and reusability.To address technical needs, key enabling technologies are suitable to convert relevant health data into machine actionable data and to develop algorithms for computerized decision support. To enable data conversions, existing classification and terminology systems serve as definition providers for natural language processing through (un)supervised learning.To facilitate clinical reasoning and personalized healthcare using LHSs, the development of personomics and functionomics are useful in allied healthcare and nursing. Developing these omics will be determined via text and data mining. This will focus on the relationships between social, psychological, cultural, behavioral and economic determinants, and human functioning.Furthermore, multiparty collaboration is crucial to develop LHSs, and man-machine interaction studies are required to develop a functional design and prototype. During development, validation and maintenance of the LHS continuous attention for challenges like data-drift, ethical, technical and practical implementation difficulties is required.
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Affiliation(s)
- Mark van Velzen
- Data Supported Healthcare: Data-Science unit, Research Center Innovations in care, Rotterdam University of Applied Sciences, Rotterdam, the Netherlands.
- Department of Anesthesiology, Erasmus Medical Center, Rotterdam, the Netherlands.
| | - Helen I de Graaf-Waar
- Data Supported Healthcare: Data-Science unit, Research Center Innovations in care, Rotterdam University of Applied Sciences, Rotterdam, the Netherlands
- Department of Anesthesiology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Tanja Ubert
- Institute for Communication, media and information Technology, Rotterdam University of Applied Sciences, Rotterdam, the Netherlands
| | - Robert F van der Willigen
- Institute for Communication, media and information Technology, Rotterdam University of Applied Sciences, Rotterdam, the Netherlands
| | - Lotte Muilwijk
- Data Supported Healthcare: Data-Science unit, Research Center Innovations in care, Rotterdam University of Applied Sciences, Rotterdam, the Netherlands
- Institute for Communication, media and information Technology, Rotterdam University of Applied Sciences, Rotterdam, the Netherlands
| | - Maarten A Schmitt
- Data Supported Healthcare: Data-Science unit, Research Center Innovations in care, Rotterdam University of Applied Sciences, Rotterdam, the Netherlands
| | - Mark C Scheper
- Data Supported Healthcare: Data-Science unit, Research Center Innovations in care, Rotterdam University of Applied Sciences, Rotterdam, the Netherlands
- Department of Anesthesiology, Erasmus Medical Center, Rotterdam, the Netherlands
- Allied Health professions, faculty of medicine and science, Macquarrie University, Sydney, Australia
| | - Nico L U van Meeteren
- Department of Anesthesiology, Erasmus Medical Center, Rotterdam, the Netherlands
- Top Sector Life Sciences and Health (Health~Holland), The Hague, the Netherlands
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Schoenweger P, Kirschneck M, Biersack K, Di Meo AF, Reindl-Spanner P, Prommegger B, Ditzen-Janotta C, Henningsen P, Krcmar H, Gensichen J, Jung-Sievers C. Community indicators for mental health in Europe: a scoping review. Front Public Health 2023; 11:1188494. [PMID: 37538274 PMCID: PMC10396773 DOI: 10.3389/fpubh.2023.1188494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 06/19/2023] [Indexed: 08/05/2023] Open
Abstract
Background Community indicators may predict and influence individuals` mental health, and support or impede mental health management. However, there is no consensus on which indicators should be included in predictions, prognostic algorithms, or management strategies for community-based mental health promotion and prevention approaches. Therefore, this scoping review provides an overview of relevant community-level indicators for mental health in the general as well as risk populations in a European context. Methods We conducted a scoping review in the following electronic databases: PubMed, Embase, and PsycInfo. Eligible studies focused on context factors such as either the physical or social environment, reporting at least one mental health outcome and referring to a European population. Publications between 2012 and March 8, 2022 are considered. Results In total, the search yielded 12,200 identified records. After the removal of duplicates, 10,059 records were screened against the eligibility criteria. In total, 169 studies were included in the final analysis. Out of these included studies, 6% focused on pan-European datasets and 94% on a specific European country. Populations were either general or high-risk populations (56 vs. 44%, respectively) with depressive disorder as the main reported outcome (49%), followed by general mental health (33%) and anxiety (23%). Study designs were cross-sectional studies (59%), longitudinal (27%), and others (14%). The final set of indicators consisted of 53 indicators, which were grouped conceptually into 13 superordinate categories of community indicators. These were divided into the domains of the physical and social environment. The most commonly measured and reported categories of community indicators associated with mental health outcomes were social networks (n = 87), attitudinal factors toward vulnerable groups (n = 76), and the characteristics of the built environment (n = 56). Conclusion This review provides an evidence base of existing and novel community-level indicators that are associated with mental health. Community factors related to the physical and social environment should be routinely recorded and considered as influencing factors or potentially underestimated confounders. The relevance should be analyzed and included in clinical outcomes, data, monitoring and surveillance as they may reveal new trends and targets for public mental health interventions.
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Affiliation(s)
- Petra Schoenweger
- Institute of Medical Data Processing, Biometrics and Epidemiology (IBE), Faculty of Medicine, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Michaela Kirschneck
- Institute of Medical Data Processing, Biometrics and Epidemiology (IBE), Faculty of Medicine, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Katharina Biersack
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital, Technical University of Munich, Munich, Germany
| | - Anna-Francesca Di Meo
- Institute of Medical Data Processing, Biometrics and Epidemiology (IBE), Faculty of Medicine, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Philipp Reindl-Spanner
- TUM School of Computation, Information and Technology, Technical University of Munich, Munich, Germany
| | - Barbara Prommegger
- TUM School of Computation, Information and Technology, Technical University of Munich, Munich, Germany
| | - Claudia Ditzen-Janotta
- Institute of Medical Data Processing, Biometrics and Epidemiology (IBE), Faculty of Medicine, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Peter Henningsen
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital, Technical University of Munich, Munich, Germany
| | - Helmut Krcmar
- TUM School of Computation, Information and Technology, Technical University of Munich, Munich, Germany
| | - Jochen Gensichen
- Institute of General Practice and Family Medicine, University Hospital of Ludwig-Maximilians-University Munich, Munich, Germany
| | - Caroline Jung-Sievers
- Institute of Medical Data Processing, Biometrics and Epidemiology (IBE), Faculty of Medicine, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
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The impact of built environment on mental health: A COVID-19 lockdown perspective. Health Place 2022; 77:102889. [PMID: 36027740 PMCID: PMC9385772 DOI: 10.1016/j.healthplace.2022.102889] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 07/06/2022] [Accepted: 08/02/2022] [Indexed: 02/08/2023]
Abstract
Tackling mental health has become a priority for governments around the world because it influences not only individuals but also the whole society. As people spend a majority of their time (i.e., around 90%) in buildings, it is pivotal to understand the relationship between built environment and mental health, particularly during COVID-19 when people have experienced recurrent local and national lockdowns. Despite the demonstration by previous research that the design of the built environment can affect mental health, it is not clear if the same influence pattern remains when a 'black swan' event (e.g., COVID-19) occurs. To this end, we performed logistic regression and hierarchical regression analyses to examine the relationship between built environment and mental health utilising a data sample from the United Kingdom (UK) residents during the COVID-19 lockdown while considering their social demographics. Our results show that compared with depression and anxiety, people were more likely to feel stressed during the lockdown period. Furthermore, general house type, home workspace, and neighbourhood environment and amenity were identified to have significantly contributed to their mental health status. With the ensuing implications, this study represents one of the first to inform policymakers and built environment design professionals of how built environment should be designed to accommodate features that could mitigate mental health problems in any future crisis. As such, it contributes to the body of knowledge of built environment planning by considering mental health during the COVID-19 lockdown.
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Gabr H, Baragilly M, Willis BH. Measuring and exploring mental health determinants: a closer look at co-residents’ effect using a multilevel structural equations model. BMC Med Res Methodol 2022; 22:236. [PMID: 36045347 PMCID: PMC9429464 DOI: 10.1186/s12874-022-01711-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 08/12/2022] [Indexed: 11/17/2022] Open
Abstract
Objective Previous research has demonstrated that individual risk of mental illness is associated with individual, co-resident, and household risk factors. However, modelling the overall effect of these risk factors presents several methodological challenges. In this study we apply a multilevel structural equation model (MSEM) to address some of these challenges and the impact of the different determinants when measuring mental health risk. Study design and setting Two thousand, one hundred forty-three individuals aged 16 and over from 888 households were analysed based on the Household Survey for England-2014 dataset. We applied MSEM to simultaneously measure and identify psychiatric morbidity determinants while accounting for the dependency among individuals within the same household and the measurement errors. Results Younger age, female gender, non-working status, headship of the household, having no close relationship with other people, having history of mental illness and obesity were all significant (p < 0.01) individual risk factors for psychiatric morbidity. A previous history of mental illness in the co-residents, living in a deprived household, and a lack of closeness in relationships among residents were also significant predictors. Model fit indices showed a very good model specification (CFI = 0.987, TLI = 0.980, RMSEA = 0.023, GFI = 0.992). Conclusion Measuring and addressing mental health determinants should consider not only an individual’s characteristics but also the co-residents and the households in which they live. Supplementary Information The online version contains supplementary material available at 10.1186/s12874-022-01711-9.
