1
|
Kim K, Joyce BT, Zheng Y, Nannini DR, Wang J, Gordon-Larsen P, Bhatt A, Gabriel K, Shikany JM, Hu M, Chen A, Reges O, Carnethon MR, Lloyd-Jones DM, Zhang K, Hou L. Associations of Urban Blue and Green Spaces With Coronary Artery Calcification in Black Individuals and Disadvantaged Neighborhoods. Circulation 2024; 150:203-214. [PMID: 38934130 PMCID: PMC11250927 DOI: 10.1161/circulationaha.123.067992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 06/07/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Proximity to urban blue and green spaces has been associated with improved cardiovascular health; however, few studies have examined the role of race and socioeconomic status in these associations. METHODS Data were from the CARDIA study (Coronary Artery Risk Development in Young Adults). We included longitudinal measurements (1985-1986 to 2010-2011) of blue and green spaces, including percentage of blue space cover, distance to the nearest river, green space cover, and distance to the nearest major park. Presence of coronary artery calcification (CAC) was measured with noncontrast cardiac computed tomography in 2010 to 2011. The associations of blue and green spaces with CAC were assessed with generalized estimating equation regression with adjustment for demographics, individual and neighborhood socioeconomic status, health-related behaviors, and other health conditions. We conducted stratified analyses by race and neighborhood deprivation score to investigate whether the association varied according to social determinants of health. RESULTS The analytic sample included 1365 Black and 1555 White participants with a mean±SD age of 50.1±3.6 years. Among Black participants, shorter distance to a river and greater green space cover were associated with lower odds of CAC (per interquartile range decrease [1.45 km] to the river: odds ratio [OR], 0.90 [95% CI, 0.84-0.96]; per 10 percentage-point increase of green space cover: OR, 0.85 [95% CI, 0.75-0.95]). Among participants in deprived neighborhoods, greater green space cover was associated with lower odds of CAC (per a 10 percentage-point increase: OR, 0.89 [95% CI, 0.80-0.99]), whereas shorter distance to the park was associated with higher odds of CAC (per an interquartile range decrease [5.3 km]: OR, 1.07 [95% CI, 1.00-1.15]). Black participants in deprived neighborhoods had lower odds of CAC with shorter distance to a river (per an interquartile range decrease: OR, 0.90 [95% CI, 0.82-0.98]) and greater green space cover (per a 10 percentage-point increase: OR, 0.85 [95% CI, 0.75-0.97]). There was no statistical interaction between the blue and green spaces and race or neighborhood characteristics in association with CAC. CONCLUSIONS Longitudinally, shorter distance to a river and greater green space cover were associated with less CAC among Black participants and those in deprived neighborhoods. Shorter distance to a park was associated with increased odds of CAC among participants in deprived neighborhoods. Black participants residing in more deprived neighborhoods showed lower odds of CAC in association with greater exposure to river and green space cover.
Collapse
Affiliation(s)
- Kyeezu Kim
- Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon-si, Gyeonggi-do, South Korea
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Brian T. Joyce
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Yinan Zheng
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Drew R. Nannini
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jun Wang
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Penny Gordon-Larsen
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Ankeet Bhatt
- Kaiser Permanente San Francisco Medical Center, Kaiser Permanente Northern California Division of Research, San Francisco, CA, USA
| | - Kelley Gabriel
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - James M. Shikany
- Division of Preventive Medicine, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Ming Hu
- School of Architecture, University of Notre Dame, Notre Dame, IN, USA
| | - Aimin Chen
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Orna Reges
- Department of Health Systems Management, Ariel University, Israel
| | - Mercedes R. Carnethon
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Donald M. Lloyd-Jones
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Kai Zhang
- Department of Environmental Health Sciences, University of Albany, State University of New York, Rensselaer, NY, USA
| | - Lifang Hou
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| |
Collapse
|
2
|
Huang H, Lu Z, Fan X, Zhai W, Zhang L, Xu D, Liu Z, Li Y, Ye X, Qin H, Lanza K, Hang Y. Urban heatwave, green spaces, and mental health: A review based on environmental health risk assessment framework. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 948:174816. [PMID: 39019287 DOI: 10.1016/j.scitotenv.2024.174816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Revised: 06/28/2024] [Accepted: 07/13/2024] [Indexed: 07/19/2024]
Abstract
Utilizing the framework of environmental health risk assessment and healing, the article reviews the effectiveness and potential of green space systems in mitigating the impact of high temperatures, promoting mental health, and improving the risk characteristics of high-temperature heat waves. We utilized CiteSpace software to conduct a time-zone analysis of the relationship between heatwaves, green spaces, and health using clustered data from 2001 to 2023. This study evaluates the role of green space systems in mitigating high temperatures and enhancing mental health within the environmental health risk assessment framework. Using CiteSpace software, we analyzed literature from 2001 to 2023, focusing on the interactions among heatwaves, green spaces, and health. Our results indicate that most existing research concentrates on hazard identification, with insufficient exploration of the dose-response relationships between green spaces and temperature reduction. Quantitative studies on green space design and spatial optimization are scarce, and guidance on effective configurations remains limited. Additionally, the health impacts of heatwaves vary by region, with a noticeable imbalance in research focus; Asia and Africa, in particular, are underrepresented in studies addressing heatwave effects. We conclude that effective mitigation strategies require: (1) a comprehensive environmental health risk assessment framework that integrates advanced methods like big data analysis and geospatial simulations to improve green space planning and design; (2) further theoretical exploration into the mechanisms by which green spaces regulate temperature and mental health, including detailed analysis of spatiotemporal patterns and the functional optimization of green space structures; and (3) the development of robust parameterized design guidance based on specific therapeutic dosages (green space stimulus) to optimize configurations and enhance the effectiveness of green spaces in mitigating adverse mental health impacts from deteriorating thermal environments. Future research should prioritize underrepresented regions, focusing on exposure levels, dose-response relationships, and high-temperature warning systems while fostering multidisciplinary collaboration to develop effective urban planning and climate adaptation strategies.
Collapse
Affiliation(s)
- Huanchun Huang
- College of Landscape Architecture, Nanjing Forestry University, Nanjing, Jiang Su 210037, China; School of Architecture & Planning, University of Texas at San Antonio, San Antonio, TX 78249, USA; Department of Environmental & Occupational Health Sciences, School of Public Health, The University of Texas Health Science Center at Houston, TX 77030, USA
| | - Zefeng Lu
- College of Landscape Architecture, Nanjing Forestry University, Nanjing, Jiang Su 210037, China
| | - Xinmei Fan
- College of Landscape Architecture, Nanjing Forestry University, Nanjing, Jiang Su 210037, China
| | - Wei Zhai
- School of Architecture & Planning, University of Texas at San Antonio, San Antonio, TX 78249, USA.
| | - Linchun Zhang
- College of Landscape Architecture, Nanjing Forestry University, Nanjing, Jiang Su 210037, China
| | - Di Xu
- School of Geographical Sciences, East China Normal University, Shanghai 200241, China
| | - Zhifeng Liu
- State Key Laboratory of Earth Surface Processes and Resource Ecology, Beijing Normal University, Beijing 100875, China
| | - Yong Li
- The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiang Su 210029, China
| | - Xinyue Ye
- School of Architecture, Texas Agricultural and Mechanical University, College Station, TX 77843, USA
| | - Haoming Qin
- School of Civil & Environmental Engineering and Construction Management, University of Texas at San Antonio, San Antonio, TX 78249, USA
| | - Kevin Lanza
- Department of Environmental & Occupational Health Sciences, School of Public Health, The University of Texas Health Science Center at Houston, TX 77030, USA
| | - Yun Hang
- Department of Environmental & Occupational Health Sciences, School of Public Health, The University of Texas Health Science Center at Houston, TX 77030, USA.
| |
Collapse
|
3
|
Cardinali M, Beenackers MA, Timmeren AV, Pottgiesser U. Urban green spaces, self-rated air pollution and health: A sensitivity analysis of green space characteristics and proximity in four European cities. Health Place 2024; 89:103300. [PMID: 38924920 DOI: 10.1016/j.healthplace.2024.103300] [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: 12/20/2023] [Revised: 06/11/2024] [Accepted: 06/12/2024] [Indexed: 06/28/2024]
Abstract
Exploring the influence of green space characteristics and proximity on health via air pollution mitigation, our study analysed data from 1,365 participants across Porto, Nantes, Sofia, and Høje-Taastrup. Utilizing OpenStreetMap and the AID-PRIGSHARE tool, we generated nine green space indicators around residential addresses at 15 distances, ranging from 100m to 1500m. We performed a mediation analysis for these 135 green space variables and revealed significant associations between self-rated air pollution and self-rated health for specific green space characteristics. In our study, indirect positive effects on health via air pollution were mainly associated with green corridors in intermediate Euclidean distances (800-1,000m) and the amount of accessible green spaces in larger network distances (1,400-1,500m). Our results suggest that the amount of connected green spaces measured in intermediate surroundings seems to be a prime green space characteristic that could drive the air pollution mitigation pathway to health.
Collapse
Affiliation(s)
- Marcel Cardinali
- Faculty of Architecture and the Built Environment, TU Delft, P.O.Box 5043, 2600GA, Delft, the Netherlands; Institute for Design Strategies, OWL University of Applied Sciences and Arts, 32756, Detmold, Germany.
| | - Mariëlle A Beenackers
- Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands
| | - Arjan van Timmeren
- Faculty of Architecture and the Built Environment, TU Delft, P.O.Box 5043, 2600GA, Delft, the Netherlands
| | - Uta Pottgiesser
- Faculty of Architecture and the Built Environment, TU Delft, P.O.Box 5043, 2600GA, Delft, the Netherlands; Institute for Design Strategies, OWL University of Applied Sciences and Arts, 32756, Detmold, Germany
| |
Collapse
|
4
|
Jia Y, He Z, Liu F, Li J, Liang F, Huang K, Chen J, Cao J, Li H, Shen C, Yu L, Liu X, Hu D, Huang J, Zhao Y, Liu Y, Lu X, Gu D, Chen S. Dietary intake changes the associations between long-term exposure to fine particulate matter and the surrogate indicators of insulin resistance. ENVIRONMENT INTERNATIONAL 2024; 186:108626. [PMID: 38626493 DOI: 10.1016/j.envint.2024.108626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 03/31/2024] [Accepted: 04/02/2024] [Indexed: 04/18/2024]
Abstract
The relationship of fine particulate matter (PM2.5) exposure and insulin resistance remains inclusive. Our study aimed to investigate this association in the project of Prediction for Atherosclerotic Cardiovascular Disease Risk in China (China-PAR). Specifically, we examined the associations between long-term PM2.5 exposure and three surrogate indicators of insulin resistance: the triglyceride-glucose index (TyG), TyG with waist circumference (TyG-WC) and metabolic score for insulin resistance (METS-IR). Additionally, we explored potential effect modification of dietary intake and components. Generalized estimating equations were used to evaluate the associations between PM2.5 and the indicators with an unbalanced repeated measurement design. Our analysis incorporated a total of 162,060 observations from 99,329 participants. Each 10 μg/m3 increment of PM2.5 was associated with an increase of 0.22 % [95 % confidence interval (CI): 0.20 %, 0.25 %], 1.60 % (95 % CI: 1.53 %, 1.67 %), and 2.05 % (95 % CI: 1.96 %, 2.14 %) in TyG, TyG-WC, and METS-IR, respectively. These associations were attenuated among participants with a healthy diet, particularly those with sufficient intake of fruit and vegetable, fish or tea (pinteraction < 0.0028). For instance, among participants with a healthy diet, TyG increased by 0.11 % (95 % CI: 0.08 %, 0.15 %) per 10 μg/m3 PM2.5 increment, significantly lower than the association observed in those with an unhealthy diet. The findings of this study emphasize the potential of a healthy diet to mitigate these associations, highlighting the urgency for improving air quality and implementing dietary interventions among susceptible populations in China.
Collapse
Affiliation(s)
- Yanhui Jia
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing 100037, China; Vanke School of Public Health, Tsinghua University, Beijing 100084, China
| | - Zhi He
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing 100037, China
| | - Fangchao Liu
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing 100037, China
| | - Jianxin Li
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing 100037, China
| | - Fengchao Liang
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen 518055, China
| | - Keyong Huang
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing 100037, China
| | - Jichun Chen
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing 100037, China
| | - Jie Cao
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing 100037, China
| | - Hongfan Li
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing 100037, China
| | - Chong Shen
- School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Ling Yu
- Department of Cardiology, Fujian Provincial Hospital, Fuzhou 350014, China
| | - Xiaoqing Liu
- Division of Epidemiology, Guangdong Provincial People's Hospital and Cardiovascular Institute, Guangzhou 510080, China
| | - Dongsheng Hu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China; Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University, Shenzhen 518060, China
| | - Jianfeng Huang
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing 100037, China
| | - Yingxin Zhao
- Cardio-Cerebrovascular Control and Research Center, Institute of Basic Medicine, Shandong First Medical University (Shandong Academy of Medicine Sciences), Jinan 271099, China
| | - Yang Liu
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Xiangfeng Lu
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing 100037, China
| | - Dongfeng Gu
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing 100037, China; School of Public Health and Emergency Management, School of Medicine, Southern University of Science and Technology, Shenzhen 518055, China
| | - Shufeng Chen
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing 100037, China.
| |
Collapse
|
5
|
Cui Z, Pan R, Liu J, Yi W, Huang Y, Li M, Zhang Z, Kuang L, Liu L, Wei N, Song R, Yuan J, Li X, Yi X, Song J, Su H. Green space and its types can attenuate the associations of PM 2.5 and its components with prediabetes and diabetes-- a multicenter cross-sectional study from eastern China. ENVIRONMENTAL RESEARCH 2024; 245:117997. [PMID: 38157960 DOI: 10.1016/j.envres.2023.117997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 12/12/2023] [Accepted: 12/19/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND The effect of fine particulate matter (PM2.5) components on prediabetes and diabetes is of concern, but the evidence is limited and the specific role of different green space types remains unclear. This study aims to investigate the relationship of PM2.5 and its components with prediabetes and diabetes as well as the potential health benefits of different types and combinations of green spaces. METHODS A multicenter cross-sectional study was conducted in eastern China by using a multi-stage random sampling method. Health screening and questionnaires for 98,091 participants were performed during 2017-2020. PM2.5 and its five components were estimated by the inverse distance weighted method, and green space was reflected by the Normalized Difference Vegetation Index (NDVI), percentages of tree or grass cover. Multivariate logistic regression and quantile g-computing were used to explore the associations of PM2.5 and five components with prediabetes and diabetes and to elucidate the potential moderating role of green space and corresponding type combinations in these associations. RESULTS Each interquartile range (IQR) increment of PM2.5 was associated with both prediabetes (odds ratio [OR]: 1.15, 95%CI [confidence interval]: 1.10-1.20) and diabetes (OR: 1.18, 95% CI: 1.11-1.25), respectively. All five components of PM2.5 were related to prediabetes and diabetes. The ORs of PM2.5 on diabetes were 1.49 (1.35-1.63) in the low tree group and 0.90 (0.82-0.98) in the high tree group, respectively. In the high tree-high grass group, the harmful impacts of PM2.5 and five components were significantly lower than in the other groups. CONCLUSION Our study suggested that PM2.5 and its components were associated with the increased risk of prediabetes and diabetes, which could be diminished by green space. Furthermore, the coexistence of high levels of tree and grass cover provided greater benefits. These findings had critical implications for diabetes prevention and green space-based planning for healthy city.
Collapse
Affiliation(s)
- Zhiqian Cui
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, 230032, China
| | - Rubing Pan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, 230032, China
| | - Jintao Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, 230032, China
| | - Weizhuo Yi
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, 230032, China
| | - Yuxin Huang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, 230032, China
| | - Ming Li
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, 230032, China
| | - Zichen Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, 230032, China
| | - Lingmei Kuang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, 230032, China
| | - Li Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, 230032, China
| | - Ning Wei
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, 230032, China
| | - Rong Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, 230032, China
| | - Jiajun Yuan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, 230032, China
| | - Xuanxuan Li
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, 230032, China
| | - Xingxu Yi
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, 230032, China
| | - Jian Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, 230032, China
| | - Hong Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, 230032, China.
| |
Collapse
|
6
|
Guo T, Cheng X, Wei J, Chen S, Zhang Y, Lin S, Deng X, Qu Y, Lin Z, Chen S, Li Z, Sun J, Chen X, Chen Z, Sun X, Chen D, Ruan X, Tuohetasen S, Li X, Zhang M, Sun Y, Zhu S, Deng X, Hao Y, Jing Q, Zhang W. Unveiling causal connections: Long-term particulate matter exposure and type 2 diabetes mellitus mortality in Southern China. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 274:116212. [PMID: 38489900 DOI: 10.1016/j.ecoenv.2024.116212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 03/09/2024] [Accepted: 03/11/2024] [Indexed: 03/17/2024]
Abstract
Evidence of the potential causal links between long-term exposure to particulate matters (PM, i.e., PM1, PM2.5, and PM1-2.5) and T2DM mortality based on large cohorts is limited. In contrast, the existing evidence usually suffers from inherent bias with the traditional association assessment. A prospective cohort of 580,757 participants in the southern region of China were recruited during 2009 and 2015 and followed up through December 2020. PM exposure at each residential address was estimated by linking to the well-established high-resolution simulation dataset. Hazard ratios (HRs) were calculated using time-varying marginal structural Cox models, an established causal inference approach, after adjusting for potential confounders. During follow-up, a total of 717 subjects died from T2DM. For every 1 μg/m3 increase in PM2.5, the adjusted HRs and 95% confidence interval (CI) for T2DM mortality was 1.036 (1.019-1.053). Similarly, for every 1 μg/m3 increase in PM1 and PM1-2.5, the adjusted HRs and 95% CIs were 1.032 (1.003-1.062) and 1.085 (1.054-1.116), respectively. Additionally, we observed a generally more pronounced impact among individuals with lower levels of education or lower residential greenness which as measured by the Normalized Difference Vegetation Index (NDVI). We identified substantial interactions between NDVI and PM1 (P-interaction = 0.003), NDVI and PM2.5 (P-interaction = 0.019), as well as education levels and PM1 (P-interaction = 0.049). The study emphasizes the need to consider environmental and socio-economic factors in strategies to reduce T2DM mortality. We found that PM1, PM2.5, and PM1-2.5 heighten the peril of T2DM mortality, with education and green space exposure roles in modifying it.
