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Werder E, Lawrence K, Deng X, Braxton Jackson W, Christenbury K, Buller I, Engel L, Sandler D. Residential air pollution, greenspace, and adverse mental health outcomes in the U.S. Gulf Long-term Follow-up Study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 946:174434. [PMID: 38960154 PMCID: PMC11332601 DOI: 10.1016/j.scitotenv.2024.174434] [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: 12/19/2023] [Revised: 06/06/2024] [Accepted: 06/30/2024] [Indexed: 07/05/2024]
Abstract
Air pollution and greenness are environmental determinants of mental health, though existing evidence typically considers each exposure in isolation. We evaluated relationships between co-occurring air pollution and greenspace levels and depression and anxiety. We estimated cross-sectional associations among 9015 Gulf Long-term Follow-up Study participants living in the southeastern U.S. who completed the Patient Health Questionnaire-9 (depression: score ≥ 10) and Generalized Anxiety Disorder Questionnaire-7 (anxiety: score ≥ 10). Participant residential addresses were linked to annual average concentrations of particulate matter (1 km PM2.5) and nitrogen dioxide (1 km NO2), as well as satellite-based greenness (2 km Enhanced Vegetation Index (EVI)). We used adjusted log-binomial regression to estimate prevalence ratios (PR) and 95 % confidence intervals (CI) for associations between exposures (quartiles) and depression and anxiety. In mutually adjusted models (simultaneously modeling PM2.5, NO2, and EVI), the highest quartile of PM2.5 was associated with increased prevalence of depression (PR = 1.17, 95 % CI: 1.06-1.29), whereas the highest quartile of greenness was inversely associated with depression (PR = 0.89, 95 % CI: 0.80-0.99). Joint exposure to greenness mitigated the impact of PM2.5 on depression (PRPM only = 1.20, 95 % CI: 1.06-1.36; PRPM+green = 0.98, 95 % CI: 0.83-1.16) and anxiety (PRPM only = 1.10, 95 % CI: 1.00-1.22; PRPM+green = 0.95, 95 % CI: 0.83-1.09) overall and in subgroup analyses. Observed associations were stronger in urbanized areas and among nonwhite participants, and varied by neighborhood deprivation. NO2 exposure was not independently associated with depression or anxiety in this population. Relationships between PM2.5, greenness, and depression were strongest in the presence of characteristics that are highly correlated with lower socioeconomic status, underscoring the need to consider mental health as an environmental justice issue.
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Affiliation(s)
| | | | | | - W Braxton Jackson
- Social & Scientific Systems, Inc., a DLH Holdings Company, Durham, NC, USA
| | - Kate Christenbury
- Social & Scientific Systems, Inc., a DLH Holdings Company, Durham, NC, USA
| | - Ian Buller
- Social & Scientific Systems, Inc., a DLH Holdings Company, Durham, NC, USA
| | - Lawrence Engel
- Epidemiology Branch, NIEHS, NC, USA; Department of Epidemiology, UNC Gillings School of Public Health, NC, USA
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Roberts MC, Holt KE, Del Fiol G, Baccarelli AA, Allen CG. Precision public health in the era of genomics and big data. Nat Med 2024; 30:1865-1873. [PMID: 38992127 DOI: 10.1038/s41591-024-03098-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 05/29/2024] [Indexed: 07/13/2024]
Abstract
Precision public health (PPH) considers the interplay between genetics, lifestyle and the environment to improve disease prevention, diagnosis and treatment on a population level-thereby delivering the right interventions to the right populations at the right time. In this Review, we explore the concept of PPH as the next generation of public health. We discuss the historical context of using individual-level data in public health interventions and examine recent advancements in how data from human and pathogen genomics and social, behavioral and environmental research, as well as artificial intelligence, have transformed public health. Real-world examples of PPH are discussed, emphasizing how these approaches are becoming a mainstay in public health, as well as outstanding challenges in their development, implementation and sustainability. Data sciences, ethical, legal and social implications research, capacity building, equity research and implementation science will have a crucial role in realizing the potential for 'precision' to enhance traditional public health approaches.
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Affiliation(s)
- Megan C Roberts
- Division of Pharmaceutical Outcomes and Policy, University of North Carolina Eshelman School of Pharmacy, Chapel Hill, NC, USA.
| | - Kathryn E Holt
- Department of Infection Biology, London School of Hygiene & Tropical Medicine, London, UK
- Department of Infectious Diseases, School of Translational Medicine, Monash University, Melbourne, Victoria, Australia
| | - Guilherme Del Fiol
- Biomedical Informatics, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Andrea A Baccarelli
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Caitlin G Allen
- Department of Public Health Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USA
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Jenkins AIC, Surachman A, Armendariz M. Where I'm Livin' and How I'm Feelin': Associations among community stress, gender, and mental-emotional health among Black Americans. Soc Sci Med 2024; 348:116763. [PMID: 38552549 DOI: 10.1016/j.socscimed.2024.116763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 01/12/2024] [Accepted: 03/05/2024] [Indexed: 04/29/2024]
Abstract
RATIONALE Structural racism is a primary avenue for the perpetuation of racial health disparities. For Black Americans, both historically and contemporarily, the neighborhood context serves as one of the most striking examples of structural racism, with stressful neighborhood contexts contributing to the well-documented inequalities in psychological functioning among this population. OBJECTIVE Thus, in this study, we adapted an intersectional-ecological framework to investigate the links between community stress and multiple dimensions of mental-emotional health for Black men and women. METHODS Drawing on cross-sectional data from 842 Black Americans from the Milwaukee area, we tested both objective (Area Deprivation Index; ADI) and subjective (perceived neighborhood disadvantage; PND) indicators of community stress as simultaneous predictors of negative and positive affect and the odds of psychological disorder (depression, anxiety) in multilevel models, examining gender differences in these linkages. RESULTS Results showed greater objective community stress was related to lower levels of negative affect for both men and women and lower odds of psychological disorder for women specifically. Greater subjective community stress was related to higher levels of negative affect and lower levels of positive affect for both men and women and to higher odds of psychological disorder for women specifically. CONCLUSIONS Findings highlight the complex intersectional nature of the links between community stress and Black Americans' mental-emotional health. Specifically, findings demonstrate the pernicious psychological effects of perceived community stress and allude to Black Americans', particularly women's, active resistance and resilience to objective disadvantage, potentially through investing in social relationships in their neighborhoods.
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Affiliation(s)
- August I C Jenkins
- Department of Human Development and Family Studies, University of Illinois-Urbana Champaign, Urbana, IL, USA.
| | - Agus Surachman
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Marina Armendariz
- Department of Public Health, University of Texas at San Antonio, San Antonio, TX, USA
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Addas A. Telepresence robots as facilitators of physical exercise during COVID-19: a feasibility and acceptance study. Front Public Health 2023; 11:1277479. [PMID: 38222084 PMCID: PMC10787647 DOI: 10.3389/fpubh.2023.1277479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 10/09/2023] [Indexed: 01/16/2024] Open
Abstract
The COVID-19 pandemic and associated restrictions on mobility and access to green space have disrupted exercise habits worldwide. According to the World Health Organization (WHO), approximately 1.4 billion adults were insufficiently physically active in 2016, with detrimental impacts on health. The proposed study investigated the use of telepresence-robot-based personal trainers to facilitate remote exercise during the pandemic-related lockdowns. Several adults aged 18-65 were recruited for a four-week intervention and thorough research investigation. The intervention involved one-hour outdoor exercise sessions held three times per week in a local park with a human instructor connected via a telepresence robot. Surveys assessed perceptions of social presence, usability, the intention to use the robot and the psychological benefits of access to green space. System logs tracked participation and technical errors. At baseline, 30% of the participants met the WHO physical activity (PA) recommendations, compared to 80% after the intervention. The study shows significant increases in many parameters. These are perceived in social presence (p < 0.021), usability (p < 0.04), intentions for long-term use (p < 0.05), and the mental health benefits of accessing green spaces (p < 0.013). Attendance was found to be 90%, with a 7% technical failure rate. This investigation demonstrates the promise of telepresence robots for safely providing remote access to green spaces. They can be used to facilitate exercise during public health crises, overcoming the barriers to maintaining PA.