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Zhang R, He X, Liu Y, Li M, Zhou C. The Relationship Between Built Environment and Mental Health of Older Adults: Mediating Effects of Perceptions of Community Cohesion and Community Safety and the Moderating Effect of Income. Front Public Health 2022; 10:881169. [PMID: 35784206 PMCID: PMC9247295 DOI: 10.3389/fpubh.2022.881169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 05/23/2022] [Indexed: 12/03/2022] Open
Abstract
Many studies revealed a significant correlation between low-density built environment and the mental health of older adults in developed countries. However, scholars and decision-makers recently began to pay close attention to the effect of this relationship in high-density built environments and in developing countries. Using point-of-interest (POI) data from Baidu and data on 20 communities in Guangzhou, China, which were collected through a questionnaire survey, this study aimed to examine the relationship between built environment and the mental health of older adults as well as the physiological–psychological mediating paths between the two, so as to enrich the research on population aging in the high-density urban context in developing countries. The findings indicated that facility accessibility and distance to parks significantly positively correlated with the mental health of older adults and the number of public transit stations, and the distance to these stations significantly negatively correlated with the mental health of older adults. Also, the perceptions of community cohesion and community safety had a significant mediating effect between the built environment and the mental health of older adults. Furthermore, the moderating effect analysis results verified the moderating effect of income: with an increase in income, the perception of community cohesion enhanced the protection of the mental health of older adults and reduced the mediating effect of the perception of community safety. The results provided a reference for policy-makers and urban planners in their efforts to plan and build health-supporting communities and a healthy aging society.
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Affiliation(s)
- Rongrong Zhang
- School of Geography and Planning, Sun Yat-sen University, Guangzhou, China
| | - Xiong He
- School of Geography and Planning, Sun Yat-sen University, Guangzhou, China
| | - Ying Liu
- School of Geography and Planning, Sun Yat-sen University, Guangzhou, China
| | - Ming Li
- Land Consolidation and Rehabilitation Center MNR, Beijing, China
| | - Chunshan Zhou
- School of Geography and Planning, Sun Yat-sen University, Guangzhou, China
- *Correspondence: Chunshan Zhou
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Selected Research Issues of Urban Public Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095553. [PMID: 35564947 PMCID: PMC9105718 DOI: 10.3390/ijerph19095553] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/27/2022] [Accepted: 04/29/2022] [Indexed: 01/17/2023]
Abstract
Health is created within the urban settings of people’s everyday lives. In this paper we define Urban Public Health and compile existing evidence regarding the spatial component of health and disease in urban environments. Although there is already a substantial body of single evidence on the links between urban environments and human health, focus is mostly on individual health behaviors. We look at Urban Public Health through a structural lens that addresses health conditions beyond individual health behaviors and identify not only health risks but also health resources associated with urban structures. Based on existing conceptual frameworks, we structured evidence in the following categories: (i) build and natural environment, (ii) social environment, (iii) governance and urban development. We focused our search to review articles and reviews of reviews for each of the keywords via database PubMed, Cochrane, and Google Scholar in order to cover the range of issues in urban environments. Our results show that linking findings from different disciplines and developing spatial thinking can overcome existing single evidence and make other correlations visible. Further research should use interdisciplinary approaches and focus on health resources and the transformation of urban structures rather than merely on health risks and behavior.
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Citizen science in the community: Gaining insight in community and participant health in four deprived neighbourhoods in the Netherlands. Health Place 2022; 75:102798. [PMID: 35364470 DOI: 10.1016/j.healthplace.2022.102798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 02/14/2022] [Accepted: 03/18/2022] [Indexed: 11/23/2022]
Abstract
The aim of this study was to examine if citizen science contributes to gaining insight into community health and to the health of the citizen scientists themselves. Therefore, thirteen citizens in four deprived neighbourhoods were trained as citizen scientists to conduct research in their own communities. Results showed that the citizen scientists identified forty (health related) themes in their communities. The citizen scientists reported an increase in their overall self-perceived health which, however, was not significantly demonstrated in the prequestionnaire and postquestionnaire.
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Study on Spatial–Temporal Patterns and Factors Influencing Human Settlement Quality in Beijing. SUSTAINABILITY 2022. [DOI: 10.3390/su14073752] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Human settlements lay the basis for urban sustainable development and embody comprehensive urban competitiveness. Based on data from the period 2010–2019, the entropy value method, global spatial correlation, and local spatial correlation are adopted to systematically analyze the overall level and spatial–temporal pattern of human settlement quality in Beijing. In particular, this study sought to uncover the factors that influence human settlement quality in Beijing by using the panel data model. The results show that the quality of human settlements in Beijing has generally followed an upward trend, with slow growth and a slight decline since 2017. Despite significant spatial positive correlations and stable local spatial self-correlation, the spatial difference is still evident, and regional correlation needs further improvement. Medical resources, economic development, public services, governance investment, and infrastructure are significantly and positively correlated with human settlement quality, while population growth is significantly and negatively correlated with it. Based on this study, specific recommendations are proposed which can be used as a reference for Beijing and other cities’ human settlement construction and its improvement.
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Avery H, Sjögren Forss K, Rämgård M. Empowering communities with health promotion labs: result from a CBPR programme in Malmö, Sweden. Health Promot Int 2022; 37:daab069. [PMID: 34263320 PMCID: PMC8851348 DOI: 10.1093/heapro/daab069] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Health promotion is thus not only a participatory practice, but a practice for empowerment and social justice. The study describes findings from a community-based participatory and challenge-driven research program. that aimed to improve health through health promotion platform in an ethnically diverse low-income neighbourhood of Malmö, Sweden. Local residents together with lay health promoters living in the area were actively involved in the planning phase and decided on the structure and content of the program. Academic, public sector and commercial actors were involved, as well as NGOs and residents. Empowerment was used as a lens to analyse focus group interviews with participants (n=322) in six co-creative health-promoting labs on three occasions in the period 2017-2019. The CBPR interview guide focused on the dimensions of participation, collaboration and experience of the activities. The CBPR approach driven by community member contributed to empowerment processes within the health promotion labs: Health promotors building trust in social places for integration, Participants motivate each other by social support and Participants acting for community health in wider circle. CBPR Health promotion program should be followed up longitudielly with community participants to be able to see the processes of change and empowerment on the community level.
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Affiliation(s)
- Helen Avery
- Center for Middle Eastern studies, Lund University, Lund, Sweden
| | - Katarina Sjögren Forss
- Faculty of Health and Society, Department of Care Science, Malmö university, Malmö, Sweden
| | - Margareta Rämgård
- Faculty of Health and Society, Department of Care Science, Malmö university, Malmö, Sweden
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Zhong W, Suo J, Ren X, Li G. The Influence of Emotional Health on the Activity Characteristics of the Elderly and the Selection of Environmental Quality Factors in Residential Areas. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312618. [PMID: 34886338 PMCID: PMC8657121 DOI: 10.3390/ijerph182312618] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 11/27/2021] [Accepted: 11/28/2021] [Indexed: 11/16/2022]
Abstract
The environment in urban residential areas is the main field of daily activity for the elderly. Environmental renewal has played a significant role in improving residents' quality of life and promoting physical and mental health. However, there is a general tendency that more attention has been focused on the environment during environmental renewal but not the residents. There is a continued lack of discussion on the emotional status of the elderly and its impact on outdoor activities. Based on the investigation of four types of typical residential environments in the Dalian residential area, a hierarchical linear model (HLM) has been constructed to reveal the influence of the emotional status of elderly persons on their activity characteristics and the selection of environmental quality factors. The results show that the distribution of older people with different emotional statuses varies among different residential types. The proportion of positive emotion is relatively high in the flat land in rows category, and the activity characteristics are significantly different under different emotional statuses. Among the four kinds of residential environments, which are (flat land in rows, flat land enclosed, slope, and mountainous) the environmental quality factors that have the highest impact on the emotional status of the elderly are greening quality (0.395), acoustic environment (0.167), environmental cleanliness (0.269), and greening quality (0.230), respectively. In the mountainous type, the impact of environmental quality factors on the emotional status of the elderly is the highest (39.7%), and the impact contributions of the other three environmental types are 23.3%, 8.9% and 20.1%, respectively. These research results provide helpful guidance for the scientific community about practical implementation of residential environmental renewal for the elderly.
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Affiliation(s)
| | - Jian Suo
- Correspondence: ; Tel.: +86-138-4090-7234
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Berkers E, Pop I, Cloïn M, Eugster A, van Oers H. The relative effects of self-reported noise and odour annoyance on psychological distress: Different effects across sociodemographic groups? PLoS One 2021; 16:e0258102. [PMID: 34597345 PMCID: PMC8486134 DOI: 10.1371/journal.pone.0258102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 09/19/2021] [Indexed: 11/18/2022] Open
Abstract
In earlier research, both higher levels of noise and odour annoyance have been associated with decreased mental health. Presumably, these perceptions can trigger feelings of threat and stress reactions and in turn evoke psychological distress. There are two important lacunas in the research on this topic: most studies only consider either noise or odour annoyance and not their relative effect on psychological distress and there is scarce evidence about whether different sociodemographic groups experience more psychological distress due to noise and odour annoyance. Starting from the diversity in the available coping resources and in their daily life patterns, we distinguish gender, age and educational level as relevant sociodemographic variables. Using data from the Health Monitor (n = 25236) in Noord-Brabant, we found using Ordinary Least Squares Regression that individuals that reported higher levels of noise and odour annoyance reported higher levels of psychological distress. Furthermore, the effect of noise annoyance was relatively stronger compared to that of odour annoyance. Regarding the interaction effects, we found that younger adults’ psychological distress was more strongly affected by noise annoyance compared to older adults, but not by odour annoyance. The psychological distress of individuals with no or primary education was more strongly affected by both noise and odour annoyance compared those with tertiary education, but not when compared to those who completed lower or higher secondary education. Contrary to our expectations, we did not find different effects between men and women. Though the evidence for the interactions was mixed, classic health inequalities along age and education lines are reinforced when considering the relationship between noise and odour annoyance and psychological distress.