Collapse
Affiliation(s)
- Tong Guo
- Department of Medical Statistics, School of Public Health & Research Center for Health Information & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Xi Cheng
- Department of Medical Statistics, School of Public Health & Research Center for Health Information & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Jing Wei
- Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, Maryland 20740, USA
| | - Shirui Chen
- Department of Medical Statistics, School of Public Health & Research Center for Health Information & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Yuqin Zhang
- Department of Medical Statistics, School of Public Health & Research Center for Health Information & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Shao Lin
- Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, NY, USA
| | - Xinlei Deng
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC, USA
| | - Yanji Qu
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangdong, China
| | - Ziqiang Lin
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, Guangdong, China
| | - Shimin Chen
- Department of Medical Statistics, School of Public Health & Research Center for Health Information & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Zhiqiang Li
- Department of Medical Statistics, School of Public Health & Research Center for Health Information & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Jie Sun
- Department of Medical Statistics, School of Public Health & Research Center for Health Information & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Xudan Chen
- Department of Medical Statistics, School of Public Health & Research Center for Health Information & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Zhibing Chen
- Department of Medical Statistics, School of Public Health & Research Center for Health Information & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Xurui Sun
- Department of Medical Statistics, School of Public Health & Research Center for Health Information & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Dan Chen
- Department of Medical Statistics, School of Public Health & Research Center for Health Information & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Xingling Ruan
- Department of Medical Statistics, School of Public Health & Research Center for Health Information & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Shaniduhaxi Tuohetasen
- Department of Medical Statistics, School of Public Health & Research Center for Health Information & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Xinyue Li
- Department of Medical Statistics, School of Public Health & Research Center for Health Information & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Man Zhang
- Department of nosocomial infection management, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
| | - Yongqing Sun
- Department of Ultrasound, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
| | - Shuming Zhu
- Department of Medical Statistics, School of Public Health & Research Center for Health Information & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Xueqing Deng
- Department of Medical Statistics, School of Public Health & Research Center for Health Information & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Yuantao Hao
- Peking University Center for Public Health and Epidemic Preparedness & Response, Peking, China.
| | - Qinlong Jing
- Guangzhou Municipal Health Commission, Guangzhou, China.
| | - Wangjian Zhang
- Department of Medical Statistics, School of Public Health & Research Center for Health Information & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, Guangdong 510080, China.
| |
Collapse
|
7
|
Mizen A, Thompson DA, Watkins A, Akbari A, Garrett JK, Geary R, Lovell R, Lyons RA, Nieuwenhuijsen M, Parker SC, Rowney FM, Song J, Stratton G, Wheeler BW, White J, White MP, Williams S, Rodgers SE, Fry R. The use of Enhanced Vegetation Index for assessing access to different types of green space in epidemiological studies. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2024:10.1038/s41370-024-00650-5. [PMID: 38424359 DOI: 10.1038/s41370-024-00650-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 01/24/2024] [Accepted: 01/24/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND Exposure to green space can protect against poor health through a variety of mechanisms. However, there is heterogeneity in methodological approaches to exposure assessments which makes creating effective policy recommendations challenging. OBJECTIVE Critically evaluate the use of a satellite-derived exposure metric, the Enhanced Vegetation Index (EVI), for assessing access to different types of green space in epidemiological studies. METHODS We used Landsat 5-8 (30 m resolution) to calculate average EVI for a 300 m radius surrounding 1.4 million households in Wales, UK for 2018. We calculated two additional measures using topographic vector data to represent access to green spaces within 300 m of household locations. The two topographic vector-based measures were total green space area stratified by type and average private garden size. We used linear regression models to test whether EVI could discriminate between publicly accessible and private green space and Pearson correlation to test associations between EVI and green space types. RESULTS Mean EVI for a 300 m radius surrounding households in Wales was 0.28 (IQR = 0.12). Total green space area and average private garden size were significantly positively associated with corresponding EVI measures (β = < 0.0001, 95% CI: 0.0000, 0.0000; β = 0.0001, 95% CI: 0.0001, 0.0001 respectively). In urban areas, as average garden size increases by 1 m2, EVI increases by 0.0002. Therefore, in urban areas, to see a 0.1 unit increase in EVI index score, garden size would need to increase by 500 m2. The very small β values represent no 'measurable real-world' associations. When stratified by type, we observed no strong associations between greenspace and EVI. IMPACT It is a widely implemented assumption in epidiological studies that an increase in EVI is equivalent to an increase in greenness and/or green space. We used linear regression models to test associations between EVI and potential sources of green reflectance at a neighbourhood level using satellite imagery from 2018. We compared EVI measures with a 'gold standard' vector-based dataset that defines publicly accessible and private green spaces. We found that EVI should be interpreted with care as a greater EVI score does not necessarily mean greater access to publicly available green spaces in the hyperlocal environment.
Collapse
Affiliation(s)
- Amy Mizen
- Swansea University Medical School, Swansea University, Swansea, UK.
| | | | - Alan Watkins
- Swansea University Medical School, Swansea University, Swansea, UK
| | - Ashley Akbari
- Swansea University Medical School, Swansea University, Swansea, UK
| | - Joanne K Garrett
- European Centre for Environment and Human Health, University of Exeter Medical School, University of Exeter, Truro, UK
| | - Rebecca Geary
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | - Rebecca Lovell
- European Centre for Environment and Human Health, University of Exeter Medical School, University of Exeter, Truro, UK
| | - Ronan A Lyons
- Swansea University Medical School, Swansea University, Swansea, UK
| | - Mark Nieuwenhuijsen
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Sarah C Parker
- Swansea University Medical School, Swansea University, Swansea, UK
| | - Francis M Rowney
- School of Geography, Earth and Environmental Sciences, University of Plymouth, Plymouth, UK
| | | | - Gareth Stratton
- ASTEM Research Centre, Faculty of Science and Engineering, Swansea University, Swansea, UK
| | - Benedict W Wheeler
- European Centre for Environment and Human Health, University of Exeter Medical School, University of Exeter, Truro, UK
| | - James White
- Centre for Trials Research, School of Medicine, Cardiff University, Cardiff, UK
| | - Mathew P White
- European Centre for Environment and Human Health, University of Exeter Medical School, University of Exeter, Truro, UK
- Cognitive Science Hub, University of Vienna, Vienna, Austria
| | | | - Sarah E Rodgers
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | - Richard Fry
- Swansea University Medical School, Swansea University, Swansea, UK
| |
Collapse
|
8
|
Bhatnagar A, Keith R, Yeager R, Riggs D, Sears C, Bucknum B, Smith T, Fleischer D, Chandler C, Walker KL, Hart JL, Srivastava S, Turner J, Rai S. The Green Heart Project: Objectives, Design, and Methods. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.12.05.23299461. [PMID: 38105951 PMCID: PMC10723507 DOI: 10.1101/2023.12.05.23299461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
The Green Heart Project is a community-based trial to evaluate the effects of increasing greenery on urban environment and community health. The study was initiated in 2018 in a low-to-middle-income mixed-race residential area of nearly 28,000 residents in Louisville, KY. The 4 square mile area was surveyed for land use, population characteristics, and greenness, and assigned to 8 paired clusters of demographically- and environmentally matched "target" (T) and adjacent "control" (C), clusters. Ambient levels of ultrafine particles, ozone, oxides of nitrogen, and environmental noise were measured in each cluster. Individual-level data were acquired during in-person exams of 735 participants in Wave 1 (2018-2019) and 545 participants in Wave 2 (2021) to evaluate sociodemographic and psychosocial factors. Blood, urine, nail, and hair samples were collected to evaluate standard cardiovascular risk factors, inflammation, stress, and pollutant exposure. Cardiovascular function was assessed by measuring arterial stiffness and flow-mediated dilation. After completion of Wave 2, more than 8,000 mature, mostly evergreen, trees and shrubs were planted in the T clusters in 2022. Post planting environmental and individual-level data were collected during Wave 3 (2022) from 561 participants. We plan to continue following changes in area characteristics and participant health to evaluate the long-term impact of increasing urban greenery.
Collapse
Affiliation(s)
- Aruni Bhatnagar
- Christina Lee Brown Envirome Institute
- Department of Medicine, University of Louisville, Louisville, KY
| | - Rachel Keith
- Christina Lee Brown Envirome Institute
- Department of Medicine, University of Louisville, Louisville, KY
| | - Ray Yeager
- Christina Lee Brown Envirome Institute
- Department of Medicine, University of Louisville, Louisville, KY
| | - Daniel Riggs
- Christina Lee Brown Envirome Institute
- Department of Medicine, University of Louisville, Louisville, KY
| | - Clara Sears
- Christina Lee Brown Envirome Institute
- Department of Medicine, University of Louisville, Louisville, KY
| | | | - Ted Smith
- Christina Lee Brown Envirome Institute
- Department of Medicine, University of Louisville, Louisville, KY
| | | | | | - Kandi L Walker
- Christina Lee Brown Envirome Institute
- Department of Communications, University of Louisville, Louisville, KY
| | - Joy L Hart
- Christina Lee Brown Envirome Institute
- Department of Communications, University of Louisville, Louisville, KY
| | - Sanjay Srivastava
- Christina Lee Brown Envirome Institute
- Department of Medicine, University of Louisville, Louisville, KY
| | - Jay Turner
- Department of Chemical Engineering, Washington University, St. Louis, MO
| | - Shesh Rai
- Department of Environmental Health, University of Cincinnati, Cincinnati, OH
| |
Collapse
|
9
|
Paoin K, Pharino C, Vathesatogkit P, Phosri A, Buya S, Ueda K, Seposo XT, Ingviya T, Saranburut K, Thongmung N, Yingchoncharoen T, Sritara P. Associations between residential greenness and air pollution and the incident metabolic syndrome in a Thai worker cohort. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2023; 67:1965-1974. [PMID: 37735284 DOI: 10.1007/s00484-023-02554-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 07/25/2023] [Accepted: 09/12/2023] [Indexed: 09/23/2023]
Abstract
Increasing air pollution and decreasing exposure to greenness may contribute to the metabolic syndrome (MetS). We examined associations between long-term exposure to residential greenness and air pollution and MetS incidence in the Bangkok Metropolitan Region, Thailand. Data from 1369 employees (aged 52-71 years) from the Electricity Generating Authority of Thailand cohort from 2002 to 2017 were analyzed. The greenness level within 500 m of each participant's residence was measured using the satellite-derived Normalized Difference Vegetation Index (NDVI) and Enhanced Vegetation Index (EVI). The kriging approach was used to generate the average concentration of each air pollutant (PM10, CO, SO2, NO2, and O3) at the sub-district level. The average long-term exposure to air pollution and greenness for each participant was calculated over the same period of person-time. Cox proportional hazards models were used to analyze the greenness-air pollution-MetS associations. The adjusted hazard ratio of MetS was 1.42 (95% confidence interval (CI): 1.32, 1.53), 1.22 (95% CI: 1.15, 1.30), and 2.0 (95% CI: 1.82, 2.20), per interquartile range increase in PM10 (9.5 μg/m3), SO2 (0.9 ppb), and CO (0.3 ppm), respectively. We found no clear association between NDVI or EVI and the incidence of MetS. On the contrary, the incident MetS was positively associated with NDVI and EVI for participants exposed to PM10 at concentrations more than 50 μg/m3. In summary, the incidence of MetS was positively associated with long-term exposure to air pollution. In areas with high levels of air pollution, green spaces may not benefit health outcomes.
Collapse
Affiliation(s)
- Kanawat Paoin
- Department of Environmental Engineering, Faculty of Engineering, Chulalongkorn University, Phayathai Rd., Wangmai, Pratumwan, Bangkok, 10330, Thailand.
| | - Chanathip Pharino
- Department of Environmental Engineering, Faculty of Engineering, Chulalongkorn University, Phayathai Rd., Wangmai, Pratumwan, Bangkok, 10330, Thailand.
| | - Prin Vathesatogkit
- Department of Internal Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Arthit Phosri
- Department of Environmental Health Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Suhaimee Buya
- School of Information, Computer and Communication Technology, Sirindhorn International Institute of Technology, Thammasat University, Khlong Nueng, Pathum Thani, Thailand
- School of Knowledge Science, Japan Advanced Institute of Science and Technology, Nomi, Ishikawa, Japan
| | - Kayo Ueda
- Department of Hygiene, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
- Department of Environmental Engineering, Graduate School of Engineering, Kyoto University, Kyoto, Japan
- Graduate School of Global Environmental Sciences, Kyoto University, Kyoto, Japan
| | - Xerxes Tesoro Seposo
- Department of Hygiene, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Thammasin Ingviya
- Air Pollution and Health Effect Research Center, Prince of Songkla University, Songkhla, Thailand
- Medical Data Center for Research and Innovation, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Krittika Saranburut
- Cardiovascular and Metabolic Center, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Nisakron Thongmung
- Research Center, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Teerapat Yingchoncharoen
- Department of Internal Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Piyamitr Sritara
- Department of Internal Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| |
Collapse
|
10
|
Guan Q, Zhu C, Zhang G, Wang J, Xiang H, Chen Y, Cui H. Association of land urbanization and type 2 diabetes mellitus prevalence and mediation of greenness and physical activity in Chinese adults. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 337:122579. [PMID: 37741540 DOI: 10.1016/j.envpol.2023.122579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 09/15/2023] [Accepted: 09/16/2023] [Indexed: 09/25/2023]
Abstract
The prevalence of type 2 diabetes (T2D) is higher in urban than in rural areas. Limited information is available on the association between T2D and Land urbanization (LU) while LU influences not only greenness and Particulate Matter 2.5 (PM2.5) but also inhabitant behavior. We aimed to explore the association between the LU level and T2D prevalence, as well as whether greenness, PM2.5, or conscious physical activity mediated any of the observed associations. This study encompassed 27,633 adult participants from Shandong Province who completed the sixth National Health Service Survey in 2018. Ambient LU exposure was estimated by spatial characteristics, including the existing impervious surface area (ISA), road density (RD), and annual night light (NL). Exposures were estimated using satellite images and OpenStreetMap, with 1000 m used as the main analysis buffer. Two-level logistic regression models were used to investigate the association between the LU metrics and T2D. Additionally, we explored potential mechanisms of the association through mediation analysis. The prevalence of T2D among participants was 5.14%, with average exposures to ISA_1000m of 1.441 km2, RD_1000m of 3.856 km/km2, and NL_1000m of 9.821 nW/cm2/sr. Higher levels of LU exposure were associated with higher T2D ORs [for each interquartile of ISA_1000m, RD_1000m, and NL_1000m, the adjusted OR (95% CI) for the T2D prevalence were 1.29 (1.19-1.4), 1.25 (1.15-1.36), and 1.25 (1.15-1.36), respectively]. This relationship persisted in several sensitivity analyses including use of different buffer sizes. We observed stronger associations among participants younger than 65 years or in men. Greenness mediated a 20.78%-65.36% of the estimated associations, conscious physical activity mediated a 10.35%-15.85%, while PM2.5 mediated insignificantly. These results suggest a deleterious association between higher levels of LU and T2D among adult residents in a developing country. Greenness and conscious physical activity mediate the association.
Collapse
Affiliation(s)
- Qing Guan
- State Key Laboratory of Information Engineering in Surveying, Mapping, and Remote Sensing, Wuhan University, Wuhan 430079, China.
| | - Chunyang Zhu
- State Key Laboratory of Information Engineering in Surveying, Mapping, and Remote Sensing, Wuhan University, Wuhan 430079, China.
| | - Guo Zhang
- State Key Laboratory of Information Engineering in Surveying, Mapping, and Remote Sensing, Wuhan University, Wuhan 430079, China.
| | - Jian Wang
- Dong Fureng Institute of Economic and Social Development, Wuhan University, Wuhan 430072, China.
| | - Hao Xiang
- Department of Global Health, School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan, China.
| | - Yujia Chen
- State Key Laboratory of Information Engineering in Surveying, Mapping, and Remote Sensing, Wuhan University, Wuhan 430079, China.
| | - Hao Cui
- State Key Laboratory of Information Engineering in Surveying, Mapping, and Remote Sensing, Wuhan University, Wuhan 430079, China.
| |
Collapse
|
11
|
Yi W, Wang W, Xu Z, Liu L, Wei N, Pan R, Song R, Li X, Liu J, Yuan J, Song J, Cheng J, Huang Y, Su H. Association of outdoor artificial light at night with metabolic syndrome and the modifying effect of tree and grass cover. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 264:115452. [PMID: 37696078 DOI: 10.1016/j.ecoenv.2023.115452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 09/05/2023] [Accepted: 09/05/2023] [Indexed: 09/13/2023]
Abstract
BACKGROUND Epidemiological studies show that outdoor artificial light at night (ALAN) is linked to metabolic hazards, but its association with metabolic syndrome (MetS) remains unclear. We aimed to investigate the association of outdoor ALAN with MetS in middle-aged and elderly Chinese. METHODS From 2017-2020, we conducted a cross-sectional study in a total of 109,452 participants living in ten cities of eastern China. MetS was defined by fasting blood glucose (FG), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), blood pressure (BP), and waist circumference (WC). In 2021, we followed up 4395 participants without MetS at the baseline. Each participant's five-year average exposure to outdoor ALAN, as well as their exposure to green space type, were measured through matching to their address. Generalized linear models were used to assess the associations of outdoor ALAN with MetS. Stratified analyses were performed by sex, age, region, physical activity, and exposure to green space. RESULTS In the cross-sectional study, compared to the first quantile (Q1) of outdoor ALAN exposure, the odds ratios (ORs) of MetS were 1.156 [95 % confidence interval (CI): 1.111-1.203] and 1.073 (95 %CI: 1.021-1.128) respectively in the third and fourth quantiles (Q3, Q4) of outdoor ALAN exposure. The follow-up study found that, compared to the first quantile (Q1) of outdoor ALAN exposure, the OR of MetS in Q4 of ALAN exposure was 1.204 (95 %CI: 1.019-1.422). Adverse associations of ALAN with MetS components, including high FG, high TG, and obesity, were also found. Greater associations of ALAN with MetS were found in males, the elderly, urban residents, those with low frequency of physical activity, and those living in areas with low levels of grass cover and tree cover. CONCLUSIONS Outdoor ALAN exposure is associated with an increased MetS risk, especially in males, the elderly, urban residents, those lacking physical activity, and those living in lower levels of grass cover and tree cover.
