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Doiron D, Setton EM, Syer J, Redivo A, McKee A, Noaeen M, Patel P, Booth GL, Brauer M, Fuller D, Kestens Y, Rosella LC, Stieb D, Villeneuve PJ, Brook JR. HealthyPlan.City: A Web Tool to Support Urban Environmental Equity and Public Health in Canadian Communities. J Urban Health 2024; 101:497-507. [PMID: 38587782 PMCID: PMC11190122 DOI: 10.1007/s11524-024-00855-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/08/2024] [Indexed: 04/09/2024]
Abstract
Urban environmental factors such as air quality, heat islands, and access to greenspaces and community amenities impact public health. Some vulnerable populations such as low-income groups, children, older adults, new immigrants, and visible minorities live in areas with fewer beneficial conditions, and therefore, face greater health risks. Planning and advocating for equitable healthy urban environments requires systematic analysis of reliable spatial data to identify where vulnerable populations intersect with positive or negative urban/environmental characteristics. To facilitate this effort in Canada, we developed HealthyPlan.City ( https://healthyplan.city/ ), a freely available web mapping platform for users to visualize the spatial patterns of built environment indicators, vulnerable populations, and environmental inequity within over 125 Canadian cities. This tool helps users identify areas within Canadian cities where relatively higher proportions of vulnerable populations experience lower than average levels of beneficial environmental conditions, which we refer to as Equity priority areas. Using nationally standardized environmental data from satellite imagery and other large geospatial databases and demographic data from the Canadian Census, HealthyPlan.City provides a block-by-block snapshot of environmental inequities in Canadian cities. The tool aims to support urban planners, public health professionals, policy makers, and community organizers to identify neighborhoods where targeted investments and improvements to the local environment would simultaneously help communities address environmental inequities, promote public health, and adapt to climate change. In this paper, we report on the key considerations that informed our approach to developing this tool and describe the current web-based application.
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Affiliation(s)
- Dany Doiron
- Respiratory Epidemiology and Clinical Research Unit, Research Institute of the McGill University Health Centre, Montréal, Québec, Canada.
| | - Eleanor M Setton
- Geography Department, University of Victoria, Victoria, BC, Canada
| | - Joey Syer
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Andre Redivo
- Geography Department, University of Victoria, Victoria, BC, Canada
| | - Allan McKee
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Mohammad Noaeen
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Priya Patel
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Gillian L Booth
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Michael Brauer
- School of Population and Public Health, The University of British Columbia, Vancouver, BC, Canada
| | - Daniel Fuller
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Yan Kestens
- École de Santé Publique de L'Université de Montréal, Montréal, QC, Canada
| | - Laura C Rosella
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Dave Stieb
- Environmental Health Science and Research Bureau, Health Canada, Vancouver, BC, Canada
| | | | - Jeffrey R Brook
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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Karczewski HA, Blackwood J. Assessing Physical Therapists' Outdoor Walking Recommendations and Neighborhood Walkability for Older Adults. J Aging Phys Act 2024:1-6. [PMID: 38823791 DOI: 10.1123/japa.2023-0404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 02/26/2024] [Accepted: 03/27/2024] [Indexed: 06/03/2024]
Abstract
BACKGROUND/OBJECTIVES Neighborhood walkability is the extent to which built and social environments support walking. Walkability influences older adults' participation in outdoor physical activity. Identifying factors that influence physical therapists' (PTs) decisions about prescribing outdoor walking is needed, especially for those who are aging in place. The purpose of this study is to describe the neighborhood walkability knowledge, perceptions, and assessment practices of PTs who work with community-dwelling older adults. METHODS A cross-sectional survey was sent via email to 5,000 PTs nationwide. The 40-item survey assessed walking prescriptions, walkability perceptions and assessments, and gathered demographic data. Categorical variables were compared using Chi-square analyses. RESULTS Using a total of 122 PTs who worked in outpatient geriatric physical therapy settings, a significant difference was found between perceptions of whether PTs should assess walkability and whether they actually assess walkability (χ2 = 78.7, p < .001). Decisions to prescribe outdoor walking were influenced by the availability (n = 79, 64.8%) and maintenance (n = 11, 9.0%) of sidewalks, crime (n = 9, 7.4%), terrain (n = 7, 5.7%), and aesthetics (n = 6, 4.9%). Objective walkability measures were not used by the respondents. CONCLUSION When considering the assessment of walkability, PTs prioritize the built environment over the social environment. Although most believe it is the responsibility of the PT to assess walkability, most do not. Significance/Implications: Assessment of walkability may allow PTs to identify barriers and make more informed recommendations concerning outdoor walking for older adults. Objective measures are available for PTs when prescribing outdoor walking.
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Affiliation(s)
- Hannah A Karczewski
- Physical Therapy Department, The University of Michigan-Flint, Flint, MI, USA
| | - Jennifer Blackwood
- Physical Therapy Department, The University of Michigan-Flint, Flint, MI, USA
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Rundle AG, Neckerman KM, Judd SE, Colabianchi N, Moore KA, Quinn JW, Hirsch JA, Lovasi GS. Cumulative Experience of Neighborhood Walkability and Change in Weight and Waist Circumference in REGARDS. Am J Epidemiol 2023; 192:1960-1970. [PMID: 37312569 PMCID: PMC10691194 DOI: 10.1093/aje/kwad134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/24/2023] [Accepted: 06/04/2023] [Indexed: 06/15/2023] Open
Abstract
Neighborhood walkability-features of the built environment that promote pedestrian activity-has been associated with greater physical activity and lower body mass index (BMI; calculated as weight (kg)/height (m)2) among neighborhood residents. However, much of the literature has been cross-sectional and only a few cohort studies have assessed neighborhood features throughout follow-up. Using data from the Reasons for Geographic and Racial Differences in Stroke Study (2003-2016) and a neighborhood walkability index (NWI) measured annually during follow-up, we assessed whether the cumulative experience of neighborhood walkability (NWI-years) predicted BMI and waist circumference after approximately 10 years of follow-up, controlling for these anthropometric measures at enrollment. Analyses were adjusted for individual-level sociodemographic covariates and the cumulative experience of neighborhood poverty rate and neighborhood greenspace coverage. Almost a third (29%) of participants changed address at least once during follow-up. The first change of residence, on average, brought the participants to neighborhoods with higher home values and lower NWI scores than their originating neighborhoods. Compared with those having experienced the lowest quartile of cumulative NWI-years, those who experienced the highest quartile had 0.83 lower BMI (95% confidence interval, -1.5, -0.16) and 1.07-cm smaller waist circumference (95% confidence interval, -1.96, -0.19) at follow-up. These analyses provide additional longitudinal evidence that residential neighborhood features that support pedestrian activity are associated with lower adiposity.
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Affiliation(s)
- Andrew G Rundle
- Correspondence to Dr. Andrew Rundle, Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY 10032 (e-mail: )
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Belsky DW, Baccarelli AA. To promote healthy aging, focus on the environment. NATURE AGING 2023; 3:1334-1344. [PMID: 37946045 DOI: 10.1038/s43587-023-00518-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 09/27/2023] [Indexed: 11/12/2023]
Abstract
To build health equity for an aging world marked by dramatic disparities in healthy lifespan between countries, regions and population groups, research at the intersections of biology, toxicology and the social and behavioral sciences points the way: to promote healthy aging, focus on the environment. In this Perspective, we suggest that ideas and tools from the emerging field of geroscience offer opportunities to advance the environmental science of aging. Specifically, the capacity to measure the pace and progress of biological processes of aging within individuals from relatively young ages makes it possible to study how changing environments can change aging trajectories from early in life, in time to prevent or delay aging-related disease and disability and build aging health equity.
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Affiliation(s)
- Daniel W Belsky
- Robert N. Butler Columbia Aging Center and Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Andrea A Baccarelli
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA.
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Kim SJ, Blesoff JR, Tussing-Humphrys L, Fitzgibbon ML, Peterson CE. The association between neighborhood conditions and weight loss among older adults living in a large urban city. J Behav Med 2023; 46:882-889. [PMID: 37000323 PMCID: PMC10544679 DOI: 10.1007/s10865-023-00410-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 03/12/2023] [Indexed: 04/01/2023]
Abstract
To elucidate the role of neighborhood walkability and crime on weight loss, we examined data from older adults residing in Chicago who participated in a randomized controlled trial lifestyle intervention. Controlling for individual demographic characteristics and the intervention assignment, the neighborhood homicide rate was significantly associated with weight change. Participants who resided in neighborhoods above the 50th percentile of homicide rate actually gained weight between pre- and post-intervention. On the other hand, there was no significant relationship between the level of walkability and weight loss. Our findings suggest that the social environment related to neighborhood crime may play a more important role in weight loss than the built environment, such as walkability. Urban characteristics related to walkability, such as sidewalks, may increase physical activity, however, interventions aiming to increase physical activity to promote weight loss will benefit by addressing the neighborhood social environment that determines how people navigate space.
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Affiliation(s)
- Sage J Kim
- School of Public Health, Division of Health Policy & Administration, University of Illinois at Chicago, 1603 W. Taylor St. #781, Chicago, IL, 60612, USA.
| | - Jamine R Blesoff
- School of Public Health, Division of Health Policy & Administration, University of Illinois at Chicago, 1603 W. Taylor St. #781, Chicago, IL, 60612, USA
| | - Lisa Tussing-Humphrys
- College of Applied Health Sciences, Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, USA
| | - Marian L Fitzgibbon
- Pediatrics and Health Policy and Administration, Associate Director for Population Science, University of Illinois at Chicago, UI Cancer Center, Chicago, USA
| | - Caryn E Peterson
- School of Public Health, Division of Epidemiology & Biostatistics, University of Illinois at Chicago, Chicago, USA
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Lai KY, Webster C, Gallacher JE, Sarkar C. Associations of Urban Built Environment with Cardiovascular Risks and Mortality: a Systematic Review. J Urban Health 2023; 100:745-787. [PMID: 37580546 PMCID: PMC10447831 DOI: 10.1007/s11524-023-00764-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/28/2023] [Indexed: 08/16/2023]
Abstract
With rapid urbanization, built environment has emerged as a set of modifiable factors of cardiovascular disease (CVD) risks. We conducted a systematic review to synthesize evidence on the associations of attributes of urban built environment (e.g. residential density, land use mix, greenness and walkability) with cardiovascular risk factors (e.g. hypertension and arterial stiffness) and major CVD events including mortality. A total of 63 studies, including 31 of cross-sectional design and 32 of longitudinal design conducted across 21 geographical locations and published between 2012 and 2023 were extracted for review. Overall, we report moderately consistent evidence of protective associations of greenness with cardiovascular risks and major CVD events (cross-sectional studies: 12 of 15 on hypertension/blood pressure (BP) and 2 of 3 on arterial stiffness; and longitudinal studies: 6 of 8 on hypertension/BP, 7 of 8 on CVD mortality, 3 of 3 on ischemic heart disease mortality and 5 of 8 studies on stroke hospitalization or mortality reporting significant inverse associations). Consistently, walkability was associated with lower risks of hypertension, arterial stiffness and major CVD events (cross-sectional studies: 11 of 12 on hypertension/BP and 1 of 1 on arterial stiffness; and longitudinal studies: 3 of 6 on hypertension/BP and 1 of 2 studies on CVD events being protective). Sixty-seven percent of the studies were rated as "probably high" risk of confounding bias because of inability to adjust for underlying comorbidities/family history of diseases in their statistical models. Forty-six percent and 14% of the studies were rated as "probably high" risk of bias for exposure and outcome measurements, respectively. Future studies with robust design will further help elucidate the linkages between urban built environment and cardiovascular health, thereby informing planning policies for creating healthy cities.
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Affiliation(s)
- Ka Yan Lai
- Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Knowles Building, Pokfulam Road, Hong Kong Special Administrative Region, China.
