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Nguyen QC, Alirezaei M, Yue X, Mane H, Li D, Zhao L, Nguyen TT, Patel R, Yu W, Hu M, Quistberg DA, Tasdizen T. Leveraging computer vision for predicting collision risks: a cross-sectional analysis of 2019-2021 fatal collisions in the USA. Inj Prev 2024:ip-2023-045153. [PMID: 38844338 DOI: 10.1136/ip-2023-045153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 04/19/2024] [Indexed: 07/12/2024]
Abstract
OBJECTIVE The USA has higher rates of fatal motor vehicle collisions than most high-income countries. Previous studies examining the role of the built environment were generally limited to small geographic areas or single cities. This study aims to quantify associations between built environment characteristics and traffic collisions in the USA. METHODS Built environment characteristics were derived from Google Street View images and summarised at the census tract level. Fatal traffic collisions were obtained from the 2019-2021 Fatality Analysis Reporting System. Fatal and non-fatal traffic collisions in Washington DC were obtained from the District Department of Transportation. Adjusted Poisson regression models examined whether built environment characteristics are related to motor vehicle collisions in the USA, controlling for census tract sociodemographic characteristics. RESULTS Census tracts in the highest tertile of sidewalks, single-lane roads, streetlights and street greenness had 70%, 50%, 30% and 26% fewer fatal vehicle collisions compared with those in the lowest tertile. Street greenness and single-lane roads were associated with 37% and 38% fewer pedestrian-involved and cyclist-involved fatal collisions. Analyses with fatal and non-fatal collisions in Washington DC found streetlights and stop signs were associated with fewer pedestrians and cyclists-involved vehicle collisions while road construction had an adverse association. CONCLUSION This study demonstrates the utility of using data algorithms that can automatically analyse street segments to create indicators of the built environment to enhance understanding of large-scale patterns and inform interventions to decrease road traffic injuries and fatalities.
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Affiliation(s)
- Quynh C Nguyen
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, Maryland, USA
| | - Mitra Alirezaei
- Department of Electrical and Computer Engineering, Scientific Computing and Imaging Institute, The University of Utah, Salt Lake City, Utah, USA
| | - Xiaohe Yue
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, Maryland, USA
| | - Heran Mane
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, Maryland, USA
| | - Dapeng Li
- Department of Geography and the Environment, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Lingjun Zhao
- Department of Computer Science, University of Maryland Institute for Advanced Computer Studies, University of Maryland, College Park, Maryland, USA
| | - Thu T Nguyen
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, Maryland, USA
| | - Rithik Patel
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, Maryland, USA
| | - Weijun Yu
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, Maryland, USA
| | - Ming Hu
- School of Architecture, University of Notre Dame, Notre Dame, Indiana, USA
| | - D Alex Quistberg
- Urban Health Collaborative, Drexel University School of Public Health, Philadelphia, Pennsylvania, USA
- Department of Environmental and Occupational Health, Drexel University School of Public Health, Philadelphia, Pennsylvania, USA
| | - Tolga Tasdizen
- Department of Electrical and Computer Engineering, Scientific Computing and Imaging Institute, The University of Utah, Salt Lake City, Utah, USA
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Michael YL, Senerat AM, Buxbaum C, Ezeanyagu U, Hughes TM, Hayden KM, Langmuir J, Besser LM, Sánchez B, Hirsch JA. Systematic Review of Longitudinal Evidence and Methodologies for Research on Neighborhood Characteristics and Brain Health. Public Health Rev 2024; 45:1606677. [PMID: 38596450 PMCID: PMC11002187 DOI: 10.3389/phrs.2024.1606677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 02/20/2024] [Indexed: 04/11/2024] Open
Abstract
Objective: Synthesize longitudinal research evaluating neighborhood environments and cognition to identify methodological approaches, findings, and gaps. Methods: Included studies evaluated associations between neighborhood and cognition longitudinally among adults >45 years (or mean age of 65 years) living in developed nations. We extracted data on sample characteristics, exposures, outcomes, methods, overall findings, and assessment of disparities. Results: Forty studies met our inclusion criteria. Most (65%) measured exposure only once and a majority focused on green space and/or blue space (water), neighborhood socioeconomic status, and recreation/physical activity facilities. Similarly, over half studied incident impairment, cognitive function or decline (70%), with one examining MRI (2.5%) or Alzheimer's disease (7.5%). While most studies used repeated measures analysis to evaluate changes in the brain health outcome (51%), many studies did not account for any type of correlation within neighborhoods (35%). Less than half evaluated effect modification by race/ethnicity, socioeconomic status, and/or sex/gender. Evidence was mixed and dependent on exposure or outcome assessed. Conclusion: Although longitudinal research evaluating neighborhood and cognitive decline has expanded, gaps remain in types of exposures, outcomes, analytic approaches, and sample diversity.
