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Gabison J, Palazzolo B, Saleh C, Ritchie O, Sheehan K, Othman A, Harper DM, Oshman L. Supporting faculty development for obesity education: A National Survey of United States family medicine residency programme directors. Clin Obes 2024; 14:e12654. [PMID: 38525544 DOI: 10.1111/cob.12654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 12/04/2023] [Accepted: 01/29/2024] [Indexed: 03/26/2024]
Abstract
Obesity is the most common chronic condition in the United States (US), yet primary care physicians face barriers in providing obesity treatment. This study examines the prevalence of American Board of Obesity Medicine (ABOM) certified obesity specialists on the faculty of US Family Medicine residency training programmes, the preparedness of graduating resident physicians to treat obesity, and residency training programme director preferences for supporting faculty development to improve residency education in obesity management. This cross-sectional on-line survey of programme directors addressed the number of ABOM-certified faculty, perceived graduate preparedness to treat obesity, and priorities to improve faculty expertise and obesity curriculum. Of 672 eligible programme directors, 298 (44%) responded to our survey. Most programmes (76%) had no ABOM-certified faculty. The proportion of programme directors assessing their graduates as prepared to care for patients with obesity has significantly decreased in the last 5 years (2018: 74%, 2022: 58%, p = .016). Residents in programmes with ABOM-certified faculty member were more likely to be assessed as very prepared to provide medical care (18% vs. 7.8% p = .047). A majority (54%) of programme directors identified limited faculty training and expertise as the biggest faculty and resident-level barrier to quality obesity care. This study demonstrates an important trend towards increasing ABOM-certification among Family Medicine residency programme faculty and an urgent need to prioritise faculty development to improve faculty expertise and resident training to address the obesity epidemic.
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Affiliation(s)
- Jonathan Gabison
- Department of Family Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Beatrice Palazzolo
- Department of Family Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Christina Saleh
- Department of Family Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Olivia Ritchie
- Department of Family Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Kayla Sheehan
- Department of Family Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Amal Othman
- Department of Family Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Diane M Harper
- Department of Family Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Lauren Oshman
- Department of Family Medicine, University of Michigan, Ann Arbor, Michigan, USA
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2
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Cavaillès C, Barnett TA, Sylvestre MP, Smyrnova A, Van Hulst A, O'Loughlin J. Prospective associations between neighborhood features and body mass index in Montreal adolescents. Ann Epidemiol 2024:S1047-2797(24)00085-1. [PMID: 38821155 DOI: 10.1016/j.annepidem.2024.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 05/20/2024] [Accepted: 05/26/2024] [Indexed: 06/02/2024]
Abstract
PURPOSE To investigate the association between the neighborhood built environment and trajectories of body mass index (BMI) in youth. METHODS Data were collected in a prospective study of 1293 adolescents in Montreal. Built environment variables were obtained from public databases for road networks, land use, and the Canadian Census. Anthropometric data were collected when participants were ages 12.5, 15 and 17 years. We undertook hierarchical cluster analysis to identify contrasting neighborhood types based on features of the built environment (e.g., vegetation, population density, walkability). Associations between neighborhood type and trajectories of BMI z-score (BMIz) were estimated using multivariable linear mixed regression analyses, stratified by sex. RESULTS We identified three neighborhood types: Urban, Suburban, and Village. In contrast to the Urban type, the Suburban type was characterized by more vegetation, few services and low population density. Village and Suburban types were similar, but the former had greater land use diversity, population density with more parks and a denser food environment. Among girls, living in Urban types was associated with decreasing BMIz trajectories. Living in Village types was associated with increasing BMIz trajectories. No associations were observed among boys. CONCLUSIONS Neighborhoods characterized by greater opportunities for active living appear to be less obesogenic, particularly among girls.
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Affiliation(s)
| | - Tracie Ann Barnett
- Department of Family Medicine, McGill University, Montreal, QC, Canada; Research Center, Sainte-Justine University Hospital Research Center, Montreal, Quebec, Canada.
| | - Marie-Pierre Sylvestre
- Department of Social and Preventive Medicine, École de santé publique de l'Université de Montréal (ESPUM), Montreal, Canada
| | - Anna Smyrnova
- Research Center, Sainte-Justine University Hospital Research Center, Montreal, Quebec, Canada
| | - Andrea Van Hulst
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
| | - Jennifer O'Loughlin
- Department of Social and Preventive Medicine, École de santé publique de l'Université de Montréal (ESPUM), Montreal, Canada
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Xu M, Wilson JP, Bruine de Bruin W, Lerner L, Horn AL, Livings MS, de la Haye K. New insights into grocery store visits among east Los Angeles residents using mobility data. Health Place 2024; 87:103220. [PMID: 38492528 DOI: 10.1016/j.healthplace.2024.103220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 02/16/2024] [Accepted: 02/19/2024] [Indexed: 03/18/2024]
Abstract
In this study, we employed spatially aggregated population mobility data, generated from mobile phone locations in 2021, to investigate patterns of grocery store visits among residents east and northeast of Downtown Los Angeles, in which 60% of the census tracts had previously been designated as "food deserts". Further, we examined whether the store visits varied with neighborhood sociodemographics and grocery store accessibility. We found that residents averaged 0.4 trips to grocery stores per week, with only 13% of these visits within home census tracts, and 40% within home and neighboring census tracts. The mean distance from home to grocery stores was 2.2 miles. We found that people visited grocery stores more frequently when they lived in neighborhoods with higher percentages of Hispanics/Latinos, renters and foreign-born residents, and a greater number of grocery stores. This research highlights the utility of mobility data in elucidating grocery store use, and factors that may facilitate or be a barrier to store access. The results point to limitations of using geographically constrained metrics of food access like food deserts.
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Affiliation(s)
- Mengya Xu
- Spatial Sciences Institute, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, 3616 Trousdale Parkway AHF B55, Los Angeles, CA 90089, USA.
| | - John P Wilson
- Spatial Sciences Institute, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, 3616 Trousdale Parkway AHF B55, Los Angeles, CA 90089, USA; Department of Sociology, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, 851 Downey Way HSH 314, Los Angeles, CA 90089, USA; Department of Civil & Environmental Engineering and Computer Science, Viterbi School of Engineering, University of Southern California, 3650 McClintock Avenue, Los Angeles, CA 90089, USA; Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 1845 N Soto Street, Los Angeles, CA 90032, USA; School of Architecture, University of Southern California, 850 Bloom Walk WAH 204, Los Angeles, CA 90089, USA.
| | - Wändi Bruine de Bruin
- Sol Price School of Public Policy, University of Southern California, 650 Childs Way RGL 311, Los Angeles, CA 90089, USA; Department of Psychology, Dornsife College of Letters, Arts and Sciences, University of Southern California, 3620 S McClintock Avenue SGM 501, Los Angeles, CA 90089, USA; Center for Economic and Social Research, University of Southern California, Los Angeles, 635 Downey Way VPD, Los Angeles, CA 90089, USA.
| | - Leo Lerner
- Spatial Sciences Institute, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, 3616 Trousdale Parkway AHF B55, Los Angeles, CA 90089, USA.
| | - Abigail L Horn
- Information Sciences Institute and Department of Industrial and Systems Engineering, Viterbi School of Engineering, University of Southern California, 3650 McClintock Avenue, Los Angeles, CA 90089, USA.
| | - Michelle Sarah Livings
- Center for Research on Child and Family Wellbeing, School of Public & International Affairs, Princeton University, Princeton, NJ 08544, USA.
| | - Kayla de la Haye
- Spatial Sciences Institute, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, 3616 Trousdale Parkway AHF B55, Los Angeles, CA 90089, USA; Center for Economic and Social Research, University of Southern California, Los Angeles, 635 Downey Way VPD, Los Angeles, CA 90089, USA.
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4
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Sharifi Y, Sobhani S, Ramezanghorbani N, Payab M, Ghoreshi B, Djalalinia S, Nouri Ghonbalani Z, Ebrahimpur M, Eslami M, Qorbani M. Association of greenspaces exposure with cardiometabolic risk factors: a systematic review and meta-analysis. BMC Cardiovasc Disord 2024; 24:170. [PMID: 38509487 PMCID: PMC10953288 DOI: 10.1186/s12872-024-03830-1] [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: 12/15/2023] [Accepted: 03/05/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Cardiometabolic conditions are major contributors to the global burden of disease. An emerging body of evidence has associated access to and surrounding public open spaces (POS) and greenspace with cardiometabolic risk factors, including obesity, body mass index (BMI), hypertension (HTN), blood glucose (BG), and lipid profiles. This systematic review aimed to synthesize this evidence. METHODS This systematic review was conducted based on the PRISMA guidelines. Four electronic databases including Web of Science, PubMed, Scopus, and Google Scholar were searched for eligible articles published until July 2023. All observational studies which assessed the association of greenspace and POS with cardiometabolic risk factors including obesity, BMI, HTN, BG, and lipid profiles were included and reviewed by two authors independently. Heterogeneity between studies was assessed using the I2 index and Cochrane's Q test. Random/fixed effect meta-analyses were used to combine the association between greenspace exposure with cardiometabolic risk factors. RESULTS Overall, 118 relevant articles were included in our review. The majority of the articles were conducted in North America or Europe. In qualitative synthesis, access or proximity to greenspaces or POS impacts BMI and blood pressure or HTN, BG, and lipid profiles via various mechanisms. According to the random effect meta-analysis, more access to greenspace was significantly associated with lower odds of HTN (odds ratio (OR): 0.81, 95% confidence intervals (CIs): 0.61-0.99), obesity (OR: 0.83, 95% CIs: 0.77-0.90), and diabetes (OR:0.79, 95% CI: 0.67,0.90). CONCLUSIONS Findings of this systematic review and meta-analysis suggested that greenspace accessibility is associated with some cardiometabolic risk factors. Improving greenspace accessibility could be considered as one of the main strategies to reduce cardiometabolic risk factors at population level.
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Affiliation(s)
- Yasaman Sharifi
- Department of Radiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sahar Sobhani
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Nahid Ramezanghorbani
- Department of Development and Coordination Scientific Information and Publications, Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran
| | - Moloud Payab
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Behnaz Ghoreshi
- Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Shirin Djalalinia
- Development of Research & Technology Center, Ministry of Health and Medical Education, Tehran, Iran
| | - Zahra Nouri Ghonbalani
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Mahbube Ebrahimpur
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maysa Eslami
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.
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García Bulle Bueno B, Horn AL, Bell BM, Bahrami M, Bozkaya B, Pentland A, de la Haye K, Moro E. Effect of mobile food environments on fast food visits. Nat Commun 2024; 15:2291. [PMID: 38480685 PMCID: PMC10937966 DOI: 10.1038/s41467-024-46425-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 02/26/2024] [Indexed: 03/17/2024] Open
Abstract
Poor diets are a leading cause of morbidity and mortality. Exposure to low-quality food environments saturated with fast food outlets is hypothesized to negatively impact diet. However, food environment research has predominantly focused on static food environments around home neighborhoods and generated mixed findings. In this work, we leverage population-scale mobility data in the U.S. to examine 62M people's visits to food outlets and evaluate how food choice is influenced by the food environments people are exposed to as they move through their daily routines. We find that a 10% increase in exposure to fast food outlets in mobile environments increases individuals' odds of visitation by 20%. Using our results, we simulate multiple policy strategies for intervening on food environments to reduce fast-food outlet visits. This analysis suggests that optimal interventions are informed by spatial, temporal, and behavioral features and could have 2x to 4x larger effect than traditional interventions focused on home food environments.
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Affiliation(s)
| | - Abigail L Horn
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90089, USA
- Department of Industrial and Systems Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, 90089, USA
- Information Sciences Institute, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, 90292, USA
| | - Brooke M Bell
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90089, USA
- Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, New Haven, CT, 06510, USA
| | - Mohsen Bahrami
- Institute for Data, Systems, and Society, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Burçin Bozkaya
- Sabanci Business School, Sabanci University, 34956, Tuzla, Istanbul, Turkey
| | - Alex Pentland
- Institute for Data, Systems, and Society, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Kayla de la Haye
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, 90089, USA
| | - Esteban Moro
- Institute for Data, Systems, and Society, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA.
- Grupo Interdisciplinar de Sistemas Complejos (GISC), Department of Mathematics and GISC, Universidad Carlos III de Madrid, 28911, Leganés, Spain.
- Network Science Institute, Northeastern University, Boston, MA, 02115, USA.
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6
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Libuy N, Church D, Ploubidis G, Fitzsimons E. Fast food proximity and weight gain in childhood and adolescence: Evidence from Great Britain. HEALTH ECONOMICS 2024; 33:449-465. [PMID: 37971895 PMCID: PMC10952272 DOI: 10.1002/hec.4770] [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: 09/29/2022] [Revised: 09/08/2023] [Accepted: 09/18/2023] [Indexed: 11/19/2023]
Abstract
We study the relationship between proximity to fast food restaurants and weight gain from late childhood to early adolescence. We use the Millennium Cohort Study, a UK-wide nationally representative longitudinal study, linked with granular geocoded food outlet data to measure the presence of fast food outlets around children's homes and schools from ages 7 to 14. We find that proximity to fast food outlets is associated with increased weight (body mass index, overweight, obese, body fat, weight), but only among those with maternal education below degree level. Within this sample, those with lower levels of emotional regulation are at heightened risk of weight gain.
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Affiliation(s)
- Nicolás Libuy
- Centre for Longitudinal Studies, Social Research Institute, UCLLondonUK
| | - David Church
- Centre for Longitudinal Studies, Social Research Institute, UCLLondonUK
| | - George Ploubidis
- Centre for Longitudinal Studies, Social Research Institute, UCLLondonUK
| | - Emla Fitzsimons
- Centre for Longitudinal Studies, Social Research Institute, UCLLondonUK
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7
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Padda I, Fabian D, Farid M, Mahtani A, Sethi Y, Ralhan T, Das M, Chandi S, Johal G. Social determinants of health and its impact on cardiovascular disease in underserved populations: A critical review. Curr Probl Cardiol 2024; 49:102373. [PMID: 38185436 DOI: 10.1016/j.cpcardiol.2024.102373] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 01/03/2024] [Indexed: 01/09/2024]
Abstract
In the United States, a patient succumbs to cardiovascular disease (CVD) every 33 seconds and costs the healthcare system close to $240 billion dollars annually. Social determinants of health (SDOH) are key factors responsible in structuring the well-being of individuals and communities. It significantly influences health outcomes and is reliant on several factors such as economic stability, education, healthcare access, community composition, and governmental policies. This review explores the impact of SDOH on the escalating global burden of CVD and identifies potential modifiable risk factors that contribute to acute coronary syndrome (ACS) among underserved communities. In addition, it also addresses the necessity for interventions to narrow healthcare related disparities ensuring improvement in CVD outcomes in this subgroup of population.