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Affiliation(s)
- Abdullah Addas
- Department of Civil Engineering, College of Engineering, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
- Landscape Architecture Department, Faculty of Architecture and Planning, King Abdulaziz University, Jeddah, Saudi Arabia
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Harris JC, Liuzzi MT, Malames BA, Larson CL, Lisdahl KM. Differences in parent and youth perceived neighborhood threat on nucleus accumbens-frontoparietal network resting state connectivity and alcohol sipping in children enrolled in the ABCD study. Front Psychiatry 2023; 14:1237163. [PMID: 37928910 PMCID: PMC10622767 DOI: 10.3389/fpsyt.2023.1237163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 09/25/2023] [Indexed: 11/07/2023] Open
Abstract
Purpose Evidence has shown neighborhood threat (NT) as a social driver of emotional and brain development. Few studies have examined the relationship between NT and neural function. Altered functional connectivity in the nucleus accumbens (NAcc) with the frontoparietal network (FPN) has been implicated in the development of substance use, however, little is known about perceived NT-related brain function or downstream alcohol sipping during early adolescence. This study examined the longitudinal relationship between youth and combined youth/parent perceived NT, resting state functional connectivity (RSFC) of the NAcc-FPN, and alcohol sipping behavior during late childhood and preadolescence. Methods This study used data (N = 7,744) from baseline to 2-year follow-up (FU) of the Adolescent Brain Cognitive Development Study (ABCD; Release 4.0). Relationships between youth and combined youth/parent perceive NT, alcohol sipping (baseline to two-year FU), and NAcc-FPN (left/right) connectivity, adjusting for demographics, family/peer history of alcohol use, parental monitoring and warmth, externalizing symptoms, and site, were examined in a mediation model via PROCESS in R. Results Greater youth-reported NT at baseline was significantly associated with lower RSFC between the right (but not left) NAcc-FPN holding covariates constant (R2 = 0.01, B = -0.0019 (unstandardized), F (12, 7,731) = 8.649, p = 0.0087) and increased odds of alcohol sipping at baseline up to the two-year FU (direct effect = 0.0731, 95% CI = 0.0196, 0.1267). RSFC between the right NAcc-FPN did not significantly predict alcohol sipping at the two-year FU (b = -0.0213, SE = 0.42349, p = 0.9599; 95% CI = -0.8086, 0.8512). No significant relationships were observed for combined youth/parent report predicting alcohol sipping or NAcc-FPN connectivity. Conclusion Findings suggest notable reporting differences in NT. Combined youth/parent report did not reveal significant findings; youth perceived NT was related to increased likelihood of alcohol sipping and lower neural connectivity between the right NAcc-FPN during late childhood and early adolescence. NT context - and source of reporting - may be crucial in examining links with downstream neuronal function and health behaviors. Future research should investigate reward processing and threat as the cohort ages into later adolescence.
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Tan TH, Idris I. Assessing the significance of first place and online third places in supporting Malaysian seniors' well-being during the pandemic. HUMANITIES & SOCIAL SCIENCES COMMUNICATIONS 2023; 10:149. [PMID: 37041889 PMCID: PMC10080517 DOI: 10.1057/s41599-023-01655-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 03/27/2023] [Indexed: 05/21/2023]
Abstract
The enforced lockdowns and social distancing measures associated with COVID-19 may have influenced older adults' preferences towards their homes and neighborhoods as well as social spaces. One objective of this research is to determine whether home and neighborhood environments ("first place") affect how satisfied older adults are with their lives during the epidemic. This study also examined the extent to which social spaces that exist in the virtual world ("online third places") affect older adults' life satisfaction when they would have to practice risk-averse behaviors in times of pandemic. To collect data, this study analyzed the responses of 500 active older adults and conducted in-depth interviews with seven older adults who served as neighborhood leaders in Klang Valley, Malaysia. The study found that there is a direct relationship between older adults' satisfaction with their current housing and their overall life satisfaction during the pandemic. Similarly, having a quality neighborhood nearby increases the likelihood of living a satisfied life during the pandemic. Most online third parties, with the exception of instant messaging apps, do not appear to provide older adults with an adequate platform to interact with their friends, participate in social networking, and join communities for emotional support during the pandemic. The findings and recommendations of this study would be very useful in developing effective interventions to promote aging in place during the coronavirus outbreak.
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Affiliation(s)
- Teck Hong Tan
- Xiamen University Malaysia, School of Economics and Management, Bandar Sansuria, Malaysia
| | - Izian Idris
- Sunway University, Sunway Business School, Bandar Sunway, Malaysia
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Zhang J, Zheng Y, Wen T, Yang M, Feng QM. The impact of built environment on physical activity and subjective well-being of urban residents: A study of core cities in the Yangtze River Delta survey. Front Psychol 2022; 13:1050486. [PMID: 36570995 PMCID: PMC9773078 DOI: 10.3389/fpsyg.2022.1050486] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 11/18/2022] [Indexed: 12/14/2022] Open
Abstract
Objective In cities with high population density in China, the impact of built environment on human health is rather complicated. Physical activities are an important factor in promoting people's health. This study is aimed to explore ways of enhancing the residents' intensity of physical activities and psychological health in a limited built environment. For this purpose, this study conducted research on 1875 residents from cities in the Yangtze River Delta in China to clarify the complicated correlations among the residents' physical activities, the multi-dimensional geographic environment characteristics, and subjective well-being. Methods First, Neighborhood Environment Walkability Scale (NEWS-A), International Physical Activity Questionnaire Short Form (IPAQ-SF), and Subjective Well-being Scale for Chinese Citizens (SWBS-CC) were used to measure built environment characteristics, intensity of physical activities, and subjective well-being. Second, the correlations among built environment, physical activities, and subjective well-being were analyzed, which reflected different effects of built environment characteristics on physical activities and subjective well-being. Third, physical activities were viewed as a mediating variable in SEM to analyze the influence mechanism of each built environment characteristic on the subjective well-being of residents. Result Residents with different individual characteristics may have different levels of perception and usage of built environment. The intensity of physical activities has significant positive correlations with proximity to supporting facilities, accessibility of destinations, and public security, while no significant correlation with overall environmental aesthetics and street connectivity. The residents' subjective well-being has significant positive correlations with accessibility of destinations, overall environmental aesthetics, and public security, while no significant correlation with proximity to supporting facilities and street connectivity. Physical activities not only have a direct effect on subjective well-being, but also a mediating effect on the correlations between subjective well-being and built environment characteristics. Conclusion In the future, more research could be conducted on the optimization of correlations between residential built environment characteristics and physical activities as well as subjective well-being, so as to gain a deeper understanding about the impact of residential built environment on people's physical and mental health.
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Affiliation(s)
- Jing Zhang
- Faculty of Physical Education, Shanghai International Studies University, Shanghai, China
| | - Yan Zheng
- Faculty of Physical Education, Shanghai International Studies University, Shanghai, China
| | - Tao Wen
- Faculty of Physical Education, Shanghai International Studies University, Shanghai, China
| | - Min Yang
- Office of Campus Security, Shanghai International Studies University, Shanghai, China
| | - Qiang ming Feng
- Faculty of Physical Education, Shanghai International Studies University, Shanghai, China,*Correspondence: Qiang ming Feng,
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Chen YR, Hanazato M, Koga C, Ide K, Kondo K. The association between street connectivity and depression among older Japanese adults: the JAGES longitudinal study. Sci Rep 2022; 12:13533. [PMID: 35941206 PMCID: PMC9360019 DOI: 10.1038/s41598-022-17650-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 07/28/2022] [Indexed: 11/09/2022] Open
Abstract
Mental health is important in older age; neighborhood environment is considered a protective factor of depression. Research has established that a critical indicator of neighborhood environment, street connectivity, is related to older people's health. However, little is known about the relationship between street connectivity and depression. We examined the relationship between street connectivity and depression among older people. Using Japan Gerontological Evaluation Study 2013-2016, the target population comprised 24,141 independent older people without depression (Geriatric Depression Scale scores below 5) in 2013. The outcome variable was depression in 2016; the explanatory variable was street connectivity calculated by intersection density and space syntax within 800 m around the subject's neighborhood in 2013. We used logistic regression analysis to calculate the odds ratio and 95% confidence interval for the new occurrence of depression among participants in 2016. This analysis demonstrated incidence of new depression after 3 years that is 17% and 14% lower among participations living in high-intersection density and high-street-connectivity areas, respectively, than those living in low-intersection density and low-street-connectivity areas. The association held after adjusting for physical activities and social interaction. Given the established connection between street connectivity and mental health, the findings can contribute to healthy urban planning.
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Affiliation(s)
- Yu-Ru Chen
- Graduate School of Medical and Pharmaceutical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8672, Japan.