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Affiliation(s)
- Yvonne L. Michael
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States
| | - Araliya M. Senerat
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States
| | - Channa Buxbaum
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States
| | - Ugonwa Ezeanyagu
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States
| | - Timothy M. Hughes
- Department of Internal Medicine, Medical Center Boulevard, Winston-Salem, NC, United States
| | - Kathleen M. Hayden
- Department of Social Sciences and Health Policy, Bowman Gray Center for Medical Education, Winston-Salem, NC, United States
| | - Julia Langmuir
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States
| | - Lilah M. Besser
- Department of Neurology, Comprehensive Center for Brain Health, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Brisa Sánchez
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States
| | - Jana A. Hirsch
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States
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Kash TA, Ledyard RF, Mullin AM, Burris HH. Neighborhood Walkability as a Risk Factor for Preterm Birth Phenotypes in Two Philadelphia Hospitals from 2013-2016. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5932. [PMID: 37297536 PMCID: PMC10252293 DOI: 10.3390/ijerph20115932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 03/31/2023] [Accepted: 05/17/2023] [Indexed: 06/12/2023]
Abstract
A total of one in ten infants is born preterm in the U.S. with large racial disparities. Recent data suggest that neighborhood exposures may play a role. Walkability-how easily individuals can walk to amenities-may encourage physical activity. We hypothesized that walkability would be associated with a decreased risk of preterm birth (PTB) and that associations would vary by PTB phenotype. PTB can be spontaneous (sPTB) from conditions such as preterm labor and preterm premature rupture of membranes, or medically indicated (mPTB) from conditions such as poor fetal growth and preeclampsia. We analyzed associations of neighborhood walkability (quantified by their Walk Score® ranking) with sPTB and mPTB in a Philadelphia birth cohort (n = 19,203). Given racial residential segregation, we also examined associations in race-stratified models. Walkability (per 10 points of Walk Score ranking) was associated with decreased odds of mPTB (aOR 0.90, 95% CI: 0.83, 0.98), but not sPTB (aOR 1.04, 95% CI: 0.97, 1.12). Walkability was not protective for mPTB for all patients; there was a non-significant protective effect for White (aOR 0.87, 95% CI: 0.75, 1.01), but not Black patients (aOR 1.05, 95% CI: 0.92, 1.21) (interaction p = 0.03). Measuring health effects of neighborhood characteristics across populations is key for urban planning efforts focused on health equity.