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Affiliation(s)
- Inderbir Padda
- Department of Internal Medicine, Richmond University Medical Center/Mount Sinai, Staten Island, NY, USA; PearResearch, Dehradun, India.
| | - Daniel Fabian
- Department of Internal Medicine, Richmond University Medical Center/Mount Sinai, Staten Island, NY, USA
| | - Meena Farid
- Department of Internal Medicine, Richmond University Medical Center/Mount Sinai, Staten Island, NY, USA
| | - Arun Mahtani
- Department of Internal Medicine, Richmond University Medical Center/Mount Sinai, Staten Island, NY, USA
| | - Yashendra Sethi
- PearResearch, Dehradun, India; Department of Medicine, Government Doon Medical College, Dehradun
| | - Tushar Ralhan
- School of Medicine, St. George's University, True Blue, Grenada
| | - Maumita Das
- School of Medicine, St. George's University, True Blue, Grenada
| | - Sonam Chandi
- Department of Quality and Patient Safety, Richmond University Medical Center/Mount Sinai, Staten Island, NY, USA
| | - Gurpreet Johal
- Valley Medical Centre, University of Washington, Seattle, US
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8
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Goldfinger E, Stoler J, Goel N. A Multiscale Spatiotemporal Epidemiological Analysis of Neighborhood Correlates of Triple-Negative Breast Cancer. Cancer Epidemiol Biomarkers Prev 2024; 33:279-287. [PMID: 37971370 DOI: 10.1158/1055-9965.epi-22-1255] [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: 11/29/2022] [Revised: 02/18/2023] [Accepted: 11/15/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Women living in disadvantaged neighborhoods present with increased prevalence rates of triple-negative breast cancer (TNBC). This study takes a spatiotemporal epidemiological approach to understand the impact of socioenvironmental contextual factors on TNBC prevalence rates. METHODS We analyzed 935 TNBC cases from a major cancer center registry, between 2005 and 2017, to explore spatial and space-time clusters of TNBC prevalence rates at the census tract and neighborhood scales. Spatial regression analysis was performed to examine relationships between nine socioenvironmental factors and TNBC prevalence rates at both ecological scales. RESULTS We observed spatial clustering of high TNBC prevalence rates along a north-south corridor of Miami-Dade County along Interstate 95, a region containing several majority non-Hispanic Black neighborhoods. Among the ecologic measures, the percent of a region designated as a brownfield was associated with TNBC prevalence rates at the tract-level (β = 4.27; SE = 1.08; P < 0.001) and neighborhood-level (β = 8.61; SE = 2.20; P < 0.001). CONCLUSIONS Our spatiotemporal analysis identified robust patterns of hot spots of TNBC prevalence rates in a corridor of several disadvantaged neighborhoods in the northern half of the county. These patterns of TNBC align with the literature regarding at-risk groups and neighborhood-level effects on TNBC; however, remain to be validated in a population-based sample. IMPACT Spatial epidemiological approaches can help public health officials and cancer care providers improve place-specific screening, patient care, and understanding of socioenvironmental factors that may shape breast cancer subtype through gene-environment and epigenetic interactions.
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Affiliation(s)
- Erica Goldfinger
- Department of Geography and Sustainable Development, University of Miami, Coral Gables, Florida
- Abess Center for Ecosystem Science and Policy, University of Miami, Coral Gables, Florida
| | - Justin Stoler
- Department of Geography and Sustainable Development, University of Miami, Coral Gables, Florida
- Abess Center for Ecosystem Science and Policy, University of Miami, Coral Gables, Florida
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - Neha Goel
- Department of Surgery, Division of Surgical Oncology, University of Miami Miller School of Medicine, Coral Gables, Florida
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Coral Gables, Florida
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
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9
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Cao Y, Yang JA, Nara A, Jankowska MM. Designing and Evaluating a Hierarchical Framework for Matching Food Outlets across Multi-sourced Geospatial Datasets: a Case Study of San Diego County. J Urban Health 2024; 101:155-169. [PMID: 38167974 PMCID: PMC10897078 DOI: 10.1007/s11524-023-00817-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/29/2023] [Indexed: 01/05/2024]
Abstract
Research on retail food environment (RFE) relies on data availability and accuracy. However, the discrepancies in RFE datasets may lead to imprecision when measuring association with health outcomes. In this research, we present a two-tier hierarchical point of interest (POI) matching framework to compare and triangulate food outlets across multiple geospatial data sources. Two matching parameters were used including the geodesic distance between businesses and the similarity of business names according to Levenshtein distance (LD) and Double Metaphone (DM). Sensitivity analysis was conducted to determine thresholds of matching parameters. Our Tier 1 matching used more restricted parameters to generate high confidence-matched POIs, whereas in Tier 2 we opted for relaxed matching parameters and applied a weighted multi-attribute model on the previously unmatched records. Our case study in San Diego County, California used government, commercial, and crowdsourced data and returned 20.2% matched records from Tier 1 and 18.6% matched from Tier 2. Our manual validation shows a 100% matching rate for Tier 1 and up to 30.6% for Tier 2. Matched and unmatched records from Tier 1 were further analyzed for spatial patterns and categorical differences. Our hierarchical POI matching framework generated highly confident food POIs by conflating datasets and identified some food POIs that are unique to specific data sources. Triangulating RFE data can reduce uncertain and invalid POI listings when representing food environment using multiple data sources. Studies investigating associations between food environment and health outcomes may benefit from improved quality of RFE.
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Affiliation(s)
- Yanjia Cao
- Department of Geography, The University of Hong Kong, Pok Fu Lam, Hong Kong.
| | - Jiue-An Yang
- Department of Population Sciences, Beckman Research Institute, City of Hope, Duarte, CA, USA
| | - Atsushi Nara
- Department of Geography, San Diego State University, San Diego, CA, USA
| | - Marta M Jankowska
- Department of Population Sciences, Beckman Research Institute, City of Hope, Duarte, CA, USA
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10
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Jindal M, Barnert E, Chomilo N, Gilpin Clark S, Cohen A, Crookes DM, Kershaw KN, Kozhimannil KB, Mistry KB, Shlafer RJ, Slopen N, Suglia SF, Nguemeni Tiako MJ, Heard-Garris N. Policy solutions to eliminate racial and ethnic child health disparities in the USA. THE LANCET. CHILD & ADOLESCENT HEALTH 2024; 8:159-174. [PMID: 38242598 PMCID: PMC11163982 DOI: 10.1016/s2352-4642(23)00262-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 08/28/2023] [Accepted: 09/27/2023] [Indexed: 01/21/2024]
Abstract
Societal systems act individually and in combination to create and perpetuate structural racism through both policies and practices at the local, state, and federal levels, which, in turn, generate racial and ethnic health disparities. Both current and historical policy approaches across multiple sectors-including housing, employment, health insurance, immigration, and criminal legal-have the potential to affect child health equity. Such policies must be considered with a focus on structural racism to understand which have the potential to eliminate or at least attenuate disparities. Policy efforts that do not directly address structural racism will not achieve equity and instead worsen gaps and existing disparities in access and quality-thereby continuing to perpetuate a two-tier system dictated by racism. In Paper 2 of this Series, we build on Paper 1's summary of existing disparities in health-care delivery and highlight policies within multiple sectors that can be modified and supported to improve health equity, and, in so doing, improve the health of racially and ethnically minoritised children.
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Affiliation(s)
- Monique Jindal
- Department of Medicine, University of Illinois Chicago School of Medicine, Chicago, IL, USA.
| | - Elizabeth Barnert
- Department of Pediatrics, David Geffen School of Medicine at UCLA, University of California, Los Angeles, CA, USA
| | - Nathan Chomilo
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Shawnese Gilpin Clark
- Smith Child Health Outcomes, Research, and Evaluation Center, Stanley Manne Children's Research Institute, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, IL, USA; Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Alyssa Cohen
- Smith Child Health Outcomes, Research, and Evaluation Center, Stanley Manne Children's Research Institute, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, IL, USA; Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Danielle M Crookes
- Department of Health Sciences, Bouvé College of Health Sciences, Northeastern University, Boston, MA, USA; Department of Sociology and Anthropology, College of Social Sciences and Humanities, Northeastern University, Boston, MA, USA
| | - Kiarri N Kershaw
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Katy Backes Kozhimannil
- Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Kamila B Mistry
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Office of Extramural Research, Education, and Priority Populations, Agency for Healthcare Research and Quality, US Department of Health and Human Services, Rockville, MD, USA
| | - Rebecca J Shlafer
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Natalie Slopen
- Department of Social and Behavioral Sciences, Harvard T H Chan School of Public Health, Boston, MA, USA; Center on the Developing Child, Harvard University, Boston, MA, USA
| | - Shakira F Suglia
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | | | - Nia Heard-Garris
- Smith Child Health Outcomes, Research, and Evaluation Center, Stanley Manne Children's Research Institute, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, IL, USA; Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Institute for Policy Research, Northwestern University, Chicago, IL, USA
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11
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Rollings KA, Dannenberg AL, Frumkin H, Jackson RJ. Built Environment and Public Health: More Than 20 Years of Progress. Am J Public Health 2024; 114:27-33. [PMID: 38091569 PMCID: PMC10726940 DOI: 10.2105/ajph.2023.307451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Affiliation(s)
- Kimberly A Rollings
- Kimberly A. Rollings is with the Health & Design Research Fellowship Program, University of Michigan Medical School, the Institute for Healthcare Policy and Innovation, and the Institute for Social Research, University of Michigan, Ann Arbor. Andrew L. Dannenberg is with the Department of Environmental and Occupational Health Sciences, School of Public Health, and the Department of Urban Design and Planning, College of Built Environments, University of Washington, Seattle. Howard Frumkin is with the Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, and the Land and People Lab, Trust for Public Land, San Francisco, CA. Richard J. Jackson is with the Department of Environmental Health Sciences, Fielding School of Public Health, University of California, Los Angeles
| | - Andrew L Dannenberg
- Kimberly A. Rollings is with the Health & Design Research Fellowship Program, University of Michigan Medical School, the Institute for Healthcare Policy and Innovation, and the Institute for Social Research, University of Michigan, Ann Arbor. Andrew L. Dannenberg is with the Department of Environmental and Occupational Health Sciences, School of Public Health, and the Department of Urban Design and Planning, College of Built Environments, University of Washington, Seattle. Howard Frumkin is with the Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, and the Land and People Lab, Trust for Public Land, San Francisco, CA. Richard J. Jackson is with the Department of Environmental Health Sciences, Fielding School of Public Health, University of California, Los Angeles
| | - Howard Frumkin
- Kimberly A. Rollings is with the Health & Design Research Fellowship Program, University of Michigan Medical School, the Institute for Healthcare Policy and Innovation, and the Institute for Social Research, University of Michigan, Ann Arbor. Andrew L. Dannenberg is with the Department of Environmental and Occupational Health Sciences, School of Public Health, and the Department of Urban Design and Planning, College of Built Environments, University of Washington, Seattle. Howard Frumkin is with the Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, and the Land and People Lab, Trust for Public Land, San Francisco, CA. Richard J. Jackson is with the Department of Environmental Health Sciences, Fielding School of Public Health, University of California, Los Angeles
| | - Richard J Jackson
- Kimberly A. Rollings is with the Health & Design Research Fellowship Program, University of Michigan Medical School, the Institute for Healthcare Policy and Innovation, and the Institute for Social Research, University of Michigan, Ann Arbor. Andrew L. Dannenberg is with the Department of Environmental and Occupational Health Sciences, School of Public Health, and the Department of Urban Design and Planning, College of Built Environments, University of Washington, Seattle. Howard Frumkin is with the Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, and the Land and People Lab, Trust for Public Land, San Francisco, CA. Richard J. Jackson is with the Department of Environmental Health Sciences, Fielding School of Public Health, University of California, Los Angeles
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12
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Xu J, Liu Y, Liu Y, An R, Tong Z. Integrating street view images and deep learning to explore the association between human perceptions of the built environment and cardiovascular disease in older adults. Soc Sci Med 2023; 338:116304. [PMID: 37907059 DOI: 10.1016/j.socscimed.2023.116304] [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: 04/20/2023] [Revised: 08/10/2023] [Accepted: 10/05/2023] [Indexed: 11/02/2023]
Abstract
Understanding how built environment attributes affect health remains important. While many studies have explored the objective characteristics of built environments that affect health outcomes, few have examined the role of human perceptions of built environments on physical health. Baidu Street View images and computer vision technological advances have helped researchers overcome the constraints of traditional methods of measuring human perceptions (e.g., these methods are laborious, time-consuming, and costly), allowing for large-scale measurements of human perceptions. This study estimated human perceptions of the built environment (e.g., beauty, boredom, depression, safety, vitality, and wealth) by adopting Baidu Street View images and deep learning algorithms. Negative binomial regression models were employed to analyze the relationship between human perceptions and cardiovascular disease in older adults (e.g., ischemic heart disease and cerebrovascular disease). The results indicated that wealth perception is negatively related to the risk of cardiovascular disease. However, depression and vitality perceptions are positively associated with the risk of cardiovascular disease. Furthermore, we found no relationship between beauty, boredom, safety perceptions, and the risk of cardiovascular disease. Our findings highlight the importance of human perceptions in the development of healthy city planning and facilitate a comprehensive understanding of the relationship between built environment characteristics and health outcomes in older adults. They also demonstrate that street view images have the potential to provide insights into this complicated issue, assisting in the formulation of refined interventions and health policies.