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Affiliation(s)
- Eline Berkers
- Department of Sociology, Tilburg University, Tilburg, The Netherlands
- Tranzo, Tilburg University, Tilburg, The Netherlands
- * E-mail:
| | - Ioana Pop
- Department of Sociology, Tilburg University, Tilburg, The Netherlands
| | | | - Antje Eugster
- Tranzo, Tilburg University, Tilburg, The Netherlands
- GGD Brabant-Zuidoost, Eindhoven, The Netherlands
| | - Hans van Oers
- Tranzo, Tilburg University, Tilburg, The Netherlands
- Ministry of Health, Welfare and Sports, The Hague, The Netherlands
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Is Loneliness an Undervalued Pathway between Socio-Economic Disadvantage and Health? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910177. [PMID: 34639477 PMCID: PMC8508269 DOI: 10.3390/ijerph181910177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 09/13/2021] [Accepted: 09/23/2021] [Indexed: 01/06/2023]
Abstract
Loneliness is a growing public health issue. It is more common in disadvantaged groups and has been associated with a range of poor health outcomes. Loneliness may also form an independent pathway between socio-economic disadvantage and poor health. Therefore, the aim of this study was to explore the contribution of loneliness to socio-economic health inequalities. These contributions were studied in a Dutch national sample (n = 445,748 adults (≥19 y.o.)) in Poisson and logistic regression models, controlling for age, gender, marital status, migration background, BMI, alcohol consumption, smoking, and physical activity. Loneliness explained 21% of socioeconomic health inequalities between the lowest and highest socio-economic groups in self-reported chronic disease prevalence, 27% in poorer self-rated health, and 51% in psychological distress. Subgroup analyses revealed that for young adults, loneliness had a larger contribution to socioeconomic gaps in self-rated health (37%) than in 80+-year-olds (16%). Our findings suggest that loneliness may be a social determinant of health, contributing to the socioeconomic health gap independently of well-documented factors such as lifestyles and demographics, in particular for young adults. Public health policies targeting socioeconomic health inequalities could benefit from integrating loneliness into their policies, especially for young adults.
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Hwang EJ, Sim IO. The structural equation modeling of personal aspects, environmental aspects, and happiness among older adults living alone: a cross-sectional study. BMC Geriatr 2021; 21:479. [PMID: 34481453 PMCID: PMC8418737 DOI: 10.1186/s12877-021-02430-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 08/26/2021] [Indexed: 11/13/2022] Open
Abstract
Background The happiness of older adults living alone warrants attention because they are more vulnerable to unhappiness than those living with families. The present study aimed to construct and test a structural equation model to elucidate the relationship among participation in social activities, satisfaction with the neighborhood environment, subjective health status, and happiness in older adults living alone in South Korea. Methods Secondary data of 2768 older adults (605 males and 2163 females) living on their own were extracted from the 2017 Korean Community Health Survey and used in this cross-sectional study. Data were collected via self-reported questionnaires and analyzed using SPSS version 20.0 and AMOS version 20.0. Results The hypothetical model exhibited a good fit: χ2 = 342.06 (df = 58, p < .001), goodness-of-fit index = .98, adjected goodness-of-fit index = .97, root mean square error of approximation = .04, and nonstandard fit index = .92. Participation in social activities had a significant effect on participants’ subjective health status (path coefficient = .45, p = .001) and happiness (path coefficient = .20, p = .003). Conclusions Interventions to improve the health and happiness of older adults living alone should aim to enhance their social and physical environmental dimensions based on the participants’ various social activities and their neighborhoods’ characteristics.
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Affiliation(s)
- Eun Jeong Hwang
- Department of Nursing, Sehan University, 1113 Noksaek-ro, Samho-eup, Yeongam-gun, Jeollanam-do, 58447, Republic of Korea
| | - In Ok Sim
- Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul, 06974, Republic of Korea.
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Chen Y, Guo M, Xu H, Liu Z, Barry LC, Wu C. Association between early life circumstances and depressive symptoms among Chinese older adults: Results from China health and retirement longitudinal study: Early life circumstances and depression. J Affect Disord 2021; 292:345-351. [PMID: 34139407 DOI: 10.1016/j.jad.2021.05.067] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 03/26/2021] [Accepted: 05/30/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND A growing body of literature suggests that early life circumstances can influence mental health throughout the lifespan. However, how these early life circumstances cumulatively contribute to depression in old age is not completely understood. The aim of this study was to examine the associations of eight factors with depression among community-dwelling older adults. METHODS Data were from the China Health and Retirement Longitudinal Study. We included 8,239 community-dwelling individuals who were ≥60 years, completed the life history questionnaire, and had assessment of depression. An early life disadvantage index was established using risk factors that were significantly associated with depression. Logistic regression was used to examine the association of each early life risk factor and the index with depression. RESULTS Of 8239 individuals included, 2,055 (24.9%) had depression. In bivariate analysis, each of eight early life risk factors was significantly associated with depression. Except for maternal and paternal education, all risk factors persisted to be associated with depression after multivariable adjustment. In the multivariable-adjusted model, a one-point higher in the early life disadvantage index (range: 0-6) was associated with a 45% (95% CI: 37%, 53%) higher odds of depression. LIMITATIONS Depressive symptoms were measured in our study only by the CES-D scale. Some early life experiences might not be fully reliable due to recall bias. CONCLUSION There was a strong association between early life environments and depressive symptoms among Chinese community-dwelling older adults. Adverse early life circumstances could contribute cumulatively to depression in old age.
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Affiliation(s)
- Yan Chen
- Global Health Research Center, Duke Kunshan University, Jiangsu, China; Global Health Institute, Wuhan University, Hubei, China
| | - Man Guo
- School of Social Work, University of Iowa, IA, USA
| | - Hanzhang Xu
- Department of Family Medicine and Community Health and School of Nursing, Duke University, NC, USA
| | - Zuyun Liu
- Department of Precision Health and Data Science, School of Public Health and the Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang, China
| | | | - Chenkai Wu
- Global Health Research Center, Duke Kunshan University, Jiangsu, China.
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15
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Liu P, Wang J, Wang X, Nie W, Zhen F. Measuring the Association of Self-Perceived Physical and Social Neighborhood Environment with Health of Chinese Rural Residents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168380. [PMID: 34444130 PMCID: PMC8391976 DOI: 10.3390/ijerph18168380] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 08/04/2021] [Accepted: 08/05/2021] [Indexed: 12/17/2022]
Abstract
(1) Objectives: Using cross-sectional datasets, we investigated whether better self-perceived physical and social neighborhood environment was associated with perceived health status and health-related behaviors among Chinese rural residents. (2) Study Design: The study was based on the 2016 China Family Panel Studies (CFPS) survey. The sample consisted of 7191 rural residents over 18 in China. (3) Methods: The article measured physical neighborhood environment from the two aspects of dwelling environment (DE) and public facilities convenience (PFC), and social neighborhood environment from public security (PS) and neighborhood relationship (NR). Associations between health status/health-related behaviors and self-perceived physical/social neighborhood environment were analyzed using multivariable logistic regression models adjusted for socio-demographic characteristics. (4) Results: The results suggested that rural residents who live in a good neighborhood environment reported having a better health status. Specifically, rural residents who reported living in good DE were less likely to have a depressive mood and poor health conditions. Those who reported good PFC were less likely to have depressive mood, poor self-rated health and chronic diseases. Rural residents who reported having good PS were less likely to have a depressive mood. Those who reported good NR were less likely to have a depressive mood, poor self-rated health, chronic diseases and obesity. Regarding neighborhood environment and health-related behaviors, the results showed that rural residents who reported good PFC were more likely to do physical exercise. Notably, the regression results of the education level variable showed that education level significantly promoted the health-related behaviors (time sleeping weekday, physical exercise and smoking) of rural residents. (5) Conclusions: This article suggested that there was strong evidence for a relationship between physical and social neighborhood environment and the general health of rural residents due to all causes. According to the conclusion of this article, in order to improve the health of rural residents, policy interventions should give priority to improving the neighborhood environment. In addition, the improvement in the degree that rural residents are exposed to education is of the same importance, which helps more rural residents to maintain good health-related behaviors.
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Affiliation(s)
- Pengcheng Liu
- School of Economics, Qingdao University, Qingdao 266061, China; (P.L.); (J.W.)
| | - Jing Wang
- School of Economics, Qingdao University, Qingdao 266061, China; (P.L.); (J.W.)
| | - Xiaojie Wang
- School of Management, Ocean University of China, Qingdao 266100, China;
- Correspondence:
| | - Wenjie Nie
- School of Management, Ocean University of China, Qingdao 266100, China;
| | - Fangfang Zhen
- College of Foreign Languages, Hebei University of Economics and Business, Shijiazhuang 050061, China;
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16
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Baranyi G, Di Marco MH, Russ TC, Dibben C, Pearce J. The impact of neighbourhood crime on mental health: A systematic review and meta-analysis. Soc Sci Med 2021; 282:114106. [PMID: 34139480 DOI: 10.1016/j.socscimed.2021.114106] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 04/19/2021] [Accepted: 06/02/2021] [Indexed: 01/20/2023]
Abstract
BACKGROUND Growing evidence indicates that the residential neighbourhood contributes to the complex aetiology of mental disorders. Although local crime and violence, key neighbourhood stressors, may be linked to mental health through direct and indirect pathways, studies are inconclusive. This systematic review and meta-analysis aimed to synthetize the evidence on the association between neighbourhood crime and individual-level mental health problems. METHOD We searched 11 electronic databases, grey literature and reference lists to identify relevant studies published before September 14, 2020. Studies were included if they reported confounder-adjusted associations between objective or perceived area-level crime and anxiety, depression, psychosis or psychological distress/internalising symptoms in non-clinical samples. Effect measures were first converted into Fisher's z-s, pooled with three-level random-effects meta-analyses, and then transformed into Pearson's correlation coefficients. Univariate and multivariate mixed-effects models were used to explore between-study heterogeneity. RESULTS We identified 63 studies reporting associations between neighbourhood crime and residents' mental health. Pooled associations were significant for depression (r = 0.04, 95% CI 0.03-0.06), psychological distress (r = 0.04, 95% CI 0.02-0.06), anxiety (r = 0.05, 95% CI 0.01-0.10), and psychosis (r = 0.04, 95% CI 0.01-0.07). Moderator analysis for depression and psychological distress identified stronger associations with perceived crime measurement and weaker in studies adjusted for area-level deprivation. Importantly, even after accounting for study characteristics, neighbourhood crime remained significantly linked to depression and psychological distress. Findings on anxiety and psychosis were limited due to low number of included studies. CONCLUSIONS Neighbourhood crime is an important contextual predictor of mental health with implications for prevention and policy. Area-based crime interventions targeting the determinants of crime, prevention and service allocation to high crime neighbourhoods may have public mental health benefits. Future research should investigate the causal pathways between crime exposure and mental health, identify vulnerably groups and explore policy opportunities for buffering against the detrimental effect of neighbourhood stressors.
