Children in the urban environment: an issue for the new public health agenda

A Critical Review of Standards to Examine the Parameters of Child-Friendly Environment (CFE) in Parks and Open Space of Planned Neighborhoods: A Case of Lucknow City, India

The creation of cities has been one of the most phenomenal achievements of human endeavor. Adults are the major stakeholders for such achievements but the children are helpless and representationless. The current research paper aims at understanding the issues faced by the children in the rapidly urbanized world where the lack of child-friendly environments/open spaces for their outdoor activities is cause for concern. The research paper looked at various national and international norms, standards, and practices of parks and open spaces to identify various child-friendly environmental parameters. The research adopted the Delphi method as a tool for the validation of child-friendly environment parameters. It also used children’s drawings and essays to understand children’s perceptions about the child-friendly environment. It is observed that present government norms and policies do not adhere to those parameters. The research found that Lucknow city does not meet the defined quantitative norms and standards as laid out by the national norms and standards for open spaces and parks. The quality dimensions for planning a child-friendly environment are weakly addressed by cities and neighborhoods. The city neighborhoods lack the physical, cognitive, perceptional, emotional, and social dimensions of a child-friendly environment. There is a need to adopt suitable norms and standards with measurable parameters as part of various dimensions and implement these in creating a child-friendly environment in planned neighborhoods.

Supporting Children’s Independent Activities in Smart and Playable Public Places

The global process of urbanization, and the modification of social interaction determined by the pandemic crisis, poses the issue of the place of vulnerable users and, in particular, children, within the contemporary city. This research aimed to elaborate a theoretical and methodological framework, based on the concepts of affordance and capability, for analyzing the potential of public spaces to enable and support children’s independent activities. This potential, or meaningful usefulness, is expressed by the Index of Meaningful Usefulness of public Urban Spaces (IUIS). The latter is calculated via the tool ‘Opportunities for Children in Urban Spaces’ (OCUS). This methodology is applied to the analysis of significant public spaces within the historic center of the city of Iglesias in Sardinia, Italy. The results reveal adequate usefulness of the selected spaces, while underlining criticalities related to intrinsic spatial and physical attributes. The application to the case study confirms the validity of the theoretical and methodological framework embodied in the OCUS tool for supporting urban design and planning by orienting place-shaping processes towards the acknowledgement of children’s needs.

Smart City Governance and Children’s Agency: An Assessment of the Green Infrastructure Impact on Children’s Activities in Cagliari (Italy) with the Tool “Opportunities for Children in Urban Spaces (OCUS)”

The increases in urbanization, pollution, resource depletion, and climate change underline the need for urban planning policies that incorporate blue–green infrastructure (BGI) and ecosystem services. This paper proposes a framework for assessing BGI’s effect on children’s outdoor activities. This effect, called meaningful usefulness, is a central issue due to the influence of experiences with nature on children’s development and the global trend of concentration of children in urban areas. Based on the concept of affordance, the methodology formalizes meaningful usefulness in terms of an index of usefulness of individual settings (IUIS) and a synthetic index of usefulness of BGI in a specific area (ISGI). These are determined via an audit protocol, Opportunities for Children in Urban Spaces (OCUS), which incorporates a set of indicators measuring micro-scale properties of individual places and contextual macro-scale factors. The methodology is applied to BGI components in Cagliari, Sardinia, Italy, which was selected for its superior density of urban green spaces. The application of the OCUS tool confirms its usefulness for investigating functional affordances incorporated into the trans-scalar structures of BGIs. The analytic protocol further contributes to the implementation of urban planning strategies within the smart city paradigm.

Sur le chemin de l’école : perceptions de parents et d’enfants du primaire face au risque routier lors de la mise en place d’un Trottibus au Québec

Cadre de la recherche : Dans les pays occidentaux, la marche pour se rendre à l’école est en forte diminution depuis la fin des années 1990. Cette diminution des déplacements à pied modifie le rapport des enfants aux espaces publics. Pour enrayer la diminution de la marche vers l’école, les Pédibus sont un programme d’incitation à la marche vers l’école sous la forme de l’organisation d’un ramassage scolaire pédestre sous la supervision d’un adulte.

Objectifs : Ces programmes ont fait l’objet d’évaluations, mais peu de recherches ont ciblé les différenciations des perceptions des parents et des enfants. L’objectif de cet article est d’analyser les différences de perceptions entre les parents et les enfants sur le risque routier lors de la mise en place d’un Pédibus afin d’interroger l’apprentissage de l’autonomie et le rapport aux espaces publics.