Collapse
Affiliation(s)
- Weizhuo Yi
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China; School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
| | - Weiqiang Wang
- Suzhou Hospital of Anhui Medical University, China; Suzhou Municipal Hospital of Anhui Province, China
| | - Zhiwei Xu
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
| | - Li Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Ning Wei
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Rubing Pan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Rong Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Xuanxuan Li
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Jintao Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Jiajun Yuan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Jian Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Jian Cheng
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Yuee Huang
- School of Public Health, Wannan Medical College, Wuhu, Anhui, China.
| | - Hong Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China.
| |
Collapse
|
12
|
Pan M, Liu F, Zhang K, Chen Z, Tong J, Wang X, Zhou F, Xiang H. Independent and interactive associations between greenness and ambient pollutants on novel glycolipid metabolism biomarkers: A national repeated measurement study. ENVIRONMENTAL RESEARCH 2023; 233:116393. [PMID: 37308069 DOI: 10.1016/j.envres.2023.116393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 05/22/2023] [Accepted: 06/09/2023] [Indexed: 06/14/2023]
Abstract
This study aims to investigate the independent and interactive effects of greenness and ambient pollutants on novel glycolipid metabolism biomarkers. A repeated national cohort study was conducted among 5085 adults from 150 counties/districts across China, with levels of novel glycolipid metabolism biomarkers of TyG index, TG/HDL-c, TC/HDL-c, and non-HDL-c measured. Exposure levels of greenness and ambient pollutants (including PM1, PM2.5, PM10, and NO2) for each participant were determined based on their residential location. Linear mixed-effect and interactive models were used to evaluate the independent and interactive effects between greenness and ambient pollutants on the four novel glycolipid metabolism biomarkers. In the main models, the changes [β (95% CIs)] of TyG index, TG/HDL-c, TC/HDL-c, and non-HDL-c were -0.021 (-0.036, -0.007), -0.120 (-0.175, -0.066), -0.092 (-0.122, -0.062), and -0.445 (-1.370, 0.480) for every 0.1 increase in NDVI, and were 0.004 (0.003, 0.005), 0.014 (0.009, 0.019), 0.009 (0.006, 0.011), and 0.067 (-0.019, 0.154) for every 1 μg/m3 increase in PM1. Results of interactive analyses demonstrated that individuals living in low-polluted areas could get greater benefits from greenness than those living in highly-polluted areas. Additionally, the results of mediation analyses revealed that PM2.5 mediated 14.40% of the association between greenness and the TyG index. Further research is needed to validate our findings.
Collapse
Affiliation(s)
- Mengnan Pan
- Department of Global Health, School of Public Health, Wuhan University, 115# Donghu Road, Wuhan, 430071, China; Global Health Institute, School of Public Health, Wuhan University, 115# Donghu Road, Wuhan, 430071, China
| | - Feifei Liu
- Department of Global Health, School of Public Health, Wuhan University, 115# Donghu Road, Wuhan, 430071, China; Global Health Institute, School of Public Health, Wuhan University, 115# Donghu Road, Wuhan, 430071, China
| | - Ke Zhang
- Department of Global Health, School of Public Health, Wuhan University, 115# Donghu Road, Wuhan, 430071, China; Global Health Institute, School of Public Health, Wuhan University, 115# Donghu Road, Wuhan, 430071, China
| | - Zhongyang Chen
- Department of Global Health, School of Public Health, Wuhan University, 115# Donghu Road, Wuhan, 430071, China; Global Health Institute, School of Public Health, Wuhan University, 115# Donghu Road, Wuhan, 430071, China
| | - Jiahui Tong
- Department of Global Health, School of Public Health, Wuhan University, 115# Donghu Road, Wuhan, 430071, China; Global Health Institute, School of Public Health, Wuhan University, 115# Donghu Road, Wuhan, 430071, China
| | - Xiangxiang Wang
- Department of Global Health, School of Public Health, Wuhan University, 115# Donghu Road, Wuhan, 430071, China; Global Health Institute, School of Public Health, Wuhan University, 115# Donghu Road, Wuhan, 430071, China
| | - Feng Zhou
- Department of Global Health, School of Public Health, Wuhan University, 115# Donghu Road, Wuhan, 430071, China; Global Health Institute, School of Public Health, Wuhan University, 115# Donghu Road, Wuhan, 430071, China
| | - Hao Xiang
- Department of Global Health, School of Public Health, Wuhan University, 115# Donghu Road, Wuhan, 430071, China; Global Health Institute, School of Public Health, Wuhan University, 115# Donghu Road, Wuhan, 430071, China.
| |
Collapse
|
13
|
Tharrey M, Klein O, Bohn T, Malisoux L, Perchoux C. Nine-year exposure to residential greenness and the risk of metabolic syndrome among Luxembourgish adults: A longitudinal analysis of the ORISCAV-Lux cohort study. Health Place 2023; 81:103020. [PMID: 37028115 DOI: 10.1016/j.healthplace.2023.103020] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 03/20/2023] [Accepted: 03/21/2023] [Indexed: 04/09/2023]
Abstract
Growing evidence shows a beneficial effect of exposure to greenspace on cardiometabolic health, although limited by the cross-sectional design of most studies. This study examined the long-term associations of residential greenness exposure with metabolic syndrome (MetS) and MetS components within the ORISCAV-LUX study (Wave 1: 2007-2009, Wave 2: 2016-2017, n = 395 adults). Objective exposure to residential greenness was measured in both waves by the Soil-Adjusted Vegetation Index (SAVI) and by Tree Cover Density (TCD). Linear mixed models were fitted to estimate the effect of baseline levels and change in residential greenness on MetS (continuous score: siMS score) and its components (waist circumference, triglycerides, HDL-cholesterol, fasting plasma glucose and systolic blood pressure), respectively. This study provides evidence that an increase in SAVI, but not TCD, may play a role in preventing MetS, as well as improving HDL-cholesterol and fasting plasma glucose levels. Greater baseline SAVI was also associated with lower fasting plasma glucose levels in women and participants living in municipalities with intermediate housing price, and greater baseline TCD was associated with larger waist circumference. Overall, findings suggest a mixed impact of increased greenness on cardiometabolic outcomes. Further longitudinal research is needed to better understand the potential effects of different types of greenness exposure on cardiometabolic outcomes.
Collapse
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.
| | - 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
| | - Laurent Malisoux
- 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
| |
Collapse
|
14
|
Aarthi GR, Mehreen Begum TS, Moosawi SA, Kusuma D, Ranjani H, Paradeepa R, Padma V, Mohan V, Anjana RM, Fecht D. Associations of the built environment with type 2 diabetes in Asia: a systematic review. BMJ Open 2023; 13:e065431. [PMID: 37015791 PMCID: PMC10083821 DOI: 10.1136/bmjopen-2022-065431] [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] [Indexed: 04/06/2023] Open
Abstract
OBJECTIVES Our study aimed to systematically review the literature and synthesise findings on potential associations of built environment characteristics with type 2 diabetes (T2D) in Asia. DESIGN Systematic review of the literature. DATA SOURCES Online databases Medline, Embase and Global Health were used to identify peer-reviewed journal articles published from inception to 23 January 2023. ELIGIBILITY CRITERIA Eligible studies included cohort, cross-sectional and case-control studies that explored associations of built environment characteristics with T2D among adults 18 years and older in Asia. DATA EXTRACTION AND SYNTHESIS Covidence online was used to remove duplicates and perform title, abstract and full-text screening. Data extraction was carried out by two independent reviewers using the OVID database and data were imported into MS Excel. Out of 5208 identified studies, 28 studies were included in this systematic review. Due to heterogeneity in study design, built environment and outcome definitions, a semiqualitative analysis was conducted, which synthesised results using weighted z-scores. RESULTS Five broad categories of built environment characteristics were associated with T2D in Asia. These included urban green space, walkability, food environment, availability and accessibility of services such as recreational and healthcare facilities and air pollution. We found very strong evidence of a positive association of particulate matter (PM2.5, PM10), nitrogen dioxide and sulfur dioxide (p<0.001) with T2D risk. CONCLUSION Several built environment attributes were significantly related to T2D in Asia. When compared with Western countries, very few studies have been conducted in Asia. Further research is, therefore, warranted to establish the importance of the built environment on T2D. Such evidence is essential for public health and planning policies to (re)design neighbourhoods and help improve public health across Asian countries. PROSPERO REGISTRATION NUMBER CRD42020214852.
Collapse
Affiliation(s)
- Garudam Raveendiran Aarthi
- Department of Research Operations, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
- School of Public Health, SRM Institute of Science and Technology, Kattankulathur, Tamil Nadu, India
| | - Thaharullah Shah Mehreen Begum
- Department of Research Operations, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
- School of Public Health, Imperial College London, London, UK
| | | | - Dian Kusuma
- Centre for Health Economics and Policy Innovations, Imperial College Business School, London, UK
| | - Harish Ranjani
- Department of Translational Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Rajendra Paradeepa
- Department of Diabetology, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Venkatasubramanian Padma
- School of Public Health, SRM Institute of Science and Technology, Kattankulathur, Tamil Nadu, India
| | - Viswanathan Mohan
- Department of Diabetology, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Ranjit Mohan Anjana
- School of Public Health, SRM Institute of Science and Technology, Kattankulathur, Tamil Nadu, India
- Department of Diabetology, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Daniela Fecht
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| |
Collapse
|
15
|
Jia H, Luo H, Wu Z, Meng X, Zhang L, Hu W, Yu K, Chen R, Sun X. Residential greenness exposure and decreased prevalence of diabetic retinopathy: A nationwide analysis in China. ENVIRONMENTAL RESEARCH 2023; 221:115302. [PMID: 36642124 DOI: 10.1016/j.envres.2023.115302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 01/11/2023] [Accepted: 01/12/2023] [Indexed: 06/17/2023]
Abstract
OBJECTIVE Diabetic retinopathy (DR) is a leading cause of vision impairment and blindness among diabetics. We aimed to explore whether long-term exposure to residential greenness was beneficial to DR. RESEARCH DESIGN AND METHODS We used data from a large-scale, cross-sectional screening survey conducted in 129 cities of 27 provincial regions of China from 2018 to 2021 among patients with diabetes. We measured residential greenness exposure as the 3-year average of annual maximum Normalized Difference Vegetation Index (NDVI) at a spatial resolution of 250 m. DR was assessed by ophthalmologists based on fundus photographs. The primary outcome was DR, and secondary outcome included DR severity status (i.e., nonproliferative and proliferative), hallmarks of retinal lesions and macular oedema. RESULTS A total of 484,380 adult participants with diabetes were included in the current analysis, and 15.7% of them were diagnosed with DR. NDVI was inversely and linearly associated with DR prevalence, and an increment of 0.1 NDVI was associated with a 10% (9%-10%) decrease in DR prevalence. Significant and inverse associations were further found for nonproliferative and proliferative DR, hallmarks of lesions and macular oedema. The association between greenness and DR was stronger among participants who were older, obese, lived in the south, had longer duration of diabetes or did not take antidiabetic medications. CONCLUSIONS This large-scale nationwide study provides the first-hand epidemiological evidence on the associations of residential greenness with DR. Our findings highlight the importance of residential greenness in alleviating DR risk especially in an era of aging and urbanization.
Collapse
Affiliation(s)
- Huixun Jia
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China; Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China; National Clinical Research Center for Eye Diseases, Shanghai, China
| | - Huihuan Luo
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Zhenyu Wu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China.
| | - Xia Meng
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Lina Zhang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Weiting Hu
- Shanghai Phoebus Medical Co. Ltd., Shanghai, China
| | - Kexin Yu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China.
| | - Xiaodong Sun
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China; National Clinical Research Center for Eye Diseases, Shanghai, China.
| |
Collapse
|
16
|
Paoin K, Pharino C, Vathesatogkit P, Phosri A, Buya S, Saranburut K, Ueda K, Seposo XT, Ingviya T, Kitiyakara C, Thongmung N, Sritara P. Residential greenness and kidney function: A cohort study of Thai employees. Health Place 2023; 80:102993. [PMID: 36791509 DOI: 10.1016/j.healthplace.2023.102993] [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: 11/24/2022] [Revised: 01/26/2023] [Accepted: 02/08/2023] [Indexed: 02/16/2023]
Abstract
Higher residential greenness is associated with a lower risk of chronic kidney disease, but evidence on the association between greenness exposure and kidney function has not been conducted. Using cohort data from Electricity Generating Authority of Thailand (EGAT) employees, we investigated the association between long-term exposure to greenness and kidney function using estimated glomerular filtration rate (eGFR) in Bangkok Metropolitan Region (BMR), Thailand. We analyzed data from 2022 EGAT workers (aged 25-55 years at baseline) from 2009 to 2019. The level of greenness was calculated using the satellite-derived Enhanced Vegetation Index (EVI) and Normalized Difference Vegetation Index (NDVI). From 2008 to 2019, the average concentration of each air pollutant (PM10, O3, NO2, SO2, and CO) at the sub-district level in BMR was generated using the Kriging method. Long-term exposure for each participant was defined as the 1-year average concentrations before the date of the physical examination in 2009, 2014, and 2019. We employed linear mixed effects models to evaluate associations of NDVI and EVI with eGFR. The robustness of the results was also tested by including air pollutants in the models. After relevant confounders were controlled, the interquartile range increase in NDVI was associated with higher eGFR [1.03% (95%CI: 0.33, 1.74)]. After PM10 and SO2 were included in the models, the associations between NDVI and eGFR became weaker. The additions of O3, NO2, and CO strengthened the associations between them. In contrast, we did not find any association between EVI and eGFR. In conclusion, there was a positive association between NDVI and eGFR, but not for EVI. Air pollutants had a significant impact on the relationship between NDVI and eGFR. Additional research is needed to duplicate this result in various settings and populations to confirm our findings.
Collapse
Affiliation(s)
- Kanawat Paoin
- Department of Environmental Engineering, Faculty of Engineering, Chulalongkorn University, Bangkok, Thailand.
| | - Chanathip Pharino
- Department of Environmental Engineering, Faculty of Engineering, Chulalongkorn University, Bangkok, Thailand.
| | - Prin Vathesatogkit
- Department of Internal Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Arthit Phosri
- Department of Environmental Health Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Suhaimee Buya
- School of Information, Computer and Communication Technology, Sirindhorn International Institute of Technology, Thammasat University, Pathum Thani, Thailand; School of Knowledge Science, Japan Advanced Institute of Science and Technology, Nomi, Ishikawa, Japan
| | - Krittika Saranburut
- Cardiovascular and Metabolic Center, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Kayo Ueda
- Department of Hygiene, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan; Department of Environmental Engineering, Graduate School of Engineering, Kyoto University, Kyoto, Japan; Graduate School of Global Environmental Sciences, Kyoto University, Kyoto, Japan
| | - Xerxes Tesoro Seposo
- Department of Hygiene, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Thammasin Ingviya
- Air Pollution and Health Effect Research Center, Prince of Songkla University, Songkhla, Thailand; Medical Data Center for Research and Innovation, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Chagriya Kitiyakara
- Department of Internal Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Nisakron Thongmung
- Research Center, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Piyamitr Sritara
- Department of Internal Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| |
Collapse
|
17
|
Paoin K, Pharino C, Phosri A, Ueda K, Seposo XT, Kelly M, Seubsman SA, Sleigh A. Association between greenness and cardiovascular risk factors: Results from a large cohort study in Thailand. ENVIRONMENTAL RESEARCH 2023; 220:115215. [PMID: 36610535 DOI: 10.1016/j.envres.2023.115215] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 12/30/2022] [Accepted: 01/02/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND The risk of cardiovascular diseases may be reduced by residing in green environments. However, there are relatively few longitudinal cohort studies, especially in Southeast Asia, that focused on the health benefits of long-term greenness exposure in young adults. The present study examined the association between long-term exposure to residential greenness and self-reported morbidities in participants of the Thai Cohort Study (TCS) in Thailand from 2005 to 2013. METHODS The self-reported outcomes, including high blood pressure, high blood cholesterol, and diabetes, were reported in 2005, 2009, and 2013, where the study participants provided the exact year of disease occurrence. Greenness was assessed by the satellite-based Normalized Difference Vegetation Index (NDVI) and Enhanced Vegetation Index (EVI), with a spatial resolution of 250 m. Long-term exposure to NDVI and EVI of each participant's sub-district was averaged over the period of person-time. We used Cox proportional hazards models to examine the association between greenness and health outcomes. Associations with self-reported morbidity were measured using hazard ratios (HRs) per interquartile range (IQR) increase in NDVI and EVI. RESULTS After adjusting for potential confounders, we observed that an IQR increase in NDVI was associated with lower incidence of high blood pressure (HR = 0.92, 95% CI: 0.89, 0.97) and high blood cholesterol (HR = 0.89, 95%CI: 0.87, 0.92), but not significantly associated with diabetes (HR = 0.93, 95%CI: 0.85, 1.01). EVI was also inversely associated with self-reported high blood pressure (HR = 0.92, 95%CI: 0.88, 0.96), high blood cholesterol (HR = 0.89, 95%CI: 0.87, 0.91), and diabetes (HR = 0.92, 95%CI: 0.85, 0.99). CONCLUSIONS Long-term exposure to residential greenness was inversely associated with self-reported high blood pressure, high blood cholesterol, and diabetes in participants of TCS. Our study provides evidence that greenness exposure may reduce cardiovascular disease risk factors in adult population.