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Affiliation(s)
- Jiwei Xu
- School of Resource and Environmental Sciences, Wuhan University, Wuhan, 430079, PR China
| | - Yaolin Liu
- School of Resource and Environmental Sciences, Wuhan University, Wuhan, 430079, PR China; Collaborative Innovation Center of Geospatial Technology, Wuhan University, Wuhan, 430079, PR China; Key Laboratory of Geographic Information System of Ministry of Education, Wuhan University, Wuhan, 430079, PR China; Duke Kunshan University, Kunshan, 215316, PR China.
| | - Yanfang Liu
- School of Resource and Environmental Sciences, Wuhan University, Wuhan, 430079, PR China; Collaborative Innovation Center of Geospatial Technology, Wuhan University, Wuhan, 430079, PR China; Key Laboratory of Geographic Information System of Ministry of Education, Wuhan University, Wuhan, 430079, PR China
| | - Rui An
- School of Resource and Environmental Sciences, Wuhan University, Wuhan, 430079, PR China
| | - Zhaomin Tong
- School of Resource and Environmental Sciences, Wuhan University, Wuhan, 430079, PR China
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13
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Horn AL, Bell BM, Bulle Bueno BG, Bahrami M, Bozkaya B, Cui Y, Wilson JP, Pentland A, Moro E, de la Haye K. Population mobility data provides meaningful indicators of fast food intake and diet-related diseases in diverse populations. NPJ Digit Med 2023; 6:208. [PMID: 37968446 PMCID: PMC10651929 DOI: 10.1038/s41746-023-00949-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 10/18/2023] [Indexed: 11/17/2023] Open
Abstract
The characteristics of food environments people are exposed to, such as the density of fast food (FF) outlets, can impact their diet and risk for diet-related chronic disease. Previous studies examining the relationship between food environments and nutritional health have produced mixed findings, potentially due to the predominant focus on static food environments around people's homes. As smartphone ownership increases, large-scale data on human mobility (i.e., smartphone geolocations) represents a promising resource for studying dynamic food environments that people have access to and visit as they move throughout their day. This study investigates whether mobility data provides meaningful indicators of diet, measured as FF intake, and diet-related disease, evaluating its usefulness for food environment research. Using a mobility dataset consisting of 14.5 million visits to geolocated food outlets in Los Angeles County (LAC) across a representative sample of 243,644 anonymous and opted-in adult smartphone users in LAC, we construct measures of visits to FF outlets aggregated over users living in neighborhood. We find that the aggregated measures strongly and significantly correspond to self-reported FF intake, obesity, and diabetes in a diverse, representative sample of 8,036 LAC adults included in a population health survey carried out by the LAC Department of Public Health. Visits to FF outlets were a better predictor of individuals' obesity and diabetes than their self-reported FF intake, controlling for other known risks. These findings suggest mobility data represents a valid tool to study people's use of dynamic food environments and links to diet and health.
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Affiliation(s)
- Abigail L Horn
- Information Sciences Institute and Department of Industrial and Systems Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, USA.
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
| | - Brooke M Bell
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, New Haven, CT, USA
| | | | - Mohsen Bahrami
- Institute for Data, Systems, and Society, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Burçin Bozkaya
- Sabanci Business School, Sabanci University, Istanbul, Turkey
| | - Yan Cui
- Los Angeles County Department of Public Health, Los Angeles, CA, USA
| | - John P Wilson
- Spatial Sciences Institute, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, CA, USA
- Departments of Civil & Environmental Engineering and Computer Science, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, USA
| | - Alex Pentland
- Institute for Data, Systems, and Society, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Esteban Moro
- Institute for Data, Systems, and Society, Massachusetts Institute of Technology, Cambridge, MA, USA
- Departamento de Matemáticas & GISC, Universidad Carlos III de Madrid, Leganés, Spain
| | - Kayla de la Haye
- Institute for Food System Equity, Center for Economic and Social Research, University of Southern California, Los Angeles, CA, USA
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14
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Xu J, Jing Y, Xu X, Zhang X, Liu Y, He H, Chen F, Liu Y. Spatial scale analysis for the relationships between the built environment and cardiovascular disease based on multi-source data. Health Place 2023; 83:103048. [PMID: 37348293 DOI: 10.1016/j.healthplace.2023.103048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 05/12/2023] [Accepted: 05/19/2023] [Indexed: 06/24/2023]
Abstract
To examine what built environment characteristics improve the health outcomes of human beings is always a hot issue. While a growing literature has analyzed the link between the built environment and health, few studies have investigated this relationship across different spatial scales. In this study, eighteen variables were selected from multi-source data and reduced to eight built environment attributes using principal component analysis. These attributes included socioeconomic deprivation, urban density, street walkability, land-use diversity, blue-green space, transportation convenience, ageing, and street insecurity. Multiscale geographically weighted regression was then employed to clarify how these attributes relate to cardiovascular disease at different scales. The results indicated that: (1) multiscale geographically weighted regression showed a better fit of the association between the built environment and cardiovascular diseases than other models (e.g., ordinary least squares and geographically weighted regression), and is thus an effective approach for multiscale analysis of the built environment and health associations; (2) built environment variables related to cardiovascular diseases can be divided into global variables with large scales (e.g., socioeconomic deprivation, street walkability, land-use diversity, blue-green space, transportation convenience, and ageing) and local variables with small scales (e.g., urban density and street insecurity); and (3) at specific spatial scales, global variables had trivial spatial variation across the area, while local variables showed significant gradients. These findings provide greater insight into the association between the built environment and lifestyle-related diseases in densely populated cities, emphasizing the significance of hierarchical and place-specific policy formation in health interventions.
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Affiliation(s)
- Jiwei Xu
- School of Resource and Environmental Sciences, Wuhan University, Wuhan, 430079, PR China
| | - Ying Jing
- Business School, Ningbo Institute of Technology, Zhejiang University, Ningbo, 315100, PR China
| | - Xinkun Xu
- Fujian Provincial Expressway Information Technology Company Limited, Fuzhou, 350000, PR China
| | - Xinyi Zhang
- School of Resource and Environmental Sciences, Wuhan University, Wuhan, 430079, PR China
| | - Yanfang Liu
- School of Resource and Environmental Sciences, Wuhan University, Wuhan, 430079, PR China; Key Laboratory of Geographic Information System of Ministry of Education, Wuhan University, Wuhan, 430079, PR China; Collaborative Innovation Center of Geospatial Technology, Wuhan University, Wuhan, 430079, PR China
| | - Huagui He
- Guangzhou Urban Planning & Design Survey Research Institute, Guangzhou, 510060, PR China
| | - Fei Chen
- Guangzhou Urban Planning & Design Survey Research Institute, Guangzhou, 510060, PR China
| | - Yaolin Liu
- School of Resource and Environmental Sciences, Wuhan University, Wuhan, 430079, PR China; Key Laboratory of Geographic Information System of Ministry of Education, Wuhan University, Wuhan, 430079, PR China; Collaborative Innovation Center of Geospatial Technology, Wuhan University, Wuhan, 430079, PR China.
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15
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Selvakumaran S, Lin CY, Hadgraft N, Chandrabose M, Owen N, Sugiyama T. Area-level socioeconomic inequalities in overweight and obesity: Systematic review on moderation by built-environment attributes. Health Place 2023; 83:103101. [PMID: 37625238 DOI: 10.1016/j.healthplace.2023.103101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 08/03/2023] [Accepted: 08/13/2023] [Indexed: 08/27/2023]
Abstract
Residents of lower socioeconomic status (SES) areas are at a higher risk of overweight/obesity than those from higher SES areas. Built environment attributes may mitigate such inequalities. This systematic review synthesised findings of studies examining built environment attributes as potential moderators of the associations between area-level SES and overweight/obesity in adults. From five databases, nine eligible studies were identified. The SES-overweight/obesity relationship was stronger in inner areas and suburbs of large cities, while it was weaker in more rural areas. Two studies examined walkability and reported contrasting findings: no moderation in one and marginally significant moderation (less inequality in higher walkability areas) in the other. No evidence of moderation was found for street connectivity, population density, the food environment, access to physical activity facilities and several perceived environmental attributes. Further research is needed on other built environment attributes (e.g., access to, quantity and quality of green spaces, active transport features), and ideally using prospective study designs and objective makers of adiposity.
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Affiliation(s)
- Sungkavi Selvakumaran
- Centre for Urban Transitions, Swinburne University of Technology, Level 1 EW Building, Hawthorn, VIC, 3122, Australia.
| | - Chien-Yu Lin
- Centre for Urban Transitions, Swinburne University of Technology, Level 1 EW Building, Hawthorn, VIC, 3122, Australia; Department of Public Health, College of Public Health, China Medical University, No. 100, Sec. 1, Jingmao Rd., Beitun Dist., Taichung, 406040, Taiwan; Faculty of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa City, Saitama, 359-1192, Japan.
| | - Nyssa Hadgraft
- Centre for Urban Transitions, Swinburne University of Technology, Level 1 EW Building, Hawthorn, VIC, 3122, Australia; Baker Heart & Diabetes Institute, 75 Commercial Rd, Melbourne, VIC, 3004, Australia.
| | - Manoj Chandrabose
- Centre for Urban Transitions, Swinburne University of Technology, Level 1 EW Building, Hawthorn, VIC, 3122, Australia; Baker Heart & Diabetes Institute, 75 Commercial Rd, Melbourne, VIC, 3004, Australia.
| | - Neville Owen
- Centre for Urban Transitions, Swinburne University of Technology, Level 1 EW Building, Hawthorn, VIC, 3122, Australia; Baker Heart & Diabetes Institute, 75 Commercial Rd, Melbourne, VIC, 3004, Australia.
| | - Takemi Sugiyama
- Centre for Urban Transitions, Swinburne University of Technology, Level 1 EW Building, Hawthorn, VIC, 3122, Australia; Baker Heart & Diabetes Institute, 75 Commercial Rd, Melbourne, VIC, 3004, Australia.
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16
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Mujahid MS, Maddali SR, Gao X, Oo KH, Benjamin LA, Lewis TT. The Impact of Neighborhoods on Diabetes Risk and Outcomes: Centering Health Equity. Diabetes Care 2023; 46:1609-1618. [PMID: 37354326 PMCID: PMC10465989 DOI: 10.2337/dci23-0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 06/05/2023] [Indexed: 06/26/2023]
Abstract
Neighborhood environments significantly influence the development of diabetes risk factors, morbidity, and mortality throughout an individual's life. The social, economic, and physical environments of a neighborhood all affect the health risks of individuals and communities and also affect population health inequities. Factors such as access to healthy food, green spaces, safe housing, and transportation options can impact the health outcomes of residents. Social factors, including social cohesion and neighborhood safety, also play an important role in shaping neighborhood environments and can influence the development of diabetes. Therefore, understanding the complex relationships between neighborhood environments and diabetes is crucial for developing effective strategies to address health disparities and promote health equity. This review presents landmark findings from studies that examined associations between neighborhood socioeconomic, built and physical, and social environmental factors and diabetes-related risk and outcomes. Our framework emphasizes the historical context and structural and institutional racism as the key drivers of neighborhood environments that ultimately shape diabetes risk and outcomes. To address health inequities in diabetes, we propose future research areas that incorporate health equity principles and place-based interventions.
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Affiliation(s)
- Mahasin S. Mujahid
- Division of Epidemiology, School of Public Health, University of California Berkeley, Berkeley, CA
| | - Sai Ramya Maddali
- Division of Epidemiology, School of Public Health, University of California Berkeley, Berkeley, CA
| | - Xing Gao
- Division of Epidemiology, School of Public Health, University of California Berkeley, Berkeley, CA
| | - Khin H. Oo
- Division of Epidemiology, School of Public Health, University of California Berkeley, Berkeley, CA
| | - Larissa A. Benjamin
- Division of Epidemiology, School of Public Health, University of California Berkeley, Berkeley, CA
| | - Tené T. Lewis
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
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17
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Purohit BM, Dawar A, Bansal K, Nilima, Malhotra S, Mathur VP, Duggal R. Sugar-sweetened beverage consumption and socioeconomic status: A systematic review and meta-analysis. Nutr Health 2023; 29:465-477. [PMID: 36384341 DOI: 10.1177/02601060221139588] [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] [Indexed: 06/16/2023]
Abstract
BACKGROUND Sugar-sweetened beverages (SSB) are an independent risk factor for obesity and other non-communicable diseases. Socioeconomic status (SES) is one of the key drivers for the purchase and consumption of SSBs among children and adults; however, there is a lack of strong evidence. This study aims to determine the association between SES and consumption patterns of SSBs across populations. RESULTS The review was conducted according to PRISMA guidelines. PubMed, MEDLINE, Scopus, EMBASE, LILACS, Web of Science, Cochrane, and CINHAL databases were searched for relevant articles until 2022. Participants included children, adolescents, and adults who consumed different SSBs and were assessed based on their SES. The random-effects model was used to obtain the pooled odds ratio (OR). Twenty-one studies (152,070 participants) met the inclusion criteria. The risk of bias was assessed using the Newcastle-Ottawa tool, with the majority of the studies indicating medium to high quality. Eight ORs from four studies (34,454 participants) were considered for meta-analysis. Results showed those belonging to high SES had 48% lower odds of consuming the SSBs (OR 0.52; 95% CI: 0.42-0.61; p = 0.017). The overall quality of evidence was ascertained using GRADE criteria, illustrating a moderate certainty of evidence between SSB consumption and SES. CONCLUSION Meta-analysis suggests that SES influences the consumption pattern of SSBs, with high SES having lower odds of SSB consumption.
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Affiliation(s)
- Bharathi M Purohit
- Division of Public Health Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Anika Dawar
- Division of Periodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Kalpana Bansal
- Division of Pedodontics and Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Nilima
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Sumit Malhotra
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Vijay P Mathur
- Division of Paediatric and Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Ritu Duggal
- Division of Orthodontics and Dentofacial Deformities, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
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18
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Ho I, Chng T, Kleve S, Choi T, Brimblecombe J. Exploration of the food environment in different socioeconomic areas in Hong Kong and Singapore: a cross-sectional case study. BMC Public Health 2023; 23:1127. [PMID: 37308892 DOI: 10.1186/s12889-023-15953-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 05/22/2023] [Indexed: 06/14/2023] Open
Abstract
This study explored the local food environment of Hong Kong and Singapore using a qualitative case study approach to inform future upstream public health nutrition policies. Food outlets that provide food to be eaten in the home were mapped in selected areas of high and low socioeconomic status (SES) of Hong Kong and Singapore. Food outlet density relative to land area was determined. In both countries, lower SES areas surveyed were shown to have higher food outlet density while higher SES areas had fewer but larger food outlets. In Hong Kong, both SES areas reported similar proportions of healthy and unhealthy food outlets.This study highlights the accessibility of food outlet types through their geographical location and density. Future research assessing the differences in eating culture between these two countries should be considered alongside this study's findings, to investigate strategies influencing the food environment in order to promote healthier eating habits.
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Affiliation(s)
- Ivan Ho
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Monash University, Melbourne, Vic, 3168, Australia
| | - Tricia Chng
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Monash University, Melbourne, Vic, 3168, Australia
| | - Sue Kleve
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Monash University, Melbourne, Vic, 3168, Australia
| | - Tammie Choi
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Monash University, Melbourne, Vic, 3168, Australia
| | - Julie Brimblecombe
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Monash University, Melbourne, Vic, 3168, Australia.