Méthodologie : Pour répondre à ces questionnements, nous nous appuyons sur une recherche concernant la mise en place de projets Trottibus, programme de Pédibus au Québec financé par la Société Canadienne du Cancer (SCC-Québec). Une enquête a été autoadministrée par Internet auprès de 189 parents et d’un de leurs enfants âgés de 5 à 11 ans avant ou au tout début de leur participation à un Trottibus.

Résultats : Les résultats montrent un plus grand sentiment de sécurité de la part des enfants lorsqu’ils marchent sur un espace sécurisé pour les piétons et une plus forte confiance dans les autres usagers quant au respect des piétons. Pour les parents, le Trottibus a des bienfaits éducatifs quant à l’apprentissage de la mobilité piétonne. Les enfants et les parents mettent en avant les dimensions de sociabilité de ce programme.

Conclusions : Les résultats permettent de mieux comprendre la familiarisation du trajet scolaire par les enfants et leurs perceptions de la sécurité routière sous divers scénarios (marcher sur le trottoir, traverser, jouer dans la rue, etc.) ainsi que de documenter les différences entre les attentes des parents et des enfants.

Contribution : L’accompagnement par les adultes interroge le rapport à la ville et l’acquisition de l’autonomie. Si les parents craignent de laisser leur enfant marcher seul pour un trajet connu entre le domicile et l’école à l’âge où s’expérimente la mobilité autonome, les enfants risquent d’acquérir plus tardivement les compétences pour se déplacer en sécurité et expérimenter les espaces publics des villes.

Active Transportation: The Role of Parent Attitude, The Physical Environment, and Social Capital

BACKGROUND

Despite recommendation and confirmed physical activity benefits, participation in active transportation to school (ATS) has continued to decline. This study's purpose was to create and test a model of ATS that is directly explained by the constructs of parent attitude, the physical environment, and social capital controlling for age and gender.

METHODS

Participants were parents (N = 248) of children at 6 elementary and 2 middle schools in 1 district in the Southwestern United States. The survey included previously validated behavior, environmental, attitude, and social items (eg, Safe Routes to School Parent Survey/U.S. General Social Survey). Structural equation modeling was used to test the fit of the model and whether parent attitude, the physical environment, and social capital were associated with active transportation.

RESULTS

An adjusted measurement model was a good fit for the data. The physical environment (β = 0.391; P < .01) as well as parent attitude (β = 0.535; P < .001) were positively associated with ATS.

CONCLUSION

This study supports a model of ATS, affirming that parent attitude, the physical environment, and social capital are effective constructs from which to conceptualize associations with walking and biking to school.

Social and physical environmental correlates of independent mobility in children: a systematic review taking sex/gender differences into account

BACKGROUND

Children's independent mobility (CIM) is an important contributor to physical activity and health in children. However, in the last 20 years CIM has significantly decreased. To develop effective intervention programs to promote CIM, the impact of the environment on CIM must be identified. This review seeks to provide an overview of sex/gender-specific socio-ecological correlates of CIM.

METHODS

A systematic literature search of five databases (PubMed, PsycInfo, Scopus, Medline, Web of Science) was conducted with a priori defined eligibility criteria and identified 1838 potential articles published between January 1990 and November 2017. Two independent reviewers screened the literature and identified and rated methodological quality of the studies. Related factors of CIM were summarized separately for CIM license (parental permission to travel independently) and CIM destination (destinations to which a child travels independently), and separately for boys and girls using a semi-quantitative method.

RESULTS

Twenty-seven peer-reviewed journal articles were identified which examined the relationship between the social and physical environment and CIM. Only seven studies reported results divided by sex/gender. Most associations between the environment and CIM were found in the expected direction (positive or negative) or not associated at all. The social environment seemed to be more influential for ensuring CIM than the physical environment. Neighborhood safety, fear of crime and stranger, parental support, and perception of traffic were important social environmental factors influencing CIM, while car ownership, distance, and neighborhood design were relevant physical environmental attributes. Few studies examined sex/gender-related environmental correlates of independent mobility, and those findings were inconsistent.

CONCLUSION

The findings of this systematic review serve as suggestions for intervention programs to increase CIM and to identify future directions in research. To establish a robust comprehension of the impact of the social and physical environment on CIM, further sex/gender-sensitive studies using comparable measurements for CIM and environmental correlates are needed.