Collapse
Affiliation(s)
- Kanawat Paoin
- Department of Environmental Engineering, Faculty of Engineering, Chulalongkorn University, Bangkok, Thailand.
| | - Chanathip Pharino
- Department of Environmental Engineering, Faculty of Engineering, Chulalongkorn University, Bangkok, Thailand.
| | - Arthit Phosri
- Department of Environmental Health Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Kayo Ueda
- Department of Hygiene, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan; Department of Environmental Engineering, Graduate School of Engineering, Kyoto University, Kyoto, Japan; Graduate School of Global Environmental Sciences, Kyoto University, Kyoto, Japan
| | - Xerxes Tesoro Seposo
- Department of Hygiene, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Matthew Kelly
- Department of Global Health, Research School of Population Health, Australian National University, Canberra, Australia
| | - Sam-Ang Seubsman
- School of Human Ecology, Sukhothai Thammathirat Open University, Nonthaburi, Thailand
| | - Adrian Sleigh
- Department of Global Health, Research School of Population Health, Australian National University, Canberra, Australia
| |
Collapse
|
18
|
Yu W, Li X, Zhong W, Dong S, Feng C, Yu B, Lin X, Yin Y, Chen T, Yang S, Jia P. Rural-urban disparities in the associations of residential greenness with diabetes and prediabetes among adults in southeastern China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 860:160492. [PMID: 36435247 DOI: 10.1016/j.scitotenv.2022.160492] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 11/18/2022] [Accepted: 11/21/2022] [Indexed: 06/16/2023]
Abstract
AIMS Greenness offers health benefits to prevent diabetes in urban areas. However, urban-rural disparities in this association have not been explored, with the underlying pathways understudied as well. We aimed to investigate and compare the associations and potential pathways between residential greenness and the risks for diabetes and prediabetes in urban and rural areas. METHODS Diabetes and prediabetes were diagnosed by fasting blood glucose (FBG). The participants' residential greenness exposure was estimated by the normalized difference vegetation index (NDVI) and enhanced vegetation index (EVI). The association of residential greenness with the risks for diabetes and prediabetes was estimated by logistic regression and the generalized additive model. The potential mediation effects of air pollution, body mass index (BMI), and physical activity (PA) were examined by causal mediation analysis. RESULTS Of the 50,593 included participants, and the prevalence of prediabetes and diabetes were 21.22 % and 5.63 %, respectively. Each 0.1-unit increase in EVI500m and NDVI500m for healthy people reduced the risk for prediabetes by 12 % and 8 %, respectively, and substantially reduced the risk for diabetes by 23 % and 19 %, respectively. For those with prediabetes, each 0.1-unit increase in EVI500m and NDVI500m reduced the diabetes risk by 14 % and 12 %, respectively. Compared to the risks for diabetes at the 25th percentile of EVI500m/NDVI500m, such risks significantly reduced when EVI500m (NDVI500m) increased over 0.43 (0.48) and 0.28 (0.39) in urban and rural areas, respectively. The residential greenness-prediabetes/diabetes associations were mediated by air pollution and PA in urban areas and by air pollution and BMI in rural areas. CONCLUSIONS Exposure to residential greenness was associated with a lower risk for prediabetes and diabetes in urban areas and, more strongly, in rural areas, which were partly mediated by air pollution, PA, and BMI.
Collapse
Affiliation(s)
- Wanqi Yu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xiaoqing Li
- Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
| | - Wenling Zhong
- Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
| | - Shu Dong
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Chuanteng Feng
- Institute for Disaster Management and Reconstruction, Sichuan University-The Hong Kong Polytechnic University, Chengdu, China; West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Bin Yu
- Institute for Disaster Management and Reconstruction, Sichuan University-The Hong Kong Polytechnic University, Chengdu, China
| | - Xi Lin
- Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
| | - Yanrong Yin
- Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
| | - Tiehui Chen
- Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
| | - Shujuan Yang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China; International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, China; Department of Health Management Center, Clinical Medical College & Affiliated Hospital, Chengdu University, Chengdu, China.
| | - Peng Jia
- International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, China; School of Resource and Environmental Sciences, Wuhan University, Wuhan, China
| |
Collapse
|
19
|
Chen L, Jia Y, Guo Y, Chen G, Ciren Z, Chen H, Duoji Z, Xu J, Yang T, Xu H, Feng S, Jiang Y, Guo B, Meng Q, Zhao X. Residential greenness associated with decreased risk of metabolic- dysfunction-associated fatty liver disease: Evidence from a large population-based epidemiological study. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 249:114338. [PMID: 36508840 DOI: 10.1016/j.ecoenv.2022.114338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 11/22/2022] [Accepted: 11/23/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Numerous studies have shown that residential greenness positively correlates with enhanced health. Metabolic dysfunction-associated fatty liver disease (MAFLD) affects about a quarter of the population while lacking specific treatments. Given that the association between green space and MAFLD is still unknown, we explored the association between residential greenness and MAFLD as well as the potential mechanisms based on the baseline survey of the China Multi-Ethnic Cohort (CMEC). METHODS Residential greenness was expressed as normalized difference vegetation index (NDVI) and enhanced vegetation index (EVI). MAFLD was assessed through hepatic steatosis, the presence of overweight/obesity, type 2 diabetes mellitus, and evidence of metabolic dysregulation. We used logistic regression to examine the association between NDVI/EVI and the prevalence of MAFLD. Moreover, we utilized causal mediation analyses to explore the role of physical activity and ambient particulate matters (PM1, PM2.5, and PM10) on the association between residential greenness and MAFLD. RESULTS We included 72,368 participants from the CMEC and found that residential greenness was negatively associated with the prevalence of MAFLD. For an interquartile range (IQR) increase in NDVI500 m and EVI500 m, the odds ratio (OR) of MAFLD were 0.78 (95 %CI: 0.75, 0.81) and 0.81 (95 %CI: 0.78, 0.84), respectively. Greater association between residential greenness and MAFLD was observed among males. Air pollutants and physical activity could mediate a partial effect (8.5-22.9 %) of residential greenness on MAFLD. CONCLUSION Higher residential greenness was associated with decreased risk of MAFLD. Moreover, the association was greater among males. The protective effects of residential greenness may be achieved by mitigating the hazardous effects of air pollutants and encouraging physical activity.
Collapse
Affiliation(s)
- Lin Chen
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yiping Jia
- Department of Ultrasound, West China School of Public Health and West China Fourth Hospital, Sichuan, China
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Gongbo Chen
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China; Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Zhuoga Ciren
- Tibet Center for Disease Control and Prevention, Lhasa, Tibet, China
| | - Heng Chen
- Chengdu Center for Disease Control & Prevention, China
| | - Zhuoma Duoji
- School of Medicine, Tibet University, Lhasa, Tibet, China
| | - Jie Xu
- Chongqing Municipal Center for Disease Control and Prevention, China
| | - Tingting Yang
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang 550025, China
| | - Huan Xu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Shiyu Feng
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ye Jiang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Bing Guo
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China.
| | - Qiong Meng
- Department of Epidemiology and Health Statistics School of Public Health, Kunming Medical University, West Chunrong Road, Chenggong Zone, Kunming, Yunnan 650500, China.
| | - Xing Zhao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China.
| |
Collapse
|
20
|
Yu Z, Feng Y, Chen Y, Zhang X, Zhao X, Chang H, Zhang J, Gao Z, Zhang H, Huang C. Green space, air pollution and gestational diabetes mellitus: A retrospective cohort study in central China. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 249:114457. [PMID: 38321676 DOI: 10.1016/j.ecoenv.2022.114457] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 12/08/2022] [Accepted: 12/19/2022] [Indexed: 02/08/2024]
Abstract
Emerging evidence suggests residential surrounding green space is beneficial for human health. The association between green space and GDM showed inconsistent results, and potential effect modification of green space with air pollution is still unclear. This study aims to evaluate the association between green space and GDM, and further explore potential interaction and medication effects. Participants were recruited from a retrospective cohort study between 2015 and 2020 in Henan, China. Residential green space based on normalized difference vegetation index (NDVI) and air pollution exposure were estimated using spatial-statistical models. Multivariate logistic regression was applied to evaluate the association between per 0.1 unit increase in NDVI with 4 buffer sizes (250 m, 500 m, 1000 m, 2000 m) and GDM. We examined potential interaction of green space and air pollutants on GDM. Mediating effects of air pollution associated with green space exposure on GDM were also investigated by causal mediation analyses. A total of 46,665 eligible pregnant women were identified. There were 4092 (8.8 %) women diagnosed with GDM according to the IADPSG criteria. We found that per 0.1-unit increment in NDVI250 m, NDVI500 m, NDVI1000 m and NDVI2000 m in second trimester were associated with the decreased risk of GDM, with adjusted OR of 0.921(95 %CI: 0.890-0.953), 0.922 (95 %CI: 0.891-0.953), 0.921 (95 %CI: 0.892-0.952) and 0.921 (95 %CI: 0.892-0.951), respectively. We identified significant interactions between second trimester PM2.5 and O3 exposure and NDVI for GDM (Pinteraction < 0.001). The causal mediation analysis showed that PM2.5 mediated approximately 2.5-5.5 % of the association between green space and GDM, while the estimated mediating effect of O3 was approximately 30.1-38.5 %. In conclusion, our study indicates that residential green space was associated with a reduced risk of GDM, particularly second trimester. Green space may benefit to GDM partly mediated by a reduction in PM2.5 and O3.
Collapse
Affiliation(s)
- Zengli Yu
- School of Public Health, Zhengzhou University, Zhengzhou, China; NHC Key Laboratory of Birth Defects Prevention & Henan Key Laboratory of Population Defects Prevention, Zhengzhou, China
| | - Yang Feng
- School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Yao Chen
- The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiaoan Zhang
- The Third Hospital of Zhengzhou University, Zhengzhou, China
| | - Xin Zhao
- The Third Hospital of Zhengzhou University, Zhengzhou, China
| | - Hui Chang
- The Third Hospital of Zhengzhou University, Zhengzhou, China
| | - Junxi Zhang
- NHC Key Laboratory of Birth Defects Prevention & Henan Key Laboratory of Population Defects Prevention, Zhengzhou, China
| | - Zhan Gao
- The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Huanhuan Zhang
- School of Public Health, Zhengzhou University, Zhengzhou, China.
| | - Cunrui Huang
- Vanke School of Public Health, Tsinghua University, Beijing, China
| |
Collapse
|
21
|
Kang N, Song X, Zhang C, Li R, Yuchi Y, Liao W, Hou X, Liu X, Mao Z, Huo W, Hou J, Wang C. Association of household air pollution with glucose homeostasis markers in Chinese rural women: Effect modification of socioeconomic status. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 248:114283. [PMID: 36371884 DOI: 10.1016/j.ecoenv.2022.114283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 11/07/2022] [Accepted: 11/08/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Socioeconomic status (SES) was a crucial influencing factor of household air pollution (HAP). However, few studies have explored the potential effect modification of SES on the associations of HAP with type 2 diabetes mellitus (T2DM) and glucose homeostasis. METHODS A total of 20900 participants were obtained from the Henan Rural Cohort. HAP reflected by cooking fuel type and cooking duration was assessed via questionnaire. SES was evaluated by two dimensions: educational level and average monthly income. Associations of cooking fuel type, cooking duration with T2DM and glucose homeostasis indices (insulin, fasting plasma glucose (FPG), and HOMA-β) were assessed by the generalized linear model. Analyses were also conducted in different SES groups to explore the potential effect modification. RESULTS Significant negative association of cooking fuel type and cooking duration with T2DM, FPG, and HOMA-β was not observed. However, cooking with solid fuel and long-duration cooking were associated with decreased insulin level in women, and the adjusted coefficients were - 0.35 (95% confidence interval (95% CI): - 0.53, - 0.17) and - 0.36 (95% CI: -0.50, -0.21), respectively. Results from stratified analyses showed that these associations were more prominent in women with low average monthly income, with corresponding coefficient of - 0.57 (95% CI: -0.77, -0.37) for cooking with solid fuel and - 0.34 (95% CI: -0.52, -0.16) for long-duration cooking. Among women with low average monthly income, the largest decreased insulin level was observed in those who cooked with solid fuel, long-duration and poor kitchen ventilation, while the negative association of cooking fuel type and cooking duration with insulin level was slightly alleviated in the good kitchen ventilation group. CONCLUSIONS Low average monthly income aggravated the negative association of HAP and insulin level among rural women, while improving kitchen ventilation may be a practical intervention. TRAIL REGISTRATION The Henan Rural Cohort Study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699). Date of registration: 06 July, 2015. http://www.chictr.org.cn/showproj.aspx?proj=11375.
Collapse
Affiliation(s)
- Ning Kang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Xiaoqin Song
- Physical Examination Center, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, PR China
| | - Caiyun Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Ruiying Li
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Yinghao Yuchi
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Wei Liao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Xiaoyu Hou
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Xiaotian Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Zhenxing Mao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Wenqian Huo
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Jian Hou
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China.
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China.
| |
Collapse
|
22
|
Klompmaker JO, Laden F, Browning MHEM, Dominici F, Jimenez MP, Ogletree SS, Rigolon A, Zanobetti A, Hart JE, James P. Associations of Greenness, Parks, and Blue Space With Neurodegenerative Disease Hospitalizations Among Older US Adults. JAMA Netw Open 2022; 5:e2247664. [PMID: 36538329 PMCID: PMC9856892 DOI: 10.1001/jamanetworkopen.2022.47664] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 10/31/2022] [Indexed: 12/24/2022] Open
Abstract
Importance Exposure to natural environments has been associated with health outcomes related to neurological diseases. However, the few studies that have examined associations of natural environments with neurological diseases report mixed findings. Objective To evaluate associations of natural environments with hospital admissions for Alzheimer disease and related dementias (ADRD) and Parkinson disease (PD) among older adults in the US. Design, Setting, and Participants This open cohort study included fee-for-service Medicare beneficiaries aged 65 years or older who lived in the contiguous US from January 1, 2000, to December 31, 2016. Beneficiaries entered the cohort on January 1, 2000, or January 1 of the year after enrollment. Data from US Medicare enrollment and Medicare Provider Analysis and Review files, which contain information about individual-level covariates and all hospital admissions for Medicare fee-for-service beneficiaries, were analyzed between January 2021 and September 2022. Exposures Differences in IQRs for zip code-level greenness (normalized difference vegetation index [NDVI]), percentage park cover, and percentage blue space cover (surface water; ≥1.0% vs <1.0%). Main Outcomes and Measures The main outcome was first hospitalizations with a primary or secondary discharge diagnosis of ADRD or PD. To examine associations of exposures to natural environments with ADRD and PD hospitalization, we used Cox-equivalent Poisson models. Results We included 61 662 472 and 61 673 367 Medicare beneficiaries in the ADRD and PD cohorts, respectively. For both cohorts, 55.2% of beneficiaries were women. Most beneficiaries in both cohorts were White (84.4%), were not eligible for Medicaid (87.6%), and were aged 65 to 74 years (76.6%) at study entry. We observed 7 737 609 and 1 168 940 first ADRD and PD hospitalizations, respectively. After adjustment for potential individual- and area-level confounders (eg, Medicaid eligibility and zip code-level median household income), NDVI was negatively associated with ADRD hospitalization (hazard ratio [HR], 0.95 [95% CI, 0.94-0.96], per IQR increase). We found no evidence of an association of percentage park and blue space cover with ADRD hospitalization. In contrast, NDVI (HR, 0.94 [95% CI, 0.93-0.95], per IQR increase), percentage park cover (HR, 0.97 [95% CI, 0.97-0.98], per IQR increase), and blue space cover (HR, 0.97 [95% CI, 0.96-0.98], ≥1.0% vs <1.0%) were associated with a decrease in PD hospitalizations. Patterns of effect modification by demographics differed between exposures. Conclusions and Relevance The findings of this cohort study suggest that some natural environments are associated with a decreased risk of ADRD and PD hospitalization.
Collapse
Affiliation(s)
- Jochem O. Klompmaker
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Francine Laden
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | | | - Francesca Dominici
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Marcia P. Jimenez
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
| | - S. Scott Ogletree
- OPENspace Research Centre, School of Architecture and Landscape Architecture, University of Edinburgh, Edinburgh, United Kingdom
| | - Alessandro Rigolon
- Department of City and Metropolitan Planning, University of Utah, Salt Lake City
| | - Antonella Zanobetti
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Jaime E. Hart
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Peter James
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
| |
Collapse
|
23
|
Wang Q, Duoji Z, Feng C, Fei T, Ma H, Wang S, Ciren W, Yang T, Ling H, Ma B, Yu W, Liu H, Zhou J, Zhao X, Jia P, Yang S. Associations and pathways between residential greenness and hyperuricemia among adults in rural and urban China. ENVIRONMENTAL RESEARCH 2022; 215:114406. [PMID: 36152883 DOI: 10.1016/j.envres.2022.114406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 09/01/2022] [Accepted: 09/19/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Residential greenness may decrease the risk for hyperuricemia in rural areas, but the urban-rural disparities in this association and underlying pathways have not been studied. OBJECTIVES To investigate the associations and potential pathways between residential greenness and hyperuricemia in urban and rural areas. METHODS The baseline survey of the China Multi-Ethnic Cohort (CMEC) was used. Hyperuricemia was defined as serum uric acid (SUA) > 417 μmol/L for men and >357 μmol/L for women. The satellite-based normalized difference vegetation index (NDVI) and enhanced vegetation index (EVI) were used to capture residential greenness. A propensity score inverse-probability weighting method was used to assess urban-rural differences in the associations between residential greenness and hyperuricemia, with possible mediation effects of physical activity (PA), body mass index (BMI), PM2.5, and NO2 examined by causal mediation analyses. RESULTS A total of 72,372 participants were included. The increases in the EVI500m and NDVI500m residential greenness were associated with a decreased risk for hyperuricemia and the SUA level in both urban and rural areas. For example, each 0.1-unit increase in EVI500m was associated with a decreased hyperuricemia risk of 7% (OR = 0.93 [0.91, 0.96]) and a decreased SUA level of -1.77 μmol/L [-2.60, -0.93], respectively; such associations were stronger in urban areas for both the risk for hyperuricemia (OR = 0.84 [0.83, 0.86]) and SUA level (-7.18 μmol/L [-7.91, -6.46]). The subgroup analysis showed that the greenness-hyperuricemia/SUA association varied by age, sex, and annual household income. The percentage of the joint mediation effect of PA, BMI, PM2.5, and NO2 on the association between EVI500m and the risk for hyperuricemia was higher in urban (34.92%) than rural areas (15.40%). BMI, PM2.5, and PA showed significantly independently mediation effects for the greenness-hyperuricemia association in both rural and urban areas. CONCLUSIONS Exposure to residential greenness was associated with a decreased risk for hyperuricemia, partially through the pathways of PA, BMI, PM2.5, and NO2, which varied in urban and rural areas.
Collapse
Affiliation(s)
- Qinjian Wang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Zhuoma Duoji
- School of Medicine, Tibet University, Lhasa, China
| | - Chuanteng Feng
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China; Institute for Disaster Management and Reconstruction, Sichuan University-The Hongkong Polytechnic University, Chengdu, China
| | - Teng Fei
- School of Resource and Environmental Sciences, Wuhan University, Wuhan, China
| | - Hua Ma
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Songmei Wang
- School of Public Health, Kunming Medical University, Kunming, China
| | - Wangla Ciren
- Lhasa Chengguan District Center for Disease Control and Prevention, Lhasa, China
| | - Tingting Yang
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Hua Ling
- Chongqing Center for Disease Control and Prevention, Chongqing, China
| | - Bangjing Ma
- Qingbaijiang District Center for Disease Control and Prevention, Chengdu, China
| | - Wanqi Yu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Hongyun Liu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Junmin Zhou
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xing Zhao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Peng Jia
- School of Resource and Environmental Sciences, Wuhan University, Wuhan, China; International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, China.
| | - Shujuan Yang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China; International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, China.
| |
Collapse
|
24
|
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.