- Department of Urban Planning and Design, Faculty of Architecture, The University of Hong Kong, Knowles Building, Pokfulam Road, Hong Kong Special Administrative Region, China.
| | - Chris Webster
- Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Knowles Building, Pokfulam Road, Hong Kong Special Administrative Region, China
- Department of Urban Planning and Design, Faculty of Architecture, The University of Hong Kong, Knowles Building, Pokfulam Road, Hong Kong Special Administrative Region, China
- Urban Systems Institute, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - John Ej Gallacher
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, UK
| | - Chinmoy Sarkar
- Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Knowles Building, Pokfulam Road, Hong Kong Special Administrative Region, China
- Department of Urban Planning and Design, Faculty of Architecture, The University of Hong Kong, Knowles Building, Pokfulam Road, Hong Kong Special Administrative Region, China
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, UK
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Kinsey EW, Widen EM, Quinn JW, Huynh M, Van Wye G, Lovasi GS, Neckerman KM, Caniglia EC, Rundle AG. Neighborhood Food Environment and Birth Weight Outcomes in New York City. JAMA Netw Open 2023; 6:e2317952. [PMID: 37306998 PMCID: PMC10261997 DOI: 10.1001/jamanetworkopen.2023.17952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 04/21/2023] [Indexed: 06/13/2023] Open
Abstract
Importance Infants born with unhealthy birth weight are at greater risk for long-term health complications, but little is known about how neighborhood characteristics (eg, walkability, food environment) may affect birth weight outcomes. Objective To assess whether neighborhood-level characteristics (poverty rate, food environment, and walkability) are associated with risk of unhealthy birth weight outcomes and to evaluate whether gestational weight gain mediated these associations. Design, Setting, and Participants The population-based cross-sectional study included births in the 2015 vital statistics records from the New York City Department of Health and Mental Hygiene. Only singleton births and observations with complete birth weight and covariate data were included. Analyses were performed from November 2021 to March 2022. Exposures Residential neighborhood-level characteristics, including poverty, food environment (healthy and unhealthy food retail establishments), and walkability (measured by both walkable destinations and a neighborhood walkability index combining walkability measures like street intersection and transit stop density). Neighborhood-level variables categorized into quartiles. Main Outcomes and Measures The main outcomes were birth certificate birth weight measures including small for gestational age (SGA), large for gestational age (LGA), and sex-specific birth weight for gestational age z-score. Generalized linear mixed-effects models and hierarchical linear models estimated risk ratios for associations between density of neighborhood-level characteristics within a 1-km buffer of residential census block centroid and birth weight outcomes. Results The study included 106 194 births in New York City. The mean (SD) age of pregnant individuals in the sample was 29.9 (6.1) years. Prevalence of SGA and LGA were 12.9% and 8.4%, respectively. Residence in the highest density quartile of healthy food retail establishments compared with the lowest quartile was associated with lower adjusted risk of SGA (with adjustment for individual covariates including gestational weight gain z-score: risk ratio [RR], 0.89; 95% CI 0.83-0.97). Higher neighborhood density of unhealthy food retail establishments was associated with higher adjusted risk of delivering an infant classified as SGA (fourth vs first quartile: RR, 1.12; 95% CI, 1.01-1.24). The RR for the association between density of unhealthy food retail establishments and risk of LGA was higher after adjustment for all covariates in each quartile compared with quartile 1 (second: RR, 1.12 [95% CI, 1.04-1.20]; third: RR, 1.18 [95% CI, 1.08-1.29]; fourth: RR, 1.16; [95% CI, 1.04-1.29]). There were no associations between neighborhood walkability and birth weight outcomes (SGA for fourth vs first quartile: RR, 1.01 [95% CI, 0.94-1.08]; LGA for fourth vs first quartile: RR, 1.06 [95% CI, 0.98-1.14]). Conclusions and Relevance In this population-based cross-sectional study, healthfulness of neighborhood food environments was associated with risk of SGA and LGA. The findings support use of urban design and planning guidelines to improve food environments to support healthy pregnancies and birth weight.
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Affiliation(s)
- Eliza W. Kinsey
- Department of Family Medicine & Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Elizabeth M. Widen
- Department of Nutritional Sciences and Population Research Center, University of Texas at Austin
| | - James W. Quinn
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Mary Huynh
- Bureau of Vital Statistics, New York City Department of Health and Mental Hygiene, New York
| | - Gretchen Van Wye
- Bureau of Vital Statistics, New York City Department of Health and Mental Hygiene, New York
| | - Gina S. Lovasi
- Epidemiology and Biostatistics, Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | | | - Ellen C. Caniglia
- Department of Biostatistics, Epidemiology & Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Andrew G. Rundle
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
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Rundle AG, Kinsey EW, Widen EM, Quinn JW, Huynh M, Lovasi GS, Neckerman KM, Van Wye G. Neighbourhood walkability is associated with risk of gestational diabetes: A cross-sectional study in New York City. Paediatr Perinat Epidemiol 2023; 37:212-217. [PMID: 36633306 PMCID: PMC10404343 DOI: 10.1111/ppe.12952] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 12/14/2022] [Accepted: 12/25/2022] [Indexed: 01/13/2023]
Abstract
BACKGROUND Despite the links between neighbourhood walkability and physical activity, body size and risk of diabetes, there are few studies of neighbourhood walkability and risk of gestational diabetes (GD). OBJECTIVES Assess whether higher neighbourhood walkability is associated with lower risk of GD in New York City (NYC). METHODS Cross-sectional analyses of a neighbourhood walkability index (NWI) score and density of walkable destinations (DWD) and risk of GD in 109,863 births recorded in NYC in 2015. NWI and DWD were measured for the land area of 1 km radius circles around the geographic centroid of each Census block of residence. Mixed generalised linear models, with robust standard error estimation and random intercepts for NYC Community Districts, were used to estimate risk ratios for GD for increasing quartiles of each of the neighbourhood walkability measures after adjustment for the pregnant individual's age, race and ethnicity, parity, education, nativity, and marital status and the neighbourhood poverty rate. RESULTS Overall, 7.5% of pregnant individuals experienced GD. Risk of GD decreased across increasing quartiles of NWI, with an adjusted risk ratio of 0.81 (95% Confidence Interval (CI) 0.75, 0.87) comparing those living in areas in the 4th quartile of NWI to those in the first quartile. Similarly, for comparisons of the 4th to 1st quartile of DWD, the adjusted risk ratio for GD was 0.77 (95% CI 0.71, 0.84). CONCLUSIONS These analyses find support for the hypothesis that higher neighbourhood walkability is associated with a lower risk of GD. The analyses provide further health related support for urban design policies to increase walkability.
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Affiliation(s)
- Andrew G Rundle
- Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Eliza W Kinsey
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Elizabeth M Widen
- College of Natural Sciences, The University of Texas at Austin, Austin, Texas, USA
| | - James W Quinn
- Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Mary Huynh
- School of Health Sciences, Human Services, & Nursing, Lehman College, New York, New York, USA
| | - Gina S Lovasi
- Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| | - Kathryn M Neckerman
- Columbia Population Research Center, Columbia University, New York, New York, USA
| | - Gretchen Van Wye
- Bureau of Vital Statistics, New York City Department of Health and Mental Hygiene, New York, New York, USA
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Wang ML, Narcisse MR, McElfish PA. Higher walkability associated with increased physical activity and reduced obesity among United States adults. Obesity (Silver Spring) 2023; 31:553-564. [PMID: 36504362 PMCID: PMC9877111 DOI: 10.1002/oby.23634] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 10/03/2022] [Accepted: 10/11/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE This study examined associations among perceived neighborhood walkability, physical activity (PA), and obesity among United States adults. METHODS Data from the 2020 National Health Interview Survey were analyzed. Walkability was assessed using a summative scale and was categorized as low, medium, or high. PA was categorized as insufficient (0-149 min/wk) or sufficient (150+ min/wk). Multivariable regressions estimated an association between obesity and BMI and PA/walkability. Mediation analysis was used to partition contribution of PA as a mediator. Effect modification by race and ethnicity in the association between walkability and BMI was explored. RESULTS The sample included N = 31,568 adults. Compared with those in low-walkability neighborhoods, participants in high-walkability neighborhoods had increased odds of sufficient PA (odds ratio [OR] = 1.48; 95% CI: 1.30-1.69) and decreased obesity odds (OR = 0.76; 95% CI: 0.66-0.87). PA partially mediated the association between walkability and BMI (23.4%; 95% CI: 14.6%-62.7%). The association between walkability and BMI was modified by race and ethnicity (F[5,567] = 2.75; p = 0.018). Among White, Black, Hispanic, and Asian adults, BMI decreased with increasing walkability; among American Indian/Alaska Native and multiracial/other adults, BMI increased with increasing walkability. CONCLUSIONS The findings highlight the importance of investing in the built environment to improve perceptions of walkability and promote PA and healthy weight, as well as developing interventions to target racial and ethnic disparities in these outcomes.
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Affiliation(s)
- Monica L. Wang
- Boston University School of Public Health, Department of Community Health Sciences, 715 Albany St., Boston, MA 02118, USA
- Boston University Center for Antiracist Research, 1 Silber Way, Boston, MA 02215, USA
- Harvard T.H. Chan School of Public Health, Department of Health Policy and Management, 677 Huntington Ave., Boston, MA 02115, USA
| | - Marie-Rachelle Narcisse
- University of Arkansas for Medical Sciences Northwest, College of Medicine, 2708 S. 48 St., Springdale, AR 72762, USA
| | - Pearl A. McElfish
- University of Arkansas for Medical Sciences Northwest, College of Medicine, 2708 S. 48 St., Springdale, AR 72762, USA
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Digital phenotyping in molecular psychiatry-a missed opportunity? Mol Psychiatry 2023; 28:6-9. [PMID: 36171355 PMCID: PMC9812759 DOI: 10.1038/s41380-022-01795-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 08/31/2022] [Accepted: 09/09/2022] [Indexed: 01/09/2023]
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India-Aldana S, Rundle AG, Clendenen TV, Quinn JW, Arslan AA, Afanasyeva Y, Koenig KL, Liu M, Neckerman KM, Thorpe LE, Zeleniuch-Jacquotte A, Chen Y. Neighborhood walkability and sex steroid hormone levels in women. ENVIRONMENTAL RESEARCH 2022; 215:114285. [PMID: 36088991 PMCID: PMC10039647 DOI: 10.1016/j.envres.2022.114285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 09/01/2022] [Accepted: 09/03/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Neighborhood walkability (NW) has been linked to increased physical activity, which in turn is associated with lower concentrations of sex hormones and higher concentration of SHBG in women. However, no study has directly examined the association of NW with female sex hormone levels. OBJECTIVE We conducted a cross-sectional study to evaluate the association between NW and circulating levels of sex hormones and SHBG in pre- and post-menopausal women. METHODS We included 797 premenopausal and 618 postmenopausal women from the New York University Women's Health Study (NYUWHS) who were healthy controls in previous nested case-control studies in which sex hormones (androstenedione, testosterone, DHEAS, estradiol and estrone) and SHBG had been measured in serum at enrollment. Baseline residential addresses were geo-coded and the Built Environment and Health Neighborhood Walkability Index (BEH-NWI) was calculated. Generalized Estimating Equations were used to assess the association between BEH-NWI and sex hormone and SHBG concentrations adjusting for individual- and neighborhood-level factors. RESULTS In premenopausal women, a one standard deviation (SD) increment in BEH-NWI was associated with a 3.5% (95% CI 0.9%-6.1%) lower DHEAS concentration. In postmenopausal women, a one SD increment in BEH-NWI was related to an 8.5% (95% CI 5.4%-11.5%) lower level of DHEAS, a 3.7% (95% CI 0.5%-6.8%) lower level of testosterone, a 1.8% (95% CI 0.5%-3.0%) lower level of estrone, and a 4.2% (95% CI 2.7%-5.7%) higher level of SHBG. However, the associations with respect to DHEAS and estrone became apparent only after adjusting for neighborhood-level variables. Sensitivity analyses using fixed effects meta-analysis and inverse probability weighting accounting for potential selection bias yielded similar results. CONCLUSION Our findings suggest that NW is associated with lower concentrations of androgens and estrone, and increased SHBG, in postmenopausal women, and lower levels of DHEAS in premenopausal women.
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Affiliation(s)
- Sandra India-Aldana
- Division of Epidemiology, Department of Population Health, NYU Grossman School of Medicine, 180 Madison Avenue, 5th Fl., New York, NY, 10016, USA
| | - Andrew G Rundle
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY, 10032, USA
| | - Tess V Clendenen
- Division of Epidemiology, Department of Population Health, NYU Grossman School of Medicine, 180 Madison Avenue, 5th Fl., New York, NY, 10016, USA
| | - James W Quinn
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY, 10032, USA
| | - Alan A Arslan
- Division of Epidemiology, Department of Population Health, NYU Grossman School of Medicine, 180 Madison Avenue, 5th Fl., New York, NY, 10016, USA; Department of Obstetrics and Gynecology, NYU Grossman School of Medicine, New York, NY, USA; Department of Environmental Medicine, NYU Grossman School of Medicine, New York, NY, USA
| | - Yelena Afanasyeva
- Division of Epidemiology, Department of Population Health, NYU Grossman School of Medicine, 180 Madison Avenue, 5th Fl., New York, NY, 10016, USA
| | - Karen L Koenig
- Division of Epidemiology, Department of Population Health, NYU Grossman School of Medicine, 180 Madison Avenue, 5th Fl., New York, NY, 10016, USA
| | - Mengling Liu
- Department of Environmental Medicine, NYU Grossman School of Medicine, New York, NY, USA; Division of Biostatistics, Department of Population Health, NYU Grossman School of Medicine, 180 Madison Avenue, 5th Fl., New York, NY, 10016, USA
| | - Kathryn M Neckerman
- Columbia Population Research Center, Columbia University, 1255 Amsterdam Avenue, New York, NY, 10027, USA
| | - Lorna E Thorpe
- Division of Epidemiology, Department of Population Health, NYU Grossman School of Medicine, 180 Madison Avenue, 5th Fl., New York, NY, 10016, USA
| | - Anne Zeleniuch-Jacquotte
- Division of Epidemiology, Department of Population Health, NYU Grossman School of Medicine, 180 Madison Avenue, 5th Fl., New York, NY, 10016, USA
| | - Yu Chen
- Division of Epidemiology, Department of Population Health, NYU Grossman School of Medicine, 180 Madison Avenue, 5th Fl., New York, NY, 10016, USA; Department of Environmental Medicine, NYU Grossman School of Medicine, New York, NY, USA.