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Affiliation(s)
- Gergő Baranyi
- Centre for Research on Environment, Society and Health, School of GeoSciences, University of Edinburgh, Edinburgh, United Kingdom.
| | - Martín Hernán Di Marco
- National Scientific and Technical Research Council, Buenos Aires, Argentina; Gino Germani Research Institute, Buenos Aires University, Buenos Aires, Argentina
| | - Tom C Russ
- Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, United Kingdom
| | - Chris Dibben
- Centre for Research on Environment, Society and Health, School of GeoSciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Jamie Pearce
- Centre for Research on Environment, Society and Health, School of GeoSciences, University of Edinburgh, Edinburgh, United Kingdom
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17
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Hwang EJ, Sim IO. Association of living arrangements with happiness attributes among older adults. BMC Geriatr 2021; 21:100. [PMID: 33541268 PMCID: PMC7860621 DOI: 10.1186/s12877-021-02017-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 01/11/2021] [Indexed: 12/02/2022] Open
Abstract
Background In Korea, along with the rapid aging of the population, older adults’ living arrangements have changed in various ways. In particularly, the happiness of older adults living alone warrants attention because they are more vulnerable to unhappiness than those living with families are. This study reports on the level of happiness among older adults in Korean and examines the potential mediating roles of depressive symptoms, present health status, socio-physical environment, social support networks, and social activities, and happiness in three different living arrangements, older adults living alone, with their spouse, or with their family. Method Data for this study were extracted from the secondary data from the 2017 Korean Community Health Survey, a non-experimental, cross-sectional survey conducted among Korean individuals that were aged 65 and above (n = 14,687). The chi-square test, one-way ANOVA, and Logistic regression were used to explore the related factors of happiness among the three groups. Results Findings revealed a significant difference in the happiness index among older adults living alone (6.22 ± 2.11), older adults living with their spouse (6.76 ± 1.99), and older adults living with their family (6.46 ± 1.94) (F = 88.69, p < .001). As the result of logistic regression, older adults living alone (odds ratio (OR) = 0.75, 95% confidence interval (CI) = 0.57–0.99) and those living with their family (OR = 0.80, 95% CI = 0.65–0.99) demonstrated greater happiness as the frequency of contact with their family increased. Older adults living with their spouse indicated an increase in happiness when their contact with friends was higher (OR = 0.69, 95% CI = 0.56–0.84). Conclusion It was recognized that factors influencing happiness differed according to older adults’ living arrangements, thus suggesting that older adults’ happiness could be facilitated through interventions that consider their circumstances, including living arrangements.
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Affiliation(s)
- Eun Jeong Hwang
- Department of Nursing, Sehan University, 1113 Samho-eup, Yeongam-gun, Jeollanam-do, 58447, Republic of Korea
| | - In Ok Sim
- Red Cross College of Nursing, Chung- Ang University, 84 Heukseok-ro, Dongjak-Gu, Seoul, 06974, Republic of Korea.
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18
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Noordzij JM, Beenackers MA, Oude Groeniger J, Timmermans E, Chaix B, Doiron D, Huisman M, Motoc I, Ruiz M, Wissa R, Avendano M, van Lenthe FJ. Green spaces, subjective health and depressed affect in middle-aged and older adults: a cross-country comparison of four European cohorts. J Epidemiol Community Health 2021; 75:470-476. [PMID: 33500323 PMCID: PMC8053337 DOI: 10.1136/jech-2020-214257] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 11/12/2020] [Accepted: 01/17/2021] [Indexed: 01/12/2023]
Abstract
Background Studies on associations between urban green space and mental health have yielded mixed results. This study examines associations of green space exposures with subjective health and depressed affect of middle-aged and older adults in four European cohorts. Methods Data came from four Western-European and Central-European ageing cohorts harmonised as part of the Mindmap project, comprising 16 189 adults with an average age of 50–71 years. Green space exposure was based on the distance to the nearest green space and the amount of green space within 800 m buffers around residential addresses. Cohort-specific and one-step individual participant data (IPD) meta-analyses were used to examine associations of green space exposures with subjective health and depressed affect. Results The amount of green spaces within 800 m buffers was lowest for Residential Environment and CORonary heart Disease (Paris, 15.0 hectares) and highest for Health, Alcohol and Psychosocial factors In Eastern Europe (Czech Republic, 35.9 hectares). IPD analyses indicated no evidence of an association between the distance to the nearest green space and depressed affect (OR 0.98, 95% CI 0.96 to 1.00) or good self-rated health (OR 1.01, 95% CI 0.99 to 1.02). Likewise, the amount of green space within 800 m buffers did not predict depressed affect (OR 0.98, 95% CI 0.96 to 1.00) or good self-rated health (OR 1.01, 95% CI 0.99 to 1.02). Findings were consistent across all cohorts. Conclusions Data from four European ageing cohorts provide no support for the hypothesis that green space exposure is associated with subjective health or depressed affect. While longitudinal evidence is required, these findings suggest that green space may be less important for older urban residents.
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Affiliation(s)
- J Mark Noordzij
- Public Health, Erasmus Medical Center, Rotterdam, The Netherlands
| | | | | | - Erik Timmermans
- Department of Epidemiology and Biostatistics, Amsterdam UMC - Locatie VUMC, Amsterdam, The Netherlands
| | - Basile Chaix
- INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Sorbonne Universités, Paris, France
| | - Dany Doiron
- Maelstrom Research, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Martijn Huisman
- Department of Epidemiology and Biostatistics, Amsterdam UMC - Locatie VUMC, Amsterdam, Netherlands.,Department of Sociology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Irina Motoc
- Department of Epidemiology and Biostatistics, Amsterdam UMC - VUMC location, Amsterdam, The Netherlands
| | - Milagros Ruiz
- Research Department of Epidemiology and Public Health, University College London, London, UK
| | - Rita Wissa
- Maelstrom Research, McGill University Faculty of Medicine, Montreal, Quebec, Canada
| | - Mauricio Avendano
- Department of Global Health and Social Medicine, King's College London School of Social Science and Public Policy, London, UK.,Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Cambridge, Massachusetts, USA
| | - Frank J van Lenthe
- Public Health, Erasmus Medical Center, Rotterdam, The Netherlands.,Faculty of Geosciences, Utrecht University, Utrecht, The Netherlands
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19
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Choi E, Bhandari TR, Shrestha N. Social inequality, noise pollution, and quality of life of slum dwellers in Pokhara, Nepal. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2020; 77:149-160. [PMID: 33355030 DOI: 10.1080/19338244.2020.1860880] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
This work is a cross-sectional comparative study conducted on 528 residents in the slum and non-slum areas of Pokhara, Nepal. Of the total number of respondents, 90.2% in the slums and 63.3% in the non-slums indicated the existence of a main source of noise, and 80.7% in the slums and 66.0% in the non-slums replied that they had been highly annoyed by noise. The indoor noise levels measured for 24 h were higher in slums than in non-slums, ranging from 59 to 78 dBA and from 51 to 69 dBA, respectively. The Mann-Whitney U test showed a significantly poorer status of slum dwellers in four health domains. Logistic regression analysis identified that living in a slum was a significant predictor (OR, 2.35; 95% CI, 1.35-4.09) of a low level of health. Meanwhile, a high level of noise annoyance was a good determinant (OR, 6.71; 95% CI, 3.13-14.36) of low quality of life among slum dwellers revealing a distinguishing negative effect of the high level of noise annoyance in the slum areas.
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Affiliation(s)
- Eunhwa Choi
- Faculty of Health Sciences, Pokhara University, Lekhnath, Nepal
- Institute of Construction and Environmental Engineering, Seoul National University, Seoul, Republic of Korea
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20
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Chiarini B, D'Agostino A, Marzano E, Regoli A. The perception of air pollution and noise in urban environments: A subjective indicator across European countries. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2020; 263:110272. [PMID: 32883469 DOI: 10.1016/j.jenvman.2020.110272] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Revised: 02/11/2020] [Accepted: 02/12/2020] [Indexed: 06/11/2023]
Abstract
Although urbanization has been a fundamental feature of economic development, increasingly important concerns about environmental quality have led to a wide-ranging debate about the concept of urban sustainability. In this paper, we examine how living in urban areas affects people's perceptions of two specific aspects of environmental quality, namely, air pollution and noise. Specifically, for every country, we develop an indicator that is based on these perceptions. The findings confirm that among European countries, the effects of urban agglomerations on the households' perceptions of environmental quality reflect a certain degree of heterogeneity. The proposed indicator provides new evidence about previously unexplored interactions between perceptions and macro-economic factors, such as income inequality, public spending on the environment and public debt. Through a comparison with an objective measure of the exposure of urban inhabitants to noise and air pollution, we find support for the intuition that subjective perceptions can be employed jointly with objective indicators to obtain full and comprehensive knowledge of the quality of urban environments.