Collapse
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
| |
Collapse
|
25
|
Yu L, Li T, Yang Z, Zhang X, Xu L, Wu Y, Yu Z, Shen P, Lin H, Shui L, Tang M, Jin M, Chen K, Wang J. Long-term exposure to residential surrounding greenness and incidence of diabetes: A prospective cohort study. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 310:119821. [PMID: 35870530 DOI: 10.1016/j.envpol.2022.119821] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 06/27/2022] [Accepted: 07/18/2022] [Indexed: 06/15/2023]
Abstract
Exposure to residential greenness might affect population health through increasing physical activity and social engagement, improving mental health, and reducing harmful environmental exposure. However, evidence on the association of greenness with risk of diabetes is still controversial. In this study, we recruited a total of 22,535 participants aged ≥18 years from Yinzhou District, Ningbo, Zhejiang Province, China to investigate the associations between residential greenness and risk of diabetes incidence. Residential greenness was estimated using Normalized Difference Vegetation Index (NDVI), Enhanced Vegetation Index (EVI), and Vegetation Continuous Field (VCF). We also calculated cumulative average NDVI, EVI and VCF values, and changes in NDVI, EVI and VCF during the follow-up period. We used Cox proportional hazards models controlling for demographic characteristics, lifestyles, individual socioeconomic status, history of diseases and particulate matter with an aerodynamic diameter ≤2.5 μm (PM2.5) to examine hazard ratios (HRs) and 95% confidence intervals (95% CIs) and assessed physical activity, body mass index (BMI) or PM2.5 as potential mediators. During 84,992.64 person-years of follow-up, a total of 1,154 incident cases of diabetes occurred. In multivariable models, living in the highest quartile of cumulative average NDVI, EVI and VCF within 250-m buffer was associated with 57% (HR = 0.43, 95% CI: 0.36, 0.52), 62% (HR = 0.38, 95% CI: 0.32, 0.45), and 55% (HR = 0.45, 95% CI: 0.38, 0.54) reduction in diabetes risk compared with the lowest quartile, respectively. Results remained similar for NDVI, EVI, and VCF within 500-m and 1000-m buffers. Stratified analyses showed stronger association for residential greenness and diabetes among older people. The association between greenness and diabetes did not appear to be mediated by physical activity, PM2.5 or BMI. Our findings suggested that higher residential greenness was significantly associated with lower risk of diabetes.
Collapse
Affiliation(s)
- Luhua Yu
- Department of Epidemiology and Biostatistics at School of Public Health and National Clinical Research Center for Child Health of the Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Tiezheng Li
- Department of Epidemiology and Biostatistics at School of Public Health and National Clinical Research Center for Child Health of the Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Zongming Yang
- Department of Epidemiology and Biostatistics at School of Public Health and National Clinical Research Center for Child Health of the Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Xinhan Zhang
- Department of Epidemiology and Biostatistics at School of Public Health and the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Lisha Xu
- Department of Epidemiology and Biostatistics at School of Public Health and National Clinical Research Center for Child Health of the Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Yonghao Wu
- Department of Epidemiology and Biostatistics at School of Public Health and National Clinical Research Center for Child Health of the Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Zhebin Yu
- Department of Epidemiology and Biostatistics at School of Public Health and the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Peng Shen
- Department of Chronic Disease and Health Promotion, Yinzhou District Center for Disease Control and Prevention, Ningbo, 315040, China
| | - Hongbo Lin
- Department of Chronic Disease and Health Promotion, Yinzhou District Center for Disease Control and Prevention, Ningbo, 315040, China
| | - Liming Shui
- Yinzhou District Health Bureau of Ningbo, Ningbo, 315040, China
| | - Mengling Tang
- Department of Epidemiology and Biostatistics at School Public Health and the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Mingjuan Jin
- Department of Epidemiology and Biostatistics at School of Public Health and the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Kun Chen
- Department of Epidemiology and Biostatistics at School of Public Health and the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Jianbing Wang
- Department of Epidemiology and Biostatistics at School of Public Health and National Clinical Research Center for Child Health of the Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China.
| |
Collapse
|
26
|
Sillman D, Rigolon A, Browning MHEM, Yoon HV, McAnirlin O. Do sex and gender modify the association between green space and physical health? A systematic review. ENVIRONMENTAL RESEARCH 2022; 209:112869. [PMID: 35123971 DOI: 10.1016/j.envres.2022.112869] [Citation(s) in RCA: 39] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 01/19/2022] [Accepted: 01/28/2022] [Indexed: 06/14/2023]
Abstract
A growing literature shows that green space can have protective effects on human health. As a marginalized group, women often have worse life outcomes than men, including disparities in some health outcomes. Given their marginalization, women might have "more to gain" than men from living near green spaces. Yet, limited research has deliberately studied whether green space-health associations are stronger for women or men. We conducted a systematic review to synthesize empirical evidence on whether sex or gender modifies the protective associations between green space and seven physical health outcomes (cardiovascular disease, cancer, diabetes, general physical health, non-malignant respiratory disease, mortality, and obesity-related health outcomes). After searching five databases, we identified 62 articles (including 81 relevant analyses) examining whether such effect modification existed. We classified analyses based on whether green space-health were stronger for women, no sex/gender differences were detected, or such associations were stronger for men. Most analyses found that green space-physical health associations were stronger for women than for men when considering study results across all selected health outcomes. Also, women showed stronger protective associations with green space than men for obesity-related outcomes and mortality. Additionally, the protective green space-health associations were slightly stronger among women for green land cover (greenness, NDVI) than for public green space (parks), and women were also favored over men when green space was measured very close to one's home (0-500 m). Further, the green space-health associations were stronger for women than for men in Europe and North America, but not in other continents. As many government agencies and nongovernmental organizations worldwide work to advance gender equity, our review shows that green space could help reduce some gender-based health disparities. More robust empirical studies (e.g., experimental) are needed to contribute to this body of evidence.
Collapse
Affiliation(s)
- Delaney Sillman
- Department of City & Metropolitan Planning, The University of Utah, Salt Lake City, UT, 84112, USA.
| | - Alessandro Rigolon
- Department of City & Metropolitan Planning, The University of Utah, Salt Lake City, UT, 84112, USA.
| | - Matthew H E M Browning
- Department of Parks, Recreation and Tourism Management, Clemson University, Clemson, SC, 29634, USA.
| | - Hyunseo Violet Yoon
- Department of Recreation, Sport, and Tourism, University of Illinois at Urbana-Champaign, Champaign, IL, 61820, USA.
| | - Olivia McAnirlin
- Department of Parks, Recreation and Tourism Management, Clemson University, Clemson, SC, 29634, USA.
| |
Collapse
|
27
|
Peng W, Dong Y, Tian M, Yuan J, Kan H, Jia X, Wang W. City-level greenness exposure is associated with COVID-19 incidence in China. ENVIRONMENTAL RESEARCH 2022; 209:112871. [PMID: 35123969 PMCID: PMC8812109 DOI: 10.1016/j.envres.2022.112871] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 01/09/2022] [Accepted: 01/28/2022] [Indexed: 05/05/2023]
Abstract
Accumulating studies have suggested an important role of environmental factors (e.g. air pollutants) on the occurrence and development of coronavirus disease 2019 (COVID-19). Evidence concerning the relationship of greenness on COVID-19 is still limited. This study aimed to assess the association between greenness and COVID-19 incidence in 266 Chinese cities. A total of 12,377 confirmed COVID-19 cases were identified through February 29th, 2020. We used the average normalized difference vegetation index (NDVI) during January and February 2020 from MOD13A2 product, to represent the city-level greenness exposure. A generalized linear mixed-effects model was used to estimate the association between NDVI exposure and COVID-19 incidence using COVID-19 cases as the outcome. We evaluated whether the association was modified by population density, GDP per capita, and urbanization rate, and was mediated by air pollutants. We also performed a series of sensitivity analyses to discuss the robustness of our results. Per 0.1 unit increment in NDVI was negatively associated with COVID-19 incidence (IRR: 0.921, 95% CI: 0.898, 0.944) after adjustment for confounders. Associations with COVID-19 incidence were stronger in cities with lower population density, lower GDP per capita, and lower urbanization rate. We failed to detect any mediation effect of air pollutants on the association between NDVI and COVID-19 incidence. Sensitivity analyses also indicated consistent estimates. In conclusion, our study suggested a beneficial association between city-level greenness and COVID-19 incidence. We could not establish which mechanisms may explain this relationship.
Collapse
Affiliation(s)
- Wenjia Peng
- School of Public Health, Fudan University, Shanghai, China; Key Laboratory of Public Health Safety (Ministry of Education), Fudan University, Shanghai, China
| | - Yilin Dong
- School of Public Health, Bengbu Medical College, Bengbu, Anhui, China
| | - Meihui Tian
- School of Public Health, Bengbu Medical College, Bengbu, Anhui, China
| | - Jiacan Yuan
- IRDR-ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Haidong Kan
- School of Public Health, Fudan University, Shanghai, China; Key Laboratory of Public Health Safety (Ministry of Education), Fudan University, Shanghai, China; IRDR-ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Xianjie Jia
- School of Public Health, Bengbu Medical College, Bengbu, Anhui, China
| | - Weibing Wang
- School of Public Health, Fudan University, Shanghai, China; Key Laboratory of Public Health Safety (Ministry of Education), Fudan University, Shanghai, China; IRDR-ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China.
| |
Collapse
|
28
|
Liu L, Yan LL, Lv Y, Zhang Y, Li T, Huang C, Kan H, Zhang J, Zeng Y, Shi X, Ji JS. Air pollution, residential greenness, and metabolic dysfunction biomarkers: analyses in the Chinese Longitudinal Healthy Longevity Survey. BMC Public Health 2022; 22:885. [PMID: 35509051 PMCID: PMC9066955 DOI: 10.1186/s12889-022-13126-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 03/31/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We hypothesize higher air pollution and fewer greenness exposures jointly contribute to metabolic syndrome (MetS), as mechanisms on cardiometabolic mortality. METHODS We studied the samples in the Chinese Longitudinal Healthy Longevity Survey. We included 1755 participants in 2012, among which 1073 were followed up in 2014 and 561 in 2017. We used cross-sectional analysis for baseline data and the generalized estimating equations (GEE) model in a longitudinal analysis. We examined the independent and interactive effects of fine particulate matter (PM2.5) and Normalized Difference Vegetation Index (NDVI) on MetS. Adjustment covariates included biomarker measurement year, baseline age, sex, ethnicity, education, marriage, residence, exercise, smoking, alcohol drinking, and GDP per capita. RESULTS At baseline, the average age of participants was 85.6 (SD: 12.2; range: 65-112). Greenness was slightly higher in rural areas than urban areas (NDVI mean: 0.496 vs. 0.444; range: 0.151-0.698 vs. 0.133-0.644). Ambient air pollution was similar between rural and urban areas (PM2.5 mean: 49.0 vs. 49.1; range: 16.2-65.3 vs. 18.3-64.2). Both the cross-sectional and longitudinal analysis showed positive associations of PM2.5 with prevalent abdominal obesity (AO) and MetS, and a negative association of NDVI with prevalent AO. In the longitudinal data, the odds ratio (OR, 95% confidence interval-CI) of PM2.5 (per 10 μg/m3 increase) were 1.19 (1.12, 1.27), 1.16 (1.08, 1.24), and 1.14 (1.07, 1.21) for AO, MetS and reduced high-density lipoprotein cholesterol (HDL-C), respectively. NDVI (per 0.1 unit increase) was associated with lower AO prevalence [OR (95% CI): 0.79 (0.71, 0.88)], but not significantly associated with MetS [OR (95% CI): 0.93 (0.84, 1.04)]. PM2.5 and NDVI had a statistically significant interaction on AO prevalence (pinteraction: 0.025). The association between PM2.5 and MetS, AO, elevated fasting glucose and reduced HDL-C were only significant in rural areas, not in urban areas. The association between NDVI and AO was only significant in areas with low PM2.5, not under high PM2.5. CONCLUSIONS We found air pollution and greenness had independent and interactive effect on MetS components, which may ultimately manifest in pre-mature mortality. These study findings call for green space planning in urban areas and air pollution mitigation in rural areas.
Collapse
Affiliation(s)
- Linxin Liu
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Lijing L Yan
- Global Heath Research Center, Duke Kunshan University, Kunshan, China.,School of Public Health, Wuhan University, Wuhan, China.,Institute for Global Health and Development, Peking University, Beijing, China
| | - Yuebin Lv
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yi Zhang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Tiantian Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Cunrui Huang
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Haidong Kan
- School of Public Health, Fudan University, Shanghai, China
| | - Junfeng Zhang
- Nicholas School of the Environment and Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Yi Zeng
- Center for Healthy Aging and Development Studies, National School of Development, Peking University, Beijing, China.,Center for the Study of Aging and Human Development, Duke Medical School, Durham, NC, USA
| | - Xiaoming Shi
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China.,Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - John S Ji
- Vanke School of Public Health, Tsinghua University, Beijing, China.
| |
Collapse
|
29
|
Ponjoan A, Blanch J, Alves-Cabratosa L, Martí-Lluch R, Comas-Cufí M, Cirach M, Nieuwenhuijsen M, Garcia-Gil MDM, Ramos R. Impact of residential greenness on myocardial infarction in the population with diabetes: A sex-dependent association? ENVIRONMENTAL RESEARCH 2022; 205:112449. [PMID: 34883080 DOI: 10.1016/j.envres.2021.112449] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 10/04/2021] [Accepted: 11/24/2021] [Indexed: 06/13/2023]
Abstract
Living in urban areas with abundant greenness might provide health benefits in general population. Literature suggests that sex/gender plays a role in the association between greenness and health outcomes. But the impact of greenness in populations with moderate to high cardiovascular risk, such as persons with diabetes, is still unknown. Our aim was to evaluate the relationship between urban greenness and myocardial infarction incidence in persons with type 2 diabetes in Barcelona (Catalonia, Spain), and seek potential gender/sex differences in this association. This retrospective cohort study is based on data from the System for the Development of Research in Primary Care (SIDIAP database). We used Cox models to estimate if a 0.01 increase in Normalized Difference Vegetation Index (NDVI) at census tract level was associated to reduced risk of developing a myocardial infarction. Models were adjusted by demographic and clinical characteristics at individual level, and by environmental and socioeconomic variables at census tract level. Amongst 41,463 persons with diabetes and 154,803.85 person-years of follow-up, we observed 449 incident cases of acute myocardial infarction. For each 0.01 increment in NDVI the risk of developing a myocardial infarction decreased by 6% (Hazard Ratio, HR = 0.94; 95%CI, 0.89-0.99) in the population with diabetes. When stratifying by sex, we observed a significant association only in men (HR = 0.91; 95%CI, 0.86-0.97). People with diabetes living in urban greener areas might benefit from reduced cardiovascular risk, specially men. We observed sex/gender disparities, which could be related to different exposures and activities performed in green spaces between men and women. Further studies are needed to confirm sex/gender disparities between greenness exposure and cardiovascular outcomes. Our findings contribute to improve the health of people with diabetes who should be recommended to spent time and exercise in green areas.
Collapse
Affiliation(s)
- Anna Ponjoan
- Vascular Health Research Group (ISV)-Girona. Jordi Gol Institute for Primary Care Research (IDIAP Jordi Gol), 17002, Girona, Catalonia, Spain; Girona Biomedical Research Institute (IDIBGI), Dr.Trueta University Hospital, 17190, Girona, Catalonia, Spain.
| | - Jordi Blanch
- Vascular Health Research Group (ISV)-Girona. Jordi Gol Institute for Primary Care Research (IDIAP Jordi Gol), 17002, Girona, Catalonia, Spain.
| | - Lia Alves-Cabratosa
- Vascular Health Research Group (ISV)-Girona. Jordi Gol Institute for Primary Care Research (IDIAP Jordi Gol), 17002, Girona, Catalonia, Spain.
| | - Ruth Martí-Lluch
- Vascular Health Research Group (ISV)-Girona. Jordi Gol Institute for Primary Care Research (IDIAP Jordi Gol), 17002, Girona, Catalonia, Spain; Girona Biomedical Research Institute (IDIBGI), Dr.Trueta University Hospital, 17190, Girona, Catalonia, Spain.
| | - Marc Comas-Cufí
- Vascular Health Research Group (ISV)-Girona. Jordi Gol Institute for Primary Care Research (IDIAP Jordi Gol), 17002, Girona, Catalonia, Spain.
| | - Marta Cirach
- ISGlobal, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), 08002, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), 28029, Madrid, Spain.
| | - Mark Nieuwenhuijsen
- ISGlobal, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), 08002, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), 28029, Madrid, Spain.
| | - María Del Mar Garcia-Gil
- Vascular Health Research Group (ISV)-Girona. Jordi Gol Institute for Primary Care Research (IDIAP Jordi Gol), 17002, Girona, Catalonia, Spain.
| | - Rafel Ramos
- Vascular Health Research Group (ISV)-Girona. Jordi Gol Institute for Primary Care Research (IDIAP Jordi Gol), 17002, Girona, Catalonia, Spain; Translab Research Group, Department of Medical Sciences, School of Medicine, University of Girona, Girona, Catalonia, Spain.
| |
Collapse
|
30
|
Peng W, Kan H, Zhou L, Wang W. Residential greenness is associated with disease severity among COVID-19 patients aged over 45 years in Wuhan, China. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 232:113245. [PMID: 35093816 PMCID: PMC8786605 DOI: 10.1016/j.ecoenv.2022.113245] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/15/2022] [Accepted: 01/24/2022] [Indexed: 05/05/2023]
Abstract
Evidence regarding environmental factors associated with disease severity of COVID-19 remained scarce. This study aimed to investigate the association of residential greenness exposure with COVID-19 severity applying a retrospective cross-sectional study in Wuhan, China. We included 30,253 COVID-19 cases aged over 45 years from January 1 to February 27, 2020. Residential greenness was quantitatively assessed using normalized difference vegetation index (NDVI) and enhanced vegetation index (EVI). A multilevel generalized linear model using Poisson regression was implemented to analyze the association between greenness exposure and disease severity of COVID-19, after adjusting for potential covariates. A linear exposure-response relationship was found between greenness and COVID-19 severity. In the adjusted model, one 0.1 unit increase of NDVI and EVI in the 1000-m buffer radius was significantly associated with a 7.6% (95% confidence interval (CI): 4.0%, 11.1%) and 10.0% (95% CI: 5.1%, 14.7%) reduction of the prevalence of COVID-19 severity, respectively. The effect of residential greenness seemed to be more pronounced among participants with lower population density and economic levels. Air pollutants mediated 0.82~12.08% of the greenness and COVID-19 severity association, particularly to nitrogen dioxide. Sensitivity analyses suggested the robustness of the results. Our findings suggested that residential greenness exposure was beneficial to reduce the prevalence of COVID-19 severity.