| | - Masamichi Hanazato
- Center for Preventive Medical Sciences, Chiba University, 1-33 Yayoi-cho, Inage-ku, Chiba-shi, Chiba, 263-8522, Japan
| | - Chie Koga
- Center for Preventive Medical Sciences, Chiba University, 1-33 Yayoi-cho, Inage-ku, Chiba-shi, Chiba, 263-8522, Japan
| | - Kazushige Ide
- Center for Preventive Medical Sciences, Chiba University, 1-33 Yayoi-cho, Inage-ku, Chiba-shi, Chiba, 263-8522, Japan
- Department of Community General Support, Hasegawa Hospital, Yachimata-shi, Chiba, 289-1103, Japan
| | - Katsunori Kondo
- Center for Preventive Medical Sciences, Chiba University, 1-33 Yayoi-cho, Inage-ku, Chiba-shi, Chiba, 263-8522, Japan
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430 Morikoka-cho, Obu-shi, Aichi, 474-8511, Japan
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Yang H, Cui X, Dijst M, Tian S, Chen J, Huang J. Association Between Natural/Built Campus Environment and Depression Among Chinese Undergraduates: Multiscale Evidence for the Moderating Role of Socioeconomic Factors After Controlling for Residential Self-Selection. Front Public Health 2022; 10:844541. [PMID: 35480591 PMCID: PMC9037627 DOI: 10.3389/fpubh.2022.844541] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 02/02/2022] [Indexed: 11/13/2022] Open
Abstract
Aim Evidence on the association between natural-built environments and depression is largely derived from the general population and prone to residential self-selection bias because of the nature of cross-sectional research design. Despite emerging adulthood, which includes the university years, is a critical stage for forming life-long health habits, studies on this topic focusing on undergraduate students are limited. The current study aims to illustrate the underlying mechanisms for how the campus-based environments affect depression in undergraduate students. Methods Based on a nationwide representative analytical sample of 22,009 Chinese undergraduates in 2018, we examined participants' reports of depression and campus-centered natural/built environments within multiple buffer sizes including 0.5, 1.0, and 2.5 km. After disentangling residential self-selection, we explored the moderating role of the socioeconomic attributes of undergraduates. The depression outcome was measured by the nine-item Patient Health Questionnaire (PHQ9). Indicators of exposure to green and blue space, transportation infrastructure, and food environments were objectively assessed using different circular buffers around each campus address. Results Modeling results indicated that campus neighborhoods with more scattered trees (0.5 km), water (0.5, 1.0, and 2.5 km), and street intersections (1.0 and 2.5 km) were protective against depression. In contrast, those living near denser distributions of outlets serving take-away sweets and fast food (0.5, 1.0, and 2.5 km) were susceptible to depression. These associations were modified by undergraduates' socioeconomic attributes (e.g., grade, Hukou status, and ethnicity) and varied according to geographical scales and exposure metrics. Conclusion To deliver effective environmental interventions to curb the prevalence of depression among undergraduate students, further planning policies should focus on the careful conception of the campus-based environment, especially regarding different spatial scales.
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Affiliation(s)
- Haoran Yang
- The Centre for Modern Chinese City Studies, Research Center for China Administrative Division, Future City Lab, East China Normal University, Shanghai, China
| | - Xiangfen Cui
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming, China
| | - Martin Dijst
- Department of Urban Development and Mobility, Luxembourg Institute of Socio-Economic Research (LISER), Esch-sur-Alzette, Luxembourg
| | - Senlin Tian
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming, China
| | - Jie Chen
- Faculty of Land Resource Engineering, Kunming University of Science and Technology, Kunming, China
| | - Jianhong Huang
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming, China
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Tan TH. Perceived Environmental Attributes: Their Impact on Older Adults' Mental Health in Malaysia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3595. [PMID: 35329282 PMCID: PMC8949010 DOI: 10.3390/ijerph19063595] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 02/17/2022] [Accepted: 03/08/2022] [Indexed: 02/05/2023]
Abstract
In Malaysia, the population of older adults will increase in the coming years. In this context, there is a requirement to build an age-friendly environment to enable the elderly to age healthily. Many studies have shown that a built environment that allows older adults to age in place improves their mental health. However, person-environment analysis that considers mental well-being has remained rare for older adults living in Malaysia. This study examines the relationship between Malaysian seniors' perceptions of their surroundings at home and in the neighborhood and their mental health. Using stratified sampling, 510 seniors aged 60 and over were interviewed. The results showed that accessibility (p-value 0.033, 95% CI for coefficients 0.006, 0.146), environmental qualities (0.015, 0.014, 0.129) and neighborhood problems (0.000, -0.299, -0.146) were significant determinants of elderly people's mental health. With respect to respondents' socio-demographic characteristics, female elderly (0.000, 0.616, 0.782), older adults with an elementary education (0.000, 0.263, 0.685) or a college degree (0.026, 0.019, 0.294), being married (0.005, 0.047, 0.259), the ability to drive (0.000, 0.993, 1.315), the number of dependents in the family (0.003, -0.060, -0.012), and homeownership (0.000, -0.602, -0.271) were significantly related to mental well-being.
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Affiliation(s)
- Teck Hong Tan
- School of Economics and Management, Xiamen University Malaysia, Sepang 43900, Selangor, Malaysia
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11
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Influence of External Natural Environment Including Sunshine Exposure on Public Mental Health: A Systematic Review. PSYCHIATRY INTERNATIONAL 2022. [DOI: 10.3390/psychiatryint3010008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The COVID-19 pandemic has been raging around the world and public health measures such as lockdowns have forced people to go out less often, reducing sunlight exposure time, green space use, and physical activity. It is well known that exercise has a positive impact on mental health, but the impact of external environmental factors such as sunlight exposure and green space use on mental health has not been systematically reviewed. In this review, we categorized the major factors that may affect people’s mental health into (1) external environmental factors such as exposure to sunlight and green spaces, (2) internal life factors such as physical activity and lifestyle, and (3) mixed external and internal factors, and systematically examined the relationship between each factor and people’s mental health. The results showed that exposure to sunlight, spending leisure time in green spaces, and physical activity each had a positive impact on people’s mental health, including depression, anxiety, and stress states. Specifically, moderate physical activity in an external environment with sunlight exposure or green space was found to be an important factor. The study found that exposure to the natural environment through sunbathing and exercise is important for people’s mental health.
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Remes O, Mendes JF, Templeton P. Biological, Psychological, and Social Determinants of Depression: A Review of Recent Literature. Brain Sci 2021; 11:1633. [PMID: 34942936 PMCID: PMC8699555 DOI: 10.3390/brainsci11121633] [Citation(s) in RCA: 72] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 11/08/2021] [Accepted: 11/12/2021] [Indexed: 12/15/2022] Open
Abstract
Depression is one of the leading causes of disability, and, if left unmanaged, it can increase the risk for suicide. The evidence base on the determinants of depression is fragmented, which makes the interpretation of the results across studies difficult. The objective of this study is to conduct a thorough synthesis of the literature assessing the biological, psychological, and social determinants of depression in order to piece together the puzzle of the key factors that are related to this condition. Titles and abstracts published between 2017 and 2020 were identified in PubMed, as well as Medline, Scopus, and PsycInfo. Key words relating to biological, social, and psychological determinants as well as depression were applied to the databases, and the screening and data charting of the documents took place. We included 470 documents in this literature review. The findings showed that there are a plethora of risk and protective factors (relating to biological, psychological, and social determinants) that are related to depression; these determinants are interlinked and influence depression outcomes through a web of causation. In this paper, we describe and present the vast, fragmented, and complex literature related to this topic. This review may be used to guide practice, public health efforts, policy, and research related to mental health and, specifically, depression.
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Affiliation(s)
- Olivia Remes
- Institute for Manufacturing, University of Cambridge, Cambridge CB3 0FS, UK
| | | | - Peter Templeton
- IfM Engage Limited, Institute for Manufacturing, University of Cambridge, Cambridge CB3 0FS, UK;
- The William Templeton Foundation for Young People’s Mental Health (YPMH), Cambridge CB2 0AH, UK
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Lugova H, Andoy-Galvan JA, Patil SS, Wong YH, Baloch GM, Suleiman A, Nordin R, Chinna K. Prevalence and Associated Factors of the Severity of Depression, Anxiety and Stress Among Low-Income Community-Dwelling Adults in Kuala Lumpur, Malaysia. Community Ment Health J 2021; 57:1489-1498. [PMID: 33417170 DOI: 10.1007/s10597-020-00765-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Accepted: 12/23/2020] [Indexed: 11/28/2022]
Abstract
Growing prevalence of mental illnesses and the role they play in the global disease burden is an emerging public health issue. The prevalence of depression and anxiety is on the rise in Malaysia. Low-income urban communities are among the key affected populations with regards to mental health problems. This cross-sectional study was aimed to determine the prevalence and severity of depression, anxiety and stress, and their associated factors among adults in the low-income community of Kuala Lumpur, Malaysia. A total of 248 participants aged 18-60 years old were recruited. Data were collected via face-to-face interviews using the Depression, Anxiety and Stress Scale-21 Items (DASS-21). Chi-squared test was used to examine the association between the variables. Multiple ordinal regression model was introduced to identify the predictors of depression, anxiety and stress. The proportions of participants with depression, anxiety and stress were 24.2% (95% CI: 19.6-30.4), 36.3% (95% CI: 29.9-43.0), and 20.6% (95% CI: 15.4-26.5), respectively. There was a statistically significant association of ethnicity (p = 0.002) and age (p = 0.014) with the severity of depression, ethnicity (p = 0.001) and age (p = 0.024) with the severity of anxiety, and ethnicity (p < 0.001) and marital status (p = 0.006) with the severity of stress. In a multivariable analysis, only non-Malay ethnicity was an independent predictor of the severity of depression [OR = 2.43, 95% CI (1.25, 4.72), p = 0.009], anxiety [OR = 2.55, 95% CI (1.41, 4.62), p = 0.002] and stress [OR = 4.28, 95% CI (2.06, 8.89), p = <0.001]. Mental health interventions should target low-income communities to address social inequalities of mental health within economically disadvantaged populations.