The freedom to explore: examining the influence of independent mobility on weekday, weekend and after-school physical activity behaviour in children living in urban and inner-suburban neighbourhoods of varying socioeconomic status

BACKGROUND

Children's independent mobility (CIM) is critical to healthy development in childhood. The physical layout and social characteristics of neighbourhoods can impact opportunities for CIM. While global evidence is mounting on CIM, to the authors' knowledge, Canadian data on CIM and related health outcomes (i.e., physical activity (PA) behaviour) are missing. The purpose of this study was to examine if CIM is related to multiple characteristics of accelerometry-measured PA behaviour (total PA, light PA, moderate-to-vigorous PA, time spent sedentary) and whether associations between CIM and PA behaviour systematically vary by place of residence, stratifying by gender and type of day/period (weekdays, after-school, weekend).

METHODS

Participants were recruited through Project BEAT (Built Environment and Active Transport; http://www.beat.utoronto.ca). Children (n = 856) were stratified into four neighbourhood classifications based on the period of neighbourhood development (urban built environment (BE) (old BE) versus inner-suburban BE (new BE)) and socioeconomic status (SES; low SES and high SES). Physical activity was measured via accelerometry (ActiGraph GT1M). CIM was assessed via parental report and two categories were created (low CIM, n = 332; high CIM, n = 524). A series of two-factor ANOVAs were used to determine gender-specific differences in PA for weekdays, weekend days and the after-school period, according to level of CIM, across four neighbourhood classifications.

RESULTS

Children who were granted at least some independent mobility (high CIM) had more positive PA profiles across the school week, during the after-school period, and over the weekend; they were also less sedentary. The influence of CIM on PA behaviour was particularly salient during the after-school period. Associations of CIM with PA varied by gender, and also by neighbourhood classification. CIM seemed to matter more in urban neighbourhoods for boys and suburban neighbourhoods for girls.

CONCLUSION

Our findings highlight the importance of independent mobility to multiple characteristics of children's PA behaviour across the week. Furthermore, they emphasize that independent mobility-activity relationships need to be considered by gender and the type of neighbourhood independent mobility is offered in. Future work will focus on developing a predictive model of CIM that could be used to inform decision-making around alleviating barriers to CIM.

Neighborhood-level built environment and social characteristics associated with serious childhood motor vehicle occupant injuries

The effect of residential neighborhood characteristics on a child's risk of serious motor vehicle traffic occupant injuries was evaluated in New York State, USA, for the years 1993-2003, with particular focus on the effect of neighborhood walkability. Risk increased significantly (p < 0.0001) with decreasing street connectivity and as more workers commuted more than 30 min using means other than public transportation, along with more single-parent households and less college attainment in the neighborhood, regardless of whether New York City was in the study. After adjusting for age, gender and socio-economic community factors, the apparent loss of walkability in a child's neighborhood increases their risk of serious injury as an occupant of a motor vehicle.

Active commuting to and from school among Swedish children--a national and regional study

BACKGROUND

Active commuting to school by walking or cycling can have positive impact on children's health and development. The study investigates the prevalence of active commuting to school in Sweden, a setting where it is facilitated and promoted; and how active commuting varies according to socio-demographic and socio-economic characteristics.

METHODS

Self-reports from a national sample of Swedish children (11- to 15-year-olds, n = 4415) and a regional one from Stockholm County (13-year-olds, n = 1008) on transport to school were compared. The association that active commuting has with socio-demographic (gender, school grade, Swedish origin, type of housing, urbanicity in the local area), and socio-economic characteristics (household socio-economic status, family car ownership) was studied using logistic regression, controlling for car ownership and urbanicity, respectively.

RESULTS

Active commuting was high (62.9% in the national sample) but decreased with age-76% at the age of 11 years, 62% at the age of 13 years and 50% at the age of 15 years-whereas public transport increased (19-43%). Living in an apartment or row-house (compared with detached house) and living in a medium-sized city (compared with a metropolitan area) was associated with active commuting. In urban areas, active commuting was more common in worker households compared with intermediate- to high-level salaried employees.

CONCLUSION

Active commuting is common but decreases with age. Active commuting differed based on housing and urbanicity but not based on gender or Swedish origin, and impact of socio-economic factors differed depending on level of urbanicity.

Les parents et les déplacements entre la maison et l’école primaire : quelle place pour l’enfant dans la ville?

La forme urbaine et l’organisation du système scolaire ont une influence sur la mobilité des enfants et, en particulier, sur leurs déplacements scolaires. Les habitudes, les perceptions et les choix des parents pèsent tout autant. Le présent article porte sur les relations entre les considérations et les comportements parentaux, d’une part, et les modes de déplacement des enfants lors des déplacements entre la maison et l’école, d’autre part. Il prend appui sur une enquête par questionnaire menée par le Groupe de recherche ville et mobilité auprès de 1495 parents d’élèves du primaire (écoles publiques et privées, francophones et anglophones) de Montréal et de Trois-Rivières entre 2006 et 2008. On observe un lien entre les pratiques de déplacement des écoliers et les perceptions parentales au sujet de la sécurité dans le quartier et de l’importance du transport actif. On observe également un lien entre le mode de transport des parents et celui des enfants lors des trajets scolaires.