Collapse
Affiliation(s)
- Wenjia Peng
- School of Public Health, Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China; Key Laboratory of Public Health Safety (Ministry of Education), Fudan University, Shanghai, China
| | - Haidong Kan
- School of Public Health, Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China
| | - Lian Zhou
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China.
| | - Weibing Wang
- School of Public Health, Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China; Key Laboratory of Public Health Safety (Ministry of Education), Fudan University, Shanghai, China; IRDR-ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China.
| |
Collapse
|
31
|
Liang Z, Wang W, Yang C, Wang Y, Shen J, Li P, Ma L, Wei F, Chen R, Liang C, Li S, Zhang L. Residential greenness and prevalence of chronic kidney disease: Findings from the China National Survey of Chronic Kidney Disease. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 806:150628. [PMID: 34592294 DOI: 10.1016/j.scitotenv.2021.150628] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 09/20/2021] [Accepted: 09/23/2021] [Indexed: 06/13/2023]
Abstract
Green space is associated with many health benefits, but evidence concerning the effects on chronic kidney disease (CKD) has not been investigated. Using the nationwide cross-sectional study of 47,204 adults from the China National Survey of Chronic Kidney Disease dataset and residential greenness assessed by the normalized difference vegetation index (NDVI), this study evaluated the association between residential greenness and CKD prevalence. An interquartile range increase in NDVI1000m (0.26) was associated with decreased odds of CKD for all participants with an odds ratio (OR) of 0.79 (95% confidence interval [CI]: 0.73-0.86). Subgroup analyses demonstrated more apparent inverse associations in younger adults <65 years, male participants, people in higher socio-economic status, as well as people with smoking and alcohol drinking habit. In addition, more apparent inverse associations were found in regions with higher fine particulate matter (PM2.5) concentration levels, with OR of 0.56 (95% CI: 0.49, 0.65) for higher pollution regions, and OR of 0.95 (95% CI: 0.83, 1.09) for lower pollution regions (P for interaction <0.001). The exposure-response curves captured more apparent declines in OR of CKD when in lower NDVI1000m exposure ranges (<0.6), even controlling for the PM2.5 concentration. Our results indicated that residential greenness might be beneficial for the prevention and control of CKD at the population level, suggesting the positive significance of strengthening green space construction, particularly in regions with low greenness.
Collapse
Affiliation(s)
- Ze Liang
- Key Laboratory for Earth Surface Processes of the Ministry of Education, College of Urban and Environmental Sciences, Peking University, Beijing 100871, China
| | - Wanzhou Wang
- School of Public Health, Peking University, Beijing 100191, China
| | - Chao Yang
- Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing 100034, China; Research Units of Diagnosis and Treatment of Immune-Mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing 100034, China; Advanced Institute of Information Technology, Peking University, Hangzhou 311215, China
| | - Yueyao Wang
- Key Laboratory for Earth Surface Processes of the Ministry of Education, College of Urban and Environmental Sciences, Peking University, Beijing 100871, China
| | - Jiashu Shen
- Key Laboratory for Earth Surface Processes of the Ministry of Education, College of Urban and Environmental Sciences, Peking University, Beijing 100871, China
| | - Pengfei Li
- Advanced Institute of Information Technology, Peking University, Hangzhou 311215, China
| | - Lin Ma
- Key Laboratory for Earth Surface Processes of the Ministry of Education, College of Urban and Environmental Sciences, Peking University, Beijing 100871, China
| | - Feili Wei
- Key Laboratory for Earth Surface Processes of the Ministry of Education, College of Urban and Environmental Sciences, Peking University, Beijing 100871, China
| | - Rui Chen
- Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing 100034, China
| | - Chenyu Liang
- Key Laboratory for Earth Surface Processes of the Ministry of Education, College of Urban and Environmental Sciences, Peking University, Beijing 100871, China
| | - Shuangcheng Li
- Key Laboratory for Earth Surface Processes of the Ministry of Education, College of Urban and Environmental Sciences, Peking University, Beijing 100871, China.
| | - Luxia Zhang
- Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing 100034, China; Advanced Institute of Information Technology, Peking University, Hangzhou 311215, China; National Institute of Health Data Science at Peking University, Beijing 100191, China.
| |
Collapse
|
32
|
Guo J, Wu J, Wei D, Wang T, Hu Y, Lin Y, Chen M, Yang L, Wen Y, Cai Y, Xu X, Li H, Wu S, Xie X. Association between greenness and dyslipidemia in patients with coronary heart disease: A proteomic approach. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 231:113199. [PMID: 35042090 DOI: 10.1016/j.ecoenv.2022.113199] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 12/27/2021] [Accepted: 01/11/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Residential surrounding greenness may be protective of dyslipidemia are often theorized but remain poorly quantified. In particular, the underlying biological mechanisms of blood lipid changes with green spaces remain unclear. METHODS Our observational epidemiology study included a residentially stable sample of 1035 coronary heart disease patients, and proteomics study included 16 participants. Normalized Difference Vegetation Index (NDVI) was used to evaluate residential greenness exposures. Proteomics technology was used to identify plasma greenness-related proteome disturbance, and the pathway analysis was employed to evaluate the potential biological mechanisms of greenness decreasing dyslipidemia risk. RESULT Higher residential surrounding greenness in the 500-m area was associated with lower risks of dyslipidemia (odds ratio (OR) = 0.871, 95% confidence interval (CI): 0.763, 0.994 for per one-quartile NDVI increase). Lymphocytes mediated 18.7% of the association between greenness and dyslipidemia. Greenness related proteins (including PLXDC1, IGFBP2 and LY6D) may regulate the biological functions of lipid metabolism and transport-related proteins (including ADIPOQ and CES1) through a series of biological processes. CONCLUSION People in greener surroundings have a lower risk of dyslipidemia, which may be due to their lower inflammation, stronger lipid transporter activity, and normal cholesterol metabolism.
Collapse
Affiliation(s)
- Jianhui Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - Jieyu Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - Donghong Wei
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - Tinggui Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - Yuduan Hu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - Yawen Lin
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - Mingjun Chen
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - Le Yang
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - Yeyin Wen
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - Yingying Cai
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - Xingyan Xu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - Huanyuan Li
- Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou 350122, China.
| | - Siying Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China.
| | - Xiaoxu Xie
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China.
| |
Collapse
|
33
|
Peng W, Shi H, Li M, Li X, Liu T, Wang Y. Association of residential greenness with geriatric depression among the elderly covered by long-term care insurance in Shanghai. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:12054-12064. [PMID: 34561801 DOI: 10.1007/s11356-021-16585-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 09/13/2021] [Indexed: 05/22/2023]
Abstract
Residential greenness exposure has been linked to a number of physical and mental disorders. Nevertheless, evidence on the association between greenness and geriatric depression was limited and focused on developed countries. This study was aimed to investigate whether the relationship between residential greenness exposure and geriatric depression exists among the elderly with long-term care insurance (LTCI) in Shanghai, China. In 2018, a total of 1066 LTCI elderly from a cross-sectional survey completed a questionnaire in Shanghai. Residential greenness indicators, including normalized difference vegetation index (NDVI) and soil-adjusted vegetation index (SAVI), were calculated from the Landsat 8 imagery data in different buffers (100-m, 300-m, and 500-m). Mediation analysis by perceived social support was conducted to explore potential mechanisms underlying the associations. In the fully adjusted model, one IQR increase of NDVI and SAVI in the 300-m buffer size was associated with an 11.9% (PR: 0.881, 95% CI: 0.795, 0.977) and 14.7% (PR: 0.853, 95% CI: 0.766, 0.949) lower prevalence of geriatric depression, respectively. Stronger association was observed in the elderly with lower education level, living in non-central area, and lower family monthly income. Perceived social support significantly mediated 40.4% of the total effect for NDVI 300-m buffer and 40.3% for SAVI 300-m buffer to the greenness-depression association, respectively. Our results indicate the importance of residential greenness exposure to geriatric depression, especially for the elderly with lower education level, living in non-central area, and lower family monthly income. Perceived social support might mediate the association. Well-designed longitudinal studies are warranted to confirm our findings and investigate the underlying mechanisms.
Collapse
Affiliation(s)
- Wenjia Peng
- School of Public Health, Fudan University, Shanghai, People's Republic of China
| | - Hengyuan Shi
- Epidemiology and Health Statistics, School of Public Health, Bengbu Medical College, Bengbu, Anhui, People's Republic of China
| | - Mengying Li
- School of Public Health, Fudan University, Shanghai, People's Republic of China
| | - Xinghui Li
- School of Public Health, Fudan University, Shanghai, People's Republic of China
| | - Ting Liu
- Epidemiology and Health Statistics, School of Public Health, Bengbu Medical College, Bengbu, Anhui, People's Republic of China
| | - Ying Wang
- School of Public Health, Fudan University, Shanghai, People's Republic of China.
- School of Public Health/Key Lab of Health Technology Assessment, National Health and Family Planning Commission of the People's Republic of China, Fudan University, Shanghai, 200433, People's Republic of China.
| |
Collapse
|
34
|
Doubleday A, Knott CJ, Hazlehurst MF, Bertoni AG, Kaufman JD, Hajat A. Neighborhood greenspace and risk of type 2 diabetes in a prospective cohort: the Multi-Ethncity Study of Atherosclerosis. Environ Health 2022; 21:18. [PMID: 35034636 PMCID: PMC8762964 DOI: 10.1186/s12940-021-00824-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 12/22/2021] [Indexed: 05/25/2023]
Abstract
BACKGROUND Neighborhood greenspaces provide opportunities for increased physical activity and social interaction, and thus may reduce the risk of Type 2 diabetes. However, there is little robust research on greenspace and diabetes. In this study, we examine the longitudinal association between neighborhood greenspace and incident diabetes in the Multi-Ethnic Study of Atherosclerosis. METHODS A prospective cohort study (N = 6814; 2000-2018) was conducted to examine the association between greenspace, measured as annual and high vegetation season median greenness determined by satellite (Normalized Difference Vegetation Index) within 1000 m of participant homes, and incident diabetes assessed at clinician visits, defined as a fasting glucose level of at least 126 mg/dL, use of insulin or use of hypoglycemic medication, controlling for covariates in stages. Five thousand five hundred seventy-four participants free of prevalent diabetes at baseline were included in our analysis. RESULTS Over the study period, 886 (15.9%) participants developed diabetes. Adjusting for individual characteristics, individual and neighborhood-scale SES, additional neighborhood factors, and diabetes risk factors, we found a 21% decrease in the risk of developing diabetes per IQR increase in greenspace (HR: 0.79; 95% CI: 0.63, 0.99). CONCLUSIONS Overall, neighborhood greenspace provides a protective influence in the development of diabetes, suggesting that neighborhood-level urban planning that supports access to greenspace--along with healthy behaviors--may aid in diabetes prevention. Additional research is needed to better understand how an area's greenness influences diabetes risk, how to better characterize greenspace exposure and usage, and future studies should focus on robust adjustment for neighborhood-level confounders.
Collapse
Affiliation(s)
- Annie Doubleday
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA.
| | - Catherine J Knott
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | | | - Alain G Bertoni
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Joel D Kaufman
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Anjum Hajat
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| |
Collapse
|
35
|
Frank LD, Adhikari B, White KR, Dummer T, Sandhu J, Demlow E, Hu Y, Hong A, Van den Bosch M. Chronic disease and where you live: Built and natural environment relationships with physical activity, obesity, and diabetes. ENVIRONMENT INTERNATIONAL 2022; 158:106959. [PMID: 34768046 DOI: 10.1016/j.envint.2021.106959] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 09/24/2021] [Accepted: 10/22/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Diabetes is among the most prevalent non-communicable diseases causing significant morbidity and mortality globally. The aetiology and disease development of diabetes are influenced by genetic, lifestyle, and environmental factors. Due to an increasing number of cases each year, it is imperative to improve the understanding of modifiable environmental risk and protective factors. In this study we aimed to analyse associations between built and natural environment features and diabetes prevalence; and two major risk factors: physical activity and obesity and their mediation effects. METHODS We analysed relationships between walkability and park availability with physical activity, obesity, and diabetes, using self-reported data from a large cross-sectional survey in British Columbia, Canada (n = 22,418). We validated results with an independent cohort (n = 11,972) in a subset of the analyses. The outcome measures included walking, moderate to vigorous physical activity (MVPA), body mass index (BMI), and diabetes. Built and natural environment features within a 1 km road network buffer around residential postal code centroids were assessed using validated indicators of walkability and park availability. We used general linear multivariable models (GLM) to examine the direct relationship between environmental features, physical activity, obesity, and diabetes respectively. Path models were developed to analyse mediation effects of physical activity and obesity on the association between environmental indicators and diabetes. The relative contribution of direct versus indirect effects was assessed. All models were adjusted for age, gender, income. ethnicity, years lived in neighbourhood and regional accessibility. RESULTS Walkable neighbourhoods and areas with greater park availability were associated with lower rates of diabetes. There was a direct association of walkability and park availability on physical activity (highest vs. lowest quintile OR = 1.15; 95% CI: 1.00, 1.33 and OR = 1.28, 95% CI: 1.13, 1.45 respectively), obesity (highest vs. lowest quintile OR = 0.58, 95% CI: 0.49, 0.70 and OR = 0.57, 95% CI: 0.48, 0.68 respectively) and diabetes (highest vs. lowest quintile OR = 0.62, 95% CI: 0.45, 0.85, and OR = 0.63, 95% CI: 0.47, 0.84 respectively). Results were similar in the independent cohort. The associations between diabetes and walkability and park availability respectively were partly mediated by obesity (41% of total association for walkability and 53% of total association for park availability). The mediating effect of physical activity was negligible. CONCLUSION Results support investments in walkability through active transportation and transit infrastructure. Changes in zoning and subdivision regulations governing land use actions are required to enable compact mixed-use environments with access to parks and high quality transit service. Future studies including cost-benefit analyses of health-related economic impacts of such investments can contribute to evidence-based decisions for healthier cities.
Collapse
Affiliation(s)
- Lawrence D Frank
- Department of Urban Studies and Planning, University of California at San Diego, La Jolla, CA 92093, USA; School of Population and Public Health, The University of British Columbia, Vancouver, BC V6T 1Z3, Canada.
| | - Binay Adhikari
- School of Population and Public Health, The University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Katherine R White
- School of Population and Public Health, The University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Trevor Dummer
- School of Population and Public Health, The University of British Columbia, Vancouver, BC V6T 1Z3, Canada; Cancer Control Research, BC Cancer, Canada
| | - Jat Sandhu
- School of Population and Public Health, The University of British Columbia, Vancouver, BC V6T 1Z3, Canada; Vancouver Coastal Health Authority, Vancouver, BC, Canada
| | - Ellen Demlow
- Vancouver Coastal Health Authority, Vancouver, BC, Canada
| | - Yumian Hu
- Vancouver Coastal Health Authority, Vancouver, BC, Canada
| | - Andy Hong
- School of Population and Public Health, The University of British Columbia, Vancouver, BC V6T 1Z3, Canada; The George Institute for Global Health, University of Oxford, Oxford, UK
| | - Matilda Van den Bosch
- School of Population and Public Health, The University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| |
Collapse
|
36
|
A negative association between prevalence of diabetes and urban residential area greenness detected in nationwide assessment of urban Bangladesh. Sci Rep 2021; 11:19513. [PMID: 34593885 PMCID: PMC8484480 DOI: 10.1038/s41598-021-98585-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 09/06/2021] [Indexed: 12/13/2022] Open
Abstract
Residential area greenness may influence diabetes, but limited studies have explored this relationship in developing countries. This study assessed the association between residential area greenness and diabetes among urban adults in Bangladesh. The mediation effect of the body mass index (BMI) was also assessed. A total of 2367 adults aged ≥ 35 years were extracted from a nationally representative survey. Diabetes was characterised as fasting plasma glucose level be ≥ 7.0 mmol/L or taking prescribed medications to reduce blood sugar level. Residential area greenness was estimated by enhanced vegetation index. Binary logistic regression models were employed to estimate the association between residential area greenness and diabetes adjusting for sociodemographic factors. Mediation analysis was performed to assess whether BMI mediated the association between greenness and diabetes. Greater area greenness was associated with lower odds of diabetes (adjusted odds ratio 0.805, 95% confidence interval 0.693–0.935, p = 0.0052). BMI significantly mediated 36.4% of the estimated association between greenness and diabetes. Presence of areas of greenness adjacent to living area tends to be associated with lower diabetes prevalence. Findings emphasised the importance of preserving the local environment to tackle the growing diabetes prevalence in Bangladesh.
Collapse
|
37
|
Green Space and Health in Mainland China: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189937. [PMID: 34574854 PMCID: PMC8472560 DOI: 10.3390/ijerph18189937] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 09/03/2021] [Accepted: 09/13/2021] [Indexed: 12/12/2022]
Abstract
Non-communicable diseases (NCDs) have become a major cause of premature mortality and disabilities in China due to factors concomitant with rapid economic growth and urbanisation over three decades. Promoting green space might be a valuable strategy to help improve population health in China, as well as a range of co-benefits (e.g., increasing resilience to climate change). No systematic review has so far determined the degree of association between green space and health outcomes in China. This review was conducted to address this gap. Five electronic databases were searched using search terms on green space, health, and China. The review of 83 publications that met eligibility criteria reports associations indicative of various health benefits from more green space, including mental health, general health, healthier weight status and anthropometry, and more favorable cardiometabolic and cerebrovascular outcomes. There was insufficient evidence to draw firm conclusions on mortality, birth outcomes, and cognitive function, and findings on respiratory and infectious outcomes were inconsistent and limited. Future work needs to examine the health benefits of particular types and qualities of green spaces, as well as to take advantage of (quasi-)experimental designs to test greening interventions within the context of China's rapid urbanization and economic growth.