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Affiliation(s)
- Halyna Lugova
- Faculty of Medicine and Defence Health, National Defence University of Malaysia, Sungai Besi Prime Camp, 57000, Kuala Lumpur, Malaysia.
| | - Jo Ann Andoy-Galvan
- School of Medicine, Taylor's University Malaysia, No. 1 Jalan Taylor's, 47500, Subang Jaya, Selangor Darul Ehsan, Malaysia
| | - Sapna S Patil
- School of Medicine, Taylor's University Malaysia, No. 1 Jalan Taylor's, 47500, Subang Jaya, Selangor Darul Ehsan, Malaysia
| | - Yin How Wong
- School of Medicine, Taylor's University Malaysia, No. 1 Jalan Taylor's, 47500, Subang Jaya, Selangor Darul Ehsan, Malaysia
| | - Gul M Baloch
- School of Medicine, Taylor's University Malaysia, No. 1 Jalan Taylor's, 47500, Subang Jaya, Selangor Darul Ehsan, Malaysia
| | - Adlina Suleiman
- Faculty of Medicine and Defence Health, National Defence University of Malaysia, Sungai Besi Prime Camp, 57000, Kuala Lumpur, Malaysia
| | - Rusli Nordin
- School of Medicine, Taylor's University Malaysia, No. 1 Jalan Taylor's, 47500, Subang Jaya, Selangor Darul Ehsan, Malaysia
| | - Karuthan Chinna
- School of Medicine, Taylor's University Malaysia, No. 1 Jalan Taylor's, 47500, Subang Jaya, Selangor Darul Ehsan, Malaysia
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14
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Andrews MR, Ceasar J, Tamura K, Langerman SD, Mitchell VM, Collins BS, Baumer Y, Gutierrez Huerta CA, Dey AK, Playford MP, Mehta NN, Powell-Wiley TM. Neighborhood environment perceptions associate with depression levels and cardiovascular risk among middle-aged and older adults: Data from the Washington, DC cardiovascular health and needs assessment. Aging Ment Health 2021; 25:2078-2089. [PMID: 32691611 PMCID: PMC7855489 DOI: 10.1080/13607863.2020.1793898] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Little is understood about associations between neighborhood characteristics and depression, a cardiovascular disease (CVD) risk factor, in diverse populations. We examined relationships between perceived/objective neighborhood characteristics, depression, and CVD markers within the Washington, DC CV Health/Needs Assessment, an evaluation among predominantly African-American (AA) adults in resource-limited DC communities. METHOD Factor analysis of overall neighborhood environment perception (NEP) identified three NEP sub-scores:1) violence; 2) physical/social environment; 3) social cohesion (higher score = more favorable perception). Objective neighborhood characteristics were measured by geospatially-derived scores of walkability, transportation, and crime. Depression was defined by the revised Center for Epidemiologic Studies Depression Scale (CESD-R). We used linear-regression modeling to examine neighborhood measures and CESD-R associations. To investigate a subsequent connection with CVD risk, we examined relationships between CESD-R and CVD-associated cytokines in a population subset. RESULTS Participants (N = 99; mean age = 59.06; 99% AA) had a mean CESD-R score = 5.8(SD = 8.88). In adjusted models, CESD-R scores decreased by 0.20 units (p = 0.01) for every overall NEP unit-increase. Perceived physical/social environment (β = -0.34, p = 0.04) and social cohesion (β = -0.82, p = 0.01) were related to CESD-R while perceived violence was not (β = -0.28, p = 0.1). Of objective neighborhood environment measures (i.e. walk, transit, bike, personal crime, and property crime scores), only property crime score was associated with depression (β = 4.99, p < 0.03). In population subset (n = 42), higher CESD-R associated with higher IL-1β (β = 21.25, p < 0.01) and IL-18 (β = 0.006, p = 0.01). CONCLUSION Favorable neighborhood perceptions are related to lower depressive symptoms in a predominantly AA cohort from Washington, DC resource-limited communities. Neighborhood perceptions appear to be strongly associated with depressive symptoms compared to objective characteristics. Increasing CESD-R scores were related to higher pro-inflammatory markers. Improving neighborhood perceptions may be beneficial to psychological well-being and CV health for urban minority residents.
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Affiliation(s)
- Marcus R. Andrews
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Joniqua Ceasar
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Kosuke Tamura
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Steven D. Langerman
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Valerie M. Mitchell
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Billy S. Collins
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Yvonne Baumer
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Cristhian A. Gutierrez Huerta
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Amit K. Dey
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health, Bethesda, MD, USA
| | - Martin P. Playford
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health, Bethesda, MD, USA
| | - Nehal N. Mehta
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health, Bethesda, MD, USA
| | - Tiffany M. Powell-Wiley
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA;,Intramural Research Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
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15
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Li Z, Wei A, Palanivel V, Jackson JC. A Data-Driven Analysis of Sociocultural, Ecological, and Economic Correlates of Depression Across Nations. JOURNAL OF CROSS-CULTURAL PSYCHOLOGY 2021. [DOI: 10.1177/00220221211040243] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The prevalence of depression varies widely across nations, but we do not yet understand what underlies this variation. Here we use estimates from the Global Burden of Disease study to analyze the correlates of depression across 195 countries and territories. We begin by identifying potential cross-correlates of depression using past clinical and cultural psychology literature. We then take a data-driven approach to modeling which factors correlate with depression in zero-order analyses, and in a multiple regression model that controls for covariation between factors. Our findings reveal several potential correlates of depression, including cultural individualism, daylight hours, divorce rate, and GDP per capita. Cultural individualism is the only factor that remains significant across all our models, even when adjusting for spatial autocorrelation, mental healthcare workers per capita, multicollinearity, and outliers. These findings shed light on how depression varies around the world, the sociocultural and environmental factors that underlie this variation, and potential future directions for the study of culture and mental illness.
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Affiliation(s)
| | - Anna Wei
- University of North Carolina at Chapel Hill, USA
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16
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Fleckney P, Bentley R. The urban public realm and adolescent mental health and wellbeing: A systematic review. Soc Sci Med 2021; 284:114242. [PMID: 34333404 DOI: 10.1016/j.socscimed.2021.114242] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 07/15/2021] [Accepted: 07/16/2021] [Indexed: 10/20/2022]
Abstract
Adolescent mental health is becoming a critical concern. Mental illness rates are rising and many psychological disorders first present symptoms during teenage years. Studies consistently show associations between the built environment and mental health, including internalising mental health disorders in adults, but the evidence for adolescents is less robust and few studies attempt to isolate causality. This review examines the relationship between the urban public realm and adolescent mental health and wellbeing. Our search yielded 24 studies for inclusion. We undertook qualitative synthesis of 20 cross-sectional studies and conducted a separate quality analysis of four longitudinal studies. Greenspace and neighbourhood quality are associated with adolescent mental health and wellbeing although this may be due more to residual confounding, selection effects and same-source bias than evidence for a causal effect. Furthermore, the few longitudinal studies that seek to test causality remain prone to these biases. Overall, we find little evidence of an effect of the urban public realm on adolescent mental health and wellbeing, which, we argue, reflects the difficulty of researching complex pathways between environments and health and highlights a challenge to the field. To address this challenge, we propose a research agenda that prioritises more and better data drawn from diverse study designs, and more and better theories developed from diverse epistemologies.
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Affiliation(s)
- Paul Fleckney
- Melbourne School of Design, Faculty of Architecture, Building and Planning, University of Melbourne, Masson Road, Parkville, Victoria, 3010, Australia.
| | - Rebecca Bentley
- NHMRC Centre of Research Excellence in Healthy Housing, Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, 207 Bouverie Street, Parkville, Victoria, 3010, Australia.
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17
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Anderson CE, Broyles ST, Wallace ME, Bazzano LA, Gustat J. Association of the Neighborhood Built Environment With Incident and Prevalent Depression in the Rural South. Prev Chronic Dis 2021; 18:E67. [PMID: 34237245 PMCID: PMC8269752 DOI: 10.5888/pcd18.200605] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
INTRODUCTION A neighborhood's built environment is associated with physical activity among its residents, and physical activity is associated with depression. Our study aimed to determine whether the built environment was associated with depression among residents of the rural South and whether observed associations were mediated by physical activity. METHODS We selected 2,000 participants from the Bogalusa Heart Study who had a valid residential address, self-reported physical activity (minutes/week), and a complete Center for Epidemiologic Study-Depression (CES-D) scale assessment from 1 or more study visits between 1998 and 2013. We assessed the built environment with the Rural Active Living Assessment street segment audit tool and developed built environment scores. The association between built environment scores and depression (CES-D ≥16) in geographic buffers of various radii were evaluated by using modified Poisson regression, and mediation by physical activity was evaluated with mixed-effects models. RESULTS Depression was observed in 37% of study participants at the first study visit. One-point higher physical security and aesthetic scores for the street segment of residence were associated with 1.07 times higher (95% CI, 1.02-1.11) and 0.96 times lower (95% CI, 0.92-1.00) baseline depression prevalence. One-point higher destination scores (ie, more commercial and civic facilities) in radius buffers of 0.25 miles or more were associated with 1.06 times (95% CI, 1.00-1.13) the risk of depression during follow-up. Neighborhood poverty (defined as percentage of residents with incomes below the federal poverty level and dichotomized at 28.3%) modified cross-sectional and longitudinal associations. Associations were not mediated by physical activity. CONCLUSION The built environment was associated with prevalence and risk of depression, and associations were stronger in high-poverty neighborhoods. Built environment improvements to promote physical activity should take neighborhood context into consideration to minimize negative side effects on mental health in high-poverty communities.