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Affiliation(s)
- Bruno Chiarini
- University of Naples Parthenope, Department of Economic and Legal Studies, Via Generale Parisi 13, 80132, Napoli, Italy.
| | - Antonella D'Agostino
- University of Naples Parthenope, Department of Management and Quantitative Studies, Via Generale Parisi 13, 80132, Napoli, Italy.
| | - Elisabetta Marzano
- University of Naples Parthenope, Department of Economic and Legal Studies, Via Generale Parisi 13, 80132, Napoli, Italy; CESifo Research Network Fellow, CESifo GmbH, München, Germany.
| | - Andrea Regoli
- University of Naples Parthenope, Department of Management and Quantitative Studies, Via Generale Parisi 13, 80132, Napoli, Italy.
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21
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Li Y, Xue QL, Odden MC, Chen X, Wu C. Linking early life risk factors to frailty in old age: evidence from the China Health and Retirement Longitudinal Study. Age Ageing 2020; 49:208-217. [PMID: 31957780 PMCID: PMC7047816 DOI: 10.1093/ageing/afz160] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 10/05/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND exposures in childhood and adolescence may impact the development of diseases and symptoms in late life. However, evidence from low- and middle-income countries is scarce. In this cross-sectional study, we examined the association of early life risk factors with frailty amongst older adults using a large, nationally representative cohort of community-dwelling Chinese sample. METHODS we included 6,806 participants aged $\ge$60 years from the China Health and Retirement Longitudinal Study. We measured 13 risk factors in childhood or adolescence through self-reports, encompassing six dimensions (education, family economic status, nutritional status, domestic violence, neighbourhood and health). We used multinomial regression models to examine the association between risk factors and frailty. We further calculated the absolute risk difference for the statistically significant factors. RESULTS persons with higher personal and paternal education attainment, better childhood neighbourhood quality and better childhood health status had lower risk of being frail in old age. Severe starvation in childhood was associated with higher risk of prefrailty. The risk differences of being frail were 5.6% lower for persons with a high school or above education, 1.5% lower for those whose fathers were literate, 4.8% lower for the highest neighbourhood quality and 2.9% higher for worse childhood health status compared to their counterparts. CONCLUSIONS unfavorable socioeconomic status and worse health condition in childhood and adolescence may increase the risk of late-life frailty amongst Chinese older adults.
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Affiliation(s)
- Yaxi Li
- Global Health Research Center, Duke Kunshan University, Kunshan, China
| | - Qian-Li Xue
- Department of Medicine, School of Medicine, John Hopkins University, Baltimore, MD, USA
- Center on Aging and Health, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Michelle C Odden
- Department of Health Research and Policy, Stanford University, Stanford, CA, USA
| | - Xi Chen
- Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, USA
- Department of Economics, Yale University, New Haven, CT, USA
| | - Chenkai Wu
- Global Health Research Center, Duke Kunshan University, Kunshan, China
- Duke Global Health Institute, Duke University, Durham, NC, USA
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22
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Imaiso J. Consideration of Social Aspects and Mental Health of Community-Dwelling Elderly People: A Literature Review. Health (London) 2020. [DOI: 10.4236/health.2020.125038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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23
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Zolitschka KA, Razum O, Breckenkamp J, Sauzet O. Social Mechanisms in Epidemiological Publications on Small-Area Health Inequalities-A Scoping Review. Front Public Health 2019; 7:393. [PMID: 31956648 PMCID: PMC6951405 DOI: 10.3389/fpubh.2019.00393] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 12/05/2019] [Indexed: 12/03/2022] Open
Abstract
Background: Small-area social mechanisms—social processes involving the social environment around the place of residence—may be playing a role in the production of health inequalities. Understanding how small-area health inequalities (social environment affects health and consequently contribute to inequalities between areas) are generated and the role of social mechanisms in this process may help defining interventions to reduce inequalities. In mediation and pathway analyses, social mechanisms need to be treated as processes or factors. We aimed to identify which types of social mechanisms explaining the process leading from small-area characteristics to health inequalities have been considered and investigated in epidemiological publications and to establish how they have been operationalized. Methods: We performed a scoping review for social mechanisms in the context of small-area health inequalities in the database PubMed. Epidemiological publications identified were categorized according to the typology proposed by Galster (social networks, social contagion, collective socialization, social cohesion, competition, relative deprivation, and parental mediation). Furthermore, we assessed whether the mechanisms were operationalized at the micro or macro level and whether mechanisms were considered as processes or merely as exposure factors. Results: We retrieved 1,019 studies, 15 thereof were included in our analysis. Eight forms of operationalization were found in the category social networks and another nine in the category social cohesion. Other categories were hardly represented. Furthermore, all studies were cross sectional and did not consider mechanisms as processes. Except for one, all studies treated mechanisms merely as factors whose respective association to health outcomes was tested. Conclusion: In epidemiological publications, social mechanisms in studies on small-area effects on health inequalities are not operationalized as processes in which these mechanisms would play a role. Rather, the focus is on studying associations. To understand the production of health inequalities and the causal effect of social mechanisms on health, it is necessary to analyze mechanisms as processes. For this purpose, methods such as complex system modeling should be considered.
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Affiliation(s)
- Kim Alexandra Zolitschka
- Department of Epidemiology and International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Oliver Razum
- Department of Epidemiology and International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Jürgen Breckenkamp
- Department of Epidemiology and International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Odile Sauzet
- Department of Epidemiology and International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany.,Centre for Statistics, Bielefeld University, Bielefeld, Germany
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24
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Remes O, Lafortune L, Wainwright N, Surtees P, Khaw KT, Brayne C. Association between area deprivation and major depressive disorder in British men and women: a cohort study. BMJ Open 2019; 9:e027530. [PMID: 31767575 PMCID: PMC6886936 DOI: 10.1136/bmjopen-2018-027530] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE Studies have shown area-level deprivation can increase the risk for mental disorders over and above individual-level circumstances, such as education and social class. The objective of this study is to determine whether area deprivation is associated with major depressive disorder (MDD) in British women and men separately while adjusting for individual-level factors. DESIGN Large, population study. SETTING UK population-based cohort. PARTICIPANTS 30 445 people from the general population aged 40 years and older and living in England consented to participate at study baseline, and of these, over 20 000 participants completed a structured Health and Life Experiences Questionnaire used to capture MDD. Area deprivation was measured in 1991 using Census data, and current MDD was assessed in 1996-2000. 8236 men and 10 335 women had complete data on all covariates. PRIMARY OUTCOME MEASURE MDD identified according to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV). RESULTS In this study, 3.3% (339/10 335) of women and 2.1% (177/8236) of men had MDD. Men living in the most deprived areas were 51% more likely to have depression than those living in areas that were not deprived (OR=1.51, 95% CI 1.01 to 2.24; p=0.043), but the association between deprivation and MDD was not statistically significant in women (OR=1.24, 95% CI 0.93 to 1.65; p=0.143). CONCLUSION This study shows that the residential environment differentially affects men and women, and this needs to be taken into account by mental health policy-makers. Knowing that men living in deprived conditions are at high risk for having depression helps inform targeted prevention and intervention programmes.
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Affiliation(s)
- Olivia Remes
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Louise Lafortune
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Nick Wainwright
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Paul Surtees
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Kay-Tee Khaw
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Carol Brayne
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
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25
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Barreto PA, Lopes CS, Silveira IHD, Faerstein E, Junger WL. Is living near green areas beneficial to mental health? Results of the Pró-Saúde Study. Rev Saude Publica 2019; 53:75. [PMID: 31553378 PMCID: PMC6752646 DOI: 10.11606/s1518-8787.2019053001008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 01/11/2019] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE To investigate the association between exposure to green areas in the surroundings of the residence and the presence of common mental disorders among adults, according to different income strata. METHODS Cross-sectional study with 2,584 participants from the Pró-Saúde Study (2006), residing in the city of Rio de Janeiro. Common Mental Disorders were measured using the General Health Questionnaire (GHQ-12) and exposure to green areas was measured using the normalized difference vegetation index, in buffers with radiuses between 100 and 1,500 meters around the residence. We used the mean and maximum normalized difference vegetation index categorized into quartiles. The study population was divided into three subgroups, according to the income: low, intermediate, and high. Odds ratios and their 95% confidence intervals were estimated with logistic regression models. The models were adjusted by sex and age, with and without inclusion of physical activity practice. RESULTS The proportion of common mental disorders was 30% and 39% among men and women, respectively. The results of the adjusted models showed an inverse association between the presence of green areas in the surroundings of the residence and the occurrence of common mental disorders, in the buffer of 200 meters in the intermediate-income group and in the buffers of 400 and 1,500 meters in the low-income group. The odds ratio ranged from 0.52 (buffer of 1,500 meters) to 0.68 (buffer of 200 meters). The association found was independent of physical activity practice. CONCLUSIONS The evidence found suggests the existence of a beneficial effect of urban green areas on the mental health of lower-income individuals. These findings can help in understanding how the urban environment can affect the mental health of the population.