Exploring the neighborhood: a web-based survey on the prevalence and determinants of fear among young adolescent girls and boys

Children's independent everyday mobility can be hindered by fears experienced in their neighborhood. The aim of this study is to assess the prevalence and determinants of such fears among boys and girls in early adolescence, a period when individual freedom is expected to be on the increase. A sample of 7th grade students (age-13 years) in Stockholm County, Sweden, during 2005/06 answered a survey in class (n = 1,008). The relation that gender, housing, family characteristics, individual and peer negative experiences in the neighborhood, parental licensing, and length of stay in the neighborhood have with fear disclosure was assessed through multivariate logistic regression. A total of 60% of the girls and 40% of the boys reported experiencing fears in their neighborhood. Gender differences were significant for all of the most common fears, in particular darkness. When respondents or their friends had been chased, hit, or had something taken from them in their neighborhood, they were more likely to report fear (OR girls 2.3; 95% CI 1.6-4.5; boys 2.8; 95% CI 1.9-4.2). For girls, having one or more parents born outside Sweden was associated with fear. Boys nearly three times more often reported fear if (a) they thought their parents were negative toward adolescent independent mobility in the evening, or (b) they had lived longer than one year in their area. Many young adolescents admitted to experiencing fear in their neighborhood. Fears were more common among girls, and the types and determinants of fear seem to be gender specific.

Active school transport, physical activity levels and body weight of children and youth: a systematic review

OBJECTIVES

Active school transport (AST) may be an important source of children's physical activity (PA). Innovative solutions that increase PA time for children, without putting added pressure on the school curriculum, merit consideration. Before implementing such solutions, it is important to demonstrate that active school transport is associated with health-related outcomes.

METHODS

Following a standardized protocol, we conducted a systematic review of published research to address this question and explore whether children who actively commute to school also have a healthier body weight. Online searches of 5 electronic databases were conducted. Potential studies were screened on the basis of objective measures of physical activity.

RESULTS

Thirteen studies were included in this review. Nine studies demonstrated that children who actively commute to school accumulate significantly more PA and two studies reported that they expended significantly more kilocalories per day. Where studies examined body weight (n=10), only one reported active commuters having a lower body weight.

CONCLUSIONS

These studies demonstrate that active school commuters tend to be more physically active overall than passive commuters. However, evidence for the impact of AST in promoting healthy body weights for children and youth is not compelling.

Ethnicity and utilization of family physicians: a case study of Mainland Chinese immigrants in Toronto, Canada

This paper seeks to examine how immigrants in a multicultural society access and utilize culturally- and linguistically-diverse family physicians. It focuses on Mainland Chinese (MLC) immigrants - the most important source of immigrants to Canada since 1996 - in the Toronto Census Metropolitan Area (CMA), Canada. Specifically, the paper aims to explore the choice between Chinese-speaking and non-Chinese-speaking family physicians by MLC immigrants and to determine the underlying reasons for MLC immigrants use of ethnically- and linguistically-matched family physicians. A wide range of data are analyzed including survey and focus group data, physician data from the College of Physicians and Surgeons of Ontario (CPSO) and geo-referenced 2001 Canadian Census data. A mixed-method approach is employed combining quantitative analysis of survey data and Census data, spatial analysis of patient travel behaviour based on the survey and qualitative analysis based on focus groups. The paper reveals an overwhelming preference among MLC survey respondents for Chinese-speaking family physicians regardless of study areas and socioeconomic and demographic status. The focus groups suggest that language, culture and ethnicity are intertwined in a complex way to influence the choice of health care providers and health management strategies in the host society. The paper yields important policy implications for identifying health professional shortage areas for culturally-diverse populations, addressing issues related to foreign-trained physicians and enhancing primary care delivery relevant for immigrant populations.

'Childhood': are reports of its death greatly exaggerated?

What is happening to our children's childhoods? Is childhood itself disappearing as children become increasingly 'adultified' and commodified and as the lives and worlds of children's experiences seem to shrink in the name of protection and safety? Are contemporary concerns justified about children becoming less active and more comfortable playing Gameboys rather than games and exploring 'Sim City' rather than their own real one? Or, are these simply adult 'moral panics' about childhood based on little more than nostalgia for a mythical childhood suffused with innocence and happiness? This article explores some of the current concerns regarding the changing state of childhood and links these to some of our current child health and well-being concerns. It concludes by suggesting some small-scale 'local' initiatives that parents and adults could support relatively easily, which would help to enrich childhood.