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19
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Tharrey M, Malisoux L, Klein O, Bohn T, Perchoux C. Urban densification over 9 years and change in the metabolic syndrome: A nationwide investigation from the ORISCAV-LUX cohort study. Soc Sci Med 2023; 331:116002. [PMID: 37478660 DOI: 10.1016/j.socscimed.2023.116002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 05/02/2023] [Accepted: 05/30/2023] [Indexed: 07/23/2023]
Abstract
A growing body of evidence suggests that urban densification may be protective against obesity, type 2 diabetes, and cardiometabolic diseases, yet studies on how built environmental features relate to metabolic syndrome (MetS) and its components are scarce. This longitudinal study examines the associations of baseline urban density and densification over 9 years with MetS and MetS components, among 510 participants enrolled in both waves of the ORISCAV-LUX study (2007-2017) in Luxembourg. A continuous MetS score (siMS) was calculated for each participant. Six features of residential built environments were computed around participants' home address: street connectivity, population density, density of amenities, street network distance to the nearest bus station, density of public transport stations, and land use mix. A composite index of urban densification (UDI) was calculated by averaging the six standardized built environment variables. Using adjusted generalized estimating equation (GEE) models, one-SD increase in UDI was associated with a worsening of the siMS score (β = 0.07, 95% CI: 0.02, 0.13), higher triglyceride levels (β = 0.05, 95% CI: 0.02, 0.09), and lower HDL-c levels (β = -1.29, 95% CI: -2.20, -0.38). The detrimental effect of UDI on lipid levels was significant only for participants living in dense areas at baseline. Higher baseline UDI, as well as increased UDI over time among movers, were also associated with greater waist circumference. There were no associations between UDI, fasting plasma glucose and systolic blood pressure. Sex and neighborhood socio-economic status did not moderate the associations between UDI and the cardiometabolic outcomes. Overall, we found limited evidence for an effect of urban densification on MetS and its components. Understanding urban dynamics remains a challenge, and more research investigating the independent and joint health effect of built environment features is needed to support urban planning and design that promote cardiometabolic health.
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Affiliation(s)
- Marion Tharrey
- Department of Urban Development and Mobility, Luxembourg Institute of Socio-Economic Research, Esch/Alzette, Luxembourg; Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg.
| | - Laurent Malisoux
- Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Olivier Klein
- Department of Urban Development and Mobility, Luxembourg Institute of Socio-Economic Research, Esch/Alzette, Luxembourg
| | - Torsten Bohn
- Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Camille Perchoux
- Department of Urban Development and Mobility, Luxembourg Institute of Socio-Economic Research, Esch/Alzette, Luxembourg
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20
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Mujahid MS, Wall-Wieler E, Hailu EM, Berkowitz RL, Gao X, Morris CM, Abrams B, Lyndon A, Carmichael SL. Neighborhood disinvestment and severe maternal morbidity in the state of California. Am J Obstet Gynecol MFM 2023; 5:100916. [PMID: 36905984 PMCID: PMC10959123 DOI: 10.1016/j.ajogmf.2023.100916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 02/16/2023] [Accepted: 02/28/2023] [Indexed: 03/11/2023]
Abstract
BACKGROUND Social determinants of health, including neighborhood context, may be a key driver of severe maternal morbidity and its related racial and ethnic inequities; however, investigations remain limited. OBJECTIVE This study aimed to examine the associations between neighborhood socioeconomic characteristics and severe maternal morbidity, as well as whether the associations between neighborhood socioeconomic characteristics and severe maternal morbidity were modified by race and ethnicity. STUDY DESIGN This study leveraged a California statewide data resource on all hospital births at ≥20 weeks of gestation (1997-2018). Severe maternal morbidity was defined as having at least 1 of 21 diagnoses and procedures (eg, blood transfusion or hysterectomy) as outlined by the Centers for Disease Control and Prevention. Neighborhoods were defined as residential census tracts (n=8022; an average of 1295 births per neighborhood), and the neighborhood deprivation index was a summary measure of 8 census indicators (eg, percentage of poverty, unemployment, and public assistance). Mixed-effects logistic regression models (individuals nested within neighborhoods) were used to compare odds of severe maternal morbidity across quartiles (quartile 1 [the least deprived] to quartile 4 [the most deprived]) of the neighborhood deprivation index before and after adjustments for maternal sociodemographic and pregnancy-related factors and comorbidities. Moreover, cross-product terms were created to determine whether associations were modified by race and ethnicity. RESULTS Of 10,384,976 births, the prevalence of severe maternal morbidity was 1.2% (N=120,487). In fully adjusted mixed-effects models, the odds of severe maternal morbidity increased with increasing neighborhood deprivation index (odds ratios: quartile 1, reference; quartile 4, 1.23 [95% confidence interval, 1.20-1.26]; quartile 3, 1.13 [95% confidence interval, 1.10-1.16]; quartile 2, 1.06 [95% confidence interval, 1.03-1.08]). The associations were modified by race and ethnicity such that associations (quartile 4 vs quartile 1) were the strongest among individuals in the "other" racial and ethnic category (1.39; 95% confidence interval, 1.03-1.86) and the weakest among Black individuals (1.07; 95% confidence interval, 0.98-1.16). CONCLUSION Study findings suggest that neighborhood deprivation contributes to an increased risk of severe maternal morbidity. Future research should examine which aspects of neighborhood environments matter most across racial and ethnic groups.
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Affiliation(s)
- Mahasin S Mujahid
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, CA (Dr Mujahid, Mses Hailu, Gao, and Morris, and Dr Abrams).
| | - Elizabeth Wall-Wieler
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University (Drs Wall-Wieler and Carmichael); Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada (Dr Wall-Wieler)
| | - Elleni M Hailu
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, CA (Dr Mujahid, Mses Hailu, Gao, and Morris, and Dr Abrams)
| | - Rachel L Berkowitz
- Division of Health Policy and Management, School of Public Health, University of California, Berkeley, Berkeley, CA (Dr Berkowitz)
| | - Xing Gao
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, CA (Dr Mujahid, Mses Hailu, Gao, and Morris, and Dr Abrams)
| | - Colleen M Morris
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, CA (Dr Mujahid, Mses Hailu, Gao, and Morris, and Dr Abrams)
| | - Barbara Abrams
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, CA (Dr Mujahid, Mses Hailu, Gao, and Morris, and Dr Abrams)
| | - Audrey Lyndon
- Rory Meyers College of Nursing, New York University, New York City, NY (Dr Lyndon)
| | - Suzan L Carmichael
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University (Drs Wall-Wieler and Carmichael); Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Stanford University, Stanford, CA (Dr Carmichael)
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Tewahade S, Berrigan D, Slotman B, Stinchcomb DG, Sayer RD, Catenacci VA, Ostendorf DM. Impact of the built, social, and food environment on long-term weight loss within a behavioral weight loss intervention. Obes Sci Pract 2023; 9:261-273. [PMID: 37287525 PMCID: PMC10242259 DOI: 10.1002/osp4.645] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 10/04/2022] [Accepted: 10/10/2022] [Indexed: 11/10/2022] Open
Abstract
Background Behavioral weight loss interventions can lead to an average weight loss of 5%-10% of initial body weight, however there is wide individual variability in treatment response. Although built, social, and community food environments can have potential direct and indirect influences on body weight (through their influence on physical activity and energy intake), these environmental factors are rarely considered as predictors of variation in weight loss. Objective Evaluate the association between built, social, and community food environments and changes in weight, moderate-to-vigorous physical activity (MVPA), and dietary intake among adults who completed an 18-month behavioral weight loss intervention. Methods Participants included 93 adults (mean ± SD; 41.5 ± 8.3 years, 34.4 ± 4.2 kg/m2, 82% female, 75% white). Environmental variables included urbanicity, walkability, crime, Neighborhood Deprivation Index (includes 13 social economic status factors), and density of convenience stores, grocery stores, and limited-service restaurants at the tract level. Linear regressions examined associations between environment and changes in body weight, waist circumference (WC), MVPA (SenseWear device), and dietary intake (3-day diet records) from baseline to 18 months. Results Grocery store density was inversely associated with change in weight (β = -0.95; p = 0.02; R 2 = 0.062) and WC (β = -1.23; p < 0.01; R 2 = 0.109). Participants living in tracts with lower walkability demonstrated lower baseline MVPA and greater increases in MVPA versus participants with higher walkability (interaction p = 0.03). Participants living in tracts with the most deprivation demonstrated greater increases in average daily steps (β = 2048.27; p = 0.02; R 2 = 0.039) versus participants with the least deprivation. Limited-service restaurant density was associated with change in % protein intake (β = 0.39; p = 0.046; R 2 = 0.051). Conclusion Environmental factors accounted for some of the variability (<11%) in response to a behavioral weight loss intervention. Grocery store density was positively associated with weight loss at 18 months. Additional studies and/or pooled analyses, encompassing greater environmental variation, are required to further evaluate whether environment contributes to weight loss variability.
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Affiliation(s)
- Selam Tewahade
- Department of EpidemiologyColorado School of Public HealthUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
| | - David Berrigan
- Division of Cancer Control and Population SciencesNational Cancer InstituteBethesdaMarylandUSA
| | | | | | - R. Drew Sayer
- Department of Nutrition SciencesUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Victoria A. Catenacci
- Division of Endocrinology, Metabolism, and DiabetesDepartment of MedicineUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
- Anschutz Health and Wellness CenterDepartment of MedicineUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
| | - Danielle M. Ostendorf
- Division of Endocrinology, Metabolism, and DiabetesDepartment of MedicineUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
- Anschutz Health and Wellness CenterDepartment of MedicineUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
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22
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M H, N B, L M, J W, J K, R T, T R, J B, H T, S H, B M. The environment a young person grows up in is associated with their mental health: A nationwide geospatial study using the integrated data infrastructure, New Zealand. Soc Sci Med 2023; 326:115893. [PMID: 37119566 DOI: 10.1016/j.socscimed.2023.115893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 03/19/2023] [Accepted: 04/06/2023] [Indexed: 05/01/2023]
Abstract
BACKGROUND Mental health conditions often arise during adolescence, are multifaceted in aetiology, and may be related to the type of environment in which young people reside. This study used nationwide population-level data to investigate whether the environment a young person grows up in is associated with their mental health. METHOD Data were extracted from the Integrated Data Infrastructure (IDI), a large nationwide research repository, for 917,211 young people (aged 10-24 years) including sociodemographic and mental health data (i.e. emotional, behavioural, substance problems, and self-harm). Environmental data were sourced from the nationwide area-based Healthy Location Index (HLI), which has comprehensive data on the location of several health-constraining (i.e. fast-food outlets) and health-promoting features (i.e. physical activity facilities). Environments were classified as: i) health-promoting, ii) health-constraining, or iii) neither. Associations between the HLI and mental health were investigated using multi-level mixed effects logistic regression modelling. RESULTS Overall, there was evidence of an association between the environment a young person resided in and their mental health. Young people residing in health-constraining environments had higher odds of any mental health condition (Adjusted Odds Ratio (AOR) = 1.020 [1.001, 1.040]) and any emotional condition (AOR = 1.037 [1.012, 1.062]). Young people residing in health-promoting environments had lower odds of substance problems (AOR = 0.950 [0.905, 0.997]). There were no significant effects of the environment on behavioural conditions. CONCLUSION Our study utilises a large national sample of almost one million young people to confirm the importance of environmental determinants for mental health. It is possible that leverage points for improving the mental health of young people, and reducing the burden to the health system of mental health, can be sought in upstream environmental based interventions.
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Affiliation(s)
- Hobbs M
- Faculty of Health, University of Canterbury, Christchurch, Canterbury, New Zealand; GeoHealth Laboratory, Geospatial Research Institute, University of Canterbury, Christchurch, Canterbury, New Zealand.
| | - Bowden N
- Department of Women's and Children's Health, University of Otago, Dunedin, New Zealand
| | - Marek L
- GeoHealth Laboratory, Geospatial Research Institute, University of Canterbury, Christchurch, Canterbury, New Zealand
| | - Wiki J
- GeoHealth Laboratory, Geospatial Research Institute, University of Canterbury, Christchurch, Canterbury, New Zealand
| | - Kokaua J
- Va'a O Tautai - Centre for Pacific Health, Health Sciences, University of Otago, Dunedin, New Zealand
| | - Theodore R
- National Centre for Lifecourse Research, University of Otago, Dunedin, New Zealand
| | - Ruhe T
- Va'a O Tautai - Centre for Pacific Health, Health Sciences, University of Otago, Dunedin, New Zealand
| | - Boden J
- Christchurch Health and Development Study, Department of Psychological Medicine, University of Otago Christchurch, New Zealand
| | - Thabrew H
- The Werry Centre, Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Hetrick S
- The Werry Centre, Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Milne B
- Centre of Methods and Policy Application in the Social Sciences, University of Auckland, Auckland, New Zealand
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23
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Datar A, Nicosia N, Samek A. Heterogeneity in place effects on health: The case of time preferences and adolescent obesity. ECONOMICS AND HUMAN BIOLOGY 2023; 49:101218. [PMID: 36623470 PMCID: PMC10164697 DOI: 10.1016/j.ehb.2022.101218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 09/06/2022] [Accepted: 12/20/2022] [Indexed: 05/08/2023]
Abstract
We leverage a natural experiment in combination with data on adolescents' time preferences to assess whether there is heterogeneity in place effects on adolescent obesity. We exploit the plausibly exogenous assignment of military servicemembers, and consequently their children, to different installations to identify place effects. Adolescents' time preferences are measured by a validated survey scale. Using the obesity rate in the assigned installation county as a summary measure of its obesity-related environments, we show that exposure to counties with higher obesity rates increases the likelihood of obesity among less patient adolescents but not among their more patient counterparts.
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Affiliation(s)
- Ashlesha Datar
- Center for Economic and Social Research, University of Southern California, 635 Downey Way, Los Angeles, CA 90089, USA.
| | - Nancy Nicosia
- RAND Corporation, 20 Park Plaza # 920, Boston, MA 02116, USA.
| | - Anya Samek
- Rady School of Management, University of California, San Diego, Wells Fargo Hall, 9500 Gilman Drive #0553, La Jolla, CA 92093, USA.