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12
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Fazeli Dehkordi ZS, Khatami SM, Ranjbar E. The Associations Between Urban Form and Major Non-communicable Diseases: a Systematic Review. J Urban Health 2022; 99:941-958. [PMID: 35776285 PMCID: PMC9561495 DOI: 10.1007/s11524-022-00652-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/05/2022] [Indexed: 10/17/2022]
Abstract
In the current century, non-communicable diseases (NCDs), particularly cardiovascular diseases, diabetes, cancer, and chronic respiratory diseases, are the most important cause of mortality all over the world. Given the effect of the built environment on people's health, the present study seeks to conduct a systematic review in order to investigate the relationship between urban form and these four major NCDs as well as their main risk factors. Two independent reviewers in November 2020 after an extensive search through PubMed and Scopus identified 77 studies. Studies published in English were included if they addressed one or more attributes of urban form in relation to any major NCDs and their main risk factors. Publication date, country, geographical scale, study design, methods of built environment measurement, and findings of the relationships among variables were extracted from eligible studies. The findings suggest that the elements of urban form (density, transportation and accessibility, characteristics of building and streetscape, land use, spatial layouts and configuration) could increase or inhibit these diseases through their effect on physical activity, diet, air pollution, blood pressure, and obesity. However, there are study shortages, contradictions, and ambiguities in these relationships which are mainly due to methodological and conceptual challenges. As a result, more in-depth research is needed to achieve solid and consistent results that could be made into clear guidelines for planning and designing healthier cities.
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Affiliation(s)
| | - Seyed Mahdi Khatami
- Department of Urban Design & Planning, Tarbiat Modares University, Tehran, Iran
| | - Ehsan Ranjbar
- Department of Urban Design & Planning, Tarbiat Modares University, Tehran, Iran
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13
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Pontin FL, Jenneson VL, Morris MA, Clarke GP, Lomax NM. Objectively measuring the association between the built environment and physical activity: a systematic review and reporting framework. Int J Behav Nutr Phys Act 2022; 19:119. [PMID: 36104757 PMCID: PMC9476279 DOI: 10.1186/s12966-022-01352-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 08/18/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Objective measures of built environment and physical activity provide the opportunity to directly compare their relationship across different populations and spatial contexts. This systematic review synthesises the current body of knowledge and knowledge gaps around the impact of objectively measured built environment metrics on physical activity levels in adults (≥ 18 years). Additionally, this review aims to address the need for improved quality of methodological reporting to evaluate studies and improve inter-study comparability though the creation of a reporting framework.
Methods
A systematic search of the literature was conducted following the PRISMA guidelines. After abstract and full-text screening, 94 studies were included in the final review. Results were synthesised using an association matrix to show overall association between built environment and physical activity variables. Finally, the new PERFORM (’Physical and Environmental Reporting Framework for Objectively Recorded Measures’) checklist was created and applied to the included studies rating them on their reporting quality across four key areas: study design and characteristics, built environment exposures, physical activity metrics, and the association between built environment and physical activity.
Results
Studies came from 21 countries and ranged from two days to six years in duration. Accelerometers and using geographic information system (GIS) to define the spatial extent of exposure around a pre-defined geocoded location were the most popular tools to capture physical activity and built environment respectively. Ethnicity and socio-economic status of participants were generally poorly reported. Moderate-to-vigorous physical activity (MVPA) was the most common metric of physical activity used followed by walking. Commonly investigated elements of the built environment included walkability, access to parks and green space. Areas where there was a strong body of evidence for a positive or negative association between the built environment and physical activity were identified. The new PERFORM checklist was devised and poorly reported areas identified, included poor reporting of built environment data sources and poor justification of method choice.
Conclusions
This systematic review highlights key gaps in studies objectively measuring the built environment and physical activity both in terms of the breadth and quality of reporting. Broadening the variety measures of the built environment and physical activity across different demographic groups and spatial areas will grow the body and quality of evidence around built environment effect on activity behaviour. Whilst following the PERFORM reporting guidance will ensure the high quality, reproducibility, and comparability of future research.
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14
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Nagata S, Nakaya T, Hanibuchi T, Nakaya N, Hozawa A. Development of a method for walking step observation based on large-scale GPS data. Int J Health Geogr 2022; 21:10. [PMID: 36071501 PMCID: PMC9449285 DOI: 10.1186/s12942-022-00312-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 08/31/2022] [Indexed: 11/17/2022] Open
Abstract
Background Widespread use of smartphones has enabled the continuous monitoring of people’s movements and physical activity. Linking global positioning systems (GPS) data obtained via smartphone applications to physical activity data may allow for large-scale and retrospective evaluation of where and how much physical activity has increased or decreased due to environmental, social, or individual changes caused by policy interventions, disasters, and infectious disease outbreaks. However, little attention has been paid to the use of large-scale commercial GPS data for physical activity research due to limitations in data specifications, including limited personal attribute and physical activity information. Using GPS logs with step counts measured by a smartphone application, we developed a simple method for daily walking step estimation based on large-scale GPS data. Methods The samples of this study were users whose GPS logs were obtained in Sendai City, Miyagi Prefecture, Japan, during October 2019 (37,460 users, 36,059,000 logs), and some logs included information on daily step counts (731 users, 450,307 logs). The relationship between land use exposure and daily step counts in the activity space was modeled using the small-scale GPS logs with daily step counts. Furthermore, we visualized the geographic distribution of estimated step counts using a large set of GPS logs with no step count information. Results The estimated model showed positive relationships between visiting high-rise buildings, parks and public spaces, and railway areas and step counts, and negative relationships between low-rise buildings and factory areas and daily step counts. The estimated daily step counts tended to be higher in urban areas than in suburban areas. Decreased step counts were mitigated in areas close to train stations. In addition, a clear temporal drop in step counts was observed in the suburbs during heavy rainfall. Conclusions The relationship between land use exposure and step counts observed in this study was consistent with previous findings, suggesting that the assessment of walking steps based on large-scale GPS logs is feasible. The methodology of this study can contribute to future policy interventions and public health measures by enabling the retrospective and large-scale observation of physical activity by walking.
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Affiliation(s)
- Shohei Nagata
- Graduate School of Environmental Studies, Tohoku University, 468-1 Aoba, Aramaki, Aoba-ku, Sendai, 980-0845, Japan
| | - Tomoki Nakaya
- Graduate School of Environmental Studies, Tohoku University, 468-1 Aoba, Aramaki, Aoba-ku, Sendai, 980-0845, Japan. .,Department of Traffic and Medical Informatics in Disaster (Endowed Research Division), Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan.
| | - Tomoya Hanibuchi
- Graduate School of Environmental Studies, Tohoku University, 468-1 Aoba, Aramaki, Aoba-ku, Sendai, 980-0845, Japan
| | - Naoki Nakaya
- Department of Traffic and Medical Informatics in Disaster (Endowed Research Division), Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan.,Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan
| | - Atsushi Hozawa
- Department of Traffic and Medical Informatics in Disaster (Endowed Research Division), Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan.,Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan
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15
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Hwang S, Webber-Ritchey K, Moxley E. Comparison of GPS imputation methods in environmental health research. GEOSPATIAL HEALTH 2022; 17. [PMID: 36047344 DOI: 10.4081/gh.2022.1081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 07/04/2022] [Indexed: 06/15/2023]
Abstract
Assessment of personal exposure in the external environment commonly relies on global positioning system (GPS) measurements. However, it has been challenging to determine exposures accurately due to missing data in GPS trajectories. In environmental health research using GPS, missing data are often discarded or are typically imputed based on the last known location or linear interpolation. Imputation is said to mitigate bias in exposure measures, but methods used are hardly evaluated against ground truth. Widely used imputation methods assume that a person is either stationary or constantly moving during the missing interval. Relaxing this assumption, we propose a method for imputing locations as a function of a person's likely movement state (stop, move) during the missing interval. We then evaluate the proposed method in terms of the accuracy of imputed location, movement state, and daily mobility measures such as the number of trips and time spent on places visited. Experiments based on real data collected by participants (n=59) show that the proposed approach outperforms existing methods. Imputation to the last known location can lead to large deviation from the actual location when gap distance is large. Linear interpolation is shown to result in large errors in mobility measures. Researchers should be aware that the different treatment of missing data can affect the spatiotemporal accuracy of GPS-based exposure assessments.
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Affiliation(s)
- Sungsoon Hwang
- Department of Geography, DePaul University, Chicago, IL.
| | | | - Elizabeth Moxley
- College of Health and Human Sciences, Northern Illinois University, DeKalb, IL.
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16
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Akinci ZS, Delclòs-Alió X, Vich G, Salvo D, Ibarluzea J, Miralles-Guasch C. How different are objective operationalizations of walkability for older adults compared to the general population? A systematic review. BMC Geriatr 2022; 22:673. [PMID: 35971086 PMCID: PMC9377138 DOI: 10.1186/s12877-022-03233-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 06/09/2022] [Indexed: 01/10/2023] Open
Abstract
Background Walking is an essential activity for everyone and for older adults in particular, given that it is the most accessible form of physical activity and one of the healthiest transportation modes. Understanding how walkability (the potential of the environment to enable and/or encourage walking) has been objectively measured and analyzed for older adults is critical to create more inclusive, healthy, and sustainable environments and to promote healthy aging. Despite the numerous reviews on physical activity among older adults and its relationship with the built environment, the literature still lacks comparison reviews focusing specifically on objective operationalizations of walkability for older adults vs. the general population. Methods We conducted a systematic review of 146 empirical studies that measured walkability objectively in relation to walking-related outcomes. We compared studies focused on older adults (n = 24) and the general population (n = 122). Content analysis included the characteristics of the study design, walkability measures, spatial extent, and associations found between walkability and walking-related outcomes. Results In both groups of publications, the majority of studies were conducted in the US, Canada, and Europe, and largely in high-income countries. They were mostly published in health-related journals and used cross-sectional designs, operationalized walkability by using indexes, employed self-reported measures for walking-related outcomes, and found positive associations between walkability and walking outcomes. However, we observed some differences among studies focusing on older adults. Compared to studies focusing on the general population, a larger proportion of studies on older adults was conducted in the Middle East and Asia, and they used longitudinal designs, mixed methods to measure walking-related outcomes, variables related with land-use characteristics, safety from traffic and crime, and greenery, and a larger proportion found positive, as well as no associations between walkability and walking-related outcomes. Conclusion Although there is a promising increase in interest in older adults-focused walkability studies in the last decade, there is still a need for more studies focusing on different settings, using wider spatial extents, longitudinal designs, objective or mixed methods to collect outcome data, and specific variables and/or specially created indexes for older adults and for settings. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03233-x.
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Affiliation(s)
- Zeynep S Akinci
- Grup d'Estudis en Mobilitat, Transport i Territori (GEMOTT), Departament de Geografia, Universitat Autònoma de Barcelona, Edifici B, Campus de Bellaterra, 08193, Cerdanyola del Vallès, Barcelona, Spain.
| | - Xavier Delclòs-Alió
- Grup de Recerca en Anàlisi Territorial i Estudis Turístics (GRATET), Departament de Geografia, Universitat Rovira i Virgili, Vila-seca, Spain
| | - Guillem Vich
- Grup d'Estudis en Mobilitat, Transport i Territori (GEMOTT), Departament de Geografia, Universitat Autònoma de Barcelona, Edifici B, Campus de Bellaterra, 08193, Cerdanyola del Vallès, Barcelona, Spain.,ISGlobal (Barcelona Institute for Global Health), Doctor Aiguader, 88, 08003, Barcelona, Spain
| | - Deborah Salvo
- People, Health and Place Unit; Prevention Research Center in St. Louis; Brown School; Washington University in St Louis , St. Louis, Missouri, USA
| | - Jesús Ibarluzea
- Ministry of Health of the Basque Government, Sub-Directorate for Public Health and Addictions of Gipuzkoa, 20013, San Sebastian, Spain.,Faculty of Psychology of the University of the Basque Country, 20018, San Sebastian, Spain.,Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029, Madrid, Spain.,Biodonostia Health Research Institute, Environmental Epidemiology and Child Development Group, 20014, San Sebastian, Spain
| | - Carme Miralles-Guasch
- Grup d'Estudis en Mobilitat, Transport i Territori (GEMOTT), Departament de Geografia, Universitat Autònoma de Barcelona, Edifici B, Campus de Bellaterra, 08193, Cerdanyola del Vallès, Barcelona, Spain.,Institut de Ciència i Tecnologia Ambientals (ICTA), Universitat Autònoma de Barcelona - Edifici ICTA-ICP, Campus de Bellaterra, 08193, Cerdanyola del Vallès, Barcelona, Spain
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17
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Firth CL, Kestens Y, Winters M, Stanley K, Bell S, Thierry B, Phillips K, Poirier-Stephens Z, Fuller D. Using combined Global Position System and accelerometer data points to examine how built environments and gentrification are associated with physical activity in four Canadian cities. Int J Behav Nutr Phys Act 2022; 19:78. [PMID: 35799198 PMCID: PMC9261044 DOI: 10.1186/s12966-022-01306-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 06/01/2022] [Indexed: 11/23/2022] Open
Abstract
Background Built and social environments are associated with physical activity. Global Positioning Systems (GPS) and accelerometer data can capture how people move through their environments and provide promising tools to better understand associations between environmental characteristics and physical activity. The purpose of this study is to examine the associations between GPS-derived exposure to built environment and gentrification characteristics and accelerometer-measured physical activity in a sample of adults across four cities. Methods We used wave 1 data from the Interventions, Research, and Action in Cities Team, a cohort of adults living in the Canadian cities of Victoria, Vancouver, Saskatoon, and Montreal. A subsample of participants wore a SenseDoc device for 10 days during May 2017–January 2019 to record GPS and accelerometry data. Two physical activity outcomes were derived from SenseDoc data: time spent in light, moderate, and vigorous physical activity; and time spent in moderate or vigorous physical activity. Using corresponding GPS coordinates, we summarized physical activity outcomes by dissemination area—a Canadian census geography that represents areas where 400 to 700 people live- and joined to built (active living space, proximity to amenities, and urban compactness) and gentrification measures. We examined the associations between environmental measures and physical activity outcomes using multi-level negative binomial regression models that were stratified by city and adjusted for covariates (weekday/weekend), home dissemination area, precipitation, temperature) and participant-level characteristics obtained from a survey (age, gender, income, race). Results We found that adults spent more time being physically active near their homes, and in environments that were more walkable and near parks and less time in urban compact areas, regardless of where participants lived. Our analysis also highlighted how proximity to different amenities was linked to physical activity across different cities. Conclusions Our study provides insights into how built environment and gentrification characteristics are associated with the amount of time adults spend being physically active in four Canadian cities. These findings enhance our understanding of the influence that environments have on physical activity over time and space, and can support policies to increase physical activity. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-022-01306-z.