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Affiliation(s)
- Patricia Amado Barreto
- Universidade do Estado do Rio de Janeiro. Instituto de Medicina Social. Programa de Pós-Graduação em Saúde Coletiva. Rio de Janeiro, RJ, Brasil
| | - Claudia Souza Lopes
- Universidade do Estado do Rio de Janeiro. Instituto de Medicina Social. Departamento de Epidemiologia. Rio de Janeiro, RJ, Brasil
| | - Ismael Henrique da Silveira
- Universidade do Estado do Rio de Janeiro. Instituto de Medicina Social. Programa de Pós-Graduação em Saúde Coletiva. Rio de Janeiro, RJ, Brasil
| | - Eduardo Faerstein
- Universidade do Estado do Rio de Janeiro. Instituto de Medicina Social. Departamento de Epidemiologia. Rio de Janeiro, RJ, Brasil
| | - Washington Leite Junger
- Universidade do Estado do Rio de Janeiro. Instituto de Medicina Social. Departamento de Epidemiologia. Rio de Janeiro, RJ, Brasil
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Putrik P, van Amelsvoort L, Mujakovic S, Kunst AE, van Oers H, Kant IJ, Jansen MW, De Vries NK. Assessing the role of criminality in neighbourhood safety feelings and self-reported health: results from a cross-sectional study in a Dutch municipality. BMC Public Health 2019; 19:920. [PMID: 31288774 PMCID: PMC6617657 DOI: 10.1186/s12889-019-7197-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 06/19/2019] [Indexed: 11/10/2022] Open
Abstract
Background Neighbourhood safety has repeatedly been shown to be associated with the health and well-being of the residents. Criminality is often seen as one of the key factors affecting neighbourhood safety. However, the relationship between crime, fear of crime and feelings of safety remains underexplored. Methods Data on socio-demographic, health and safety perceptions was extracted from the Maastricht municipality survey (the Netherlands) (n = 9656 adults) and merged with data on official neighbourhood crime rates from the Police Registry. Pearson correlation coefficients and multilevel logistic regression models were computed to assess the association between aspects of objective and perceived criminality, individuals’ feelings of safety and health. Results The correlation between the police recorded crime and residents’ perceptions of the neighbourhood crime rates was weak (0.14–0.38), with the exception of violent crime (0.59), which indicates that other factors contribute to the perceptions of safety. In turn, the perception of higher rates of violent crime and more nuisance (on the scale 0–10) but not other types of crime or nuisance was positively associated with feeling unsafe (OR 1.27 [1.22;1.32] and 1.39 [1.33;1.46], respectively). Lower general feelings of safety at both the individual and neighbourhood level were consistently associated with worse self-rated health. Among different indicators of safety, the general feelings of safety had the most pronounced association with health, while subjective or objective measures of crime showed limited to no direct relationship with health. Conclusions Public health policies targeting safety as a social determinant of health should consider prioritizing areas of violent crime and nuisance to improve general feelings of safety. Further research is needed to understand which factors aside from criminality are driving residents’ feelings of safety.
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Affiliation(s)
- Polina Putrik
- Department of Health Promotion, School for Public Health and Primary Care (CAPHRI), Maastricht University, Peter Debyeplein 1, 6229HA, Maastricht, The Netherlands. .,Academic Collaborative Centre for Public Health Limburg, Public Health Service Southern Limburg, Heerlen, The Netherlands.
| | - Ludovic van Amelsvoort
- Department of Epidemiology, School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Suhreta Mujakovic
- Academic Collaborative Centre for Public Health Limburg, Public Health Service Southern Limburg, Heerlen, The Netherlands
| | - Anton E Kunst
- Public Health, Academic Medical Center, Amsterdam, The Netherlands
| | - Hans van Oers
- National Institute of Public Health and the Environment (RIVM), Bilthoven, The Netherlands.,Tranzo Scientific Centre for Care and Welfare, Tilburg University, Tilburg, The Netherlands
| | - IJmert Kant
- Department of Epidemiology, School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Maria W Jansen
- Academic Collaborative Centre for Public Health Limburg, Public Health Service Southern Limburg, Heerlen, The Netherlands.,Department of Health Services Research, School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Nanne K De Vries
- Department of Health Promotion, School for Public Health and Primary Care (CAPHRI), Maastricht University, Peter Debyeplein 1, 6229HA, Maastricht, The Netherlands
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27
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Generaal E, Hoogendijk EO, Stam M, Henke CE, Rutters F, Oosterman M, Huisman M, Kramer SE, Elders PJM, Timmermans EJ, Lakerveld J, Koomen E, ten Have M, de Graaf R, Snijder MB, Stronks K, Willemsen G, Boomsma DI, Smit JH, Penninx BWJH. Neighbourhood characteristics and prevalence and severity of depression: pooled analysis of eight Dutch cohort studies. Br J Psychiatry 2019; 215:468-475. [PMID: 31057126 PMCID: PMC7872255 DOI: 10.1192/bjp.2019.100] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Studies on neighbourhood characteristics and depression show equivocal results.AimsThis large-scale pooled analysis examines whether urbanisation, socioeconomic, physical and social neighbourhood characteristics are associated with the prevalence and severity of depression. METHOD Cross-sectional design including data are from eight Dutch cohort studies (n = 32 487). Prevalence of depression, either DSM-IV diagnosis of depressive disorder or scoring for moderately severe depression on symptom scales, and continuous depression severity scores were analysed. Neighbourhood characteristics were linked using postal codes and included (a) urbanisation grade, (b) socioeconomic characteristics: socioeconomic status, home value, social security beneficiaries and non-Dutch ancestry, (c) physical characteristics: air pollution, traffic noise and availability of green space and water, and (d) social characteristics: social cohesion and safety. Multilevel regression analyses were adjusted for the individual's age, gender, educational level and income. Cohort-specific estimates were pooled using random-effects analysis. RESULTS The pooled analysis showed that higher urbanisation grade (odds ratio (OR) = 1.05, 95% CI 1.01-1.10), lower socioeconomic status (OR = 0.90, 95% CI 0.87-0.95), higher number of social security beneficiaries (OR = 1.12, 95% CI 1.06-1.19), higher percentage of non-Dutch residents (OR = 1.08, 95% CI 1.02-1.14), higher levels of air pollution (OR = 1.07, 95% CI 1.01-1.12), less green space (OR = 0.94, 95% CI 0.88-0.99) and less social safety (OR = 0.92, 95% CI 0.88-0.97) were associated with higher prevalence of depression. All four socioeconomic neighbourhood characteristics and social safety were also consistently associated with continuous depression severity scores. CONCLUSIONS This large-scale pooled analysis across eight Dutch cohort studies shows that urbanisation and various socioeconomic, physical and social neighbourhood characteristics are associated with depression, indicating that a wide range of environmental aspects may relate to poor mental health.Declaration of interestNone.
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Affiliation(s)
- Ellen Generaal
- Postdoctoral Researcher, Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Public Health; and GGZ inGeest Specialized Mental Health Care, Research and Innovation, the Netherlands
| | - Emiel O. Hoogendijk
- Postdoctoral Researcher, Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, Amsterdam Public Health, the Netherlands
| | - Mariska Stam
- Postdoctoral Researcher, Amsterdam UMC, Vrije Universiteit Amsterdam, Section Ear & Hearing, Department of Otolaryngology-Head and Neck Surgery, Amsterdam Public Health, the Netherlands
| | - Celina E. Henke
- Data Manager, Amsterdam UMC, Vrije Universiteit Amsterdam, Section Ear & Hearing, Department of Otolaryngology-Head and Neck Surgery, Amsterdam Public Health, the Netherlands
| | - Femke Rutters
- Assistant Professor, Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, Amsterdam Public Health, the Netherlands
| | - Mirjam Oosterman
- Assistant Professor, Department of Clinical Child and Family Studies, Vrije Universiteit Amsterdam, the Netherlands
| | - Martijn Huisman
- Scientific Director, Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, Amsterdam Public Health; and Department of Sociology, Vrije Universiteit Amsterdam, the Netherlands
| | - Sophia E. Kramer
- Professor, Amsterdam UMC, Vrije Universiteit Amsterdam, Section Ear & Hearing, Department of Otolaryngology-Head and Neck Surgery, Amsterdam Public Health, the Netherlands
| | - Petra J. M. Elders
- GP/Senior Researcher, Department of General Practice and Elderly Care, Vrije Universiteit Amsterdam, the Netherlands
| | - Erik J. Timmermans
- Postdoctoral Researcher, Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, Amsterdam Public Health, the Netherlands
| | - Jeroen Lakerveld
- Senior Researcher, Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, Amsterdam Public Health, the Netherlands
| | - Eric Koomen
- Associate Professor, Spatial Information Laboratory, Department of Spatial Economics, Faculty of Economics and Business Administration, Vrije Universiteit Amsterdam, the Netherlands
| | - Margreet ten Have
- Senior Researcher, Netherlands Institute of Mental Health and Addiction, the Netherlands
| | - Ron de Graaf
- Senior Researcher, Netherlands Institute of Mental Health and Addiction, the Netherlands
| | - Marieke B. Snijder
- Senior Researcher, Amsterdam UMC, University of Amsterdam, Department of Public Health, Amsterdam Public Health; and Amsterdam UMC, University of Amsterdam, Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam Public Health, the Netherlands
| | - Karien Stronks
- Professor, Amsterdam UMC, University of Amsterdam, Department of Public Health, Amsterdam Public Health,the Netherlands
| | - Gonneke Willemsen
- Associate Professor, Department of Biological Psychology, Vrije Universiteit Amsterdam, the Netherlands
| | - Dorret I. Boomsma
- Professor, Department of Biological Psychology, Vrije Universiteit Amsterdam, the Netherlands
| | - Johannes H. Smit
- Professor, Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Public Health; and GGZ inGeest Specialized Mental Health Care, Research and Innovation, the Netherlands
| | - Brenda W. J. H. Penninx
- Professor, Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Public Health; and GGZ inGeest Specialized Mental Health Care, Research and Innovation, the Netherlands,Correspondence: Brenda W. J. H. Penninx, Oldenaller 1, 1081 HJ Amsterdam, the Netherlands.