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Affiliation(s)
- Christopher E Anderson
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St, Ste 2000, New Orleans, LA 70112.
| | - Stephanie T Broyles
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana
| | - Maeve E Wallace
- Department of Social, Behavioral, and Population Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana
| | - Lydia A Bazzano
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana
| | - Jeanette Gustat
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana
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Tarkiainen L, Moustgaard H, Korhonen K, Noordzij JM, Beenackers MA, Van Lenthe FJ, Burstrom B, Martikainen P. Association between neighbourhood characteristics and antidepressant use at older ages: a register-based study of urban areas in three European countries. J Epidemiol Community Health 2021; 75:426-432. [PMID: 32563994 PMCID: PMC8053343 DOI: 10.1136/jech-2020-214276] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 05/29/2020] [Accepted: 06/01/2020] [Indexed: 01/12/2023]
Abstract
BACKGROUND Research evidence on the association between neighbourhood characteristics and individual mental health at older ages is inconsistent, possibly due to heterogeneity in the measurement of mental-health outcomes, neighbourhood characteristics and confounders. Register-based data enabled us to avoid these problems in this longitudinal study on the associations between socioeconomic and physical neighbourhood characteristics and individual antidepressant use in three national contexts. METHODS We used register-based longitudinal data on the population aged 50+ from Turin (Italy), Stockholm (Sweden), and the nine largest cities in Finland linked to satellite-based land-cover data. This included individual-level information on sociodemographic factors and antidepressant use, and on neighbourhood socioeconomic characteristics, levels of urbanicity, green space and land-use mix (LUM). We assessed individual-level antidepressant use over 6 years in 2001-2017 using mixed-effects logistic regression. RESULTS A higher neighbourhood proportion of low-educated individuals predicted lower odds for antidepressant use in Turin and Stockholm when individual-level sociodemographic factors were controlled for. Urbanicity predicted increased antidepressant use in Stockholm (OR=1.02; 95% CI 1.01 to 1.03) together with more LUM (OR=1.03; 1.01-1.05) and population density (OR=1.08; 1.05-1.10). The two latter characteristics also predicted increased antidepressant use in the Finnish cities (OR=1.05; 1.02-1.08 and OR=1.14; 1.02-1.28, respectively). After accounting for all studied neighbourhood and individual characteristics of the residents, the neighbourhoods still varied by odds of antidepressant use. CONCLUSIONS Overall, the associations of neighbourhood socioeconomic and physical characteristics with older people's antidepressant use were small and inconsistent. However, we found modest evidence that dense physical urban environments predicted higher antidepressant use among older people in Stockholm and the Finnish cities.
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Affiliation(s)
- Lasse Tarkiainen
- Population Research Unit, University of Helsinki Faculty of Social Sciences, Helsinki, Finland
- Helsinki Institute of Urban and Regional Studies, University of Helsinki, Helsinki, Finland
| | - Heta Moustgaard
- Population Research Unit, University of Helsinki Faculty of Social Sciences, Helsinki, Finland
| | - Kaarina Korhonen
- Population Research Unit, University of Helsinki Faculty of Social Sciences, Helsinki, Finland
| | - J Mark Noordzij
- Public Health, Erasmus Medical Center, Rotterdam, Netherlands
| | | | - Frank J Van Lenthe
- Public Health, Erasmus Medical Center, Rotterdam, Netherlands
- Department of Human Geography and Spatial Planning, Utrecht University, Utrecht, Netherlands
| | - Bo Burstrom
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Pekka Martikainen
- Population Research Unit, University of Helsinki Faculty of Social Sciences, Helsinki, Finland
- Helsinki Institute of Urban and Regional Studies, University of Helsinki, Helsinki, Finland
- Max-Planck-Institute for Demographic Research, Rostock, Germany
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
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19
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Chen Y, Cui PY, Pan YY, Li YX, Waili N, Li Y. Association between housing environment and depressive symptoms among older people: a multidimensional assessment. BMC Geriatr 2021; 21:259. [PMID: 33865321 PMCID: PMC8052816 DOI: 10.1186/s12877-021-02207-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 04/08/2021] [Indexed: 12/02/2022] Open
Abstract
Background Depression is a common mental disorder among older people. This study aimed to assess the association between housing environment factors and depressive symptoms among older people using a multidimensional assessment method. Methods The study uses a population-based cross-sectional design. A total of 950 participants aged ≥ 60 years were selected using a complex multistage sampling design from 22 locations in China. All data were collected using questionnaires by face-to-face interviews. A total of 938 participants were included in the analysis, and 17.1% of males and 23.1% of females were identified as having depressive symptoms. The depressive symptoms were assessed using the 15-item Geriatric Depression Scale. The housing environment was assessed on the basis of four dimensions: physical, social, psychological, and cognition and physical function. Cumulative logistic regression analysis was used to evaluate the association between housing environment and depressive symptoms. Results The Cochran–Armitage trend test showed that the depressive symptom scores were linearly negatively associated with self-assessed housing environment, living arrangement, life satisfaction, and other physical environment factors and linearly positively associated with cognitive and physical function scores. The results of cumulative logistic regression analysis showed that the housing environment was significantly associated with depressive symptoms. The participants’ self-assessed housing environment was strongly associated with the levels of depressive symptom scores, and the odds ratio was 3.47 (95% CI, 1.14–10.82, P = 0.003). Conclusion The housing environment was significantly associated with depressive symptoms. Our results suggest that multi-dimensional assessment in the housing environment may be an effective way to develop intervention strategies of depressive symptoms among older people.
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Affiliation(s)
- Yuan Chen
- Department of Social Medicine, School of Public Health, Zhejiang University, 866 Yu-hang-tang Road, Zhejiang, 310058, Hangzhou, China
| | - Ping Yu Cui
- Department of Social Medicine, School of Public Health, Zhejiang University, 866 Yu-hang-tang Road, Zhejiang, 310058, Hangzhou, China
| | - Yi Yang Pan
- Department of Social Medicine, School of Public Health, Zhejiang University, 866 Yu-hang-tang Road, Zhejiang, 310058, Hangzhou, China
| | - Ya Xing Li
- Department of Social Medicine, School of Public Health, Zhejiang University, 866 Yu-hang-tang Road, Zhejiang, 310058, Hangzhou, China
| | - Nuremaguli Waili
- Department of Social Medicine, School of Public Health, Zhejiang University, 866 Yu-hang-tang Road, Zhejiang, 310058, Hangzhou, China
| | - Ying Li
- Department of Social Medicine, School of Public Health, Zhejiang University, 866 Yu-hang-tang Road, Zhejiang, 310058, Hangzhou, China.
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20
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Lee HH, Okuzono SS, Kim ES, De Vivo I, Raffield LM, Glover L, Sims M, Grodstein F, Kubzansky LD. Optimism and telomere length among African American adults in the Jackson Heart Study. Psychoneuroendocrinology 2021; 125:105124. [PMID: 33434830 PMCID: PMC8052931 DOI: 10.1016/j.psyneuen.2020.105124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 11/20/2020] [Accepted: 12/27/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Optimism is linked with greater longevity in both White and African American populations. Optimism may enhance longevity by slowing cellular aging, for which leukocyte telomere shortening is a biomarker. However, limited studies have examined the association of optimism with leukocyte telomere length among African Americans. METHODS Data are from 723 men and 1244 women participating in the Jackson Heart Study (age = 21-93 years). We used multivariable linear regression models to conduct cross-sectional analyses examining whether higher optimism was associated with longer mean absolute leukocyte telomere length (assayed with Southern blot analysis). Models adjusted for sociodemographic characteristics, depressive symptomatology, health conditions, and health behavior-related factors. We also considered potential effect modification by key factors. RESULTS In the age-adjusted model, optimism, measured as a continuous variable, was not associated with leukocyte telomere length (β = 0.01, 95%CI: -0.02, 0.04). This association remained null in the fully-adjusted model (β = 0.02, 95%CI: -0.02, 0.05) and was also null when considering optimism as a binary measure (higher vs. lower optimism). We found no evidence of effect modification by sex, age, body mass index, income, or chronic conditions. CONCLUSIONS Optimism was not associated with leukocyte telomere length among African American adults. Future studies should investigate alternate biological and behavioral mechanisms that may explain the optimism-health association.