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Affiliation(s)
- Caislin L Firth
- University of Washington, 1959 NE Pacific St, Seattle, WA, 98195, United States
| | - Yan Kestens
- Université de Montréal/Centre de Recherche du CHUM, Pavillon S, 850 rue St-Denis, Montréal, QC, H2X 0A9, Canada
| | - Meghan Winters
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada
| | - Kevin Stanley
- University of Saskatchewan, 105 Administration Place, Saskatoon, S7N 5A2, Canada
| | - Scott Bell
- University of Saskatchewan, 105 Administration Place, Saskatoon, S7N 5A2, Canada
| | - Benoit Thierry
- University of Saskatchewan, 105 Administration Place, Saskatoon, S7N 5A2, Canada
| | - Kole Phillips
- University of Saskatchewan, 105 Administration Place, Saskatoon, S7N 5A2, Canada
| | - Zoé Poirier-Stephens
- Université de Montréal/Centre de Recherche du CHUM, Pavillon S, 850 rue St-Denis, Montréal, QC, H2X 0A9, Canada
| | - Daniel Fuller
- University of Saskatchewan, 105 Administration Place, Saskatoon, S7N 5A2, Canada. .,Memorial University of Newfoundland, 230 Elizabeth Avenue, St. John's Newfoundland, A1C 5S7, Canada.
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18
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Marquet O, Hirsch JA, Kerr J, Jankowska MM, Mitchell J, Hart JE, Laden F, Hipp JA, James P. GPS-based activity space exposure to greenness and walkability is associated with increased accelerometer-based physical activity. ENVIRONMENT INTERNATIONAL 2022; 165:107317. [PMID: 35660954 PMCID: PMC10187790 DOI: 10.1016/j.envint.2022.107317] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 04/30/2022] [Accepted: 05/19/2022] [Indexed: 05/05/2023]
Abstract
INTRODUCTION Built and natural environments may provide opportunities for physical activity. However, studies are limited by primarily using residential addresses to define exposure and self-report to measure physical activity. We quantified associations between global positioning systems (GPS)-based activity space measures of environmental exposure and accelerometer-based physical activity. METHODS Using a nationwide sample of working female adults (N = 354), we obtained seven days of GPS and accelerometry data. We created Daily Path Area activity spaces using GPS data and linked these activity spaces to spatial datasets on walkability (EPA Smart Location Database at the Census block group level) and greenness (satellite vegetation at 250 m resolution). We utilized generalized additive models to examine nonlinear associations between activity space exposures and accelerometer-derived physical activity outcomes adjusted for demographic characteristics, socioeconomic factors, and self-rated health. RESULTS Higher activity space walkability was associated with higher levels of moderate-vigorous physical activity, and higher activity space greenness was associated with greater numbers of steps per week. No strong relationships were observed for sedentary behavior or light physical activity. Highest levels of moderate-vigorous physical activity were observed for participants with both high walkability and high greenness in their activity spaces. CONCLUSION This study contributes evidence that higher levels of physical activity occur in environments with more dense, diverse, and well-connected built environments, and with higher amounts of vegetation. These data suggest that urban planners, landscape architects, and policy makers should implement and evaluate environmental interventions to encourage higher levels of physical activity.
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Affiliation(s)
- Oriol Marquet
- Institute of Environmental Science and Technology, Autonomous University of Barcelona, Spain.
| | - Jana A Hirsch
- Urban Health Collaborative, Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Jacqueline Kerr
- Department of Family Medicine and Public Health, University of California San Diego, San Diego, CA, USA
| | - Marta M Jankowska
- Beckman Research Institute, Population Sciences, City of Hope, Duarte, CA, USA
| | - Jonathan Mitchell
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Jaime E Hart
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Francine Laden
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - J Aaron Hipp
- Center for Geospatial Analytics, NC State University, USA; Department of Parks, Recreation, and Tourism Management, NC State University, USA
| | - Peter James
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA; Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
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19
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Kinsey EW, Widen E, Quinn JW, Huynh M, Van Wye G, Lovasi GS, Neckerman K, Rundle A. Neighborhood walkability and poverty predict excessive gestational weight gain: A cross-sectional study in New York City. Obesity (Silver Spring) 2022; 30:503-514. [PMID: 35068077 PMCID: PMC8830702 DOI: 10.1002/oby.23339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 10/14/2021] [Accepted: 10/23/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE This study evaluated associations between neighborhood-level characteristics and gestational weight gain (GWG) in a population-level study of 2015 New York City births. METHODS Generalized linear mixed-effects models were used to estimate odds ratios (ORs) for associations between neighborhood-level characteristics (poverty, food environment, walkability) within 1 km of a residential Census block centroid and excessive or inadequate GWG compared with recommended GWG. All models were adjusted for individual-level sociodemographic characteristics. RESULTS Among the sample of 106,285 births, 41.8% had excessive GWG, and 26.3% had inadequate GWG. Residence in the highest versus lowest quartile of neighborhood poverty was associated with greater odds of excessive GWG (OR: 1.17, 95% CI: 1.08-1.26). Residence in neighborhoods in the quartile of highest walkability compared with the quartile of lowest walkability was associated with lower odds of excessive GWG (OR: 0.87, 95% CI: 0.81-0.93). Adjustment for prepregnancy BMI attenuated the associations for neighborhood poverty, but not for walkability. Neighborhood variables were not associated with inadequate GWG. CONCLUSIONS These analyses indicate that greater neighborhood walkability is associated with lower odds of excessive GWG, potentially from differences in pedestrian activity during pregnancy. This research provides further evidence for using urban design to support healthy weight status during pregnancy.
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Affiliation(s)
- Eliza W. Kinsey
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Elizabeth Widen
- Department of Nutritional Sciences and Population Research Center, University of Texas at Austin, Austin, TX, USA
| | - James W. Quinn
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Mary Huynh
- Bureau of Vital Statistics, New York City Department of Health and Mental Hygiene, New York, NY, USA
| | - Gretchen Van Wye
- Bureau of Vital Statistics, New York City Department of Health and Mental Hygiene, New York, NY, USA
| | - Gina S. Lovasi
- Epidemiology and Biostatistics, Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Kathryn Neckerman
- Columbia Population Research Center, Columbia University, New York, NY, USA
| | - Andrew Rundle
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
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20
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Horwitz J, Retnakaran R. Neighbourhood Walkability and Risk of Diabetes: Causal Relationship or Epidemiologic Association? Curr Diab Rep 2021; 21:57. [PMID: 34902065 DOI: 10.1007/s11892-021-01419-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/01/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE OF REVIEW We aim to evaluate whether the current literature supports (i) a causal relationship between neighbourhood walkability and risk of diabetes or instead (ii) a strictly epidemiologic association. RECENT FINDINGS Both cross-sectional and longitudinal studies have reported that neighbourhoods that are scored as having higher levels of walkability have lower rates of prevalent and incident diabetes, respectively. However, other studies have been inconclusive, with more nuanced findings suggesting that this association may be limited to particular demographic groups defined by age and socio-economics. Key factors limiting this literature include disparities in the measurement of walkability, the necessary reliance on observational study designs (recognizing the infeasibility of randomized controlled trials for addressing this question), and the difficulty of disentangling the potential concomitant effects of other components of the built environment. At this time, causality cannot be ascertained in the relationship between neighbourhood walkability and risk of diabetes.
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Affiliation(s)
- Jennifer Horwitz
- Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Canada
| | - Ravi Retnakaran
- Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Canada.
- Division of Endocrinology, University of Toronto, Toronto, Canada.
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Canada.
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21
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Bozack A, Pierre S, DeFelice N, Colicino E, Jack D, Chillrud SN, Rundle A, Astua A, Quinn JW, McGuinn L, Yang Q, Johnson K, Masci J, Lukban L, Maru D, Lee AG. Long-Term Air Pollution Exposure and COVID-19 Mortality: A Patient-Level Analysis from New York City. Am J Respir Crit Care Med 2021; 205:651-662. [PMID: 34881681 DOI: 10.1164/rccm.202104-0845oc] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Risk factors for COVID-19 mortality may include environmental exposures, such as air pollution. OBJECTIVES Determine whether, amongst adults hospitalized with PCR-confirmed COVID-19, long-term air pollution exposure is associated with risk for mortality, intensive care unit (ICU) admission or intubation. METHODS We performed a retrospective analysis of SARS-CoV-2 PCR positive patients admitted to seven New York City hospitals from March 8, 2020 to August 30, 2020. The primary outcome was mortality; secondary outcomes were ICU admission and intubation. We estimated the annual average fine particulate matter (PM2.5), nitrogen dioxide (NO2) and black carbon (BC) concentrations at patients' residential addresses. We employed double-robust Poisson regression to analyze associations between annual average PM2.5, NO2 and BC exposure and COVID-19 outcomes, adjusting for age, sex, race/ethnicity, hospital, insurance and time from onset of the pandemic. RESULTS Of the 6,542 patients, 41% were female and aged median 65 years (IQR 53, 77). Over 50% self-identified as a person of color [N=1,687 (26%) Hispanic, N=1,659 (25%) Black]. Air pollution exposures were generally low. Overall, 31% (N=2,044) of the cohort died, 19% (N=1,237) were admitted to the ICU and 16% (1,051) were intubated. In multivariable models, higher long-term exposure to PM2.5 was associated with increased risk of mortality (RR 1.11, 95% CI 1.02, 1.21 per 1µg/m3 increase in PM2.5) and ICU admission (RR 1.13, 95% CI 1.00, 1.28 per 1µg/m3 increase in PM2.5). In multivariable models, neither NO2 nor BC exposure was associated with COVID-19 mortality, ICU admission or intubation. CONCLUSIONS Amongst patients hospitalized with COVID-19, higher long-term PM2.5 exposure was associated with increased risk of mortality and ICU admission. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/).
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Affiliation(s)
- Anne Bozack
- University of California Berkeley, 1438, Berkeley, California, United States
| | - Stanley Pierre
- NYC Health and Hospitals Queens, New York, New York, United States
| | - Nicholas DeFelice
- Icahn School of Medicine at Mount Sinai, 5925, Environmental Medicine and Public Health, New York, New York, United States
| | - Elena Colicino
- Icahn School of Medicine at Mount Sinai, 5925, New York, New York, United States
| | - Darby Jack
- Columbia University Mailman School of Public Health, 33638, Environmental Health Sciences, New York, New York, United States
| | - Steven N Chillrud
- Lamont-Doherty Earth Observatory, 57699, Palisades, New York, United States
| | - Andrew Rundle
- Columbia University Mailman School of Public Health, 33638, New York, New York, United States
| | - Alfredo Astua
- Mount Sinai Health System, 5944, Internal Medicine, New York, New York, United States
| | - James W Quinn
- Columbia University Mailman School of Public Health, 33638, New York, New York, United States
| | - Laura McGuinn
- Icahn School of Medicine at Mount Sinai, 5925, Environmental Medicine and Public Health, New York, New York, United States
| | - Qiang Yang
- Lamont-Doherty Earth Observatory, 57699, Palisades, New York, United States
| | - Keely Johnson
- Icahn School of Medicine at Mount Sinai, 5925, Department of Internal Medicine, New York, New York, United States
| | - Joseph Masci
- Icahn School of Medicine at Mount Sinai, 5925, Division of Infectious Disease, New York, New York, United States
| | - Laureen Lukban
- Icahn School of Medicine at Mount Sinai, 5925, Pediatrics, New York, New York, United States
| | - Duncan Maru
- Icahn School of Medicine at Mount Sinai, 5925, Pediatrics, New York, New York, United States
| | - Alison G Lee
- Icahn School of Medicine at Mount Sinai, 5925, Division of Pulmonary, Sleep and Critical Care Medicine, New York, New York, United States;
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22
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Dalmat RR, Mooney SJ, Hurvitz PM, Zhou C, Moudon AV, Saelens BE. Walkability measures to predict the likelihood of walking in a place: A classification and regression tree analysis. Health Place 2021; 72:102700. [PMID: 34700066 PMCID: PMC8627829 DOI: 10.1016/j.healthplace.2021.102700] [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: 05/27/2021] [Revised: 10/15/2021] [Accepted: 10/15/2021] [Indexed: 10/20/2022]
Abstract
Walkability is a popular and ubiquitous term at the intersection of urban planning and public health. As the number of potential walkability measures grows in the literature, there is a need to compare their relative importance for specific research objectives. This study demonstrates a classification and regression tree (CART) model to compare five familiar measures of walkability from the literature for their relative ability to predict whether or not walking occurs in a dataset of objectively measured locations. When analyzed together, the measures had moderate-to-high accuracy (87.8% agreement: 65.6% of true walking GPS-measured points classified as walking and 93.4% of non-walking points as non-walking). On its own, the most well-known composite measure, Walk Score, performed only slightly better than measures of the built environment composed of a single variable (transit ridership, employment density, and residential density).Thus there may be contexts where transparent and longitudinally available measures of urban form are worth a marginal tradeoff in prediction accuracy. This comparison of walkability measures using CART highlights the importance for public health and urban design researchers to think carefully about how and why particular walkability measures are used.