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28
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Dearden EK, Lloyd CD, Catney G. A spatial analysis of health status in Britain, 1991–2011. Soc Sci Med 2019; 220:340-352. [DOI: 10.1016/j.socscimed.2018.11.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 10/11/2018] [Accepted: 11/06/2018] [Indexed: 10/27/2022]
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Beenackers MA, Oude Groeniger J, Kamphuis CBM, Van Lenthe FJ. Urban population density and mortality in a compact Dutch city: 23-year follow-up of the Dutch GLOBE study. Health Place 2018; 53:79-85. [PMID: 30056264 DOI: 10.1016/j.healthplace.2018.06.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 06/20/2018] [Accepted: 06/21/2018] [Indexed: 10/28/2022]
Abstract
We investigated the association and underlying pathways between urban population density and mortality in a compact mid-sized university city in the Netherlands. Baseline data from the GLOBE cohort study (N = 10,120 residents of Eindhoven) were linked to mortality after 23 years of follow up and analyzed in multilevel models. Higher population density was modestly related to increased mortality, independently of baseline socioeconomic position and health. Higher population density was related to more active transport, more perceived urban stress and smoking. Increased active transport suppressed the mortality-increasing impact of higher population density. Overall, in dense cities with good infrastructure for walking and cycling, high population density may negatively impact mortality.
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Affiliation(s)
- Mariëlle A Beenackers
- Department of Public Health, Erasmus University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands.
| | - Joost Oude Groeniger
- Department of Public Health, Erasmus University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands.
| | - Carlijn B M Kamphuis
- Department of Human Geography and Spatial Planning, Utrecht University, 3508 TC Utrecht, The Netherlands.
| | - Frank J Van Lenthe
- Department of Public Health, Erasmus University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands; Department of Human Geography and Spatial Planning, Utrecht University, 3508 TC Utrecht, The Netherlands.
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30
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Yau Y. Does high-rise residential building design shape antisocial behaviour? PROPERTY MANAGEMENT 2018. [DOI: 10.1108/pm-10-2017-0057] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this paper is to examine links between environmental design of high-rise housing communities and residents’ perceptions about antisocial behaviour (ASB).
Design/methodology/approach
A conceptual framework was proposed to investigate correlations between architectural design parameters and perceived severity of ASB activity. A questionnaire was administered to test the relationships. Residents of 14 public rental housing estates in Hong Kong participated, and 422 complete responses were analysed.
Findings
Strong correlation was discovered between elements of residential design and residents’ perceptions of ASB severity. Block layout, building height and number of flats per floor affected residents’ feelings about ASB threat. Access to outside air in communal corridors also significantly reduced residents’ complaints about ASB.
Practical implications
This study offers insights into how architectural design of high-rise residences might reduce residents’ perception of ASB severity. Findings impact current ASB research, but also architects’ and developers’ designs. Better planned built environments will enhance residents’ security and satisfaction, reinforcing communities.
Originality/value
Previous studies have ignored whether architectural design of high-rises could directly influence residents’ perception of ASB severity. This study is the first to focus on the relationship.
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31
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Olamijuwon EO, Odimegwu CO, De Wet N. Social cohesion and self-rated health among adults in South Africa: The moderating role of race. Health Place 2018; 51:89-96. [PMID: 29579699 DOI: 10.1016/j.healthplace.2018.02.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 02/20/2018] [Accepted: 02/27/2018] [Indexed: 02/01/2023]
Abstract
In African countries including South Africa, the nexus between social cohesion and health remains under-researched. Using data from the 2012 South African social attitudes survey with a sample of 1988 adults in South Africa aged 18 years or older, we used the collective efficacy theory by Sampson and colleagues to examine the relationship between social cohesion and self-rated health in an African sample. We also examined how this relationship differed by race. Results from the multivariate analysis after adjusting for covariates suggested that adults in the highest tertile of social cohesion were more likely to report moderate or good health compared to those in the lowest tertile. Sub-group analysis provided no evidence that the relationship was moderated by race. These findings corroborate prior evidence that social cohesion is important for improving the health of adults.
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Affiliation(s)
- Emmanuel O Olamijuwon
- Demography and Population Studies Programme, Schools of Public Health and Social Science, University of the Witwatersrand, Johannesburg, South Africa; Department of Statistics and Demography, Faculty of Social Science, University of Swaziland, Kwaluseni, Swaziland.
| | - Clifford O Odimegwu
- Demography and Population Studies Programme, Schools of Public Health and Social Science, University of the Witwatersrand, Johannesburg, South Africa
| | - Nicole De Wet
- Demography and Population Studies Programme, Schools of Public Health and Social Science, University of the Witwatersrand, Johannesburg, South Africa
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32
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Andress L. Using a social ecological model to explore upstream and downstream solutions to rural food access for the elderly. COGENT MEDICINE 2017. [DOI: 10.1080/2331205x.2017.1393849] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Lauri Andress
- Department of Health Policy, Management & Leadership, School of Public Health, West Virginia University Robert C. Byrd Health Sciences Center, Morgantown, WV, USA
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Shagdarsuren T, Nakamura K, McCay L. Association between perceived neighborhood environment and health of middle-aged women living in rapidly changing urban Mongolia. Environ Health Prev Med 2017; 22:50. [PMID: 29165141 PMCID: PMC5664801 DOI: 10.1186/s12199-017-0659-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 05/15/2017] [Indexed: 11/15/2022] Open
Abstract
Background This study was conducted in rapidly urbanizing Ulaanbaatar, Mongolia, to examine patterns of perceived neighborhood quality by residents and the associations between these patterns and self-reported general and mental health in middle-aged women. Methods A questionnaire survey was administered to 960 women aged 40–60 years. Demographic and socio-economic characteristics, subjects’ perception of their neighborhood environment, general health status, and mental health as measured using a 12-item General Health Questionnaire (GHQ12) were reported. Results A total of 830 women completed the questionnaire. Subjects reporting their general health as very good or good accounted for 80.3% and those with a GHQ12 ≥16, which reflects psychological distress or severe distress, accounted for 16.1%. A principal component analysis of the perceptions of neighborhood environment by the residents identified six qualities: physical environment, designed environment, neighborhood community, public safety, natural environment, and citizen services. The perception of better-quality citizen services in the neighborhood was associated with better self-reported general health (odds ratio [OR] = 1.330, 95% confidence interval [CI] 1.093–1.618), and the perception of better-quality public safety was associated with less psychological distress (OR = 0.718, 95% CI 0.589–0.876); these associations were independent of education, income, occupation, type of residential area, and number of years living in the current khoroo. Conclusions The perception of the quality of a neighborhood environment can affect the self-reported general and mental health of residents, even after accounting for the type of residential area and individual socio-economic status. Developing high-quality neighborhoods is an essential component of good planning to promote population health in urban environments.
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Affiliation(s)
- Tserendulam Shagdarsuren
- Department of Global Health Entrepreneurship, Division of Public Health, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Keiko Nakamura
- Department of Global Health Entrepreneurship, Division of Public Health, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo-ku, Tokyo, 113-8519, Japan. .,Promotion Committee for Healthy Cities, Tokyo, Japan.
| | - Layla McCay
- Department of Global Health Entrepreneurship, Division of Public Health, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo-ku, Tokyo, 113-8519, Japan.,Centre for Urban Design and Mental Health, London, UK
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Simonelli G, Dudley KA, Weng J, Gallo LC, Perreira K, Shah NA, Alcantara C, Zee PC, Ramos AR, Llabre MM, Sotres-Alvarez D, Wang R, Patel SR. Neighborhood Factors as Predictors of Poor Sleep in the Sueño Ancillary Study of the Hispanic Community Health Study/Study of Latinos. Sleep 2017; 40:2661544. [PMID: 28364454 PMCID: PMC5804993 DOI: 10.1093/sleep/zsw025] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Study Objectives To evaluate whether an adverse neighborhood environment has higher prevalence of poor sleep in a US Hispanic/Latino population. Methods A cross-sectional analysis was performed in 2156 US Hispanic/Latino participants aged 18-64 years from the Sueño ancillary study of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Participants completed surveys of neighborhood environment including perceived safety, violence and noise, the Insomnia Severity Index (ISI), and 7 days of wrist actigraphy. Results In age and sex-adjusted analyses, short sleep, low sleep efficiency, and late sleep midpoint were all more prevalent among those living in an unsafe neighborhood. After adjustment for background, site, nativity, income, employment, depressive symptoms, and sleep apnea, the absolute risk of sleeping <6 hours was 7.7 (95% CI [0.9, 14.6]) percentage points greater in those living in an unsafe compared to a safe neighborhood. There were no differences in the prevalence of insomnia by level of safety or violence. Insomnia was more prevalent among those living in a noisy neighborhood. In adjusted analysis, the absolute risk of insomnia was 4.4 (95% CI [0.4, 8.4]) percentage points greater in those living in noisy compared to non-noisy neighborhoods. Conclusion Using validated measures of sleep duration and insomnia, we have demonstrated the existence of a higher prevalence of short sleep and insomnia by adverse neighborhood factors. An adverse neighborhood environment is an established risk factor for a variety of poor health outcomes. Our findings suggest negative effects on sleep may represent one pathway by which neighborhood environment influences health.