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24
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Prados MJ, Nicosia N, Datar A. Impact of built, social, and economic environments on adolescent obesity and related health behaviors. Obesity (Silver Spring) 2023; 31:1085-1094. [PMID: 36942421 PMCID: PMC10034597 DOI: 10.1002/oby.23682] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 11/25/2022] [Accepted: 11/30/2022] [Indexed: 03/23/2023]
Abstract
OBJECTIVE This study aimed to estimate the effects of the built, social, and economic environments on adolescent obesity and related behaviors. METHODS Exploiting quasi-exogenous variation in military families' geographic location, this study estimated intent-to-treat models of the association between the assigned installation's county environments and adolescents' (mean age 13.5 years) self-reported and model-corrected BMI, overweight or obesity status, and self-reported diet and exercise. Three indices for the built, social, and economic environments characterized county-level environments (higher value implies more advantageous environments) based on 19 indicators. Multivariate linear and logistic models were estimated on the full sample (N = 1111) and on subsamples with greater exposure based on time (n = 682) and off-installation residence (n = 604). RESULTS Exposure to more advantageous built environments for more than 2 years was associated with lower probabilities of obesity (-0.18; 95% CI: -0.34 to -0.026) and overweight or obesity (-0.34; 95% CI: -0.56 to -0.12) and was associated with lower BMI z scores (-0.76; 95% CI: -1.45 to -0.02). Results for adolescents living off-installation were similar. More advantageous built environments were also associated with lower consumption of unhealthy foods, but not with physical activity. Social and economic environments were not associated with any outcomes. CONCLUSIONS The built environment, but not social and economic environments, was a strong predictor of adolescents' BMI, overweight or obesity status, and eating behaviors.
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Affiliation(s)
- María J Prados
- Center for Economic and Social Research, University of Southern California, Los Angeles, California, USA
| | | | - Ashlesha Datar
- Center for Economic and Social Research, University of Southern California, Los Angeles, California, USA
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25
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Lan F, Pan J, Zhou Y, Huang X. Impact of the Built Environment on Residents' Health: Evidence from the China Labor Dynamics Survey in 2016. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2023; 2023:3414849. [PMID: 38115991 PMCID: PMC10730250 DOI: 10.1155/2023/3414849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 10/06/2022] [Accepted: 11/24/2022] [Indexed: 12/21/2023]
Abstract
In the process of China's rapid urbanization, the health level of residents has been improved to a great extent. However, with the expansion of urban scale and spatial restructuring, a series of urban environmental problems have posed new challenges to public health. However, the impact of the built environment on residents' health is controversial, and the applicability of the conclusions based on western urban sprawl in China is not clear enough. In addition, the exploration of the impact path of the built environment on health is still not comprehensive and in-depth. Based on the China Labor Dynamics Survey (CLDS) in 2016 and relevant statistical yearbook data, this study explored the impact of the built environment at community and urban scale on residents' health and its age heterogeneity and further explored the mediating role of physical exercise, neighborhood support, and community safety. According to the research, the urban and community-built environment has significant impacts on residents' health, and the impact is significantly different at different scales. In addition, there is a significant difference in the impact of built environment factors on residents' health among populations with different life cycles. From the perspective of the impact path, greening coverage can improve residents' self-rated health by enhancing the perceived safety of living in the community. In contrast, the high community population density will not only weaken the degree of neighborhood support but also reduce the perception level of community residential safety, thus damaging residents' health. In short, from the perspective of environmental intervention, the previously mentioned results put forward possible suggestions on strengthening the construction of a healthy living environment so as to maximize the health effectiveness of cities and communities.
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Affiliation(s)
- Feng Lan
- School of Management, Xi'an University of Architecture and Technology, Xi'an 710055, China
- Key Research Base of Philosophy and Social Sciences In Shaanxi Universities-Research Center of Green Development and Mechanism Innovation of Real Estate Industry in Shaanxi Province, Xi'an, China
| | - Jingyu Pan
- School of Management, Xi'an University of Architecture and Technology, Xi'an 710055, China
- Key Research Base of Philosophy and Social Sciences In Shaanxi Universities-Research Center of Green Development and Mechanism Innovation of Real Estate Industry in Shaanxi Province, Xi'an, China
| | - Yulin Zhou
- School of Management, Xi'an University of Architecture and Technology, Xi'an 710055, China
- Key Research Base of Philosophy and Social Sciences In Shaanxi Universities-Research Center of Green Development and Mechanism Innovation of Real Estate Industry in Shaanxi Province, Xi'an, China
| | - Xin Huang
- School of Management, Xi'an University of Architecture and Technology, Xi'an 710055, China
- Key Research Base of Philosophy and Social Sciences In Shaanxi Universities-Research Center of Green Development and Mechanism Innovation of Real Estate Industry in Shaanxi Province, Xi'an, China
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26
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Rossi CE, Pinho MGM, Corrêa EN, de Abreu ÂH, Rech CR, Ferreira JRDC, de Vasconcelos FDAG. Neighborhood Availability and Use of Food, Physical Activity, and Social Services Facilities in Relation to Overweight and Obesity in Children and Adolescents. Food Nutr Bull 2023; 44:12-26. [PMID: 36601667 DOI: 10.1177/03795721221146215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To evaluate the association of a combined measure of availability and use of facilities from the food environment and overweight (including obesity) among schoolchildren, while taking into account the physical activity and social-assistance environments. METHODS Cross-sectional study with a probabilistic sample of schoolchildren aged 7 to 14 years living in a southern Brazilian city (n = 2026). Multilevel analyses were performed with overweight as outcome and the food environment as main exposure. Models were adjusted for the physical activity and social-assistance environments, as well as individual and other residential neighborhood characteristics. RESULTS Greater availability of restaurants around the home was associated with higher odds of overweight (odds ratio [OR] = 1.40; 95% CI = 1.06-1.85). Stronger associations were found for schoolchildren reporting to use restaurants (OR = 1.48; 95% CI = 1.15-1.90). This association remained significant after adjusting for the presence of other food retailers. Schoolchildren who had social-assistance facilities around their homes, but reported not to use them, showed consistently higher odds of being overweight (OR = 1.34; 95% CI = 1.01-1.78) as compared to schoolchildren who had these facilities near home and used them. The physical activity environment was not associated with the outcome. CONCLUSIONS Availability and use of the food and social-assistance environments were significantly associated with overweight (including obesity) among the schoolchildren. Future research should consider the use of environmental facilities in combination to their geographical availability. Our results highlight the need for policies that limit the access to obesogenic food outlets by children and adolescents.
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Affiliation(s)
| | - Maria Gabriela M Pinho
- Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, The Netherlands.,Upstream Team, Amsterdam UMC, Vrije Universiteit Amsterdam, The Netherlands
| | - Elizabeth Nappi Corrêa
- Universidade Federal de Santa Catarina. Rua Engenheiro Agronômico Andrei Cristian Ferreira, s/n-Centro de Ciências da Saúde, Trindade, Florianópolis-Santa Catarina, Brazil
| | - Ângelo Horta de Abreu
- Gis Especialist. Imagem-Enterprise for Geographic Intelligence Solutions. Belo Horizonte-Minas Gerais, Brazil
| | - Cassiano Ricardo Rech
- Programa de Pós-Graduação em Educação Física (PPGEF), Campus Universitário Trindade, Florianópolis-Santa Catarina, Brazil
| | | | - Francisco de Assis Guedes de Vasconcelos
- Universidade Federal de Santa Catarina. Rua Engenheiro Agronômico Andrei Cristian Ferreira, s/n-Centro de Ciências da Saúde, Trindade, Florianópolis-Santa Catarina, Brazil
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27
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Kamkuemah M, Gausi B, Oni T, Middelkoop K. Multilevel correlates of abdominal obesity in adolescents and youth living with HIV in peri-urban Cape Town, South Africa. PLoS One 2023; 18:e0266637. [PMID: 36693111 PMCID: PMC9873196 DOI: 10.1371/journal.pone.0266637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 01/11/2023] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Chronic non-communicable disease comorbidities are a major problem faced by people living with HIV (PLHIV). Obesity is an important factor contributing to such comorbidities and PLHIV face an elevated risk of obesity. However, there is data paucity on the intersection of obesity and HIV in adolescents and youth living with HIV (AYLHIV) in sub-Saharan Africa. We therefore aimed to investigate the prevalence of abdominal obesity and associated multilevel factors in AYLHIV in peri-urban Cape Town, South Africa. METHODS We conducted a cross-sectional study enrolling AYLHIV aged 15-24 years attending primary healthcare facilities in peri-urban Cape Town in 2019. All measures, except for physical examination measures, were obtained via self-report using a self-administered electronic form. Our outcome of interest was abdominal obesity (waist-to-height ratio ≥ 0.5). We collected individual-level data and data on community, built and food environment factors. Data was summarized using descriptive statistics, stratified by obesity status. Multilevel logistic regression was conducted to investigate factors associated with abdominal obesity, adjusted for sex and age. FINDINGS A total of 87 participants were interviewed, 76% were female and the median age was 20.7 (IQR 18.9-23.0) years. More than two fifths had abdominal obesity (41%; 95% CI: 31.0-51.7%), compared to published rates for young people in the general population (13.7-22.1%). In multilevel models, skipping breakfast (aOR = 5.42; 95% CI: 1.32-22.25) was associated with higher odds of abdominal obesity, while daily wholegrain consumption (aOR = 0.20; 95% CI: 0.05-0.71) and weekly physical activity (aOR = 0.24; 95% CI: 0.06-0.92) were associated with lower odds of abdominal obesity. Higher anticipated stigma was associated with reduced odds of obesity (aOR = 0.58; 95% CI: 0.33-1.00). Land-use mix diversity (aOR = 0.52; 95% CI: 0.27-0.97), access to recreational places (aOR = 0.37; 95% CI: 0.18-0.74), higher perceived pedestrian and traffic safety (aOR = 0.20; 95% CI: 0.05-0.80) and having a non-fast-food restaurant within walking distance (aOR = 0.30; 95% CI: 0.10-0.93) were associated with reduced odds of abdominal obesity. The main limitations of the study were low statistical power and possible reporting bias from self-report measures. CONCLUSIONS Our findings demonstrate a high prevalence of abdominal obesity and highlight multilevel correlates of obesity in AYLHIV in South Africa. An intersectoral approach to obesity prevention, intervening at multiple levels is necessary to intervene at this critical life stage.
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Affiliation(s)
- Monika Kamkuemah
- Research Initiative for Cities Health and Equity (RICHE), Division of Public Health Medicine, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
- * E-mail:
| | - Blessings Gausi
- Research Initiative for Cities Health and Equity (RICHE), Division of Public Health Medicine, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Tolu Oni
- Research Initiative for Cities Health and Equity (RICHE), Division of Public Health Medicine, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Keren Middelkoop
- Desmond Tutu HIV Centre, Institute of Infectious Disease & Molecular Medicine, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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Vega-Salas MJ, Murray C, Nunes R, Hidalgo-Arestegui A, Curi-Quinto K, Penny ME, Cueto S, Lovegrove JA, Sánchez A, Vimaleswaran KS. School environments and obesity: a systematic review of interventions and policies among school-age students in Latin America and the Caribbean. Int J Obes (Lond) 2023; 47:5-16. [PMID: 36216909 PMCID: PMC9549440 DOI: 10.1038/s41366-022-01226-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 09/22/2022] [Accepted: 09/26/2022] [Indexed: 02/08/2023]
Abstract
BACKGROUND The rapid rise in obesity rates among school children in Latin America and the Caribbean (LAC) could have a direct impact on the region's physical and mental health, disability, and mortality. This review presents the available interventions likely to reduce, mitigate and/or prevent obesity among school children in LAC by modifying the food and built environments within and around schools. METHODS Two independent reviewers searched five databases: MEDLINE, Web of Science, Cochrane Library, Scopus and Latin American and Caribbean Health Sciences Literature for peer-reviewed literature published from 1 January 2000 to September 2021; searching and screening prospective studies published in English, Spanish and Portuguese. This was followed by data extraction and quality assessment using the Cochrane risk-of-bias tool (RoB 2) and the Risk of Bias in Non-Randomized Studies of Interventions (ROBINS-I), adopting also the PRISMA 2020 guidelines. Due to the heterogeneity of the intervention's characteristics and obesity-related measurements across studies, a narrative synthesis was conducted. RESULTS A total of 1342 research papers were screened, and 9 studies were included; 4 in Mexico, and 1 each in Argentina, Brazil, Chile, Colombia, and Ecuador. Four studies reported strategies for modifying food provision; four other targeted the built environment, (modifying school premises and providing materials for physical activity); a final study included both food and built environment intervention components. Overall, two studies reported that the intervention was significantly associated with a lower increase over time in BMI/obesity in the intervention against the control group. The remaining studies were non-significant. CONCLUSIONS Data suggest that school environmental interventions, complementing nutritional and physical education can contribute to reduce incremental childhood obesity trends. However, evidence of the extent to which food and built environment components factor into obesogenic environments, within and around school grounds is inconclusive. Insufficient data hindered any urban/rural comparisons. Further school environmental intervention studies to inform policies for preventing/reducing childhood obesity in LAC are needed.
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Affiliation(s)
- María Jesús Vega-Salas
- Carrera de Nutrición y Dietética, Departamento de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, 7820436, Chile.
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, University of Reading, Whiteknights, Reading, RG6 6DZ, UK.
| | - Claudia Murray
- Department of Real Estate and Planning, Henley Business School, University of Reading, Reading, RG6 6UD, UK.
| | - Richard Nunes
- Department of Real Estate and Planning, Henley Business School, University of Reading, Reading, RG6 6UD, UK
| | - Alessandra Hidalgo-Arestegui
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, University of Reading, Whiteknights, Reading, RG6 6DZ, UK
| | | | - Mary E Penny
- Instituto de Investigación Nutricional (IIN), Lima, 15024, Peru
| | - Santiago Cueto
- Grupo de Análisis para el Desarrollo (GRADE), Lima, 15063, Peru
- Departamento de Psicología, Pontificia Universidad Católica del Peru, Lima, 15088, Peru
| | - Julie Anne Lovegrove
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, University of Reading, Whiteknights, Reading, RG6 6DZ, UK
- Institute for Food, Nutrition and Health (IFNH), University of Reading, Reading, RG6 6AH, UK
| | - Alan Sánchez
- Grupo de Análisis para el Desarrollo (GRADE), Lima, 15063, Peru
| | - Karani Santhanakrishnan Vimaleswaran
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, University of Reading, Whiteknights, Reading, RG6 6DZ, UK
- Institute for Food, Nutrition and Health (IFNH), University of Reading, Reading, RG6 6AH, UK
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29
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Zhou RZ, Hu Y, Tirabassi JN, Ma Y, Xu Z. Deriving neighborhood-level diet and physical activity measurements from anonymized mobile phone location data for enhancing obesity estimation. Int J Health Geogr 2022; 21:22. [PMID: 36585658 PMCID: PMC9801358 DOI: 10.1186/s12942-022-00321-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 12/10/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Obesity is a serious public health problem. Existing research has shown a strong association between obesity and an individual's diet and physical activity. If we extend such an association to the neighborhood level, information about the diet and physical activity of the residents of a neighborhood may improve the estimate of neighborhood-level obesity prevalence and help identify the neighborhoods that are more likely to suffer from obesity. However, it is challenging to measure neighborhood-level diet and physical activity through surveys and interviews, especially for a large geographic area. METHODS We propose a method for deriving neighborhood-level diet and physical activity measurements from anonymized mobile phone location data, and examine the extent to which the derived measurements can enhance obesity estimation, in addition to the socioeconomic and demographic variables typically used in the literature. We conduct case studies in three different U.S. cities, which are New York City, Los Angeles, and Buffalo, using anonymized mobile phone location data from the company SafeGraph. We employ five different statistical and machine learning models to test the potential enhancement brought by the derived measurements for obesity estimation. RESULTS We find that it is feasible to derive neighborhood-level diet and physical activity measurements from anonymized mobile phone location data. The derived measurements provide only a small enhancement for obesity estimation, compared with using a comprehensive set of socioeconomic and demographic variables. However, using these derived measurements alone can achieve a moderate accuracy for obesity estimation, and they may provide a stronger enhancement when comprehensive socioeconomic and demographic data are not available (e.g., in some developing countries). From a methodological perspective, spatially explicit models overall perform better than non-spatial models for neighborhood-level obesity estimation. CONCLUSIONS Our proposed method can be used for deriving neighborhood-level diet and physical activity measurements from anonymized mobile phone data. The derived measurements can enhance obesity estimation, and can be especially useful when comprehensive socioeconomic and demographic data are not available. In addition, these derived measurements can be used to study obesity-related health behaviors, such as visit frequency of neighborhood residents to fast-food restaurants, and to identify primary places contributing to obesity-related issues.