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Affiliation(s)
- Theresa A. Kash
- Center for Public Health Initiatives, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Rachel F. Ledyard
- Division of Neonatology, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Anne M. Mullin
- Tufts University School of Medicine, Boston, MA 02111, USA
| | - Heather H. Burris
- Division of Neonatology, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
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4
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Moon KA, Nordberg CM, Orstad SL, Zhu A, Uddin J, Lopez P, Schwartz MD, Ryan V, Hirsch AG, Schwartz BS, Carson AP, Long DL, Meeker M, Brown J, Lovasi GS, Adhikari S, Kanchi R, Avramovic S, Imperatore G, Poulsen MN. Mediation of an association between neighborhood socioeconomic environment and type 2 diabetes through the leisure-time physical activity environment in an analysis of three independent samples. BMJ Open Diabetes Res Care 2023; 11:11/2/e003120. [PMID: 36858436 PMCID: PMC9980357 DOI: 10.1136/bmjdrc-2022-003120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 02/14/2023] [Indexed: 03/03/2023] Open
Abstract
INTRODUCTION Inequitable access to leisure-time physical activity (LTPA) resources may explain geographic disparities in type 2 diabetes (T2D). We evaluated whether the neighborhood socioeconomic environment (NSEE) affects T2D through the LTPA environment. RESEARCH DESIGN AND METHODS We conducted analyses in three study samples: the national Veterans Administration Diabetes Risk (VADR) cohort comprising electronic health records (EHR) of 4.1 million T2D-free veterans, the national prospective cohort REasons for Geographic and Racial Differences in Stroke (REGARDS) (11 208 T2D free), and a case-control study of Geisinger EHR in Pennsylvania (15 888 T2D cases). New-onset T2D was defined using diagnoses, laboratory and medication data. We harmonized neighborhood-level variables, including exposure, confounders, and effect modifiers. We measured NSEE with a summary index of six census tract indicators. The LTPA environment was measured by physical activity (PA) facility (gyms and other commercial facilities) density within street network buffers and population-weighted distance to parks. We estimated natural direct and indirect effects for each mediator stratified by community type. RESULTS The magnitudes of the indirect effects were generally small, and the direction of the indirect effects differed by community type and study sample. The most consistent findings were for mediation via PA facility density in rural communities, where we observed positive indirect effects (differences in T2D incidence rates (95% CI) comparing the highest versus lowest quartiles of NSEE, multiplied by 100) of 1.53 (0.25, 3.05) in REGARDS and 0.0066 (0.0038, 0.0099) in VADR. No mediation was evident in Geisinger. CONCLUSIONS PA facility density and distance to parks did not substantially mediate the relation between NSEE and T2D. Our heterogeneous results suggest that approaches to reduce T2D through changes to the LTPA environment require local tailoring.
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Affiliation(s)
- Katherine A Moon
- Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Cara M Nordberg
- Department of Population Health Sciences, Geisinger, Danville, Pennsylvania, USA
| | - Stephanie L Orstad
- Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA
- Department of Medicine, Division of General Internal Medicine and Clinical Innovation, New York University Grossman School of Medicine, New York, NY, USA
| | - Aowen Zhu
- Department of Epidemiology, The University of Alabama at Birmingham School of Public Health, Birmingham, Alabama, USA
| | - Jalal Uddin
- Department of Epidemiology, The University of Alabama at Birmingham School of Public Health, Birmingham, Alabama, USA
| | - Priscilla Lopez
- Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA
| | - Mark D Schwartz
- Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA
- The Department of Veterans Affairs, New York Harbor Healthcare System, New York, NY, USA
| | - Victoria Ryan
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, Pennsylvania, USA
| | - Annemarie G Hirsch
- Department of Population Health Sciences, Geisinger, Danville, Pennsylvania, USA
| | - Brian S Schwartz
- Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Population Health Sciences, Geisinger, Danville, Pennsylvania, USA
| | - April P Carson
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - D Leann Long