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Affiliation(s)
- Harold H. Lee
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health (Address: 677 Huntington Ave, Boston, MA 02115)
| | - Sakurako S. Okuzono
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health (Address: 677 Huntington Ave, Boston, MA 02115)
| | - Eric S. Kim
- Department of Psychology, University of British Columbia (Address: 2136 West Mall, Vancouver, BC V6T 1Z4, Canada)
| | - Immaculata De Vivo
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, (Address: 677 Huntington Ave, Boston, MA 02115)
| | - Laura M. Raffield
- Department of Genetics, University of North Carolina at Chapel Hill (Address: Genetic Medicine Building, 120 Mason Farm Rd, Chapel Hill, NC 27514)
| | - LáShauntá Glover
- Department of Epidemiology, University of North Carolina at Chapel Hill (Address: 135 Dauer Dr, Chapel Hill, NC 27599)
| | - Mario Sims
- Department of Medicine, University of Mississippi Medical Center (Address: 2500 N State St, Jackson, MS 39216)
| | - Francine Grodstein
- Rush Alzheimer’s Disease Center (Address: 600 South Paulina Street, Suite 1028, Chicago, IL 60612)
| | - Laura D. Kubzansky
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health (Address: 677 Huntington Ave, Boston, MA 02115)
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Wang P, Goggins WB, Zhang X, Ren C, Lau KKL. Association of urban built environment and socioeconomic factors with suicide mortality in high-density cities: A case study of Hong Kong. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 739:139877. [PMID: 32534310 DOI: 10.1016/j.scitotenv.2020.139877] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 05/27/2020] [Accepted: 05/30/2020] [Indexed: 05/23/2023]
Abstract
Population ageing, climate change and urbanization have been occurring rapidly globally. Evidence-based healthy city development is required to improve living quality and mitigate the adverse impact of city living on both physical and mental health. We took a high-density city as an example to explore the association of built environment and suicide mortality and preferably to offer some implications for better future city development. Poisson generalized linear models with generalized estimation equations were employed to regress suicide mortality rate on four urban built environment variables (frontal area density (FAD), sky view factor (SVF), ground coverage ratio (GCR), and street coverage ratio (SCR)), as well as socioeconomic factors, population density, and greenery. The association for different causes of death and within different subgroups was also investigated. Generally, higher FAD and GCR were associated with higher suicide mortality while higher SVF and SCR were associated with lower suicide mortality. Age was a significant effect modifier. An interquartile range increase in FAD, SVF, and GCR was associated with 0.81 (95% confidence interval (CI) 0.71-0.92), 1.41 (95% CI 1.04-1.91), and 0.70 (95% CI 0.50-0.98) times the risk of suicide among the people aged over 70, respectively. Higher population density and unmarried status were generally associated with higher suicide rate whereas higher education level was associated with a decreased risk. Unfavorable built environment could increase risks for successful suicide attempts. Better urban development with morphological control mitigating intensifying urban heat island and other micro-environment changes are warranted to promote not only physical but psychological health.
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Affiliation(s)
- Pin Wang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, N.T., Hong Kong, China
| | - William B Goggins
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, N.T., Hong Kong, China.
| | - Xuyi Zhang
- Faculty of Architecture, The University of Hong Kong, 4/F, Knowles Building, Pokfulam Road, Hong Kong, China
| | - Chao Ren
- Faculty of Architecture, The University of Hong Kong, 4/F, Knowles Building, Pokfulam Road, Hong Kong, China
| | - Kevin Ka-Lun Lau
- Institute of Future Cities, Chung Chi College, The Chinese University of Hong Kong, Room 406B, Wong Foo Yuan Building, Shatin, New Territories, Hong Kong, China
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Owen CG, Limb ES, Nightingale CM, Rudnicka AR, Ram B, Shankar A, Cummins S, Lewis D, Clary C, Cooper AR, Page AS, Procter D, Ellaway A, Giles-Corti B, Whincup PH, Cook DG. Active design of built environments for increasing levels of physical activity in adults: the ENABLE London natural experiment study. PUBLIC HEALTH RESEARCH 2020. [DOI: 10.3310/phr08120] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background
Low physical activity is widespread and poses a serious public health challenge both globally and in the UK. The need to increase population levels of physical activity is recognised in current health policy recommendations. There is considerable interest in whether or not the built environment influences health behaviours, particularly physical activity levels, but longitudinal evidence is limited.
Objectives
The effect of moving into East Village (the former London 2012 Olympic and Paralympic Games Athletes’ Village, repurposed on active design principles) on the levels of physical activity and adiposity, as well as other health-related and well-being outcomes among adults, was examined.
Design
The Examining Neighbourhood Activities in Built Environments in London (ENABLE London) study was a longitudinal cohort study based on a natural experiment.
Setting
East Village, London, UK.
Participants
A cohort of 1278 adults (aged ≥ 16 years) and 219 children seeking to move into social, intermediate and market-rent East Village accommodation were recruited in 2013–15 and followed up after 2 years.
Intervention
The East Village neighbourhood, the former London 2012 Olympic and Paralympic Games Athletes’ Village, is a purpose-built, mixed-use residential development specifically designed to encourage healthy active living by improving walkability and access to public transport.
Main outcome measure
Change in objectively measured daily steps from baseline to follow-up.
Methods
Change in environmental exposures associated with physical activity was assessed using Geographic Information System-derived measures. Individual objective measures of physical activity using accelerometry, body mass index and bioelectrical impedance (per cent of fat mass) were obtained, as were perceptions of change in crime and quality of the built environment. We examined changes in levels of physical activity and adiposity using multilevel models adjusting for sex, age group, ethnic group, housing sector (fixed effects) and baseline household (random effect), comparing the change in those who moved to East Village (intervention group) with the change in those who did not move to East Village (control group). Effects of housing sector (i.e. social, intermediate/affordable, market-rent) as an effect modifier were also examined. Qualitative work was carried out to provide contextual information about the perceived effects of moving to East Village.
Results
A total of 877 adults (69%) were followed up after 2 years (mean 24 months, range 19–34 months, postponed from 1 year owing to the delayed opening of East Village), of whom 50% had moved to East Village; insufficient numbers of children moved to East Village to be considered further. In adults, moving to East Village was associated with only a small, non-significant, increase in mean daily steps (154 steps, 95% confidence interval –231 to 539 steps), more so in the intermediate sector (433 steps, 95% confidence interval –175 to 1042 steps) than in the social and market-rent sectors (although differences between housing sectors were not statistically significant), despite sizeable improvements in walkability, access to public transport and neighbourhood perceptions of crime and quality of the built environment. There were no appreciable effects on time spent in moderate to vigorous physical activity or sedentary time, body mass index or percentage fat mass, either overall or by housing sector. Qualitative findings indicated that, although participants enjoyed their new homes, certain design features might actually serve to reduce levels of activity.
Conclusions
Despite strong evidence of large positive changes in neighbourhood perceptions and walkability, there was only weak evidence that moving to East Village was associated with increased physical activity. There was no evidence of an effect on markers of adiposity. Hence, improving the physical activity environment on its own may not be sufficient to increase population physical activity or other health behaviours.
Funding
This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 8, No. 12. See the NIHR Journals Library website for further project information. This research was also supported by project grants from the Medical Research Council National Prevention Research Initiative (MR/J000345/1).
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Affiliation(s)
- Christopher G Owen
- Population Health Research Institute, St George’s, University of London, London, UK
| | - Elizabeth S Limb
- Population Health Research Institute, St George’s, University of London, London, UK
| | - Claire M Nightingale
- Population Health Research Institute, St George’s, University of London, London, UK
| | - Alicja R Rudnicka
- Population Health Research Institute, St George’s, University of London, London, UK
| | - Bina Ram
- Population Health Research Institute, St George’s, University of London, London, UK
| | - Aparna Shankar
- Population Health Research Institute, St George’s, University of London, London, UK
| | - Steven Cummins
- Population Health Innovation Lab, London School of Hygiene & Tropical Medicine, London, UK
| | - Daniel Lewis
- Population Health Innovation Lab, London School of Hygiene & Tropical Medicine, London, UK
| | - Christelle Clary
- Population Health Innovation Lab, London School of Hygiene & Tropical Medicine, London, UK
| | - Ashley R Cooper
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, Faculty of Social Sciences and Law, University of Bristol, Bristol, UK
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust, University of Bristol, Bristol, UK
| | - Angie S Page
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, Faculty of Social Sciences and Law, University of Bristol, Bristol, UK
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust, University of Bristol, Bristol, UK
| | - Duncan Procter
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, Faculty of Social Sciences and Law, University of Bristol, Bristol, UK
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust, University of Bristol, Bristol, UK
| | - Anne Ellaway
- Medical Research Council and Scottish Government Chief Scientist Office Social and Public Health Sciences Unit, Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - Billie Giles-Corti
- National Health and Medical Research Council Centre of Research Excellence in Healthy Liveable Communities, Centre for Urban Research, Royal Melbourne Institute of Technology University, Melbourne, VIC, Australia
| | - Peter H Whincup
- Population Health Research Institute, St George’s, University of London, London, UK
| | - Derek G Cook
- Population Health Research Institute, St George’s, University of London, London, UK
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23
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Orstad SL, Szuhany K, Tamura K, Thorpe LE, Jay M. Park Proximity and Use for Physical Activity among Urban Residents: Associations with Mental Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4885. [PMID: 32645844 PMCID: PMC7369687 DOI: 10.3390/ijerph17134885] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 06/06/2020] [Accepted: 06/08/2020] [Indexed: 01/04/2023]
Abstract
Increasing global urbanization limits interaction between people and natural environments, which may negatively impact population health and wellbeing. Urban residents who live near parks report better mental health. Physical activity (PA) reduces depression and improves quality of life. Despite PA's protective effects on mental health, the added benefit of urban park use for PA is unclear. Thus, we examined whether park-based PA mediated associations between park proximity and mental distress among 3652 New York City residents (61.4% 45 + years, 58.9% female, 56.3% non-white) who completed the 2010-2011 Physical Activity and Transit (PAT) random-digit-dial survey. Measures included number of poor mental health days in the previous month (outcome), self-reported time to walk to the nearest park from home (exposure), and frequency of park use for sports, exercise or PA (mediator). We used multiple regression with bootstrap-generated 95% bias-corrected confidence intervals (BC CIs) to test for mediation by park-based PA and moderation by gender, dog ownership, PA with others, and perceived park crime. Park proximity was indirectly associated with fewer days of poor mental health via park-based PA, but only among those not concerned about park crime (index of moderated mediation = 0.04; SE = 0.02; 95% BC CI = 0.01, 0.10). Investment in park safety and park-based PA promotion in urban neighborhoods may help to maximize the mental health benefits of nearby parks.