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Affiliation(s)
- Ronit R Dalmat
- Department of Epidemiology, University of Washington, 1959 NE Pacific Street, Seattle, USA.
| | - Stephen J Mooney
- Department of Epidemiology, University of Washington, 1959 NE Pacific Street, Seattle, USA
| | - Philip M Hurvitz
- Department of Urban Design and Planning and Urban Form Laboratory, University of Washington, 4333 Brooklyn Ave NE, Seattle, USA; Center for Studies in Demography and Ecology, University of Washington, Seattle, USA
| | - Chuan Zhou
- Seattle Children's Research Institute, 2001 Eighth Ave. Seattle, USA; Department of Pediatrics, University of Washington, Seattle, USA
| | - Anne V Moudon
- Department of Urban Design and Planning and Urban Form Laboratory, University of Washington, 4333 Brooklyn Ave NE, Seattle, USA
| | - Brian E Saelens
- Seattle Children's Research Institute, 2001 Eighth Ave. Seattle, USA; Department of Pediatrics, University of Washington, Seattle, USA
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23
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Tsai WL, Nash MS, Rosenbaum DJ, Prince SE, D'Aloisio AA, Neale AC, Sandler DP, Buckley TJ, Jackson LE. Types and spatial contexts of neighborhood greenery matter in associations with weight status in women across 28 U.S. communities. ENVIRONMENTAL RESEARCH 2021; 199:111327. [PMID: 34019899 PMCID: PMC8457404 DOI: 10.1016/j.envres.2021.111327] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 04/20/2021] [Accepted: 05/10/2021] [Indexed: 06/12/2023]
Abstract
Excess body weight is a risk factor for many chronic diseases. Studies have identified neighborhood greenery as supportive of healthy weight. However, few have considered plausible effect pathways for ecosystem services (e.g., heat mitigation, landscape aesthetics, and venues for physical activities) or potential variations by climate. This study examined associations between weight status and neighborhood greenery that capture ecosystem services most relevant to weight status across 28 U.S. communities. Weight status was defined by body mass index (BMI) reported for 6591 women from the U.S. Sister Study cohort. Measures of greenery within street and circular areas at 500 m and 2000 m buffer distances from homes were derived for each participant using 1 m land cover data. Street area was defined as a 25 m-wide zone on both sides of street centerlines multiplied by the buffer distances, and circular area was the area of the circle centered on a home within each of the buffer distances. Measures of street greenery characterized the pedestrian environment to capture physically and visually accessible greenery for shade and aesthetics. Circular greenery was generated for comparison. Greenery types of tree and herbaceous cover were quantified separately, and a combined measure of tree and herbaceous cover (i.e., aggregate greenery) was also included. Mixed models accounting for the clustering at the community level were applied to evaluate the associations between neighborhood greenery and the odds of being overweight or obese (BMI > 25) with adjustment for covariates selected using gradient boosted regression trees. Analyses were stratified by climate zone (arid, continental, and temperate). Tree cover was consistently associated with decreased odds of being overweight or obese. For example, the adjusted odds ratio [AOR] was 0.92, 95% Confidence Interval [CI]: 0.88-0.96, given a 10% increase in street tree cover at the 2000 m buffer across the 28 U.S. communities. These associations held across climate zones, with the lowest AOR in the arid climate (AOR: 0.74, 95% CI: 0.54-1.01). In contrast, associations with herbaceous cover varied by climate zone. For the arid climate, a 10% increase in street herbaceous cover at the 2000 m buffer was associated with lower odds of being overweight or obese (AOR: 0.75, 95% CI: 0.55-1.03), whereas the association was reversed for the temperate climate, the odds increased (AOR: 1.19, 95% CI: 1.05-1.35). Associations between greenery and overweight/obesity varied by type and spatial context of greenery, and climate. Our findings add to a growing body of evidence that greenery design in urban planning can support public health. These findings also justify further defining the mechanism that underlies the observed associations.
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Affiliation(s)
- Wei-Lun Tsai
- Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, NC, USA.
| | - Maliha S Nash
- Office of Research and Development, U.S. Environmental Protection Agency, Newport, OR, USA
| | - Daniel J Rosenbaum
- Oak Ridge Institute for Science and Education Research Fellow, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, NC, USA
| | - Steven E Prince
- Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, NC, USA
| | | | - Anne C Neale
- Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, NC, USA
| | - Dale P Sandler
- National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Timothy J Buckley
- Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, NC, USA
| | - Laura E Jackson
- Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, NC, USA
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24
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Boakye KA, Amram O, Schuna JM, Duncan GE, Hystad P. GPS-based built environment measures associated with adult physical activity. Health Place 2021; 70:102602. [PMID: 34139613 PMCID: PMC8328940 DOI: 10.1016/j.healthplace.2021.102602] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 06/03/2021] [Accepted: 06/04/2021] [Indexed: 10/21/2022]
Abstract
Studies often rely on home locations to access built environment (BE) influences on physical activity (PA). We use GPS and accelerometer data collected for 288 individuals over a two-week period to examine eight GPS-derived BE characteristics and moderate-to-vigorous PA (MVPA) and light-to-moderate-vigorous PA (LMVPA). NDVI, parks, blue space, pedestrian-orientated intersections, and population density were associated with increased odds of LMVPA and MVPA, while traffic air pollution and noise were associated with decreased odds of LMVPA and MVPA. Associations varied by population density and when accounting for multiple BE measures. These findings provide further information on where individuals choose to be physically active.
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Affiliation(s)
- Kwadwo A Boakye
- School of Biological and Population Health Sciences, Oregon State University, Corvallis, OR, USA.
| | - Ofer Amram
- Department of Nutrition and Exercise Physiology, Elson S. Floyd School of Medicine, Washington State University, Spokane, WA, 99202, USA; Paul G. Allen School for Global Animal Health, Washington State University, Pullman, WA, 99164, USA.
| | - John M Schuna
- School of Biological and Population Health Sciences, Oregon State University, Corvallis, OR, USA.
| | - Glen E Duncan
- Department of Nutrition and Exercise Physiology, Elson S. Floyd School of Medicine, Washington State University, Spokane, WA, 99202, USA.
| | - Perry Hystad
- School of Biological and Population Health Sciences, Oregon State University, Corvallis, OR, USA.
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Abstract
The work is focused on the integration of space syntax analysis (SSA) in a process of participatory planning focused on a neighbourhood scale where the challenge of promoting pedestrian-friendly regeneration process is a bottom-up priority. The promotion of active mobility is one of the main themes of the urban regeneration project CAST operating on the western part of the city of Potenza (capital of the Basilicata region, Italy). Both the state of the art of the case study area and the potential effects of the intervention proposed on the basis of the participatory process have been assessed by SSA as a walkability assessment method. By measuring a street network’s syntactic parameters, it was possible to further enrich the cognitive framework relating to the current situation and to simultaneously evaluate the effects (in terms of potential movement and social usage) deriving from design interventions. The paper presents a methodology to evaluate the urban pedestrian environment and to provide an insight for walking-related intervention and improvements in neighbourhood-scale planning, according to a participatory approach. The research, based on specific local characteristics, represents a transferable approach to supporting and informing policy-makers and designers engaged in inclusive and participative urban regeneration projects.
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26
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Piccone C, D'Agostino EM. Targeting Youth Transportation Equity and Self-Efficacy to Reduce Youth Physical Activity Disparities: A Novel Approach for a Public Health 3.0 Agenda. Am J Public Health 2021; 111:795-798. [PMID: 33826381 PMCID: PMC8033991 DOI: 10.2105/ajph.2020.306143] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2020] [Indexed: 11/04/2022]
Affiliation(s)
- Caitlin Piccone
- Caitlin Piccone is with the Department of Family of Medicine and Community Health in the Duke University School of Medicine, Durham, NC. Emily M. D'Agostino is with the Department of Family Medicine and Community Health and the Department of Population Health Sciences in the Duke University School of Medicine
| | - Emily M D'Agostino
- Caitlin Piccone is with the Department of Family of Medicine and Community Health in the Duke University School of Medicine, Durham, NC. Emily M. D'Agostino is with the Department of Family Medicine and Community Health and the Department of Population Health Sciences in the Duke University School of Medicine
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27
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Camplain R, Lopez NV, Cooper DM, McKenzie TL, Zheng K, Radom-Aizik S. Development of the systematic observation of COVID-19 mitigation (SOCOM): Assessing face covering and distancing in schools. J Clin Transl Sci 2021; 5:e124. [PMID: 34258031 PMCID: PMC8267337 DOI: 10.1017/cts.2021.786] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 04/12/2021] [Accepted: 04/22/2021] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION During the COVID-19 pandemic, some K-12 schools resumed in-person classes with varying degrees of mitigation plans in the fall 2020. Physical distancing and face coverings can minimize SARS-CoV-2 spread, the virus that causes COVID-19. However, no research has focused on adherence to mitigation strategies during school days. Thus, we sought to develop a systematic observation protocol to capture COVID-19 mitigation strategy adherence in school environments: The Systematic Observation of COVID-19 Mitigation (SOCOM). METHODS We extended previously validated and internationally used tools to develop the SOCOM training and implementation protocols to assess physical-distancing and face-covering behaviors. SOCOM was tested in diverse indoor and outdoor settings (classrooms, lunchrooms, physical education [PE], and recess) among diverse schools (elementary, secondary, and special needs). RESULTS For the unique metrics of physical-distancing and face-covering behaviors, areas with less activity and a maximum of 10-15 students were more favorable for accurately capturing data. Overall proportion of agreement was high for physical distancing (90.9%), face covering (88.6%), activity type (89.2%), and physical activity level (87.9%). Agreement was lowest during active recess, PE, and observation areas with ≥20 students. CONCLUSIONS Millions of children throughout the USA are likely to return to school in the months ahead. SOCOM is a relatively inexpensive research tool that can be implemented by schools to determine mitigation strategy adherence and to assess protocols that allow students return to school safely and slow the spread of COVID-19.
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Affiliation(s)
- Ricky Camplain
- Center for Health Equity Research, Northern Arizona University, Flagstaff, AZ, USA
- Department of Health Sciences, Northern Arizona University, Flagstaff, AZ, USA
| | - Nanette V. Lopez
- Department of Health Sciences, Northern Arizona University, Flagstaff, AZ, USA
| | - Dan M. Cooper
- Institute for Clinical and Translational Science, University of California Irvine, School of Medicine, Irvine, CA, USA
| | - Thomas L. McKenzie
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, USA
| | - Kai Zheng
- Institute for Clinical and Translational Science, University of California Irvine, School of Medicine, Irvine, CA, USA
- Department of Informatics, University of California, Irvine, Irvine, CA, USA
| | - Shlomit Radom-Aizik
- Pediatric Exercise and Genomics Research Center, Department of Pediatrics, University of California Irvine, School of Medicine, Irvine, CA, USA
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28
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Christensen A, Griffiths C, Hobbs M, Gorse C, Radley D. Accuracy of buffers and self-drawn neighbourhoods in representing adolescent GPS measured activity spaces: An exploratory study. Health Place 2021; 69:102569. [PMID: 33882372 DOI: 10.1016/j.healthplace.2021.102569] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 03/31/2021] [Accepted: 04/02/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND There continues to be a lack of understanding as to the geographical area at which the environment exerts influence on behaviour and health. This exploratory study compares different potential methods of both researcher- and participant-defined definitions of neighbourhood reflect an adolescent's activity space. METHODS Seven consecutive days of global positioning system (GPS) tracking data were collected at 15 s intervals using a small exploratory adolescent sample of 14-18 year olds (n = 69) in West Yorkshire, England. A total of 304,581 GPS tracking points were collected and compared 30 different definitions of researcher-defined neighbourhoods including radial, network and ellipse buffers at 400 m, 800 m, 1000 m, 1600 m and 3000 m, as well as participant-defined self-drawn neighbourhoods. RESULTS This exploratory study supports emerging evidence cautioning against the use of static neighbourhood definitions for defining exposure. Traditional buffers (network and radial) capture at most 67% of activity space (home radial), and at worst they captured only 3.5% (school network) and range from capturing between 3 and 88% of total time. Similarly, self-drawn neighbourhoods captured only 10% of actual daily movement. Interestingly, 40% of an adolescent's self-drawn neighbourhood was not used. We also demonstrate that buffers capture a range of space (22-95%) where adolescents do not go, thus misclassifying the exposure. CONCLUSION Our exploratory findings demonstrate that neither researcher- nor participant-defined definition of neighbourhood adequately captures adolescent activity space. Further research with larger samples are needed to confirm the findings of this exploratory study.