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Affiliation(s)
- Ryan Zhenqi Zhou
- grid.273335.30000 0004 1936 9887GeoAI Lab, Department of Geography, University at Buffalo, The State University of New York, Buffalo, NY 14260 USA
| | - Yingjie Hu
- grid.273335.30000 0004 1936 9887GeoAI Lab, Department of Geography, University at Buffalo, The State University of New York, Buffalo, NY 14260 USA
| | - Jill N. Tirabassi
- grid.273335.30000 0004 1936 9887Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY 14260 USA
| | - Yue Ma
- grid.273335.30000 0004 1936 9887GeoAI Lab, Department of Geography, University at Buffalo, The State University of New York, Buffalo, NY 14260 USA
| | - Zhen Xu
- grid.410625.40000 0001 2293 4910College of Landscape Architecture, Nanjing Forestry University, Nanjing, Jiangsu 210037 China
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30
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Dixon BN, Hong YR, Perri MG, Allen A, Aufmuth J, Ross KM. Access to Food and Physical Activity Environment Resources in Rural Communities: Impact of Using Driving Time Versus Physical Distance Indicators. JOURNAL OF TRANSPORT & HEALTH 2022; 27:101521. [PMID: 37982034 PMCID: PMC10655550 DOI: 10.1016/j.jth.2022.101521] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Affiliation(s)
- Brittney N. Dixon
- Department of Health Services Research, Management & Policy, University of Florida, Gainesville, FL
| | - Young-Rock Hong
- Department of Health Services Research, Management & Policy, University of Florida, Gainesville, FL
| | - Michael G. Perri
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL
| | - Acquel Allen
- Department of Health Services Research, Management & Policy, University of Florida, Gainesville, FL
| | - Joe Aufmuth
- Marston Science Library, University of Florida, Gainesville, FL
| | - Kathryn M. Ross
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL
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Howell CR, Juarez L, Agne AA, Nassel AF, Scarinci IC, Ayala GX, Cherrington AL. Assessing Hispanic/Latino and Non-Hispanic White Social Determinants of Obesity Among a Community Sample of Residents in the Rural Southeast US. J Immigr Minor Health 2022; 24:1469-1479. [PMID: 35174428 PMCID: PMC9980419 DOI: 10.1007/s10903-022-01334-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2022] [Indexed: 02/01/2023]
Abstract
Employing an ecological approach, we sought to identify social determinants of obesity among Hispanics/Latinos and non-Hispanic whites living in the Southeast US. Data on social determinants of obesity (individual, family, community and cultural/contextual) were collected from 217 participants [106 Hispanics/Latinos; 111 non-Hispanic whites]; height and weight were objectively measured. We compared prevalence of overweight and obese between ethnic groups and BMI values within each group by social determinants. Hispanics had a 1.9-fold increase (OR 1.93, 95% CI: 1.05-3.55) in overweight prevalence compared to non-Hispanic whites after adjusting for age and gender. We found positive estimates between unfavorable family-level determinants and BMI among Hispanic/Latinos. In contrast, non-Hispanic whites who reported unfavorable neighborhood characteristics had higher BMI's. Findings highlight the need for targeted approaches for the prevention and control of obesity.
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Affiliation(s)
- Carrie R Howell
- Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, 638 Medical Towers, 1717 11th Avenue South, Birmingham, AL, 35205, USA.
| | - Lucia Juarez
- Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, 638 Medical Towers, 1717 11th Avenue South, Birmingham, AL, 35205, USA
| | - April A Agne
- Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, 638 Medical Towers, 1717 11th Avenue South, Birmingham, AL, 35205, USA
| | - Ariann F Nassel
- School of Public Health, University of Alabama at Birmingham, 1665 University Blvd, Birmingham, AL, 35233, USA
| | - Isabel C Scarinci
- Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, 638 Medical Towers, 1717 11th Avenue South, Birmingham, AL, 35205, USA
| | - Guadalupe X Ayala
- School of Public Health, San Diego State University, San Diego, CA, USA
| | - Andrea L Cherrington
- Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, 638 Medical Towers, 1717 11th Avenue South, Birmingham, AL, 35205, USA
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Kobes A, Kretschmer T, Timmerman MC. The association between obesity-related legislation in the United States and adolescents’ weight. HEALTH POLICY OPEN 2022. [DOI: 10.1016/j.hpopen.2021.100056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Pauuvale AF, Vickers MH, Pamaka S, Apelu D, Fehoko ‘A, ‘Ofanoa M, Bay JL. Exploring the Retail Food Environment Surrounding Two Secondary Schools with Predominantly Pacific Populations in Tonga and New Zealand to Enable the Development of Mapping Methods Appropriate for Testing in a Classroom. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15941. [PMID: 36498013 PMCID: PMC9739248 DOI: 10.3390/ijerph192315941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 11/14/2022] [Accepted: 11/24/2022] [Indexed: 06/17/2023]
Abstract
Rates of noncommunicable diseases (NCDs) are disproportionately high among people of Pacific ethnicity. Nutrition-related environmental exposures including food access and quality contribute to the matrix of factors impacting risk. Preventative interventions in adolescence and the opportunity to integrate health promotion into school-based learning are often overlooked. This study tested the potential of a low-cost method to map the retail food environment in a 1 km radius of two secondary schools in low socioeconomic communities with predominantly Pacific populations, in Tonga and New Zealand (NZ). Mapping utilized Google Earth, Google Maps, government maps, and observations. A rubric was developed to categorize food quality. Outlets within a 1 km radius of each school, (Tonga, n = 150; NZ, n = 52) stocked predominantly unhealthy foods. The NZ data compared favorably to previous studies, indicating the method was valid. The Tongan data is novel and indicates that alternative strategies can be used when access to GIS-type tools is limited. The method produced visual data that has the potential to be analyzed using strategies appropriate for secondary schools. The method should now be tested in classrooms to assess its potential to support school-age students to engage in mapping and critiquing the retail food environment.
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Affiliation(s)
- Alvina F. Pauuvale
- Liggins Institute, University of Auckland, Auckland 1142, New Zealand
- School of Population Health, University of Auckland, Auckland 1142, New Zealand
| | - Mark H. Vickers
- Liggins Institute, University of Auckland, Auckland 1142, New Zealand
| | | | | | | | - Malakai ‘Ofanoa
- School of Population Health, University of Auckland, Auckland 1142, New Zealand
| | - Jacquie L. Bay
- Liggins Institute, University of Auckland, Auckland 1142, New Zealand
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Howell NA, Booth GL. The Weight of Place: Built Environment Correlates of Obesity and Diabetes. Endocr Rev 2022; 43:966-983. [PMID: 35201344 PMCID: PMC9695105 DOI: 10.1210/endrev/bnac005] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Indexed: 11/19/2022]
Abstract
In recent decades, the prevalence of obesity and diabetes has risen substantially in North America and worldwide. To address these dual epidemics, researchers and policymakers alike have been searching for effective means to promote healthy lifestyles at a population level. As a consequence, there has been a proliferation of research examining how the "built" environment in which we live influences physical activity levels, by promoting active forms of transportation, such as walking and cycling, over passive ones, such as car use. Shifting the transportation choices of local residents may mean that more members of the population can participate in physical activity during their daily routine without structured exercise programs. Increasingly, this line of research has considered the downstream metabolic consequences of the environment in which we live, raising the possibility that "healthier" community designs could help mitigate the rise in obesity and diabetes prevalence. This review discusses the evidence examining the relationship between the built environment, physical activity, and obesity-related diseases. We also consider how other environmental factors may interact with the built environment to influence metabolic health, highlighting challenges in understanding causal relationships in this area of research.
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Affiliation(s)
| | - Gillian L Booth
- Department of Medicine, University of Toronto, Toronto, ON, Canada.,MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,ICES, Toronto, ON, Canada
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Movement Is Life-Optimizing Patient Access to Total Joint Arthroplasty: Anemia and Sickle Cell Disease Disparities. J Am Acad Orthop Surg 2022; 30:1059-1063. [PMID: 35313324 DOI: 10.5435/jaaos-d-21-00911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 02/04/2022] [Indexed: 02/01/2023] Open
Abstract
Anemia and sickle cell anemia before surgery are often unrecognized medical comorbidities that can and should be addressed. Nearly 6% of the American population meets the criteria for anemia. The elderly, along with patients with renal disease, cancer, heart failure, or diabetes mellitus are more likely to be anemic. The most common form of anemia is due to iron deficiency, which can be easily treated before surgery. Sickle cell anemia occurs in 1 in 365 Black births and 1 in 16,300 Hispanic births, with 100,000 Americans currently living with sickle cell anemia. Patients who have anemia or sickle cell anemia are at increased risk for postoperative complications, including the need for blood transfusions and delayed healing. For those with sickle cell disease, surgeries can precipitate a sickle cell crisis. Patients with sickle cell anemia face barriers in accessing appropriate care; however, these patients can be optimized using preoperative red blood cell transfusions to dilute sickle cells and elevate the hemoglobin level. There should also be careful consideration and monitoring of the pain level of patients with sickle cell anemia in the perioperative period.
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Christensen A, Radley D, Hobbs M, Gorse C, Griffiths C. Investigating how researcher-defined buffers and self-drawn neighbourhoods capture adolescent availability to physical activity facilities and greenspaces: An exploratory study. Spat Spatiotemporal Epidemiol 2022; 43:100538. [PMID: 36460456 DOI: 10.1016/j.sste.2022.100538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 06/16/2022] [Accepted: 09/13/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Modifying the environment is considered an effective population-level approach for increasing healthy behaviours, but associations remain ambiguous. This exploratory study aims to compare researcher-defined buffers and self-drawn neighbourhoods (SDN) to objectively measured availability of physical activity (PA) facilities and greenspaces in adolescents. METHODS Seven consecutive days of GPS data were collected in an adolescent sample of 14-18 year olds (n = 69). Using Points of Interest and greenspace data, availability of PA opportunities within activity spaces were determined. We compared 30 different definitions of researcher-defined neighbourhoods and SDNs to objectively measured availability. RESULTS Findings showed low agreement for all researcher-defined buffers in measuring the availability of PA facilities in activity spaces. However, results were less clear for greenspace. SDNs also demonstrate low agreement for capturing availability to the PA environment. CONCLUSION This exploratory study highlights the inadequacy of researcher-defined buffers and SDNs to define availability to environmental features.
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Affiliation(s)
- A Christensen
- Carnegie School of Sport, Leeds Beckett University, Leeds, United Kingdom, LS6 3QT, UK.
| | - D Radley
- Carnegie School of Sport, Leeds Beckett University, Leeds, United Kingdom, LS6 3QT, UK
| | - M Hobbs
- Faculty of Health, University of Canterbury, Christchurch, Canterbury, New Zealand; GeoHealth Laboratory, Geospatial Research Institute, University of Canterbury, Christchurch, Canterbury, New Zealand
| | - C Gorse
- School of Built Environment and Engineering, Carnegie, Leeds Beckett University, Leeds, LS6 3QT, UK
| | - C Griffiths
- Carnegie School of Sport, Leeds Beckett University, Leeds, United Kingdom, LS6 3QT, UK
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Movement Is Life-Optimizing Patient Access to Total Joint Arthroplasty: Obesity Disparities. J Am Acad Orthop Surg 2022; 30:1028-1035. [PMID: 35171875 DOI: 10.5435/jaaos-d-21-00424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 12/24/2021] [Indexed: 02/01/2023] Open
Abstract
Thirty five percent of the American population is considered obese (body mass index [BMI] > 30). Obesity disproportionately affects African Americans, Hispanics, and women. Obesity is associated with postoperative complications, including wound complications, infections, and revision total joint arthroplasty (including total hip arthroplasty and total knee arthroplasty). Current BMI benchmarks (many institutions rely on a BMI of 40) selectively preclude patients from having surgery. Patients in these underserved populations can be optimized through the lens of shared decision making through the assessment of food security (eg, food deserts and food swamps), ability to afford healthy food, knowledge of social safety net and community resources to access healthy food, nutrition and weight loss referrals to programs that accept all forms of insurance, weight loss measurements as a percentage of body weight lost instead of BMI cutoffs, pharmacologic modalities, and bariatric surgery.
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Huang H. Moderating Effects of Racial Segregation on the Associations of Cardiovascular Outcomes with Walkability in Chicago Metropolitan Area. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14252. [PMID: 36361132 PMCID: PMC9657023 DOI: 10.3390/ijerph192114252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 10/01/2022] [Accepted: 10/13/2022] [Indexed: 06/16/2023]
Abstract
Cardiovascular diseases (CVDs), as the leading cause of death in the U.S., pose a disproportionate burden to racial/ethnic minorities. Walkability, as a key concept of the built environment, reflecting walking and physical activity, is associated with health behaviors that help to reduce CVDs risk. While the unequal social variation and spatial distribution inequality of the CVDs and the role of walkability in preventing CVDs have been explored, the moderating factors through which walkability affects CVDs have not been quantitatively analyzed. In this paper, the spatial statistical techniques combined with the regression model are conducted to study the distribution of the CVDs' health outcomes and factors influencing their variation in the Chicago metropolitan area. The spatial statistical results for the CVDs' health outcomes reveal that clusters of low-value incidence are concentrated in the suburban rural areas and areas on the north side of the city, while the high-value clusters are concentrated in the west and south sides of the city and areas extending beyond the western and southern city boundaries. The regression results indicate that racial segregation reduced the positive association between health outcomes and walkability, although both racial segregation and walkability factors were positively associated with CVDs' health outcomes.