Collapse
|
38
|
Hou J, Tu R, Dong Y, Liu X, Dong X, Li R, Pan M, Yin S, Hu K, Mao Z, Huo W, Guo Y, Li S, Chen G, Wang C. Associations of residing greenness and long-term exposure to air pollution with glucose homeostasis markers. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 776:145834. [PMID: 33640545 DOI: 10.1016/j.scitotenv.2021.145834] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 02/06/2021] [Accepted: 02/08/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Although long-term exposure to higher air pollutants and lower residing greenness related to disorders of glucose homeostasis have been reported, their interaction effects on glucose homeostasis in developing countries remained unclear. METHODS A total of 35, 482 participants were obtained from the Henan Rural Cohort (n = 39, 259). Exposure to air pollutants (PM1, PM2.5, PM10 and NO2) were predicted by using a spatiotemporal model-based on satellites data. Residing greenness was reflected by Enhanced Vegetation Index (EVI) and Normalized Difference Vegetation Index (NDVI) which were derived from satellites data. Independent associations of single or mixture of air pollutant or residing greenness with glucose homeostasis markers were analyzed by quantile regression models and quantile g (qg)-computation method, respectively. Furthermore, interaction effects of residing greenness and air pollution on glucose homeostasis markers were analyzed by generalized additive models. RESULTS Positive associations of single or mixture of air pollutants (PM1, PM2.5, PM10 or NO2) with fasting plasma glucose (FPG) were observed, while negative associations of single or mixture of air pollutants with insulin or HOMA-β were observed. Residing greenness was negatively associated with FPG but positively related to insulin or HOMA-β. Quantile regression revealed the heterogeneity were observed in the associations the residing greenness or air pollutants with glucose homeostasis markers (insulin or HOMA-β) across deciles of the glucose homeostasis markers distributions. Furthermore, joint associations of single air pollutant and residing greenness on glucose homeostasis markers were found. CONCLUSIONS The results indicated that exposure to air pollution had negative effect on glucose homeostasis markers and these effects may be modified by living in higher green space. These findings suggest that increased residing greenness and air pollution control may have joint effect on decreased the risk of diabetes. CLINICAL TRIAL REGISTRATION The Henan Rural Cohort study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699, http://www.chictr.org.cn/showproj.aspx?proj=11375).
Collapse
Affiliation(s)
- Jian Hou
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Runqi Tu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Yonghui Dong
- Department of Orthopedics, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Henan University People's Hospital, PR China
| | - Xiaotian Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Xiaokang Dong
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Ruiying Li
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Mingming Pan
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Shanshan Yin
- Department of health policy research, Henan Academy of Medical Sciences, Zhengzhou, PR China
| | - Kai Hu
- Department of health policy research, Henan Academy of Medical Sciences, Zhengzhou, PR China
| | - Zhenxing Mao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Wenqian Huo
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Yuming Guo
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Gongbo Chen
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China.
| |
Collapse
|
39
|
Dong X, Liu X, Zhang L, Li R, Tu R, Hou J, Mao Z, Huo W, Guo Y, Li S, Chen G, Wang C. Residential greenness associated with lower serum uric acid levels and hyperuricemia prevalence in a large Chinese rural population. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 770:145300. [PMID: 33517006 DOI: 10.1016/j.scitotenv.2021.145300] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 01/16/2021] [Accepted: 01/16/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND The association between residential greenness and hyperuricemia remains unclear, especially in developing countries. The current study aimed to explore the associations between residential greenness and both serum uric acid (SUA) levels and hyperuricemia in a Chinese rural population and to examine potential pathways of these associations. METHODS In this cross-sectional study, 38,721 rural residents were recruited from the baseline survey of the Henan Rural Cohort study in 2015-2017. Two satellite-derived vegetation indices, i.e., the normalized difference vegetation index (NDVI) and the enhanced vegetation index (EVI), were used to estimate residential greenness. Air pollution was determined by two proxies: particulate matter with aerodynamic diameter ≤ 2.5 μm (PM2.5) and nitrogen dioxide (NO2). Hyperuricemia was defined as SUA levels of >417 μmol/L and > 357 μmol/L for men and women, respectively. Multivariable-adjusted linear regression and logistic regression models were applied to investigate the associations of greenness with SUA and hyperuricemia, and mediation analyses were used to explore possible mechanisms underlying the associations. RESULTS An interquartile range (IQR) increase in both EVI and NDVI in the 500 m buffer was significantly associated with reductions in SUA levels of -7.23 μmol/L (95% confidence interval (CI): -8.96, -5.50) and -4.38 μmol/L (95% CI: -5.93, -2.83), respectively. The same increases in EVI500-m and NDVI500-m were associated with 13.8% (95% CI: 5.8%, 21.2%) and 13.0% (95% CI: 5.6%, 19.8%) lower hyperuricemia prevalence, respectively. These associations were stronger in older people (age ≥ 65), men or participants with higher averaged monthly income. The associations were partly mediated by physical activity and BMI, while no mediation effect was observed for air pollution. CONCLUSIONS Higher levels of residential greenness were significantly associated with lower SUA levels and hyperuricemia prevalence in the Chinese rural population. BMI and physical activity may play important mediating roles in the associations.
Collapse
Affiliation(s)
- Xiaokang Dong
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Xiaotian Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Lulu Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Ruiying Li
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Runqi Tu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Jian Hou
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Zhenxing Mao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Wenqian Huo
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Yuming Guo
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Gongbo Chen
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, PR China.
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China.
| |
Collapse
|
40
|
Iyer HS, James P, Valeri L, Bajunirwe F, Nankya-Mutyoba J, Njelekela M, Chiwanga F, Sewram V, Ajayi I, Adebamowo C, Dalal S, Reid TG, Rebbeck TR, Adami HO, Holmes MD. Neighborhood greenness and burden of non-communicable diseases in Sub-Saharan Africa: A multi-country cross-sectional study. ENVIRONMENTAL RESEARCH 2021; 196:110397. [PMID: 33130166 PMCID: PMC8085185 DOI: 10.1016/j.envres.2020.110397] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 10/15/2020] [Accepted: 10/23/2020] [Indexed: 05/04/2023]
Abstract
Population growth, demographic transitions and urbanization in sub-Saharan Africa (SSA) will increase non-communicable disease (NCD) burden. We studied the association between neighborhood greenness and NCDs in a multi-country cross-sectional study. Among 1178 participants, in adjusted models, a 0.11 unit NDVI increase was associated with lower BMI (β: -1.01, 95% CI: -1.35, -0.67), and lower odds of overweight/obesity (aOR: 0.73, 95% CI: 0.62, 0.85), diabetes (aOR: 0.77, 95% CI: 0.62, 0.96), and having ≥3 allostatic load components compared to none (aOR: 0.66, 95% CI: 0.52, 0.85). Except for diabetes, these remained statistically significant after Bonferroni correction. We observed no association between NDVI and hypertension or cholesterol. Our findings are consistent with health benefits of neighborhood greenness reported in other countries, suggesting greening strategies could be considered as part of broader public health interventions for NCDs.
Collapse
Affiliation(s)
- Hari S Iyer
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, USA.
| | - Peter James
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, USA
| | - Linda Valeri
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, USA
| | - Francis Bajunirwe
- Department of Community Health, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Joan Nankya-Mutyoba
- Department of Epidemiology & Biostatistics, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Marina Njelekela
- Department of Physiology, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania; Department of Internal Medicine, Muhimbili National Hospital, Dar Es Salaam, Tanzania; Deloitte Consulting Limited, Dar Es Salaam, Tanzania
| | - Faraja Chiwanga
- Department of Internal Medicine, Muhimbili National Hospital, Dar Es Salaam, Tanzania
| | - Vikash Sewram
- African Cancer Institute, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - IkeOluwapo Ajayi
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Clement Adebamowo
- Institute of Human Virology, Abuja, Nigeria; Greenebaum Comprehensive Cancer Center and Institute of Human Virology, University of Maryland School of Medicine, Baltimore, USA
| | - Shona Dalal
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, USA
| | - Todd G Reid
- Media Lab and Connection Science, Massachusetts Institute of Technology, Boston, USA; Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, USA
| | - Timothy R Rebbeck
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, USA
| | - Hans-Olov Adami
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, USA; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Clinical Effectiveness Research Group, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Michelle D Holmes
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, USA; Channing Division of Network Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, USA
| |
Collapse
|
41
|
Astell-Burt T, Feng X. Urban green space, tree canopy and prevention of cardiometabolic diseases: a multilevel longitudinal study of 46 786 Australians. Int J Epidemiol 2021; 49:926-933. [PMID: 31722373 PMCID: PMC7394941 DOI: 10.1093/ije/dyz239] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2019] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Cross-sectional studies suggest that more green space may lower the odds of prevalent diabetes, hypertension and cardiovascular diseases (CVD) in cities. We assess if these results are replicable for tree canopy exposure and then extend the study longitudinally to examine incident cardiometabolic outcomes. METHODS The study was set in the Australian cities of Sydney, Wollongong and Newcastle. Total green space and tree canopy as percentages of landcover within 1.6 km (1 mile) from home were linked to a residentially stable sample of 46 786 participants in the Sax Institute's 45 and Up Study (baseline 2006-09; follow-up 2012-15). Separate multilevel models were used to investigate whether the odds of prevalent and incident doctor-diagnosed diabetes, hypertension and CVD were associated with total green space and tree canopy provision, adjusting for age, sex, income, education, employment and couple status. RESULTS Lower odds of prevalent diabetes were observed with 1% increases in total green space [odds ratio (OR) 0.993, 95% confidence interval (CI) 0.988 to 0.998] and tree canopy (0.984, 0.978 to 0.989). Lower odds of prevalent CVD were found with a 1% increase in tree canopy only (0.996, 0.993 to 0.999). Lower odds of incident diabetes (0.988, 0.981 to 0.994), hypertension (0.993, 0.989 to 0.997) and CVD (0.993, 0.988 to 0.998) were associated with a 1% increase in tree canopy, but not total green space. At ≥30% compared with 0-9% tree canopy, there were lower odds of incident diabetes (0.687, 0.547 to 0.855), hypertension (0.828, 0.719 to 0.952) and CVD (0.782, 0.652 to 0.935). However, ≥30% compared with 0-4% total green space was associated with lower odds of prevalent diabetes only (0.695, 0.512 to 0.962). CONCLUSIONS Restoring local tree canopy in neighbourhoods may help to prevent the incidence of cardiometabolic diseases.
Collapse
Affiliation(s)
- Thomas Astell-Burt
- Population Wellbeing and Environment Research Lab (PowerLab), School of Health and Society, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia
| | - Xiaoqi Feng
- School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
| |
Collapse
|
42
|
Liu T, Cai B, Peng W, Xiao L, Shi H, Wu X, Gao H, Jia X. Association of neighborhood greenness exposure with cardiovascular diseases and biomarkers. Int J Hyg Environ Health 2021; 234:113738. [PMID: 33752171 DOI: 10.1016/j.ijheh.2021.113738] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 02/09/2021] [Accepted: 03/10/2021] [Indexed: 12/16/2022]
Abstract
AIM Living in areas with neighborhood greenness may be associated with the incidence of cardiovascular diseases (CVDs). However, little evidence in this regard has emerged from developing countries. In the present study, we examined neighborhood greenness associated with CVDs and the lipid accumulation product (LAP) and pulse pressure (PP) in China. METHODS We undertook our analysis using a community cross-sectional survey conducted in Longzihu District of Bengbu from July to August 2015. We measured triglyceride levels, waist circumference, and blood pressure. To assess exposure to neighborhood greenness, we used the average normalized difference vegetation index (NDVI) at 1,000-, 1,500-, and 2,000-m buffers in the participant community. We employed generalized mixed models to determine the association among neighborhood greenness, CVDs, LAP, and PP. We conducted stratified analysis by age, gender, income, and education. We assessed the potential mediating effects of road proximity and physical activity on greenness and CVDs, PP, and LAP. RESULTS The highest tertiles of NDVI1500-m were steadily and significantly associated with lower odds of CVDs prevalence: the adjusted OR of such prevalence was 0.612 (95% CI, 0.462-0.811); higher NDVI was significantly associated with lower PP levels. The NDVI was strongly associated with CVDs prevalence among participants who were male and had high income. Ambient road proximity significantly mediated 9.7% of the estimated association between greenness and PP, there was no evidence of mediation effects for physical activity. CONCLUSIONS Higher neighborhood greenness could have a beneficial effect on CVDs and biomarkers. There were higher associations between residential greenness and CVDs among male and higher-income individuals; road proximity partially mediated the observed association between greenness and PP.
Collapse
Affiliation(s)
- Ting Liu
- Department of Epidemiology and Statistics, School of Public Health, Bengbu Medical College, Bengbu, Anhui, China
| | - Ben Cai
- Department of Epidemiology and Statistics, School of Public Health, Bengbu Medical College, Bengbu, Anhui, China
| | - Wenjia Peng
- Department of Epidemiology and Statistics, School of Public Health, Bengbu Medical College, Bengbu, Anhui, China
| | - Liping Xiao
- Department of Epidemiology and Statistics, School of Public Health, Bengbu Medical College, Bengbu, Anhui, China
| | - Hengyuan Shi
- Department of Epidemiology and Statistics, School of Public Health, Bengbu Medical College, Bengbu, Anhui, China
| | - Xuesen Wu
- Department of Epidemiology and Statistics, School of Public Health, Bengbu Medical College, Bengbu, Anhui, China
| | - Huaiquan Gao
- Department of Epidemiology and Statistics, School of Public Health, Bengbu Medical College, Bengbu, Anhui, China.
| | - Xianjie Jia
- Department of Epidemiology and Statistics, School of Public Health, Bengbu Medical College, Bengbu, Anhui, China.
| |
Collapse
|
43
|
Green Space and Health Equity: A Systematic Review on the Potential of Green Space to Reduce Health Disparities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052563. [PMID: 33806546 PMCID: PMC7967323 DOI: 10.3390/ijerph18052563] [Citation(s) in RCA: 134] [Impact Index Per Article: 44.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 02/25/2021] [Accepted: 02/26/2021] [Indexed: 02/07/2023]
Abstract
Disadvantaged groups worldwide, such as low-income and racially/ethnically minoritized people, experience worse health outcomes than more privileged groups, including wealthier and white people. Such health disparities are a major public health issue in several countries around the world. In this systematic review, we examine whether green space shows stronger associations with physical health for disadvantaged groups than for privileged groups. We hypothesize that disadvantaged groups have stronger protective effects from green space because of their greater dependency on proximate green space, as they tend to lack access to other health-promoting resources. We use the preferred reporting items for systematic reviews and meta-analyses (PRISMA) method and search five databases (CINAHL, Cochrane, PubMed, Scopus, and Web of Science) to look for articles that examine whether socioeconomic status (SES) or race/ethnicity modify the green space-health associations. Based on this search, we identify 90 articles meeting our inclusion criteria. We find lower-SES people show more beneficial effects than affluent people, particularly when concerning public green spaces/parks rather than green land covers/greenness. Studies in Europe show stronger protective effects for lower-SES people versus higher-SES people than do studies in North America. We find no notable differences in the protective effects of green space between racial/ethnic groups. Collectively, these results suggest green space might be a tool to advance health equity and provide ways forward for urban planners, parks managers, and public health professionals to address health disparities.
Collapse
|
44
|
Association between residential greenness and glycosylated hemoglobin in pregnant women: Findings from the baseline data of Yuexiu birth cohort. Int J Hyg Environ Health 2021; 234:113721. [PMID: 33662751 DOI: 10.1016/j.ijheh.2021.113721] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 02/15/2021] [Accepted: 02/16/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Previous studies have indicated that residential greenness can affect human health, but limited studies have examined the association between residential greenness and glucose homeostasis during pregnancy. We aimed to investigate the associations of residential greenness with plasma glucose, glycosylated hemoglobin (HbA1c) and gestational diabetes mellitus (GDM). METHODS We recruited a total of 587 pregnant women aged 20-45 years in Guangzhou, China. We extracted normalized difference vegetation index with different buffers (NDVI-250m, 500m and 1000m) from remote satellite data based on maternal residential addresses. We measured plasma glucose levels and HbA1c during 20-28 weeks' gestation, and GDM was diagnosed with a 75-g oral glucose tolerance test. We collected the information of relevant covariates by face-to-face interviews and questionnaires. We used generalized linear regression to examine the associations of residential greenness with quantitative and categorized outcomes. RESULTS In the final analyses, 123 (21.0%) of the pregnant women were diagnosed as GDM at 20-28 weeks gestation. With a 0.1 unit increase in NDVI-250m, the percent of HbA1c changed by -0.05% [95% confidence interval (CI): -0.08, -0.02]. The results of HbA1c were consistent when using different resolution of NDVI [NDVI-500m: 0.03, 95%CI: -0.05, -0.01; NDVI-1000m: 0.05, 95%CI: -0.08, -0.02]. We observed non-significant associations of glucose levels and the risk of GDM in relation to NDVI with different resolutions when adjusted for confounding. The results remained robust in sensitivity analyses. CONCLUSION The present study in Guangzhou, China was the first to identify negative association of NDVI with HbA1c in pregnant women, but we did not observe its association with plasma glucose levels or the risk of GDM. The results support that building sufficient green infrastructure could be considered in urban design and planning to promote maternal health.
Collapse
|
45
|
Li R, Chen G, Jiao A, Lu Y, Guo Y, Li S, Wang C, Xiang H. Residential Green and Blue Spaces and Type 2 Diabetes Mellitus: A Population-Based Health Study in China. TOXICS 2021; 9:11. [PMID: 33467046 PMCID: PMC7830986 DOI: 10.3390/toxics9010011] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 01/13/2021] [Accepted: 01/14/2021] [Indexed: 01/02/2023]
Abstract
Evidence on the health benefits of green space in residential environments is still limited, and few studies have investigated the potential association between blue space and type 2 diabetes mellitus (T2DM) prevalence. This study included 39,019 participants who had completed the baseline survey from the Henan Rural Cohort Study, 2015-2017. The Normalized Difference Vegetation Index (NDVI) and Enhanced Vegetation Index (EVI) were employed to characterize the residential green space, and the distance from the participant's residential address to the nearest water body was considered to represent the residential blue space. Mixed effect models were applied to evaluate the associations of the residential environment with T2DM and fasting blood glucose (FBG) levels. An interquartile range (IQR) increase in NDVI and EVI was significantly associated with a 13.4% (odds ratio (OR): 0.866, 95% Confidence interval (CI): 0.830,0.903) and 14.2% (OR: 0.858, 95% CI: 0.817,0.901) decreased risk of T2DM, respectively. The residential green space was associated with lower fasting blood glucose levels in men (%change, -2.060 in men vs. -0.972 in women) and the elderly (%change, -1.696 in elderly vs. -1.268 in young people). Additionally, people who lived more than 5 km from the water body had a 15.7% lower risk of T2DM (OR: 0.843, 95% CI: 0.770,0.923) and 1.829% lower fasting blood glucose levels (95% CI: -2.335%,-1.320%) than those who lived closer to the blue space. Our findings suggest that residential green space was beneficially associated with T2DM and fasting blood glucose levels. However, further research is needed to explore more comprehensively the relationship between residential blue space and public health.