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Affiliation(s)
- A Christensen
- School of Sport, Carnegie, Leeds Beckett University, Leeds, LS6 3QT, UK; School of Built Environment and Engineering, Carnegie, Leeds Beckett University, Leeds, LS6 3QT, UK.
| | - C Griffiths
- School of Sport, Carnegie, Leeds Beckett University, Leeds, LS6 3QT, UK
| | - M Hobbs
- GeoHealth Laboratory, Geospatial Research Institute, University of Canterbury, New Zealand
| | - C Gorse
- School of Built Environment and Engineering, Carnegie, Leeds Beckett University, Leeds, LS6 3QT, UK
| | - D Radley
- School of Sport, Carnegie, Leeds Beckett University, Leeds, LS6 3QT, UK
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Katapally TR, Bhawra J, Patel P. A systematic review of the evolution of GPS use in active living research: A state of the evidence for research, policy, and practice. Health Place 2020; 66:102453. [PMID: 33137684 DOI: 10.1016/j.healthplace.2020.102453] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 09/15/2020] [Accepted: 09/18/2020] [Indexed: 10/23/2022]
Abstract
This is the first systematic review to comprehensively capture Global Positioning Systems' (GPS) utilization in active living research by investigating the influence of physical contexts and social environment on all intensities of physical activity and sedentary behavior among all age groups. An extensive search of peer-reviewed literature was conducted using six databases. Out of 2026 articles identified, 129 studies met the inclusion criteria. After describing the evolution of GPS use across four themes (study designs and methods, physical contexts and social environment, active transportation, and behaviors), evidence-based recommendations for active living research, policy, and practice were generated.
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Affiliation(s)
- Tarun R Katapally
- Johnson Shoyama Graduate School of Public Policy, University of Regina, Regina, Saskatchewan, Canada; Johnson Shoyama Graduate School of Public Policy, University of Saskatchewan, Saskatoon, Saskatchewan, Canada; Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
| | - Jasmin Bhawra
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Pinal Patel
- Johnson Shoyama Graduate School of Public Policy, University of Regina, Regina, Saskatchewan, Canada
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30
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Dong L, Dubowitz T, Haas A, Ghosh-Dastidar M, Holliday SB, Buysse DJ, Hale L, Gary-Webb TL, Troxel WM. Prevalence and correlates of obstructive sleep apnea in urban-dwelling, low-income, predominantly African-American women. Sleep Med 2020; 73:187-195. [PMID: 32846281 DOI: 10.1016/j.sleep.2020.06.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 06/19/2020] [Accepted: 06/22/2020] [Indexed: 11/29/2022]
Abstract
STUDY OBJECTIVES The current study examined the prevalence and correlates of obstructive sleep apnea in a sample of low-income, predominantly African-American women using two waves of data. METHODS Participants were adults from two urban neighborhoods who enrolled in the PHRESH Zzz Study (N = 828; Pittsburgh Hill/Homewood Research on Neighborhoods, Sleep, and Health). A subsample who reported never receiving OSA diagnosis completed home sleep apnea testing in 2016 (n = 269, mean age 55.0 years, 79.6% female) and again in 2018 (n = 135). Correlates of OSA tested included demographic and anthropometric variables, health behavior/conditions, psychological distress and general health, smoking status, actigraphy-measured sleep, and neighborhood factors measured at baseline. RESULTS 18.0% of all 2016 participants reported receiving physician diagnoses of OSA. Among those who completed in-home assessment, 19.3% had AHI ≥15 and 33.8% had AHI ≥5 plus one or more sleep symptoms. Estimates of the prevalence of OSA in all 2016 participants were 33.8%-45.7% based on physician diagnoses and AHI results, depending on the criteria used. Age, gender, BMI, blood pressure, habitual snoring, neighborhood walkability, actigraphy-measured sleep characteristics, and smoking were concurrently associated with OSA in 2016. Changes in AHI categories from 2016 to 2018 were documented. CONCLUSIONS Low-income African Americans, including women, are a high-risk group for OSA, but remain under-diagnosed and under-treated. The current findings show a high prevalence of OSA in African-American women and are among the first to demonstrate that both individual and neighborhood factors are implicated in OSA prevalence.
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Affiliation(s)
- Lu Dong
- RAND Corporation, Santa Monica, CA 90403, USA
| | | | - Ann Haas
- RAND Corporation, Pittsburgh, PA 15213, USA
| | | | | | - Daniel J Buysse
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Lauren Hale
- Program in Public Health, Department of Family, Population and Preventive Medicine, Stony Brook University, Stony Brook, NY 11794, USA
| | - Tiffany L Gary-Webb
- Departments of Epidemiology and Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15213, USA
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Measuring objective and subjective well-being: dimensions and data sources. INTERNATIONAL JOURNAL OF DATA SCIENCE AND ANALYTICS 2020. [DOI: 10.1007/s41060-020-00224-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
AbstractWell-being is an important value for people’s lives, and it could be considered as an index of societal progress. Researchers have suggested two main approaches for the overall measurement of well-being, the objective and the subjective well-being. Both approaches, as well as their relevant dimensions, have been traditionally captured with surveys. During the last decades, new data sources have been suggested as an alternative or complement to traditional data. This paper aims to present the theoretical background of well-being, by distinguishing between objective and subjective approaches, their relevant dimensions, the new data sources used for their measurement and relevant studies. We also intend to shed light on still barely unexplored dimensions and data sources that could potentially contribute as a key for public policing and social development.
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Examining the Associations between Oases Soundscape Components and Walking Speed: Correlation or Causation? SUSTAINABILITY 2020. [DOI: 10.3390/su12114619] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The feeling of calm and tranquillity provided by the oases of Algeria can disappear because of the outdated urbanization strategy which is based on the vehicle as a mode of transport. Walkability is one of the most adoptable sustainable strategies to reduce the negative mechanical transportation effects on the quality of life. This paper aimed to examine the correlation and the causation between oases soundscape components and walking speed. The methodology of this field study was based on an empirical approach at the urban settlements in three oases in Algeria. The correlation between walking speed and soundscape components was obtained through the use of the Spearman correlation test. A one-way ANOVA analysis was conducted to assess the effect of the soundscape components on walking speed. A post hoc Tukey test was adopted to explore the sound component that causes increased walking speed. In this study, no significant correlation was explored between the walking speed and the anthrophonical sounds. In contrast, the statistical analysis of the sound walks experience suggests a moderate and significant negative correlation between geophonical and biophonical sounds, with mean walking speed. The results showed that, the cause of the increase in the mean walking speed of the pedestrians is human sound. The findings suggest that further research is needed to focus on the long-term subjective investigation to explore the correlations and the effects between soundscape, walkability and walking speed.
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Buregeya JM, Loignon C, Brousselle A. Contribution analysis to analyze the effects of the health impact assessment at the local level: A case of urban revitalization. EVALUATION AND PROGRAM PLANNING 2020; 79:101746. [PMID: 31835151 DOI: 10.1016/j.evalprogplan.2019.101746] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 10/04/2019] [Accepted: 11/06/2019] [Indexed: 06/10/2023]
Abstract
The health impact assessment (HIA) is a tool used to estimate the potential impact on health of non-health-related proposals prior to implementation. While it is increasingly used in Quebec, Canada, studies have not analyzed its medium-term impacts and potential long-term impacts. We conducted a contribution analysis using in-depth interviews with key stakeholders, as well as documents, observation and images related to HIA in order to analyze its impacts on the revitalization of road infrastructure, parks and green spaces, and residential housing. Our analysis not only reflects on the decision-making process through the adoption and implementation of HIA recommendations, but also on the link between actions implemented in the field and health outcomes.
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Affiliation(s)
- Jean Marie Buregeya
- Université de Sherbrooke, Centre de recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean sur les innovations en santé, Canada.
| | - Christine Loignon
- Université de Sherbrooke, Centre de recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean sur les innovations en santé, Canada
| | - Astrid Brousselle
- Université de Sherbrooke, Centre de recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean sur les innovations en santé, Canada
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The Effects of GPS-Based Buffer Size on the Association between Travel Modes and Environmental Contexts. ISPRS INTERNATIONAL JOURNAL OF GEO-INFORMATION 2019. [DOI: 10.3390/ijgi8110514] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
To investigate the association between physical activity (including active travel modes) and environmental factors, much research has estimated contextual influences based on zones or areas delineated with buffer analysis. However, few studies to date have examined the effects of different buffer sizes on estimates of individuals’ dynamic exposures along their daily trips recorded as GPS trajectories. Thus, using a 7-day GPS dataset collected in the Chicago Regional Household Travel Inventory (CRHTI) Survey, this study addresses the methodological issue of how the associations between environmental contexts and active travel modes (ATMs) as a subset of physical activity vary with GPS-based buffer size. The results indicate that buffer size influences such associations and the significance levels of the seven environmental factors selected as predictors. Further, the findings on the effects of buffer size on such associations and the significance levels are clearly different between the ATMs of walking and biking. Such evidence of the existence of buffer-size effects for multiple environmental factors not only confirms the importance of the uncertain geographic context problem (UGCoP) but provides a resounding cautionary note to all future research on human mobility involving individuals’ GPS trajectories, including studies on physical activity and travel behaviors, especially on the reliable estimation of individual exposures to environmental factors and their health outcomes.
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Troxel WM, DeSantis A, Richardson AS, Beckman R, Ghosh-Dastidar B, Nugroho A, Hale L, Buysse DJ, Buman MP, Dubowitz T. Neighborhood disadvantage is associated with actigraphy-assessed sleep continuity and short sleep duration. Sleep 2019; 41:5054549. [PMID: 30016507 DOI: 10.1093/sleep/zsy140] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 07/13/2018] [Indexed: 12/30/2022] Open
Abstract
Study Objectives Neighborhood disadvantage has been linked to poor sleep. However, the extant research has primarily focused on self-reported assessments of sleep and neighborhood characteristics. The current study examines the association between objective and perceived neighborhood characteristics and actigraphy-assessed sleep duration, efficiency, and wakefulness after sleep onset (WASO) in an urban sample of African American adults. Methods We examined data from predominantly African American adults (n = 788, mean age 55 years; 77% female) living in two low-income neighborhoods. Perceived neighborhood characteristics included safety, social cohesion, and satisfaction with one's neighborhood as a place to live. Objective neighborhood conditions included walkability, disorder, street lighting, and crime levels. Sleep duration, efficiency, and WASO were measured via 7 days of wrist-worn actigraphy. Analyses estimated each of the sleep outcomes as a function of perceived and objective neighborhood characteristics. Individual-level sociodemographics, body mass index, and psychological distress were included as covariates. Results Greater perceived safety was associated with higher sleep efficiency and shorter WASO. Greater neighborhood disorder and street lighting were associated with poorer sleep efficiency and longer WASO and greater likelihood of short sleep duration (<7 versus 7-9 hr as referent). Higher levels of crime were associated with poorer sleep efficiency and longer WASO, but these associations were only evident in one of the neighborhoods. Conclusions Both how residents perceive their neighborhood and their exposure to objectively measured neighborhood disorder, lighting, and crime have implications for sleep continuity. These findings suggest that neighborhood conditions may contribute to disparities in sleep health.
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Affiliation(s)
| | - Amy DeSantis
- RAND Corporation, Health Division, Pittsburgh, PA
| | | | | | | | | | - Lauren Hale
- Family, Population, and Preventive Medicine, Program in Public Health, Stony Brook University, Stony Brook, NY
| | - Daniel J Buysse
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
| | - Matthew P Buman
- School of Nutrition and Health Promotion, Arizona State University, Phoenix, AZ
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Kaufman TK, Rundle A, Neckerman KM, Sheehan DM, Lovasi GS, Hirsch JA. Neighborhood Recreation Facilities and Facility Membership Are Jointly Associated with Objectively Measured Physical Activity. J Urban Health 2019; 96:570-582. [PMID: 31037481 PMCID: PMC6677841 DOI: 10.1007/s11524-019-00357-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Efforts to increase physical activity have traditionally included either individual-level interventions (e.g., educational campaigns) or neighborhood-level interventions (e.g., additional recreational facilities). Little work has addressed the interaction between spatial proximity and individual characteristics related to facility use. We aimed to better understand the synergistic impact of both physical activity environments and recreational facility membership on objectively measured physical activity. Using the New York City Physical Activity and Transit (PAT) survey (n = 644), we evaluated associations between counts of commercial physical activity facilities within 1 km of participants' home addresses with both facility membership and accelerometry-measured physical activity. Individuals living near more facilities were more likely to report membership (adjusted odds ratio for top versus bottom quartile of facility count: 3.77 (95% CI 1.54-9.20). Additionally, while amount of facilities within a neighborhood was associated with more physical activity, this association was stronger for individuals reporting gym membership. Interventions aiming to increase physical activity should consider both neighborhood amenities and potential barriers, including the financial and social barriers of membership. Evaluation of neighborhood opportunities must expand beyond physical presence to consider multiple dimensions of accessibility.
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Affiliation(s)
| | | | | | | | - Gina S Lovasi
- Urban Health Collaborative, Drexel University, 3600 Market Street 7th Floor Suite, Philadelphia, PA, 19104, USA
| | - Jana A Hirsch
- Urban Health Collaborative, Drexel University, 3600 Market Street 7th Floor Suite, Philadelphia, PA, 19104, USA.