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Affiliation(s)
- Hao Huang
- Department of Social Sciences, Illinois Institute of Technology, Chicago, IL 60616, USA
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Fernández-Escobar C, Díez J, Martínez-García A, Bilal U, O'Flaherty M, Franco M. Food availability and affordability in a Mediterranean urban context: associations by store type and area-level socio-economic status. Public Health Nutr 2022; 26:1-9. [PMID: 36274648 DOI: 10.1017/s1368980022002348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Although food environments have been highlighted as potentially effective targets to improve population diets, evidence on Mediterranean food environments is lacking. We examined differences in food availability and affordability in Madrid (Spain) by store type and area-level socio-economic status (SES). DESIGN Cross-sectional study. Trained researchers conducted food store audits using the validated Nutrition Environment Measures Survey in Stores for Mediterranean contexts (NEMS-S-MED) tool to measure the availability and price of twelve food groups (specific foods = 35). We computed NEMS-S-MED scores and summarised price data with a Relative Price Index (RPI, comparing prices across stores) and an Affordability Index (normalising prices by area-level income). We compared the availability and affordability of 'healthier-less healthy' food pairs, scores between food store types (supermarkets, specialised, convenience stores and others) and area-level SES using ANOVA and multi-level regression models. SETTING City of Madrid. 2016 and 2019 to cover a representative sample. PARTICIPANTS Food stores within a socio-economically diverse sample of sixty-three census tracts (n 151). RESULTS Supermarkets had higher food availability (37·5/49 NEMS-S-MED points), compared to convenience stores (13·5/49) and specialised stores (8/49). Supermarkets offered lower prices (RPI: 0·83) than specialised stores (RPI: 0·97) and convenience stores (RPI: 2·06). Both 'healthy' and 'less healthy' items were more available in supermarkets. We found no differences in food availability or price by area-level SES, but affordability was higher in higher-income areas. CONCLUSIONS Supermarkets offered higher food availability and affordability for healthy and less healthy food items. Promoting healthy food availability through supermarkets and specialised stores and/or limiting access to convenience stores are promising policy options to achieve a healthier food environment.
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Affiliation(s)
- Carlos Fernández-Escobar
- National School of Public Health, Institute of Health Carlos III, Madrid, Spain
- Public Health and Epidemiology Research Group, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Spain
| | - Julia Díez
- Public Health and Epidemiology Research Group, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Spain
| | - Alba Martínez-García
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, 03690Alicante, Spain
| | - Usama Bilal
- Urban Health Collaborative and Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Martin O'Flaherty
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | - Manuel Franco
- Public Health and Epidemiology Research Group, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Spain
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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D’Hooghe S, Inaç Y, De Clercq E, Deforche B, Dury S, Vandevijvere S, Van de Weghe N, Van Dyck D, De Ridder K. The CIVISANO protocol: a mixed-method study about the role of objective and perceived environmental factors on physical activity and eating behavior among socioeconomically disadvantaged adults. Arch Public Health 2022; 80:219. [PMID: 36199109 PMCID: PMC9533259 DOI: 10.1186/s13690-022-00956-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 08/19/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Overweight and obesity have a strong socioeconomic profile. Unhealthy behaviors like insufficient physical activity and an unbalanced diet, which are causal factors of overweight and obesity, tend to be more pronounced in socioeconomically disadvantaged groups in high income countries. The CIVISANO project aims to identify objective and perceived environmental factors among different socioeconomic population groups that impede or facilitate physical activity and healthy eating behavior in the local context of two peri-urban Flemish municipalities in Belgium. We also aim to identify and discuss possible local interventions and evaluate the participatory processes of the project. METHODS This study (2020-2023) will use community-based participatory tools, involving collaborative partnerships with civic and stakeholder members of the community and regular exchanges among all partners to bridge knowledge development and health promotion for socioeconomically disadvantaged citizens. Furthermore, a mixed-methods approach will be used. A population survey and geographic analysis will explore potential associations between the physical activity and eating behaviors of socioeconomically disadvantaged adults (25-65 years old) and both their perceived and objective physical, food and social environments. Profound perceptive context information will be gathered from socioeconomically disadvantaged adults by using participatory methods like photovoice, walk-along, individual map creation and group model building. An evaluation of the participatory process will be conducted simultaneously. DISCUSSION The CIVISANO project will identify factors in the local environment that might provoke inequities in adopting a healthy lifestyle. The combination of perceived and objective measures using validated strategies will provide a robust assessment of the municipality environment. Through this analysis, the project will investigate to what extent community engagement can be a useful strategy to reduce health inequities. The strong knowledge exchange and capacity-building in a local setting is expected to contribute to our understanding of how to maximize research impact in this field and generate evidence about potential linkages between a health enhancing lifestyle among socioeconomically disadvantaged groups and their physical, food and social environments.
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Affiliation(s)
- Suzannah D’Hooghe
- grid.508031.fSciensano, Department of Epidemiology and Public Health, Brussels, Belgium ,grid.5342.00000 0001 2069 7798Ghent University, Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Ghent, Belgium ,grid.8767.e0000 0001 2290 8069Vrije Universiteit Brussel (VUB), Faculty of Psychology and Educational Sciences, Adult Educational Sciences, Brussels, Belgium
| | - Yasemin Inaç
- grid.508031.fSciensano, Department of Epidemiology and Public Health, Brussels, Belgium ,grid.8767.e0000 0001 2290 8069Vrije Universiteit Brussel (VUB), Faculty of Psychology and Educational Sciences, Adult Educational Sciences, Brussels, Belgium ,grid.5342.00000 0001 2069 7798Ghent University, Faculty of Sciences, Department of Geography, Ghent, Belgium
| | - Eva De Clercq
- grid.508031.fSciensano, Department of Chemical and Physical Health Risks, Brussels, Belgium
| | - Benedicte Deforche
- grid.5342.00000 0001 2069 7798Ghent University, Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Ghent, Belgium ,grid.8767.e0000 0001 2290 8069Vrije Universiteit Brussel (VUB), Faculty of Physical Education and Physiotherapy, Department of Movement and Sport Sciences, Brussels, Belgium
| | - Sarah Dury
- grid.8767.e0000 0001 2290 8069Vrije Universiteit Brussel (VUB), Faculty of Psychology and Educational Sciences, Adult Educational Sciences, Brussels, Belgium
| | - Stefanie Vandevijvere
- grid.508031.fSciensano, Department of Epidemiology and Public Health, Brussels, Belgium
| | - Nico Van de Weghe
- grid.5342.00000 0001 2069 7798Ghent University, Faculty of Sciences, Department of Geography, Ghent, Belgium
| | - Delfien Van Dyck
- grid.5342.00000 0001 2069 7798Ghent University, Faculty of Medicine and Health Sciences, Department of Movement and Sports Sciences, Brussels, Belgium
| | - Karin De Ridder
- grid.508031.fSciensano, Department of Epidemiology and Public Health, Brussels, Belgium
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Frehlich L, Christie CD, Ronksley PE, Turin TC, Doyle-Baker P, McCormack GR. The neighbourhood built environment and health-related fitness: a narrative systematic review. Int J Behav Nutr Phys Act 2022; 19:124. [PMID: 36153538 PMCID: PMC9509561 DOI: 10.1186/s12966-022-01359-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 08/30/2022] [Indexed: 11/30/2022] Open
Abstract
Background There is increasing evidence demonstrating the importance of the neighbourhood built environment in supporting physical activity. Physical activity provides numerous health benefits including improvements in health-related fitness (i.e., muscular, cardiorespiratory, motor, and morphological fitness). Emerging evidence also suggests that the neighbourhood built environment is associated with health-related fitness. Our aim was to summarize evidence on the associations between the neighbourhood built environment and components of health-related fitness in adults. Methods We undertook a systematic review following PRISMA guidelines. Our data sources included electronic searches in MEDLINE, Embase, CINAHL, Web of Science, SPORTDiscus, Environment Complete, ProQuest Dissertations and Theses, and Transport Research International Documentation from inception to March 2021. Our eligibility criteria consisted of observational and experimental studies estimating associations between the neighbourhood built environment and health-related fitness among healthy adults (age ≥ 18 years). Eligible studies included objective or self-reported measures of the neighbourhood built environment and included either objective or self-reported measures of health-related fitness. Data extraction included study design, sample characteristics, measured neighbourhood built environment characteristics, and measured components of health-related fitness. We used individual Joanna Briggs Institute study checklists based on identified study designs. Our primary outcome measure was components of health-related fitness (muscular; cardiorespiratory; motor, and morphological fitness). Results Twenty-seven studies (sample sizes = 28 to 419,562; 2002 to 2020) met the eligibility criteria. Neighbourhood destinations were the most consistent built environment correlate across all components of health-related fitness. The greatest number of significant associations was found between the neighbourhood built environment and morphological fitness while the lowest number of associations was found for motor fitness. The neighbourhood built environment was consistently associated with health-related fitness in studies that adjusted for physical activity. Conclusion The neighbourhood built environment is associated with health-related fitness in adults and these associations may be independent of physical activity. Longitudinal studies that adjust for physical activity (including resistance training) and sedentary behaviour, and residential self-selection are needed to obtain rigorous causal evidence for the link between the neighbourhood built environment and health-related fitness. Trial registration Protocol registration: PROSPERO number CRD42020179807. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-022-01359-0.
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Associations of four indexes of social determinants of health and two community typologies with new onset type 2 diabetes across a diverse geography in Pennsylvania. PLoS One 2022; 17:e0274758. [PMID: 36112581 PMCID: PMC9480999 DOI: 10.1371/journal.pone.0274758] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 09/04/2022] [Indexed: 11/19/2022] Open
Abstract
Evaluation of geographic disparities in type 2 diabetes (T2D) onset requires multidimensional approaches at a relevant spatial scale to characterize community types and features that could influence this health outcome. Using Geisinger electronic health records (2008–2016), we conducted a nested case-control study of new onset T2D in a 37-county area of Pennsylvania. The study included 15,888 incident T2D cases and 79,435 controls without diabetes, frequency-matched 1:5 on age, sex, and year of diagnosis or encounter. We characterized patients’ residential census tracts by four dimensions of social determinants of health (SDOH) and into a 7-category SDOH census tract typology previously generated for the entire United States by dimension reduction techniques. Finally, because the SDOH census tract typology classified 83% of the study region’s census tracts into two heterogeneous categories, termed rural affordable-like and suburban affluent-like, to further delineate geographies relevant to T2D, we subdivided these two typology categories by administrative community types (U.S. Census Bureau minor civil divisions of township, borough, city). We used generalized estimating equations to examine associations of 1) four SDOH indexes, 2) SDOH census tract typology, and 3) modified typology, with odds of new onset T2D, controlling for individual-level confounding variables. Two SDOH dimensions, higher socioeconomic advantage and higher mobility (tracts with fewer seniors and disabled adults) were independently associated with lower odds of T2D. Compared to rural affordable-like as the reference group, residence in tracts categorized as extreme poverty (odds ratio [95% confidence interval] = 1.11 [1.02, 1.21]) or multilingual working (1.07 [1.03, 1.23]) were associated with higher odds of new onset T2D. Suburban affluent-like was associated with lower odds of T2D (0.92 [0.87, 0.97]). With the modified typology, the strongest association (1.37 [1.15, 1.63]) was observed in cities in the suburban affluent-like category (vs. rural affordable-like–township), followed by cities in the rural affordable-like category (1.20 [1.05, 1.36]). We conclude that in evaluating geographic disparities in T2D onset, it is beneficial to conduct simultaneous evaluation of SDOH in multiple dimensions. Associations with the modified typology showed the importance of incorporating governmentally, behaviorally, and experientially relevant community definitions when evaluating geographic health disparities.
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Retail food environment in a Brazilian metropolis over the course of a decade: evidence of restricted availability of healthy foods. Public Health Nutr 2022; 25:2584-2592. [PMID: 35343411 PMCID: PMC9991744 DOI: 10.1017/s1368980022000787] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To evaluate changes in the retail food environment profile in a Brazilian metropolis over a 10-year period. DESIGN An ecological study was conducted in the city of Belo Horizonte, Minas Gerais, Brazil. The addresses of formal food establishments were geocoded and classified according to their sold-food profile. Density changes were analysed according to neighbourhood, population size, income level and geospatial distribution. SETTING Totally, 468 neighbourhoods in the city of Belo Horizonte, Minas Gerais, Brazil. PARTICIPANTS Totally, 83 752 formal food establishments registered for operation in any one or more of those years: 2008, 2011, 2015 and 2018. RESULTS There was an increase in unhealthy establishments (154 %), followed by mixed (51 %) and healthy establishments (32 %), during the period evaluated, in addition to an increase in density according to income categories. There was a higher proportion of unhealthy establishments in relation to healthy establishments, indicating worsening of the community food environment over time. CONCLUSIONS Over the course of 10 years, changes in the neighbourhood's food environment were unfavourable for adequate access to healthy foods in lower-income neighbourhoods. The findings reinforce the need for interventions aimed at increasing the availability of businesses that offer healthy food in the city.
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Bonnell LN, Troy AR, Littenberg B. Exploring non-linear relationships between neighbourhood walkability and health: a cross-sectional study among US primary care patients with chronic conditions. BMJ Open 2022; 12:e061086. [PMID: 35985786 PMCID: PMC9396151 DOI: 10.1136/bmjopen-2022-061086] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND A recent study of licensed drivers found a non-linear relationship between density of non-residential destinations (NRDs), a proxy for walkability and body mass index (BMI) across a wide range of development patterns. It is unclear if this relationship can be replicated in a population with multiple chronic conditions or translated to health outcomes other than BMI. METHODS We obtained health data and home addresses for 2405 adults with multiple chronic conditions from 44 primary care clinics across 13 states using the Integrating Behavioral health and Primary Care Trial. In this cross-sectional study, the relationships between density of NRDs (from a commercial database) within 1 km of the home address and self-reported BMI, and mental and physical health indices were assessed using several non-linear methods, including restricted cubic splines, LOWESS smoothing curves, non-parametric regression with a spline basis and piecewise linear regression. RESULTS All methods demonstrated similar non-linear relationships. Piecewise linear regression was selected for ease of interpretation. BMI had a positive marginal rate of change below the NRD density inflection point of 15 establishments/hectare (β=+0.09 kg/m2/non-residential buildings ha-1; 95% CI +0.01 to +0.14), and a negative marginal rate of change above the inflection point (β=-0.02; 95% CI -0.06 to 0.02). Mental health decreased with NRD density below the inflection point (β=-0.24; 95% CI -0.31 to -0.17) and increased above it (β=+0.03; 95% CI -0.00 to +0.07). Results were similar for physical health (β= -0.28; 95% CI -0.35 to -0.20) and (β=+0.06; 95% CI 0.01 to +0.10). CONCLUSION Health indicators were the lowest in middle density (typically suburban) areas and got progressively better moving in either direction from the peak. NRDs may affect health differently depending on home-address NRD density. TRIAL REGISTRATION NUMBER NCT02868983.