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Affiliation(s)
- Stephanie L. Orstad
- Department of Medicine, Division of General Internal Medicine and Clinical Innovation, New York University (NYU) Grossman School of Medicine, New York, NY 10016, USA
| | - Kristin Szuhany
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NY 10016, USA;
| | - Kosuke Tamura
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA;
| | - Lorna E. Thorpe
- Department of Population Health, Division of Epidemiology, NYU Grossman School of Medicine, New York, NY 10016, USA;
| | - Melanie Jay
- Departments of Medicine and Population Health, NYU Grossman School of Medicine, New York, NY 10016, USA;
- Comprehensive Program on Obesity, NYU Langone Health, New York, NY 10016, USA
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24
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Zhang Z, Zhao D, Hong YS, Chang Y, Ryu S, Kang D, Monteiro J, Shin HC, Guallar E, Cho J. Long-Term Particulate Matter Exposure and Onset of Depression in Middle-Aged Men and Women. ENVIRONMENTAL HEALTH PERSPECTIVES 2019; 127:77001. [PMID: 31268362 PMCID: PMC6792358 DOI: 10.1289/ehp4094] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 06/04/2019] [Accepted: 06/12/2019] [Indexed: 05/20/2023]
Abstract
BACKGROUND Long-term exposure to particulate matter (PM) air pollution is associated with all-cause mortality and adverse cognitive outcomes, but the association with developing depression remains inconsistent. OBJECTIVE Our goal was to evaluate the prospective association between PM air pollution and developing depression assessed using the Center for Epidemiological Studies Depression (CES-D) scale. METHODS Subjects were drawn from a prospective cohort study of 123,045 men and women free of depressive symptoms at baseline who attended regular screening exams in Seoul and Suwon, South Korea, from 2011 to 2015. Exposure to PM with an aerodynamic diameter of [Formula: see text] ([Formula: see text] and [Formula: see text], respectively) was estimated using a land-use regression model based on each subject's residential postal code. Incident depression was defined as a CES-D score [Formula: see text] during follow-up. As a sensitivity analyses, we defined incident depression using self-reports of doctor's diagnoses or use of antidepressant medications during follow-up. RESULTS The mean baseline 12-month concentrations of [Formula: see text] and [Formula: see text] were 50.6 (4.5) and [Formula: see text], respectively. The hazard ratios (HRs) and 95% confidence intervals (CIs) for developing depression associated with a [Formula: see text] increase in 12- and 60-month [Formula: see text] exposure were 1.11 (95% CI: 1.06, 1.16) and 1.06 (95% CI: 1.01, 1.11), respectively. The corresponding HRs for 12-month [Formula: see text] exposure was 0.96 (95% CI: 0.64, 1.43). Similar results were obtained when incident depression was identified using self-reports of doctor's diagnoses or the use of antidepressant medications. CONCLUSION In this large cohort study, we found a positive association between long-term exposure to outdoor [Formula: see text] air pollution and the developing depression. We did not find an association for outdoor [Formula: see text] air pollution; however, we had a much shorter follow-up for subjects' exposure to [Formula: see text]. https://doi.org/10.1289/EHP4094.
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Affiliation(s)
- Zhenyu Zhang
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Di Zhao
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Yun Soo Hong
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Yoosoo Chang
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Seungho Ryu
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Danbee Kang
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | | | - Ho Cheol Shin
- Department of Family Medicine, Kangbuk Samsung Hospital and Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Eliseo Guallar
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Juhee Cho
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea
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25
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Abstract
PURPOSE OF REVIEW Mood disorders are highly prevalent and represent a leading cause of global disability. Urbanization holds great public health implications spanning various environmental, lifestyle behavioural, economic and social domains. Underlying risk factors for mood disorders are heterogeneous but the psychiatric literature has extended beyond individual-level risk, to account for population-level environment and social-related precursors to mental ill health. This review summarizes recent studies published since 2017 examining the impact of urbanization and associated environmental, social and lifestyle risks for mood disorders, specifically depression. RECENT FINDINGS All identified studies examined depression or subclinical mood-related symptomatology. Recent evidence suggests individuals residing in urban areas experience increased risk of depression. Mechanistic pathways include increased exposure to noise, light and air pollution, poor quality housing, reduced diet quality, physical inactivity, economic strain and diminished social networks. The role of the gut microbiome in the development of mood disorders represents a novel research domain expected to hold potential for the psychiatric and environmental field. Further research is needed to extrapolate the relationship between increased sedentary lifestyles and technology use and depression in urban societies. SUMMARY Recent evidence highlights the complexity and reciprocity of underlying driving factors in the relationship between urbanization and mood disorders. Future epidemiological research should continue to untangle such complexity. There was a dearth of evidence relating to urbanization and mood disorders other than depression. Future research should identify the unique experiences of vulnerable subgroups who experience disproportionate increased risk of adverse health experiences associated with urbanization.
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26
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Servadio JL, Lawal AS, Davis T, Bates J, Russell AG, Ramaswami A, Convertino M, Botchwey N. Demographic Inequities in Health Outcomes and Air Pollution Exposure in the Atlanta Area and its Relationship to Urban Infrastructure. J Urban Health 2019; 96:219-234. [PMID: 30478764 PMCID: PMC6458195 DOI: 10.1007/s11524-018-0318-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Environmental burdens such as air pollution are inequitably distributed with groups of lower socioeconomic statuses, which tend to comprise of large proportions of racial minorities, typically bearing greater exposure. Such groups have also been shown to present more severe health outcomes which can be related to adverse pollution exposure. Air pollution exposure, especially in urban areas, is usually impacted by the built environment, such as major roadways, which can be a significant source of air pollution. This study aims to examine inequities in prevalence of cardiovascular and respiratory diseases in the Atlanta metropolitan region as they relate to exposure to air pollution and characteristics of the built environment. Census tract level data were obtained from multiple sources to model health outcomes (asthma, chronic obstructive pulmonary disease, coronary heart disease, and stroke), pollution exposure (particulate matter and nitrogen oxides), demographics (ethnicity and proportion of elderly residents), and infrastructure characteristics (tree canopy cover, access to green space, and road intersection density). Conditional autoregressive models were fit to the data to account for spatial autocorrelation among census tracts. The statistical model showed areas with majority African-American populations had significantly higher exposure to both air pollutants and higher prevalence of each disease. When considering univariate associations between pollution and health outcomes, the only significant association existed between nitrogen oxides and COPD being negatively correlated. Greater percent tree canopy cover and green space access were associated with higher prevalence of COPD, CHD, and stroke. Overall, in considering health outcomes in connection with pollution exposure infrastructure and ethnic demographics, demographics remained the most significant explanatory variable.
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Affiliation(s)
- Joseph L Servadio
- Division of Environmental Health Sciences, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Abiola S Lawal
- Schools of Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Tate Davis
- School of City and Regional Planning, Georgia Institute of Technology, Atlanta, GA, USA
| | - Josephine Bates
- Schools of Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | | | - Anu Ramaswami
- Humphrey School of Public Affairs, University of Minnesota, Minneapolis, MN, USA
| | - Matteo Convertino
- Graduate School of Information Science and Technology, Hokkaido University, Sapporo, Japan
| | - Nisha Botchwey
- School of City and Regional Planning, Georgia Institute of Technology, Atlanta, GA, USA.