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Rundle AG, Chen Y, Quinn JW, Rahai N, Bartley K, Mooney SJ, Bader MD, Zeleniuch-Jacquotte A, Lovasi GS, Neckerman KM. Development of a Neighborhood Walkability Index for Studying Neighborhood Physical Activity Contexts in Communities across the U.S. over the Past Three Decades. J Urban Health 2019; 96:583-590. [PMID: 31214976 PMCID: PMC6677835 DOI: 10.1007/s11524-019-00370-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
To examine how urban form shapes physical activity and health over time, a measure of neighborhood walkability is needed that can be linked to cohort studies with participants living across the United States (U.S.) that have been followed over the past decades. The Built Environment and Health-Neighborhood Walkability Index (BEH-NWI), a measure of neighborhood walkability that can be calculated for communities across the United States between 1990 and 2015, was conceptualized, developed, and tested using data from the New York City Tri-State Area. BEH-NWI measures were created for 1990 and 2010 using historical data on population density, street intersection density, density of rail stops, and density of pedestrian trip generating/supporting establishments. BEH-NWI scores were calculated for 1-km buffers around the 1990 residences of NYU Women's Health Study (NYUWHS) participants and NYC Department of Health and Mental Hygiene's Physical Activity and Transit (PAT) survey participants enrolled in 2011. Higher neighborhood BEH-NWI scores were significantly associated with greater self-reported walking per week (+ 0.31 MET-hours/week per unit BEH-NWI, 95% CI 0.23, 0.36) and lower body mass index (- 0.17 BMI units per unit BEH-NWI, 95% - 0.23, - 0.12) among NYUWHS participants. Higher neighborhood BEH-NWI scores were associated with significantly higher accelerometer-measured physical activity among PAT survey participants (39% more minutes of moderate-intensity equivalent activity/week across the interquartile range of BEH-NWI, 95% CI 21%, 60%). The BEH-NWI can be calculated using historical data going back to 1990, and BEH-NWI scores predict BMI, weekly walking, and physical activity in two NYC area datasets.
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Affiliation(s)
- Andrew G Rundle
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY, 10032, USA.
| | - Yu Chen
- Division of Epidemiology, Department of Population Health and Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA
| | - James W Quinn
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY, 10032, USA
| | - Neloufar Rahai
- Division of Epidemiology, Department of Population Health and Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA
| | - Katherine Bartley
- New York City Department of Health and Mental Hygiene, Queens, New York, NY, USA
| | - Stephen J Mooney
- Department of Epidemiology, University of Washington School of Public Health, Seattle, WA, USA
| | - Michael D Bader
- Department of Sociology, American University, Washington, DC, USA
| | - Anne Zeleniuch-Jacquotte
- Division of Epidemiology, Department of Population Health and Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA
| | - Gina S Lovasi
- Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
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Drewnowski A, Aggarwal A, Rose CM, Gupta S, Delaney JA, Hurvitz PM. Activity space metrics not associated with sociodemographic variables, diet or health outcomes in the Seattle Obesity Study II. Spat Spatiotemporal Epidemiol 2019; 30:100289. [PMID: 31421799 DOI: 10.1016/j.sste.2019.100289] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 05/08/2019] [Accepted: 07/11/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Activity spaces (AS), captured using GPS tracking devices, are measures of dynamic exposure to the built environment (BE). METHODS Seven days of Global Positioning Systems (GPS) tracking data were obtained for 433 adult participants in the Seattle Obesity Study (SOS II). Heights and weights were measured. Dietary intakes from a food frequency questionnaire were used to calculate Healthy Eating Index (HEI 2010) scores. Linear regression analyses examined associations between AS measures: daily route length, convex hull, and radius of gyration, and diet quality and health outcomes, adjusting for covariates. RESULTS AS measures did not vary by age, gender, race/ethnicity, or socioeconomic status. AS measures were not associated with diet quality or with self-reported obesity or diabetes. One AS measure, route length (in miles), was associated with being employed, living in the suburbs, and with distance and time commuting to work. CONCLUSION Spatial mobility studies based on GPS tracking of environmental exposure need to demonstrate a link to relevant health outcomes.
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Affiliation(s)
- Adam Drewnowski
- Center for Public Health Nutrition, 1107 NE 45th St, University of Washington, Seattle, WA 98105, United States.
| | - Anju Aggarwal
- Center for Public Health Nutrition, 1107 NE 45th St, University of Washington, Seattle, WA 98105, United States.
| | - Chelsea M Rose
- Center for Public Health Nutrition, 1107 NE 45th St, University of Washington, Seattle, WA 98105, United States.
| | - Shilpi Gupta
- Center for Public Health Nutrition, 1107 NE 45th St, University of Washington, Seattle, WA 98105, United States.
| | - Joseph A Delaney
- Center for Public Health Nutrition, 1107 NE 45th St, University of Washington, Seattle, WA 98105, United States.
| | - Philip M Hurvitz
- Urban Form Lab, 1107 NE 45th St, University of Washington, Seattle, WA 98195, United States.
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Murillo R, Reesor LM, Hernandez DC, Obasi EM. Neighborhood Walkability and Aerobic Physical Activity among Latinos. Am J Health Behav 2019; 43:802-811. [PMID: 31239022 DOI: 10.5993/ajhb.43.4.13] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objective: In this study, we examined neighborhood social cohesion (NSC) as a moderator in the association between neighborhood walkability and meeting the aerobic physical activity guideline among US Latino adults. Methods: We used 2015 National Health Interview Survey cross-sectional data from 4525 adult US Latino participants ≥18 years of age. NSC and walkability measures were self-reported. Higher walkability scores indicating higher walkability. Aerobic activity was assessed based on self-reported frequency and duration of activity. Minutes per week of moderate and vigorous aerobic activity were then categorized based on the 2018 Physical Activity Guidelines for Americans. Survey logistic regression was used to compute odds ratios [OR] and 95% confidence intervals [CI]. Effect modification by neighborhood social cohesion was tested by inclusion of a walkability*NSC interaction term. Results: A one-unit higher walkability score was associated with higher odds of meeting the aerobic activity guideline (OR = 1.06; 95% CI: 1.02, 1.11). After adding NSC to the model, the association remained statistically significant (OR = 1.05; 95% CI: 1.01, 1.10). The walkability*NSC interaction term was not statistically significant. Conclusions: NSC did not moderate the association between neighborhood walkability and meeting the aerobic activity guideline among US Latino adults.
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Affiliation(s)
- Rosenda Murillo
- Assistant Professor, University of Houston, Department of Psychological, Health, and Learning Sciences, Houston, TX;,
| | - Layton M. Reesor
- Research Assistant, University of Houston, Department of Health and Human Performance, Houston, TX
| | - Daphne C. Hernandez
- Associate Professor, University of Houston, Department of Health and Human Performance, Houston, TX
| | - Ezemenari M. Obasi
- Professor, University of Houston, Department of Psychological, Health, and Learning Sciences, Houston, TX
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Smith L, Foley L, Panter J. Activity spaces in studies of the environment and physical activity: A review and synthesis of implications for causality. Health Place 2019; 58:102113. [PMID: 31402209 PMCID: PMC6737923 DOI: 10.1016/j.healthplace.2019.04.003] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 03/19/2019] [Accepted: 04/09/2019] [Indexed: 11/21/2022]
Abstract
Activity spaces are increasingly used to understand how people interact with their environment and engage in activity but their use may raise challenges regarding causal inference. We conducted a systematic review of findings and the methodological, analytical and conceptual issues relevant to causal inference. Studies were included if they comprised a spatial summary of locations visited, assessed any part of the causal pathway between the environment, physical activity and health, and used quantitative or qualitative methods. We searched seven electronic databases in January 2018 and screened 11910 articles for eligibility. Forty-seven studies were included for review. Studies answered research questions about features of or environmental features within activity spaces using a range of spatial and temporal summary techniques. The conceptual challenge of using activity spaces to strengthen causal inference was rarely considered, although some studies discussed circularity, temporality, and plausibility. Future studies should use longitudinal and experimental designs and consider the potential and actual use of spaces for physical activity, and their relationship with total levels of activity.
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Affiliation(s)
- Lindsey Smith
- MRC Epidemiology Unit & UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge, School of Clinical Medicine, Box 285, Cambridge Biomedical Campus, Cambridge, Cambridgeshire, CB2 0QQ, UK.
| | - Louise Foley
- National Institute for Health Research (NIHR) Global Health Research Group and Network on Diet and Activity, University of Cambridge, School of Clinical Medicine, Box 285, Cambridge Biomedical Campus, Cambridge, Cambridgeshire, CB2 0QQ, UK.
| | - Jenna Panter
- MRC Epidemiology Unit & UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge, School of Clinical Medicine, Box 285, Cambridge Biomedical Campus, Cambridge, Cambridgeshire, CB2 0QQ, UK.
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Measuring Community Mobility in Survivors of Stroke Using Global Positioning System Technology: A Prospective Observational Study. J Neurol Phys Ther 2019; 43:175-185. [PMID: 31205231 DOI: 10.1097/npt.0000000000000279] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND PURPOSE Returning to community mobility is important for people recovering from a stroke, yet few studies have directly measured this construct following inpatient rehabilitation. Using global positioning system (GPS) technology, we examined community mobility of survivors of stroke (SS) over the first year after discharge and compared them to an age-matched comparison group without neurological impairment. METHODS We conducted a prospective observational study that included SS (n = 14) and age- and location-matched comparison subjects (CS; n = 6). All participants identified target locations important to their community mobility goals and wore a GPS unit during the first, fifth and ninth weeks after discharge, or from baseline for CS, and at 26 and 52 weeks' follow up. The 6-minute walk test (SMWT), Berg balance test (BBT), Reintegration to Normal Living (RNLI), and Short Form-36 Quality of Life Survey Physical Functioning domain (SF-36-PF) were collected. Number of trips and percentage of targets visited were extracted from GPS data. RESULTS Twelve of 14 SS completed 9 weeks, 7 completed the full year, and no CS withdrew. The SS took fewer trips and attained fewer targets compared with CS at weeks 1 and 9, but not at weeks 5, 26, and 52. All 4 clinical outcome measures were significantly correlated to trips (Spearman r for SMWT = 0.5067, BBT = 0.3841, RNLI = 0.4119, and SF-36-PF = 0.4192). DISCUSSION AND CONCLUSIONS Directly measured community mobility in SS was decreased through 9 weeks following discharge from inpatient rehabilitation. The limited strength of bivariate correlations between clinical measures and number of trips supported the uniqueness of the community mobility construct.Video Abstract available for more insights from the authors (see Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A277).
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Sila-Nowicka K, Thakuriah P. Multi-sensor movement analysis for transport safety and health applications. PLoS One 2019; 14:e0210090. [PMID: 30703128 PMCID: PMC6363243 DOI: 10.1371/journal.pone.0210090] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 12/17/2018] [Indexed: 12/22/2022] Open
Abstract
Recent increases in the use of and applications for wearable technology has opened up many new avenues of research. In this paper, we consider the use of lifelogging and GPS data to extend fine-grained movement analysis for improving applications in health and safety. We first design a framework to solve the problem of indoor and outdoor movement detection from sensor readings associated with images captured by a lifelogging wearable device. Second we propose a set of measures related with hazard on the road network derived from the combination of GPS movement data, road network data and the sensor readings from a wearable device. Third, we identify the relationship between different socio-demographic groups and the patterns of indoor physical activity and sedentary behaviour routines as well as disturbance levels on different road settings.
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Affiliation(s)
- Katarzyna Sila-Nowicka
- Urban Big Data Centre, School of Political and Social Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Piyushimita Thakuriah
- Urban Big Data Centre, School of Political and Social Sciences, University of Glasgow, Glasgow, United Kingdom
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43
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Associations between Body Mass Index and Urban "Green" Streetscape in Cleveland, Ohio, USA. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15102186. [PMID: 30301237 PMCID: PMC6210302 DOI: 10.3390/ijerph15102186] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Revised: 09/30/2018] [Accepted: 10/03/2018] [Indexed: 11/23/2022]
Abstract
Public health researchers are increasingly interested in assessing the impact of neighborhood environment on physical activities and chronic health issues among humans. Walkable streets and proximity to green space have long been believed to promote active lifestyles in cities, which contribute to positive health outcomes among residents. Traditionally, urban environmental metrics were calculated at the area level to describe the physical environment of neighborhoods. However, considering the fact that streets are the basic unit for human activities in cities, it is important to understand how the streetscape environment can influence human health conditions. In this study, we investigated the influence of street greenery and walkability on body mass index in Cleveland, Ohio, USA. Different from the area level and overhead view greenery metrics, we used the green view index calculated from the Google Street View to represent the amount of street greenery. The Walk Score was used to indicate the walkability of neighborhoods also at the street level. Statistical analysis results show that the Walk Score has a more significant association with decreased BMI for males than females and the street greenery has a more significant association with decreased BMI for females than males in Cleveland, Ohio. The results of this study would provide a reference for designing gender-specific healthy cities.
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Gamache R, Kharrazi H, Weiner JP. Public and Population Health Informatics: The Bridging of Big Data to Benefit Communities. Yearb Med Inform 2018; 27:199-206. [PMID: 30157524 PMCID: PMC6115205 DOI: 10.1055/s-0038-1667081] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Objective:
To summarize the recent public and population health informatics literature with a focus on the synergistic “bridging” of electronic data to benefit communities and other populations.
Methods:
The review was primarily driven by a search of the literature from July 1, 2016 to September 30, 2017. The search included articles indexed in PubMed using subject headings with (MeSH) keywords “public health informatics” and “social determinants of health”. The “social determinants of health” search was refined to include articles that contained the keywords “public health”, “population health” or “surveillance”.