- Department of Biostatistics, University of Alabama at Birmingham School of Public Health, Birmingham, Alabama, USA
| | - Melissa Meeker
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, Pennsylvania, USA
| | - Janene Brown
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, Pennsylvania, USA
| | - Gina S Lovasi
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, Pennsylvania, USA
- The Urban Health Collaborative, Drexel University Dornsife School of Public Health, Philadelphia, PA, USA
| | - Samranchana Adhikari
- Department of Medicine, Division of General Internal Medicine and Clinical Innovation, New York University Grossman School of Medicine, New York, NY, USA
| | - Rania Kanchi
- Department of Medicine, Division of General Internal Medicine and Clinical Innovation, New York University Grossman School of Medicine, New York, NY, USA
| | - Sanja Avramovic
- Department of Health Administration and Policy, George Mason University, Fairfax, Virginia, USA
| | - Giuseppina Imperatore
- Surveillance, Epidemiology, Economics, and Statistics Branch, Division of Diabetes Translation, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Melissa N Poulsen
- Department of Population Health Sciences, Geisinger, Danville, Pennsylvania, USA
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Anza-Ramirez C, Lazo M, Zafra-Tanaka JH, Avila-Palencia I, Bilal U, Hernández-Vásquez A, Knoll C, Lopez-Olmedo N, Mazariegos M, Moore K, Rodriguez DA, Sarmiento OL, Stern D, Tumas N, Miranda JJ. The urban built environment and adult BMI, obesity, and diabetes in Latin American cities. Nat Commun 2022; 13:7977. [PMID: 36581636 PMCID: PMC9800402 DOI: 10.1038/s41467-022-35648-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 12/15/2022] [Indexed: 12/31/2022] Open
Abstract
Latin America is the world's most urbanized region and its heterogeneous urban development may impact chronic diseases. Here, we evaluated the association of built environment characteristics at the sub-city -intersection density, greenness, and population density- and city-level -fragmentation and isolation- with body mass index (BMI), obesity, and type 2 diabetes (T2D). Data from 93,280 (BMI and obesity) and 122,211 individuals (T2D) was analysed across 10 countries. Living in areas with higher intersection density was positively associated with BMI and obesity, whereas living in more fragmented and greener areas were negatively associated. T2D was positively associated with intersection density, but negatively associated with greenness and population density. The rapid urban expansion experienced by Latin America provides unique insights and vastly expand opportunities for population-wide urban interventions aimed at reducing obesity and T2D burden.
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Affiliation(s)
- Cecilia Anza-Ramirez
- grid.11100.310000 0001 0673 9488CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Mariana Lazo
- grid.166341.70000 0001 2181 3113Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA USA ,grid.166341.70000 0001 2181 3113Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, PA USA
| | - Jessica Hanae Zafra-Tanaka
- grid.11100.310000 0001 0673 9488CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Ione Avila-Palencia
- grid.166341.70000 0001 2181 3113Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA USA ,grid.4777.30000 0004 0374 7521Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, Northern Ireland UK
| | - Usama Bilal
- grid.166341.70000 0001 2181 3113Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA USA ,grid.166341.70000 0001 2181 3113Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA USA
| | - Akram Hernández-Vásquez
- grid.11100.310000 0001 0673 9488CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Carolyn Knoll
- grid.166341.70000 0001 2181 3113Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA USA
| | - Nancy Lopez-Olmedo
- grid.415771.10000 0004 1773 4764Center for Population and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Mónica Mazariegos
- grid.418867.40000 0001 2181 0430INCAP Research Center for the Prevention of Chronic Diseases (CIIPEC), Institute of Nutrition of Central America and Panama (INCAP), Guatemala City, Guatemala
| | - Kari Moore
- grid.166341.70000 0001 2181 3113Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA USA
| | - Daniel A. Rodriguez
- grid.47840.3f0000 0001 2181 7878Department of City and Regional Planning, University of California, Berkeley, CA USA
| | - Olga L. Sarmiento
- grid.7247.60000000419370714School of Medicine, Universidad de los Andes, Bogota, Colombia
| | - Dalia Stern