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Affiliation(s)
- Guido Simonelli
- Behavioral Biology Branch, Walter Reed Army Institute of Research, Silver Spring, MD
| | - Katherine A Dudley
- Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA
| | - Jia Weng
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA
| | - Linda C Gallo
- Department of Psychology San Diego State University, San Diego, CA
| | - Krista Perreira
- Department of Public Policy, University of North Carolina, Chapel Hill, NC
| | - Neomi A Shah
- Division of Pulmonary, Critical Care and Sleep, Icahn School of Medicine at Mount Sinai, New York, NY
| | | | - Phyllis C Zee
- Center for Circadian and Sleep Medicine, Northwestern University Feinberg School of Medicine, Evanston, IL
| | - Alberto R Ramos
- Department of Neurology, University of Miami, Miller School of Medicine, Miami, FL
| | - Maria M Llabre
- Department of Psychology, University of Miami, Coral Gables, FL
| | - Daniela Sotres-Alvarez
- Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
| | - Rui Wang
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA
| | - Sanjay R Patel
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA
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35
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Xie H, Li H, Liu C, Li M, Zou J. Noise exposure of residential areas along LRT lines in a mountainous city. THE SCIENCE OF THE TOTAL ENVIRONMENT 2016; 568:1283-1294. [PMID: 27138741 DOI: 10.1016/j.scitotenv.2016.03.097] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Revised: 03/04/2016] [Accepted: 03/14/2016] [Indexed: 06/05/2023]
Abstract
Light rapid transit (LRT) has been widely used in a number of Chinese cities in recent years. Different from plain cities, the urban areas in mountainous cities are featured with dense road networks and high density of buildings. The noise impact of urban LRT could be more complex and significant due to the special morphological conditions in mountainous cities. This paper aims to investigate the noise exposure of residential areas along LRT lines in a typical mountainous city, namely Chongqing in Southwest China, through a series of field measurements and questionnaire surveys. Eight typical spatial configurations were classified to represent the relationships between LRT lines and urban mountainous environment. Both the outdoor and indoor acoustic environment of residential areas along LRT lines largely exceeded the national standards by up to 15dBA, with dominant at low frequencies. The LRT noises tend to be more dominant on the 'below track' and 'passing through' rather than 'above track' areas or 'facing towards' locations. Good agreements were achieved between acoustic measurements and subjective evaluations from the local residents. Residents in the noisier areas tend to be more annoyed and influenced by the LRT noise, and 63.2% of interviewed residents once were awakened by the LRT noise. Among various urban noise sources, LRT noise resulted in the largest percentages of highly annoyed residents (30.9%), and acoustic environment was identified by 42.2% of the participants as the most urgent environmental factor to be improved. The preferred control strategies for LRT noise are possible but limited in practice. Moreover, noise sensitivity and age might significantly affect LRT noise annoyance and impact, whereas window glazing and residence time have no significant influence.
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Affiliation(s)
- Hui Xie
- Faculty of Architecture and Urban Planning, Chongqing University, Chongqing 400045, China; Key Laboratory of New Technology for Construction of Cities in Mountain Area, Ministry of Education, Chongqing University, Chongqing 400045, China.
| | - Heng Li
- Faculty of Architecture and Urban Planning, Chongqing University, Chongqing 400045, China; Key Laboratory of New Technology for Construction of Cities in Mountain Area, Ministry of Education, Chongqing University, Chongqing 400045, China
| | - Cen Liu
- Faculty of Architecture and Urban Planning, Chongqing University, Chongqing 400045, China; Key Laboratory of New Technology for Construction of Cities in Mountain Area, Ministry of Education, Chongqing University, Chongqing 400045, China
| | - Mingyue Li
- Faculty of Architecture and Urban Planning, Chongqing University, Chongqing 400045, China; Key Laboratory of New Technology for Construction of Cities in Mountain Area, Ministry of Education, Chongqing University, Chongqing 400045, China
| | - Jingwen Zou
- Faculty of Architecture and Urban Planning, Chongqing University, Chongqing 400045, China; Key Laboratory of New Technology for Construction of Cities in Mountain Area, Ministry of Education, Chongqing University, Chongqing 400045, China
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36
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Putrik P, van Amelsvoort L, De Vries NK, Mujakovic S, Kunst AE, van Oers H, Jansen M, Kant I. Neighborhood Environment is Associated with Overweight and Obesity, Particularly in Older Residents: Results from Cross-Sectional Study in Dutch Municipality. J Urban Health 2015; 92:1038-51. [PMID: 26453194 PMCID: PMC4675740 DOI: 10.1007/s11524-015-9991-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
We explored whether overweight and obesity were associated with the physical and social environment at neighborhood level. Data from Maastricht municipality survey (The Netherlands) were used (n = 9771 adults). Multinomial regression models were computed (outcome being normal weight, overweight, or obese). We found inconsistent associations between neighborhood social and physical environment characteristics and overweight and obesity in the total sample. The effects were more consistent and stronger for older residents (>65) and obesity as an outcome. Better scores on traffic nuisance, green space, social cohesion, nuisance, and safety were associated with lower odds of obesity among elderly (OR ranged between 0.71 [95% CI 0.44 to 0.93] to 0.85 [95% CI 0.74 to 0.96] for each point of improvement in neighborhood social and physical environment (scale 0-10)). We showed that there are neighborhood-level factors that are associated with obesity, particularly in elderly residents. These could be targeted in preventive strategies outside health care settings.
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Affiliation(s)
- Polina Putrik
- Department of Health Promotion, School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands.
- Academic Collaborative Centre for Public Health Limburg, Public Health Service Southern Limburg, Geleen, Netherlands.
| | - Ludovic van Amelsvoort
- Department of Epidemiology, School for Public Health and Primary Care (CAPHRI) Maastricht University, Maastricht, The Netherlands
| | - Nanne K De Vries
- Department of Health Promotion, School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Suhreta Mujakovic
- Academic Collaborative Centre for Public Health Limburg, Public Health Service Southern Limburg, Geleen, Netherlands
| | - Anton E Kunst
- Department of Public Health, Academic Medical Center, Amsterdam, The Netherlands
| | - Hans van Oers
- National Institute of Public Health and the Environment (RIVM), Bilthoven, The Netherlands
- Tranzo Scientific Centre for Care and Welfare, Tilburg University, Tilburg, The Netherlands
| | - Maria Jansen
- Academic Collaborative Centre for Public Health Limburg, Public Health Service Southern Limburg, Geleen, Netherlands
- Department of Health Services Research, School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Ijmert Kant
- Department of Epidemiology, School for Public Health and Primary Care (CAPHRI) Maastricht University, Maastricht, The Netherlands
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Putrik P, Ramiro S, Chorus AM, Keszei AP, Boonen A. Socioeconomic inequities in perceived health among patients with musculoskeletal disorders compared with other chronic disorders: results from a cross-sectional Dutch study. RMD Open 2015; 1:e000045. [PMID: 26535136 PMCID: PMC4612684 DOI: 10.1136/rmdopen-2014-000045] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Revised: 03/12/2015] [Accepted: 03/13/2015] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES To explore the impact of socioeconomic factors on physical and mental health of patients with musculoskeletal disorders (MSKDs) and compare it across patients with other disorders. METHODS A representative sample of the Dutch population (n=8904) completed a survey on sociodemographics, physician-diagnosed (co-) morbidities, and physical (physical component summary, PCS) and mental (mental component summary, MCS) subscales of SF-12 (outcome variables). Regression models were computed first in the total group of patients with MSKDs, with education, age, gender, origin and place of residence as independent variables, and, second, in individuals expected to have paid work, adding a variable on social status. Models were repeated for five other subgroups of chronic disorders (cardiovascular (CVD), diabetes, cancer, mental and respiratory) and for healthy individuals. RESULTS MSKDs confirmed by a physician were reported by 1766 (20%) participants (mean age 59 years, 38% male), 547 (6%) respondents reported to have diabetes, 1855 (21%) CVD, 270 (3%) cancer, 526 (6%) mental disorders, 679 (8%) respiratory disorders and 4525 (51%) did not report any disease. In patients with MSKDs, (primary school vs university education (-5.3 (PCS) and -3.3 (MCS)) and having a state subsidy vs paid work (-5.3 (PCS) and -4.7 (MCS)) were consistently associated with worse physical and mental health. Gender was only relevant for PCS (female vs male -2.1). Comparable differences in health by education and social status were observed in the other diseases, except for cancer. CONCLUSIONS Education and social status in MSKD have the same strong and independent association with health as in other chronic diseases. These health gradients are unfair and partly avoidable, and require consorted attention and action in and outside healthcare.
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Affiliation(s)
- P Putrik
- Department of Rheumatology, Maastricht University Medical Center, CAPHRI School for Public Health and Primary care, Maastricht, The Netherlands
- Department of Health Promotion, Maastricht University, CAPHRI School for Public Health and Primary care, Maastricht, The Netherlands
| | - S Ramiro
- Clinical Immunology & Rheumatology, Amsterdam Rheumatology Center, Amsterdam, The Netherlands
- Department of Rheumatology, Hospital Garcia de Orta, Almada, Portugal
| | - A M Chorus
- Netherlands Organization for Applied Scientific Research, Leiden, The Netherlands
| | - A P Keszei
- Department of Medical Informatics, Uniklinik RWTH Aachen University, Aachen, Germany
| | - A Boonen
- Department of Rheumatology, Maastricht University Medical Center, CAPHRI School for Public Health and Primary care, Maastricht, The Netherlands
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