Results:
Several categories were observed in the review focusing on public health's socio-technical infrastructure: evaluation of surveillance practices, surveillance methods, interoperable health information infrastructure, mobile health, social media, and population health. Common trends discussing socio-technical infrastructure included big data platforms, social determinants of health, geographical information systems, novel data sources, and new visualization techniques. A common thread connected these categories of workforce, governance, and sustainability: using clinical resources and data to bridge public and population health.
Conclusions:
Both medical care providers and public health agencies are increasingly using informatics and big data tools to create and share digital information. The intent of this “bridging” is to proactively identify, monitor, and improve a range of medical, environmental, and social factors relevant to the health of communities. These efforts show a significant growth in a range of population health-centric information exchange and analytics activities.
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Affiliation(s)
- Roland Gamache
- Center for Population Health Information Technology, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.,Gamache Consulting, Bethesda, USA
| | - Hadi Kharrazi
- Center for Population Health Information Technology, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.,Division of Health Sciences and Informatics, Johns Hopkins School of Medicine, Baltimore, USA
| | - Jonathan P Weiner
- Center for Population Health Information Technology, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
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Bödeker M. Walking and Walkability in Pre-Set and Self-Defined Neighborhoods: A Mental Mapping Study in Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1363. [PMID: 29958469 PMCID: PMC6068775 DOI: 10.3390/ijerph15071363] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 06/15/2018] [Accepted: 06/20/2018] [Indexed: 11/16/2022]
Abstract
Neighborhood walkability contributes to older adults’ walking. However, associations vary depending on the neighborhood definition applied as well as between objective and perceived walkability measures. Therefore, this study aimed to comparatively assess walkability indices for commonly used pedestrian network buffers and perceived neighborhood areas. A total of 97 adults aged ≥65 years answered a written physical activity questionnaire and 69 respondents participated in face-to-face interviews that involved mental mapping, i.e., to draw perceived neighborhood delineations on paper maps. Hierarchical regression analyses were used to compare the contribution of walkability indices for pre-set buffers and self-defined neighborhoods to older adults’ walking after adjusting for covariates. Results show that older adults’ self-defined neighborhoods are significantly larger, less home-centered, and more walkable than commonly used buffers. Furthermore, the variance accounted for in neighborhood walking increased from 35.9% to 40.4% (ΔR² = 0.046; p = 0.029), when the walkability index was calculated for self-defined neighborhoods rather than pre-set buffers. Therefore, the study supports that geometric differences between pre-set buffers and older adults’ spatial ideas of perceived neighborhoods have a significant influence on estimated walkability effects and that exposure areas should be matched with the spatial dimension of outcome variables in future research.
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Affiliation(s)
- Malte Bödeker
- Department of Prevention and Health Promotion, School of Public Health, Bielefeld University, Post Office Box 10 01 31, Bielefeld D-33501, Germany.
- Bavarian Health and Food Safety Authority, Institute of Public Health, Schweinauer Hauptstraße 80, Nuremberg D-90441, Germany.
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Guo M, O'Connor Duffany K, Shebl FM, Santilli A, Keene DE. The Effects of Length of Residence and Exposure to Violence on Perceptions of Neighborhood Safety in an Urban Sample. J Urban Health 2018. [PMID: 29541963 PMCID: PMC5906388 DOI: 10.1007/s11524-018-0229-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Perceptions of neighborhood safety shape the well-being of individuals and communities, affecting neighborhood walkability, associated physical activity behaviors, and health conditions. However, less is known about the factors that determine perceptions of safety. One factor that may affect perceptions of neighborhood safety is the length of time someone has lived in their neighborhood. We use a representative, adult sample of urban low-income residents from the 2015 New Haven Health Survey (n = 1189) to investigate the associations between length of residence (new residents of < 1 year in neighborhood versus longer-term residents of 1 or more years in neighborhood) and perceptions of neighborhood safety (whether feeling unsafe to walk at night). We then examine the potential moderating effect of exposure to neighborhood violence on these associations. We find that the association between length of residence and perceived safety differs by exposure to neighborhood violence. Among those unexposed to neighborhood violence, longer-term neighborhood residents were more likely to feel unsafe compared to new residents (OR = 2.03, 95% CI 1.19, 3.45). Additionally, the effect of exposure to violence on feelings of safety was larger for new residents (OR = 9.10, 95% CI 2.72, 30.44) compared to longer-term residents (OR = 1.88, 95% CI 1.28, 2.77). Our findings suggest that length of residence may have implications for feelings of safety, and that experiences of violence may uniquely contribute to feelings of unsafety among new residents. These findings hold implications for interventions and policy efforts aimed at neighborhood safety improvements through community development, housing, or city urban planning initiatives, particularly for new neighborhood residents or those who experience neighborhood violence.
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Affiliation(s)
- Monica Guo
- Yale School of Public Health, New Haven, CT, USA.
| | - Kathleen O'Connor Duffany
- Yale School of Public Health, New Haven, CT, USA.,Community Alliance for Research and Engagement, New Haven, CT, USA
| | - Fatma M Shebl
- Yale School of Public Health, New Haven, CT, USA.,Community Alliance for Research and Engagement, New Haven, CT, USA
| | - Alycia Santilli
- Community Alliance for Research and Engagement, New Haven, CT, USA.,Southern Connecticut State University, New Haven, CT, USA
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Sarkar C, Webster C, Gallacher J. Neighbourhood walkability and incidence of hypertension: Findings from the study of 429,334 UK Biobank participants. Int J Hyg Environ Health 2018; 221:458-468. [PMID: 29398408 DOI: 10.1016/j.ijheh.2018.01.009] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2017] [Revised: 01/04/2018] [Accepted: 01/17/2018] [Indexed: 01/28/2023]
Abstract
BACKGROUND With an estimated one billion hypertension cases worldwide, the role of the built environment in its prevention and control is still uncertain. The present study aims to examine the associations between neighbourhood walkability and hypertension in a large and diverse population-based cohort. MATERIALS AND METHODS We examined the association between neighbourhood walkability and blood pressure outcomes for N = 429,334 participants drawn from the UK Biobank and aged 38-73 years. Neighbourhood walkability was objectively modelled from detailed building footprint-level data within multi-scale functional neighbourhoods (1.0-, 1.5- and 2.0-kilometer street catchments of geocoded dwelling). A series of linear and modified Poisson regression models were employed to examine the association between walkability and outcomes of diastolic blood pressure (DBP in mmHg), systolic blood pressure (SBP in mmHg) and prevalent hypertension adjusting for socio-demographic, lifestyle and related physical environmental covariates. We also examined the relationship between walkability and change in blood pressure for a sub-sample of participants with follow-up data and tested for interaction effects of age, sex, employment status, neighbourhood SES, residential density and green exposure. RESULTS Neighbourhood walkability within one-kilometer street catchment was beneficially associated with all the three blood pressure outcomes, independent of all other factors. Each interquartile increment in walkability was associated with the lower blood pressure outcomes of DBP (β = -0.358, 95% CI: -0.42, -0.29 mmHg), SBP (β = -0.833, 95% CI: -0.95, -0.72 mmHg) as well as reduced hypertension risk (RR = 0.970, 95% CI: 0.96, 0.98). The results remained consistent across spatial and temporal scales and were sensitive to sub-groups, with pronounced protective effects among female participants, those aged between 50 and 60 years, in employment, residing in deprived, high density and greener areas. CONCLUSION This large population-based cohort found evidence of protective association between neighbourhood walkability and blood pressure outcomes. Given the enduring public health impact of community design on individual behaviour and lifestyle, of particular interest, are the targetted upstream-level interventions in city design aimed at optimizing walkability. Further long term studies are required to assess its sustained effects upon hypertension prevention and control.
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Affiliation(s)
- Chinmoy Sarkar
- Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Knowles Building, Pokfulam Road, Hong Kong, Hong Kong Special Administrative Region, China.
| | - Chris Webster
- Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Knowles Building, Pokfulam Road, Hong Kong, Hong Kong Special Administrative Region, China
| | - John Gallacher
- Department of Psychiatry, Oxford University, Warneford Hospital, Oxford OX3 7JX, United Kingdom
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Does home neighbourhood supportiveness influence the location more than volume of adolescent's physical activity? An observational study using global positioning systems. Int J Behav Nutr Phys Act 2017; 14:149. [PMID: 29096650 PMCID: PMC5667484 DOI: 10.1186/s12966-017-0607-7] [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: 04/26/2017] [Accepted: 10/23/2017] [Indexed: 11/25/2022] Open
Abstract
Background Environmental characteristics of home neighbourhoods are hypothesised to be associated with residents’ physical activity levels, yet many studies report only weak or equivocal associations. We theorise that this may be because neighbourhood characteristics influence the location of activity more than the volume. Using a sample of UK adolescents, we examine the role of home neighbourhood supportiveness for physical activity, both in terms of volume of activity undertaken and a measure of proximity to home at which activity takes place. Methods Data were analysed from 967 adolescents living in and around the city of Bristol, UK. Each participant wore an accelerometer and a GPS device for 7 days during school term time. These data were integrated into a Geographical Information System containing information on the participants’ home neighbourhoods and measures of environmental supportiveness. We then identified the amount of out-of-school activity of different intensities that adolescents undertook inside their home neighbourhood and examined how this related to home neighbourhood supportiveness. Results We found that living in a less supportive neighbourhood did not negatively impact the volume of physical activity that adolescents undertook. Indeed these participants recorded similar amounts of activity (e.g. 20.5 mins per day of moderate activity at weekends) as those in more supportive neighbourhoods (18.6 mins per day). However, the amount of activity adolescents undertook inside their home neighbourhood did differ according to supportiveness; those living in less supportive locations had lower odds of recording activity inside their home neighbourhood. This was observed across all intensities of activity including sedentary, light, moderate, and vigorous. Conclusions Our findings suggest that the supportiveness of the neighbourhood around home may have a greater influence on the location of physical activity than the volume undertaken. This finding is at odds with the premise of the socio-ecological models of physical activity that have driven this research field for the last two decades, and has implications for future research, as by simply measuring volumes of activity we may be underestimating the impact of the environment on physical activity behaviours.
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Wide Disagreement Between Alternative Assessments of Premorbid Physical Activity: Subjective Patient and Surrogate Reports and Objective Smartphone Data. Crit Care Med 2017; 45:e1036-e1042. [PMID: 28915184 DOI: 10.1097/ccm.0000000000002599] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Surrogate-decision maker and patient self-reported estimates of the distances walked prior to acute illness are subjective and may be imprecise. It may be possible to extract objective data from a patient's smartphone, specifically, step and global position system data, to quantify physical activity. The objectives were to 1) assess the agreement between surrogate-decision maker and patient self-reported estimates of distance and time walked prior to resting and daily step-count and 2) determine the feasibility of extracting premorbid physical activity (step and global position system) data from critically ill patients. DESIGN Prospective cohort study. SETTING Quaternary ICU. PATIENTS Fifty consecutively admitted adult patients who owned a smartphone, who were ambulatory at baseline, and who remained in ICU for more than 48 hours participated. MEASURMENTS AND MAIN RESULTS There was no agreement between patients and surrogates for all premorbid walking metrics (mean bias 108% [99% lower to 8,700% higher], 83% [97% to 2,100%], and 71% [96% to 1,080%], for distance, time, and steps, respectively). Step and/or global position system data were successfully extracted from 24 of 50 phones (48%; 95% CI, 35-62%). Surrogate-decision makers, but not patient self-reported, estimates of steps taken per day correlated with smartphone data (surrogates: n = 13, ρ = 0.56, p < 0.05; patients: n = 13, ρ = 0.30, p = 0.317). CONCLUSION There was a lack of agreement between surrogate-decision maker and patient self-reported subjective estimates of distance walked. Obtaining premorbid physical activity data from the current-generation smartphones was feasible in approximately 50% of patients.
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Brown BB, Smith KR. Complex active travel bout motivations: Gender, place, and social context associations. JOURNAL OF TRANSPORT & HEALTH 2017; 6:335-346. [PMID: 29104857 PMCID: PMC5667544 DOI: 10.1016/j.jth.2017.01.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Active travel bouts are healthy, but bout-specific motives, social, and physical contexts have been poorly characterized. Adults (n= 421 in 2012, 436 in 2013) described their moderate activity bouts over the past week, aided by accelerometry/GPS data integration. Participants viewed maps indicating date, time, and starting and ending locations of their past week moderate-to-vigorous active travel bouts of 3 or more minutes. These prompts helped participants recall their social and physical contexts and motives for the bouts. Three bout motivations were modeled: leisure, transportation, and their "T-L" difference scores (transportation minus leisure scores). Blends of leisure and transportation motives characterized most bouts, even though most studies do not allow participants to endorse multiple motives for their active travel. Bouts were often neighborhood-based. Leisure motives were related to pleasant place perceptions, homes, and exercise places; workplaces were associated with stronger transportation and T-L bout motives. Women's bout motives were more closely associated with place than men's. Our novel method of individual bout assessment can illuminate the social-ecological contexts and experiences of everyday healthy bouts of activity.
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Affiliation(s)
- Barbara B Brown
- Department of Family and Consumer Studies; Cancer Control and Population Sciences, Huntsman Cancer Institute, 225 S 1400 E RM 228, University of Utah, Salt Lake City, UT
| | - Ken R Smith
- Department of Family and Consumer Studies; Cancer Control and Population Sciences, Huntsman Cancer Institute, 225 S 1400 E RM 228, University of Utah, Salt Lake City, UT
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