Collapse
Affiliation(s)
- Ruijia Li
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan 430071, China; (R.L.); (A.J.)
- Global Health Institute, Wuhan University, Wuhan 430071, China
| | - Gongbo Chen
- Guangdong Environmental and Health Risk Assessment Engineering Technology Research Center, Department of Occupational and Environmental Hygiene, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China;
| | - Anqi Jiao
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan 430071, China; (R.L.); (A.J.)
- Global Health Institute, Wuhan University, Wuhan 430071, China
| | - Yuanan Lu
- Environmental Health Laboratory, Department of Public Health Sciences, University Hawaii at Manoa, Honolulu, HI 96822, USA;
| | - Yuming Guo
- Department of Epidemiology and Biostatistics, School of Public Health, Zhengzhou University, Zhengzhou 450001, China;
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3010, Australia;
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3010, Australia;
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Zhengzhou University, Zhengzhou 450001, China;
| | - Hao Xiang
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan 430071, China; (R.L.); (A.J.)
- Global Health Institute, Wuhan University, Wuhan 430071, China
| |
Collapse
|
46
|
Olvera-Alvarez HA, Browning MHEM, Neophytou AM, Bratman GN. Associations of Residential Brownness and Greenness with Fasting Glucose in Young Healthy Adults Living in the Desert. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:E520. [PMID: 33435223 PMCID: PMC7826883 DOI: 10.3390/ijerph18020520] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 12/28/2020] [Accepted: 01/05/2021] [Indexed: 11/23/2022]
Abstract
Evolutionary psychology theories propose that contact with green, natural environments may benefit physical health, but little comparable evidence exists for brown, natural environments, such as the desert. In this study, we examined the association between "brownness" and "greenness" with fasting glucose among young residents of El Paso, Texas. We defined brownness as the surface not covered by vegetation or impervious land within Euclidian buffers around participants' homes. Fasting glucose along with demographic and behavioral data were obtained from the Nurse Engagement and Wellness Study (n = 517). We found that residential proximity to brownness was not associated with fasting glucose when modeled independently. In contrast, we found that residential greenness was associated with decreased levels of fasting glucose, despite the relatively low levels of greenness within the predominantly desert environment of El Paso. A difference between the top and bottom greenness exposure quartiles within a 250 m buffer was associated with a 3.5 mg/dL decrease in fasting glucose levels (95% confidence interval: -6.2, -0.8). Our results suggest that within the understudied context of the desert, green vegetation may be health promoting to a degree that is similar to other, non-desert locations in the world that have higher baselines levels of green.
Collapse
Affiliation(s)
- Hector A. Olvera-Alvarez
- School of Nursing, Oregon Health and Science University, 3455 SW U.S. Veterans Hospital Rd., Portland, OR 97239, USA
| | - Matthew H. E. M. Browning
- Virtual Reality and Nature Lab, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, SC 29634, USA;
| | - Andreas M. Neophytou
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO 80523, USA;
| | - Gregory N. Bratman
- School of Environmental and Forest Sciences, University of Washington, Seattle, WA 98195, USA;
| |
Collapse
|
47
|
Sadeh M, Brauer M, Dankner R, Fulman N, Chudnovsky A. Remote sensing metrics to assess exposure to residential greenness in epidemiological studies: A population case study from the Eastern Mediterranean. ENVIRONMENT INTERNATIONAL 2021; 146:106270. [PMID: 33276312 DOI: 10.1016/j.envint.2020.106270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 10/20/2020] [Accepted: 11/05/2020] [Indexed: 06/12/2023]
Abstract
INTRODUCTION/AIMS Application of remote sensing-based metrics of exposure to vegetation in epidemiological studies of residential greenness is typically limited to several standard products. The Normalized Difference Vegetation Index (NDVI) is the most widely used, but its precision varies with vegetation density and soil color/moisture. In areas with heterogeneous vegetation cover, the Soil-adjusted Vegetation Index (SAVI) corrects for soil brightness. Linear Spectral Unmixing (LSU), measures the relative contribution of different land covers, and estimates percent of each over a unit area. We compared the precision of NDVI, SAVI and LSU for quantifying residential greenness in areas with high spatial heterogeneity in vegetation cover. METHODS NDVI, SAVI, and LSU in a 300 m radius surrounding homes of 3,188 cardiac patients living in Israel (Eastern Mediterranean) were derived from Landsat 30 m spatial resolution imagery. Metrics were compared to assess shifts in exposure quartiles and differences in vegetation detection as a function of overall greenness, climatic zones, and population density, using NDVI as the reference method. RESULTS For the entire population, the dispersion (SD) of the vegetation values detected was 60% higher when greenness was measured using LSU compared to NDVI: mean (SD) NDVI: 0.17 (0.05), LSU (%): 0.23 (0.08), SAVI: 0.12 (0.03). Importantly, with an increase in population density, the sensitivity of LSU, compared to NDVI, doubled: There was a 95% difference between the LSU and NDVI interquartile range in the highest population density quartile vs 47% in the lowest quartile. Compared to NDVI, exposures estimated by LSU resulted in 21% of patients changing exposure quartiles. In urban areas, the shift in exposure quartile depended on land cover characteristics. An upward shift occurred in dense urban areas, while no shift occurred in high and low vegetated urban areas. CONCLUSIONS LSU was shown to outperform the commonly used NDVI in terms of accuracy and variability, especially in dense urban areas. Therefore, LSU potentially improves exposure assessment precision, implying reduced exposure misclassification.
Collapse
Affiliation(s)
- Maya Sadeh
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler School of Medicine, Tel Aviv University, Ramat Aviv, Israel.
| | - Michael Brauer
- School of Population & Public Health, University of British Columbia, Canada
| | - Rachel Dankner
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler School of Medicine, Tel Aviv University, Ramat Aviv, Israel; Unit for Cardiovascular Epidemiology, the Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, Israel
| | - Nir Fulman
- Department of Geography and Human Environment, Porter School of the Environment and Earth Sciences, Faculty of Exact Sciences, Tel Aviv University
| | - Alexandra Chudnovsky
- AIR-O Lab, Porter School of Environment and Geosciences, Faculty of Exact Sciences, Department of Geography and Human Environment, Tel Aviv University, Israel.
| |
Collapse
|
48
|
Qu Y, Yang B, Lin S, Bloom MS, Nie Z, Ou Y, Mai J, Wu Y, Gao X, Dong G, Liu X. Associations of greenness with gestational diabetes mellitus: The Guangdong Registry of Congenital Heart Disease (GRCHD) study. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2020; 266:115127. [PMID: 32650202 DOI: 10.1016/j.envpol.2020.115127] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 06/25/2020] [Accepted: 06/26/2020] [Indexed: 06/11/2023]
Abstract
Gestational diabetes mellitus (GDM) is associated with adverse short- and long-term health outcomes among mothers and their offspring. GDM affects 0.6%-15% of pregnancies worldwide and its incidence is increasing. However, intervention strategies are lacking for GDM. Previous studies indicated a protective association between greenspace and type 2 diabetes mellitus (T2DM), while few studies have explored the association between greenness and GDM. This study aimed to investigate the association between residential greenness and GDM among women from 40 clinical centers in Guangdong province, south China. The study population comprised 5237 pregnant mothers of fetuses and infants without birth defects, from 2004 to 2016. There were n = 157 diagnosed with GDM according to World Health Organization criteria. We estimated residential greenness using the Normalized Difference Vegetation Index (NDVI), derived from satellite imagery using a spatial-statistical model. Associations between greenness during pregnancy and GDM were assessed by confounder-adjusted random effects log-binomial regression models, with participating centers as the random effect. One interquartile increments of NDVI250m, NDVI500m and NDVI1000m were associated with 13% (RR = 0.87, 95%CI: 0.87-0.87), 8% (RR = 0.92, 95%CI: 0.91-0.92) and 3% (RR = 0.97, 95%CI: 0.97-0.97) lower risks for GDM, respectively. However, NDVI3000m was not significantly associated with GDM (RR = 0.96, 95%CI: 0.78-1.19). The risk for GDM decreased monotonically with greater NDVI. The protective effect of greenness on GDM was stronger among women with lower socioeconomic status and in environments with a lower level air pollutants. Our results suggest that greenness might provide an effective intervention to decrease GDM. Greenness and residential proximity to greenspace should be considered in community planning to improve maternal health outcomes.
Collapse
Affiliation(s)
- Yanji Qu
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, Guangdong, China
| | - Boyi Yang
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, Guangdong, China
| | - Shao Lin
- Department of Environmental Health Sciences, University at Albany, State University of New York, One University Place, Rensselaer, Albany, NY, 12144, USA; Department of Epidemiology and Biostatistics, University at Albany, State University of New York, One University Place, Rensselaer, Albany, NY, 12144, USA
| | - Michael S Bloom
- Department of Environmental Health Sciences, University at Albany, State University of New York, One University Place, Rensselaer, Albany, NY, 12144, USA; Department of Epidemiology and Biostatistics, University at Albany, State University of New York, One University Place, Rensselaer, Albany, NY, 12144, USA
| | - Zhiqiang Nie
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, Guangdong, China
| | - Yanqiu Ou
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, Guangdong, China
| | - Jinzhuang Mai
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, Guangdong, China
| | - Yong Wu
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, Guangdong, China
| | - Xiangmin Gao
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, Guangdong, China
| | - Guanghui Dong
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, Guangdong, China
| | - Xiaoqing Liu
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, Guangdong, China.
| |
Collapse
|
49
|
Yang BY, Hu LW, Jalaludin B, Knibbs LD, Markevych I, Heinrich J, Bloom MS, Morawska L, Lin S, Jalava P, Roponen M, Gao M, Chen DH, Zhou Y, Yu HY, Liu RQ, Zeng XW, Zeeshan M, Guo Y, Yu Y, Dong GH. Association Between Residential Greenness, Cardiometabolic Disorders, and Cardiovascular Disease Among Adults in China. JAMA Netw Open 2020; 3:e2017507. [PMID: 32955574 PMCID: PMC7506516 DOI: 10.1001/jamanetworkopen.2020.17507] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
IMPORTANCE Living in areas with more vegetation (referred to as residential greenness) may be associated with cardiovascular disease (CVD), but little data are available from low- and middle-income countries. In addition, it remains unclear whether the presence of cardiometabolic disorders modifies or mediates the association between residential greenness and CVD. OBJECTIVE To evaluate the associations between residential greenness, cardiometabolic disorders, and CVD prevalence among adults in China. DESIGN, SETTING, AND PARTICIPANTS This analysis was performed as part of the 33 Communities Chinese Health Study, a large population-based cross-sectional study that was conducted in 33 communities (ranging from 0.25-0.64 km2) in 3 cities within the Liaoning province of northeastern China between April 1 and December 31, 2009. Participants included adults aged 18 to 74 years who had resided in the study area for 5 years or more. Greenness levels surrounding each participant's residential community were assessed using the normalized difference vegetation index and the soil-adjusted vegetation index from 2010. Lifetime CVD status (including myocardial infarction, heart failure, coronary heart disease, cerebral thrombosis, cerebral hemorrhage, cerebral embolism, and subarachnoid hemorrhage) was defined as a self-report of a physician diagnosis of CVD at the time of the survey. Cardiometabolic disorders, including hypertension, diabetes, dyslipidemia, and overweight or obese status, were measured and defined clinically. Generalized linear mixed models were used to evaluate the association between residential greenness levels and CVD prevalence. A 3-way decomposition method was used to explore whether the presence of cardiometabolic disorders mediated or modified the association between residential greenness and CVD. Data were analyzed from October 10 to May 30, 2020. MAIN OUTCOMES AND MEASURES Lifetime CVD status, the presence of cardiometabolic disorders, and residential greenness level. RESULTS Among 24 845 participants, the mean (SD) age was 45.6 (13.3) years, and 12 661 participants (51.0%) were men. A total of 1006 participants (4.1%) reported having a diagnosis of CVD. An interquartile range (1-IQR) increase in the normalized difference vegetation index within 500 m of a community was associated with a 27% lower likelihood (odds ratio [OR], 0.73; 95% CI, 0.65-0.83; P < .001) of CVD prevalence, and an IQR increase in the soil-adjusted vegetation index within 500 m of a community was associated with a 26% lower likelihood (OR, 0.74; 95% CI, 0.66-0.84; P < .001) of CVD prevalence. The presence of cardiometabolic disorders was found to mediate the association between residential greenness and CVD, with mediation effects of 4.5% for hypertension, 4.1% for type 2 diabetes, 3.1% for overweight or obese status, 12.7% for hypercholesterolemia, 8.7% for hypertriglyceridemia, and 11.1% for high low-density lipoprotein cholesterol levels. CONCLUSIONS AND RELEVANCE In this cross-sectional study, higher residential greenness levels were associated with lower CVD prevalence, and this association may be partially mediated by the presence of cardiometabolic disorders. Further studies, preferably longitudinal, are warranted to confirm these findings.
Collapse
Affiliation(s)
- Bo-Yi Yang
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, Sun Yat-sen University School of Public Health, Guangzhou, China
| | - Li-Wen Hu
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, Sun Yat-sen University School of Public Health, Guangzhou, China
| | - Bin Jalaludin
- Centre for Air Quality and Health Research and Evaluation, Glebe, New South Wales, Australia
- Population Health, South Western Sydney Local Health District, Liverpool, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
- University of New South Wales School of Public Health and Community Medicine, Kensington, New South Wales, Australia
| | - Luke D. Knibbs
- University of Queensland School of Public Health, Herston, Queensland, Australia
| | - Iana Markevych
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
- Institute of Epidemiology, Helmholtz Zentrum Munchen–German Research Center for Environmental Health, Neuherberg, Germany
| | - Joachim Heinrich
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
- Comprehensive Pneumology Center Munich, German Center for Lung Research, Munich, Germany
| | - Michael S. Bloom
- Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer
- Department of Epidemiology and Biostatics, University at Albany, State University of New York, Rensselaer
| | - Lidia Morawska
- International Laboratory for Air Quality and Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Shao Lin
- Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer
- International Laboratory for Air Quality and Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Pasi Jalava
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
| | - Marjut Roponen
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
| | - Meng Gao
- Department of Geography, Hong Kong Baptist University, Hong Kong SAR, China
| | - Duo-Hong Chen
- Guangdong Environmental Monitoring Center, State Environmental Protection Key Laboratory of Regional Air Quality Monitoring, Guangdong Environmental Protection Key Laboratory of Atmospheric Secondary Pollution, Guangzhou, China
| | - Yang Zhou
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, Sun Yat-sen University School of Public Health, Guangzhou, China
| | - Hong-Yao Yu
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, Sun Yat-sen University School of Public Health, Guangzhou, China
| | - Ru-Qing Liu
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, Sun Yat-sen University School of Public Health, Guangzhou, China
| | - Xiao-Wen Zeng
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, Sun Yat-sen University School of Public Health, Guangzhou, China
| | - Mohammed Zeeshan
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, Sun Yat-sen University School of Public Health, Guangzhou, China
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, Monash University School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia
| | - Yunjiang Yu
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou, China
| | - Guang-Hui Dong
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, Sun Yat-sen University School of Public Health, Guangzhou, China
| |
Collapse
|
50
|
Jimenez MP, Oken E, Gold DR, Luttmann-Gibson H, Requia WJ, Rifas-Shiman SL, Gingras V, Hivert MF, Rimm EB, James P. Early life exposure to green space and insulin resistance: An assessment from infancy to early adolescence. ENVIRONMENT INTERNATIONAL 2020; 142:105849. [PMID: 32593049 PMCID: PMC7784302 DOI: 10.1016/j.envint.2020.105849] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 05/29/2020] [Accepted: 06/01/2020] [Indexed: 05/13/2023]
Abstract
BACKGROUND Recent studies suggest that greater exposure to natural vegetation, or "green space" is associated with lower diabetes risk, possibly through increasing physical activity. However, there is limited research on green space and insulin resistance in youth. We hypothesized greater green space at early-life sensitive time periods would be associated with lower insulin resistance in youth. METHODS We used data from Project Viva (N = 460), a pre-birth cohort study that recruited pregnant women in eastern Massachusetts, 1999-2002, and followed offspring into adolescence. We defined residential green space exposure at infancy (median age - 1.1 years), early childhood (3.2 years), mid-childhood (7.7 years), and early adolescence (12.8 years), using 30 m resolution Landsat satellite imagery to estimate the Normalized Difference Vegetation Index [NDVI]. Our main outcome was early adolescence estimated insulin resistance (HOMA-IR). We used multiple imputation to account for missing data and multiple linear regression models adjusted for age, sex, race/ethnicity, parental education, household income, and neighborhood median household income. RESULTS The highest green space tertile had the highest percentage of white participants (85%), college-educated mothers (87%) and fathers (85%), and households with income higher than US$70,000 (86%). Unadjusted models showed that participants living in the highest green space tertile at infancy had a 0.15 unit lower HOMA-IR (95% CI: -0.23, -0.06) in early adolescence, than those living in the lowest tertile. However, in adjusted models, we did not observe evidence of associations between green space from infancy to early adolescence and HOMA-IR in early adolescence, although some point estimates were in the hypothesized direction. For example, participants in the highest green space tertile in infancy had 0.03 units lower HOMA-IR (95%CI: -0.14, 0.08) than those living in the lowest tertile. CONCLUSIONS Exposure to green space at early life sensitive time periods was not associated with HOMA-IR in youth. Early-life longitudinal studies across diverse populations are needed to confirm or refute our results.
Collapse
Affiliation(s)
- Marcia P Jimenez
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Diane R Gold
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Heike Luttmann-Gibson
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Weeberb J Requia
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Sheryl L Rifas-Shiman
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Veronique Gingras
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Marie-France Hivert
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Eric B Rimm
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Peter James
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA; Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| |
Collapse
|