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27
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Schoner J, Chapman J, Fox EH, Iroz-Elardo N, Brookes A, MacLeod KE, Frank LD. Bringing health into transportation and land use scenario planning: Creating a National Public Health Assessment Model (N-PHAM). JOURNAL OF TRANSPORT & HEALTH 2018; 10:401-418. [PMID: 35350107 PMCID: PMC8958996 DOI: 10.1016/j.jth.2018.04.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
There is mounting evidence linking land development and transportation investments to physical activity with resulting implications for chronic disease prevention. Links between the physical environment and health have traditionally focused on harmful exposures such as air pollution, noise, and traffic injury. Given limited funds and competition for how and where investments are made, there is a need to prioritize and target resources to maximize health benefits that can include activity related chronic disease prevention. The ability to apply this evidence to decision making has been limited by the complexity and inconsistency of research methods, and lack of a direct connection with the planning contexts in which decisions are made. Scenario planning tools provide a method to apply evidence with spatial planning decisions at a range of geographic scales. The US Environmental Protection Agency commissioned the development of a National Public Health Assessment Model (N-PHAM). This project utilized built and natural environment data at the block-group level and large population surveys to model the relationships of the environment with several health outcomes for a range of age and income groups. N-PHAM is the first health assessment tool that can connect to multiple existing scenario planning platforms utilizing nationally available data and can be consistently applied nationally. Such tools can empower communities to choose investments that have the greatest potential to improve public health and quality of life, reduce health care costs, and address environmental justice related disparities.
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Affiliation(s)
- Jessica Schoner
- Urban Design 4 Health Inc., 353 Rockingham St., Rochester, NY 14620, USA
| | - Jim Chapman
- Urban Design 4 Health Inc., 353 Rockingham St., Rochester, NY 14620, USA
| | - Eric H Fox
- Urban Design 4 Health Inc., 353 Rockingham St., Rochester, NY 14620, USA
| | - Nicole Iroz-Elardo
- Urban Design 4 Health Inc., 353 Rockingham St., Rochester, NY 14620, USA
| | - Allen Brookes
- US Environmental Protection Agency, 200 S.W. 35th Street, Corvallis, OR 97333-4902, USA
| | - Kara E MacLeod
- Fielding School of Public Health, University of California, Los Angeles, Life Sciences Building, Office 5127, Los Angeles, CA 90095, USA
| | - Lawrence D Frank
- University of British Columbia Schools of Population & Public Health & Community & Regional Planning, 2206 East Mall, Vancouver, BC, Canada V6T 1Z3
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28
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Abstract
PURPOSE OF REVIEW Urban form can impact air pollution and public health. We reviewed health-related articles that assessed (1) the relationships among urban form, air pollution, and health as well as (2) aspects of the urban environment (i.e., green space, noise, physical activity) that may modify those relationships. RECENT FINDINGS Simulation and empirical studies demonstrate an association between compact growth, improved regional air quality, and health. Most studies are cross-sectional and focus on connections between transportation emissions and land use. The physical and mental health impacts of green space, public spaces that promote physical activity, and noise are well-studied aspects of the urban environment and there is evidence that these factors may modify the relationship between air pollution and health. Urban form can support efforts to design clean, health-promoting cities. More work is needed to operationalize specific strategies and to elucidate the causal pathways connecting various aspects of health.
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29
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Does Walkability Contribute to Geographic Variation in Psychosocial Distress? A Spatial Analysis of 91,142 Members of the 45 and Up Study in Sydney, Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15020275. [PMID: 29415461 PMCID: PMC5858344 DOI: 10.3390/ijerph15020275] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Revised: 01/31/2018] [Accepted: 02/01/2018] [Indexed: 01/03/2023]
Abstract
Walkability describes the capacity of the built environment to promote walking, and has been proposed as a potential focus for community-level mental health planning. We evaluated this possibility by examining the contribution of area-level walkability to variation in psychosocial distress in a population cohort at spatial scales comparable to those used for regional planning in Sydney, Australia. Data on psychosocial distress were analysed for 91,142 respondents to the 45 and Up Study baseline survey between January 2006 and April 2009. We fit conditional auto regression models at the postal area level to obtain smoothed “disease maps” for psychosocial distress, and assess its association with area-level walkability after adjusting for individual- and area-level factors. Prevalence of psychosocial distress was 7.8%; similar for low (7.9%), low-medium (7.9%), medium-high (8.0%), and high (7.4%) walkability areas; and decreased with reducing postal area socioeconomic disadvantage: 12.2% (most), 9.3%, 7.5%, 5.9%, and 4.7% (least). Unadjusted disease maps indicated strong geographic clustering of psychosocial distress with 99.0% of excess prevalence due to unobserved and spatially structured factors, which was reduced to 55.3% in fully adjusted maps. Spatial and unstructured variance decreased by 97.3% and 39.8% after adjusting for individual-level factors, and another 2.3% and 4.2% with the inclusions of area-level factors. Excess prevalence of psychosocial distress in postal areas was attenuated in adjusted models but remained spatially structured. Postal area prevalence of high psychosocial distress is geographically clustered in Sydney, but is unrelated to postal area walkability. Area-level socioeconomic disadvantage makes a small contribution to this spatial structure; however, community-level mental health planning will likely deliver greatest benefits by focusing on individual-level contributors to disease burden and inequality associated with psychosocial distress.
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30
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Helbich M. Toward dynamic urban environmental exposure assessments in mental health research. ENVIRONMENTAL RESEARCH 2018; 161:129-135. [PMID: 29136521 PMCID: PMC5773240 DOI: 10.1016/j.envres.2017.11.006] [Citation(s) in RCA: 115] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 10/09/2017] [Accepted: 11/02/2017] [Indexed: 05/16/2023]
Abstract
It is increasingly recognized that mental disorders are affected by both personal characteristics and environmental exposures. The built, natural, and social environments can either contribute to or buffer against metal disorders. Environmental exposure assessments related to mental health typically rely on neighborhoods within which people currently live. In this article, I call into question such neighborhood-based exposure assessments at one point in time, because human life unfolds over space and across time. To circumvent inappropriate exposure assessments and to better grasp the etiologies of mental disease, I argue that people are exposed to multiple health-supporting and harmful exposures not only during their daily lives, but also over the course of their lives. This article aims to lay a theoretical foundation elucidating the impact of dynamic environmental exposures on mental health outcomes. I examine, first, the possibilities and challenges for mental health research to integrate people's environmental exposures along their daily paths and, second, how exposures over people's residential history might affect mental health later in life. To push the borders of scientific inquiries, I stress that only such mobility-based approaches facilitate an exploration of exposure duration, exposure sequences, and exposure accumulation.
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Affiliation(s)
- Marco Helbich
- Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Heidelberglaan 2, 3584 CS Utrecht, The Netherlands.
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31
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Ram B, Shankar A, Nightingale CM, Giles-Corti B, Ellaway A, Cooper AR, Page A, Cummins S, Lewis D, Whincup PH, Cook DG, Rudnicka AR, Owen CG. Comparisons of depression, anxiety, well-being, and perceptions of the built environment amongst adults seeking social, intermediate and market-rent accommodation in the former London Olympic Athletes' Village. Health Place 2017; 48:31-39. [PMID: 28917115 PMCID: PMC5711255 DOI: 10.1016/j.healthplace.2017.09.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 08/14/2017] [Accepted: 09/03/2017] [Indexed: 11/19/2022]
Abstract
The Examining Neighbourhood Activities in Built Living Environments in London (ENABLE London) study provides a unique opportunity to examine differences in mental health and well-being amongst adults seeking social, intermediate (affordable rent), and market-rent housing in a purpose built neighbourhood (East Village, the former London 2012 Olympic Athletes' Village), specifically designed to encourage positive health behaviours. Multi-level logistic regression models examined baseline differences in levels of depression, anxiety and well-being across the housing groups. Compared with the intermediate group, those seeking social housing were more likely to be depressed, anxious and had poorer well-being after adjustment for demographic and health status variables. Further adjustments for neighbourhood perceptions suggest that compared with the intermediate group, perceived neighbourhood characteristics may be an important determinant of depression amongst those seeking social housing, and lower levels of happiness the previous day amongst those seeking market-rent housing. These findings add to the extensive literature on inequalities in health, and provide a strong basis for future longitudinal work that will examine change in depression, anxiety and well-being after moving into East Village, where those seeking social housing potentially have the most to gain.
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Affiliation(s)
- Bina Ram
- Population Health Research Institute, St George's, University of London, Cranmer Terrace, London SW17 0RE, UK.
| | - Aparna Shankar
- Population Health Research Institute, St George's, University of London, Cranmer Terrace, London SW17 0RE, UK
| | - Claire M Nightingale
- Population Health Research Institute, St George's, University of London, Cranmer Terrace, London SW17 0RE, UK
| | | | - Anne Ellaway
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, UK
| | - Ashley R Cooper
- Centre for Exercise, Nutrition and Health Sciences, University of Bristol, UK; National Institute for Health Research, Bristol Biomedical Research Unit in Nutrition, Diet and Lifestyle, Bristol, UK
| | - Angie Page
- Centre for Exercise, Nutrition and Health Sciences, University of Bristol, UK
| | | | - Daniel Lewis
- London School of Hygiene and Tropical Medicine, UK
| | - Peter H Whincup
- Population Health Research Institute, St George's, University of London, Cranmer Terrace, London SW17 0RE, UK
| | - Derek G Cook
- Population Health Research Institute, St George's, University of London, Cranmer Terrace, London SW17 0RE, UK
| | - Alicja R Rudnicka
- Population Health Research Institute, St George's, University of London, Cranmer Terrace, London SW17 0RE, UK
| | - Christopher G Owen
- Population Health Research Institute, St George's, University of London, Cranmer Terrace, London SW17 0RE, UK
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