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Affiliation(s)
- Levi Nicolas Bonnell
- General Internal Medicine Research, University of Vermont College of Medicine, Burlington, Vermont, USA
| | - Austin R Troy
- Urban and Regional Planning, University of Colorado Denver College of Architecture and Planning, Denver, Colorado, USA
| | - Benjamin Littenberg
- General Internal Medicine Research, University of Vermont College of Medicine, Burlington, Vermont, USA
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Brown H, Xiang H, Albani V, Goffe L, Akhter N, Lake A, Sorrell S, Gibson E, Wildman J. No new fast-food outlets allowed! Evaluating the effect of planning policy on the local food environment in the North East of England. Soc Sci Med 2022; 306:115126. [PMID: 35724588 DOI: 10.1016/j.socscimed.2022.115126] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 05/31/2022] [Accepted: 06/09/2022] [Indexed: 11/28/2022]
Abstract
The environment in which we live impacts on our health. The food available to us in our environment is likely to influence what we eat and subsequently our weight. The use of planning policy can be one way for both local and national government to help shape a healthy environment. In England there are three main types of planning policy used to promote a healthy food environment: 1) restricting new fast-food outlets near schools; 2) restricting new fast-food outlets if the density of existing outlets has surpassed a certain threshold of all retail outlets, 3) restricting new fast-food outlets if childhood obesity rates are above a certain threshold. In 2015, Gateshead council, a local authority in the North East of England implemented all three types of guidance. We utilise a longitudinal administrative dataset, the Food Standards Agency Food Hygiene Rating Scheme Data, covering the period 2012-2019 on all premises selling or preparing food in Great Britain. To analyse the impact of employing all three types of planning guidance on the density, proportion, and number of fast-food outlets in Gateshead, we employ a propensity score matching difference-in-difference approach. We match small geographical areas in Gateshead (lower super output areas) to other local authorities in the North East with similar demographic characteristics that did not implement planning guidance. Results show a reduction in density of fast-food outlets by 12.45 per 100,000 of the population and a 13.88% decrease in the proportion of fast-food outlets in Gateshead compared to other similar local authorities in the North East. There was a marginally significant reduction in the number of restaurants which became insignificant after controlling for population density. These results suggest that a multi-pronged planning approach significantly changed the proportion and density of fast-food outlets in the food environment in the short term (4 years).
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Affiliation(s)
- Heather Brown
- Newcastle University, Population Health Sciences Institute, Baddiley Clark Building, Newcastle Upon Tyne, NE2 4BN, UK.
| | - Huasheng Xiang
- Newcastle University, Population Health Sciences Institute, Baddiley Clark Building, Newcastle Upon Tyne, NE2 4BN, UK.
| | - Viviana Albani
- Newcastle University, Population Health Sciences Institute, Baddiley Clark Building, Newcastle Upon Tyne, NE2 4BN, UK.
| | - Louis Goffe
- Newcastle University, Population Health Sciences Institute, Baddiley Clark Building, Newcastle Upon Tyne, NE2 4BN, UK.
| | - Nasima Akhter
- Durham University Department of Anthropology, Durham, UK.
| | - Amelia Lake
- Teesside University SHLS Allied Health Professions Centre for Public Health, Middlesbrough, UK.
| | - Stewart Sorrell
- Environmental Health Planning Policy, Climate Change and Strategic Transport Gateshead Council, UK.
| | - Emma Gibson
- Health Promotion, Public Health, Gateshead Council, UK.
| | - John Wildman
- Newcastle University, Population Health Sciences Institute, Baddiley Clark Building, Newcastle Upon Tyne, NE2 4BN, UK.
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Medina C, Piña-Pozas M, Aburto TC, Chavira J, López U, Moreno M, Olvera AG, Gonzalez C, Huang TTK, Barquera S. Systematic literature review of instruments that measure the healthfulness of food and beverages sold in informal food outlets. Int J Behav Nutr Phys Act 2022; 19:89. [PMID: 35842649 PMCID: PMC9288710 DOI: 10.1186/s12966-022-01320-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 06/20/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Informal food outlets, defined as vendors who rarely have access to water and toilets, much less shelter and electricity, are a common component of the food environment, particularly in many non-Western countries. The purpose of this study was to review available instruments that measure the quality and particularly the healthfulness of food and beverages sold within informal food outlets. METHODS PubMed, LILACS, Web of Science, and Scopus databases were used. Articles were included if they reported instruments that measured the availability or type of healthy and unhealthy foods and beverages by informal food outlets, were written in English or Spanish, and published between January 1, 2010, and July 31, 2020. Two trained researchers reviewed the title, abstract and full text of selected articles; discrepancies were solved by two independent researchers. In addition, the list of references for selected articles was reviewed for any additional articles of relevance. The quality of published articles and documents was evaluated using JBI Critical appraisal checklist for analytical cross-sectional studies. RESULTS We identified 1078 articles of which 14 were included after applying the selection criteria. Three additional articles were considered after reviewing the references from the selected articles. From the final 17 articles, 13 measurement tools were identified. Most of the instruments were used in low- and middle-income countries (LMIC). Products were classified as healthy/unhealthy or produce/non-produce or processed/unprocessed based on availability and type. Six studies reported psychometric tests, whereas one was tested within the informal food sector. CONCLUSIONS Few instruments can measure the healthfulness of food and beverages sold in informal food outlets, of which the most valid and reliable have been used to measure formal food outlets as well. Therefore, it is necessary to develop an instrument that manages to measure, specifically, the elements available within an informal one. These actions are extremely important to better understand the food environment that is a central contributor to poor diets that are increasingly associated with the obesity and Non-communicable disease (NCD) pandemic.
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Affiliation(s)
- Catalina Medina
- Center for Health and Nutrition Research, National Institute of Public Health, Mexico. Avenida Universidad 655, Santa María Ahuacatitlán. CP. 06210, Cuernavaca, Morelos, Mexico
| | - Maricela Piña-Pozas
- Center for Information for Public Health Decisions, National Institute of Public Health, Mexico. Avenida Universidad 655, Santa María Ahuacatitlán. CP. 06210, Cuernavaca, Morelos, Mexico
| | - Tania C Aburto
- Center for Health and Nutrition Research, National Institute of Public Health, Mexico. Avenida Universidad 655, Santa María Ahuacatitlán. CP. 06210, Cuernavaca, Morelos, Mexico
| | - Julissa Chavira
- Center for Health and Nutrition Research, National Institute of Public Health, Mexico. Avenida Universidad 655, Santa María Ahuacatitlán. CP. 06210, Cuernavaca, Morelos, Mexico
| | - Uzzi López
- Center for Health and Nutrition Research, National Institute of Public Health, Mexico. Avenida Universidad 655, Santa María Ahuacatitlán. CP. 06210, Cuernavaca, Morelos, Mexico
| | - Mildred Moreno
- School of Engineering and Architecture (ESIA), National Polytechnic Institute (IPN), México, Avenida Fuentes de los Leones 28, Lomas de Tecamachalco. CP. 53955. Tecamachalco, Naucalpan, Mexico
| | - Armando G Olvera
- Center for Health and Nutrition Research, National Institute of Public Health, Mexico. Avenida Universidad 655, Santa María Ahuacatitlán. CP. 06210, Cuernavaca, Morelos, Mexico
| | - Citlali Gonzalez
- Center for Health and Nutrition Research, National Institute of Public Health, Mexico. Avenida Universidad 655, Santa María Ahuacatitlán. CP. 06210, Cuernavaca, Morelos, Mexico
| | - Terry T-K Huang
- Center for Systems and Community Design and NYU-CUNY Prevention Research Center, Graduate School of Public Health and Health Policy, City University of New York, 55W. 125 Street, Room 803, New York, NY, 10027, USA
| | - Simón Barquera
- Center for Health and Nutrition Research, National Institute of Public Health, Mexico. Avenida Universidad 655, Santa María Ahuacatitlán. CP. 06210, Cuernavaca, Morelos, Mexico.
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Marquet O, Hirsch JA, Kerr J, Jankowska MM, Mitchell J, Hart JE, Laden F, Hipp JA, James P. GPS-based activity space exposure to greenness and walkability is associated with increased accelerometer-based physical activity. ENVIRONMENT INTERNATIONAL 2022; 165:107317. [PMID: 35660954 PMCID: PMC10187790 DOI: 10.1016/j.envint.2022.107317] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 04/30/2022] [Accepted: 05/19/2022] [Indexed: 05/05/2023]
Abstract
INTRODUCTION Built and natural environments may provide opportunities for physical activity. However, studies are limited by primarily using residential addresses to define exposure and self-report to measure physical activity. We quantified associations between global positioning systems (GPS)-based activity space measures of environmental exposure and accelerometer-based physical activity. METHODS Using a nationwide sample of working female adults (N = 354), we obtained seven days of GPS and accelerometry data. We created Daily Path Area activity spaces using GPS data and linked these activity spaces to spatial datasets on walkability (EPA Smart Location Database at the Census block group level) and greenness (satellite vegetation at 250 m resolution). We utilized generalized additive models to examine nonlinear associations between activity space exposures and accelerometer-derived physical activity outcomes adjusted for demographic characteristics, socioeconomic factors, and self-rated health. RESULTS Higher activity space walkability was associated with higher levels of moderate-vigorous physical activity, and higher activity space greenness was associated with greater numbers of steps per week. No strong relationships were observed for sedentary behavior or light physical activity. Highest levels of moderate-vigorous physical activity were observed for participants with both high walkability and high greenness in their activity spaces. CONCLUSION This study contributes evidence that higher levels of physical activity occur in environments with more dense, diverse, and well-connected built environments, and with higher amounts of vegetation. These data suggest that urban planners, landscape architects, and policy makers should implement and evaluate environmental interventions to encourage higher levels of physical activity.
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Affiliation(s)
- Oriol Marquet
- Institute of Environmental Science and Technology, Autonomous University of Barcelona, Spain.
| | - Jana A Hirsch
- Urban Health Collaborative, Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Jacqueline Kerr
- Department of Family Medicine and Public Health, University of California San Diego, San Diego, CA, USA
| | - Marta M Jankowska
- Beckman Research Institute, Population Sciences, City of Hope, Duarte, CA, USA
| | - Jonathan Mitchell
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Jaime E Hart
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Francine Laden
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - J Aaron Hipp
- Center for Geospatial Analytics, NC State University, USA; Department of Parks, Recreation, and Tourism Management, NC State University, USA
| | - Peter James
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA; Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
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Bonnet C, Détang-Dessendre C, Orozco V, Rouvière E. Spatial spillovers, living environment and obesity in France: Evidence from a spatial econometric framework. Soc Sci Med 2022; 305:114999. [PMID: 35594761 DOI: 10.1016/j.socscimed.2022.114999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 03/19/2022] [Accepted: 04/29/2022] [Indexed: 10/18/2022]
Abstract
In 2019, obesity affected 17% of French adults. In this article, we use a unique data set that combines individual-level health and consumption data with living environment data (food, sports and health amenities). We develop a spatial econometric framework to address French health disparities in obesity prevalence across space. We find that regulations on fast food restaurant locations could be a policy instrument to counter the prevalence of obesity. We also establish the existence of spatial spillovers of sports and medical amenities on obesity. This new evidence points to the need to consider a wider context than just the immediate local environment in the fight against the obesity pandemic.
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Affiliation(s)
- Céline Bonnet
- Toulouse School of Economics, INRAE, Université Toulouse Capitole, 1, Esplanade de L'Université, 31080, Toulouse, France.
| | - Cécile Détang-Dessendre
- CESAER, Agrosup Dijon, INRAE, Université Bourgogne-Franche-Comté, 26, Bd Docteur Petitjean, BP 87999, 21079, Dijon Cedex, France.
| | - Valérie Orozco
- Toulouse School of Economics, INRAE, Université Toulouse Capitole, 1, Esplanade de L'Université, 31080, Toulouse, France.
| | - Elodie Rouvière
- SADAPT, AgroParisTech, INRAE, Université Paris Saclay, 16, Rue Claude Bernard, 75231, Paris Cedex 05, France.
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Marsh ATM, Jahja NA, Gleed F, Peacock O, Coley D, Codinhoto R. Developing non-exercise activity thermogenesis (NEAT) through building design. FACILITIES 2022. [DOI: 10.1108/f-01-2022-0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Physical inactivity has a considerable negative impact on health. Physical activity has reduced partly due to workplace and lifestyle changes, causing people to spend more time in buildings and increasing sedentary behaviour. The purpose of this paper is to address a largely untapped opportunity for designers and managers to improve building users’ health by designing buildings that raise users’ Non-Exercise Activity Thermogenesis (NEAT) levels. In this research a conceptual model was developed to assess buildings’ performance in providing NEAT-promoting opportunities through building design features and management, in relation to building users’ propensity for NEAT behaviours.
Design/methodology/approach
The conceptual model was developed by a multi-disciplinary team of researchers and data to populate the model was obtained through a survey of 75 buildings in Jakarta (Indonesia).
Findings
The presented proof-of-concept shows that the model’s “meso-scale” approach to study physical activity and building design can lead to potential improvements of NEAT levels and physical activity in buildings.
Originality/value
The review of precedent models shows that this subject has been researched at micro-scale (i.e. detailed monitoring of individuals’ movement) and macro-scale (i.e. epidemiological studies of populations’ health). The presented model is original, as it explores a “meso-scale”(i.e. building scale) that is unique.
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Speed S, Branscum P, Gresla A. Comparing Predictors of Intention for Physical Activity Participation between Normal and Overweight Military Spouses. AMERICAN JOURNAL OF HEALTH EDUCATION 2022. [DOI: 10.1080/19325037.2022.2071363] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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