Space, Place, and the Evidence Base: Part II-Rereading Nursing Environment Through Geographical Research

This, the second and final article in the short health geography series, articulates how, moving beyond the models and assumptions associated with the metaparadigm of Nursing Environment, as a focused subdisciplinary approach, health geography might provide unique insights into nursing. A case study of a fictional yet somewhat typical children's hospital is presented and demonstrates some wide-ranging geographical issues and research questions (and hence potential geographical data) pertaining to nursing and the allied health professions. Indeed, this broad-brush approach is purposeful to make as many connections as possible to readers with varied theoretical, methodological, empirical, and practice expertise. In addition to the case study, to indicate further how geographical inquiry might locate quite comfortably in nursing research, the article also makes some initial and tentative connections between geography and an established nursing framework for the uptake of research evidence for practice. Although it is acknowledged that geographical inquiry should certainly never have the first call on researching the relationships between nurses and their environments, it is argued that its conceptual focus on space and place provides dedicated and detailed attention and a sound basis for a reformed, "spatialized" route to a more comprehensive understanding. Moreover, it is argued that it also demonstrates great versatility in terms of the scales and the subject matter with which it might engage. Some important issues certainly remain with respect to what might be the correct form of engagement between geographical and nursing research, but arguably, as a reformed disciplinary approach, health geography has the potential to provide a wealth of focused evidence for nursing practice.

Towards a more place-sensitive nursing research: an invitation to medical and health geography

During recent years, nursing research has adopted and integrated perspectives and theoretical frameworks from a range of social science disciplines. I argue however, that a lack of attention has been paid in past research to the subdiscipline of medical geography. Although this may, in part, be attributed to a divergence between research priorities and foci, traditional 'scientific' geographical approaches may still be relevant to a wide range of nursing research. Furthermore, a recasting, redirecting and broadening of medical geography in the 1990s, towards what is termed health geography, has enhanced the discipline and provided a more cultural and expansive recognition of health, and a more comprehensive understanding of the dynamic relationship between people, health and place. Given the increasing range of places where health-care is provided and received, and some recent linkages made between nursing and place by nurse-theorists, these newer perspectives and concepts may be particularly useful for interpreting nurses' and patients' relationships both within and with a variety of healthcare settings and living spaces. Indeed, although a more place-sensitive nursing research is potentially a trans-disciplinary academic endeavor, a range of geographical approaches would be central to such a project.

"They don't trust us; we're just kids:" views about community from predominantly female inner city youth

The cornerstones of health promotion are the concepts of empowerment and community participation. There has been little research, however, on how these concepts are actualized within a youth population and even less from a gender perspective. Girls are socialized to be more compliant and cooperative; thus they feel less assertive to express themselves. The benefits of community participation, such as the development of personal identity and increased self-determination, may therefore be more important for girls' development. In this qualitative study I explored youth's perceptions about community, their ability to be heard, and their power to effect community change. Responses to focus groups and an on-line sentence completion exercise by 23 well-functioning, predominantly female (83%) youth, at an inner-city school in Canada, revealed that youth perceived that they were not heard and felt disempowered in the larger community. Three subthemes explain these threats to empowerment: "grown-ups run everything" (they had no actual decision-making power), "we're just kids" (they were low in the social hierarchy), and "they don't trust us" (they felt mutual mistrust of and by adults). Boys showed some evidence of feeling more empowered than girls. Boys and girls identified that they perceived they could make a difference, particularly in their school. Five themes of empowerment help to explain this perception, including, "adults who know us, trust us" (they were trusted by some adults), in school "they ask us what should we do" (they had some participation in decision making), "we can make a difference" (they felt self-efficacy), "we can do it as a group" (they had a belief in group action), and they could "get someone big so they would listen" (they demonstrated political efficacy). Implications for community health practitioners are discussed.

The safe journeys of an enterprising school: negotiating landscapes of opportunity and risk

In this paper, we discuss recent efforts to improve the safety of children travelling to and from New Zealand's largest primary school. The results of a travel survey completed by parents and pupils are reported, together with our recommendations for reducing congestion at the school gate and promoting healthy alternatives to car travel. Reflecting on this research, we find that market-oriented education reforms have provided schools with strong incentives for increasing their rolls--a course of action which may endanger pupils' well-being. At the same time, they have provided some schools with opportunities for resisting the present urban (dis)order and promoting community health.