- grid.415771.10000 0004 1773 4764CONACyT- Center for Population and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Natalia Tumas
- grid.5612.00000 0001 2172 2676Department of Political and Social Sciences, Research Group on Health Inequalities, Environment, Employment Conditions Knowledge Network (GREDS-EMCONET), Universitat Pompeu Fabra, Barcelona, Spain ,grid.5612.00000 0001 2172 2676Johns Hopkins University - Pompeu Fabra University Public Policy Center (UPF-BSM), Universitat Pompeu Fabra, Barcelona, Spain ,grid.10692.3c0000 0001 0115 2557Centro de Investigaciones y Estudios sobre Cultura y Sociedad, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET) y Universidad Nacional de Córdoba, Córdoba, Argentina
| | - J. Jaime Miranda
- grid.11100.310000 0001 0673 9488CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru ,grid.11100.310000 0001 0673 9488School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
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Hirsch JA, Michael YL, Moore KA, Melly S, Hughes TM, Hayden K, Luchsinger JA, Jimenez MP, James P, Besser LM, Sánchez B, Diez Roux AV. Longitudinal neighbourhood determinants with cognitive health and dementia disparities: protocol of the Multi-Ethnic Study of Atherosclerosis Neighborhoods and Aging prospective cohort study. BMJ Open 2022; 12:e066971. [PMID: 36368762 PMCID: PMC9660618 DOI: 10.1136/bmjopen-2022-066971] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION The burden of Alzheimer's disease (AD) and AD-related dementias (ADRD) is increasing nationally and globally, with disproportionate impacts on lower-income, lower education and systematically marginalised older adults. Presence of inequalities in neighbourhood factors (eg, social context, physical and built environments) may affect risk of cognitive decline and be key for intervening on AD/ADRD disparities at the population level. However, existing studies are limited by a dearth of longitudinal, detailed neighbourhood measures linked to rich, prospective cohort data. Our main objective is to identify patterns of neighbourhood change related to prevalence of-and disparities in-cognitive decline and dementia. METHODS AND ANALYSES We describe the process of collecting, processing and linking extensive neighbourhood data to the Multi-Ethnic Study of Atherosclerosis (MESA), creating a 25+ years dataset. Within the MESA parent study, the MESA Neighborhoods and Aging cohort study will characterise dynamic, longitudinal neighbourhood social and built environment variables relevant to cognition for residential addresses of MESA participants. This includes administering new surveys, expanding residential address histories, calculating new measures derived from spatial data and implementing novel deep learning algorithms on street-level imagery. Applying novel statistical techniques, we will examine associations of neighbourhood environmental characteristics with cognition and clinically relevant AD/ADRD outcomes. We will investigate determinants of disparities in outcomes by socioeconomic position and race/ethnicity and assess the contribution of neighbourhood environments to these disparities. This project will provide new evidence about pathways between neighbourhood environments and cognitive outcomes, with implications for policies to support healthy ageing. ETHICS AND DISSEMINATION This project was approved by the University of Washington and Drexel University Institutional Review Boards (protocols #00009029 and #00014523, and #180900605). Data will be distributed through the MESA Coordinating Center. Findings will be disseminated in peer-reviewed scientific journals, briefs, presentations and on the participant website.
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Affiliation(s)
- Jana A Hirsch
- Urban Health Collaborative and Department of Epidemiology and Biostatistics, Drexel University, Philadelphia, Pennsylvania, USA
| | - Yvonne L Michael
- Department of Epidemiology and Biostatistics, Drexel University, Philadelphia, Pennsylvania, USA
| | - Kari A Moore
- Urban Health Collaborative, Drexel University, Philadelphia, Pennsylvania, USA
| | - Steven Melly
- Urban Health Collaborative, Drexel University, Philadelphia, Pennsylvania, USA
| | - Timothy M Hughes
- Department of Internal Medicine, Medical Center Boulevard, Winston-Salem, Carolina, USA
| | - Kathleen Hayden
- Department of Social Sciences and Health Policy, Bowman Gray Center for Medical Education, Winston-Salem, Carolina, USA
| | - Jose A Luchsinger
- Department of Medicine, Columbia University, New York, New York, USA
| | - Marcia P Jimenez
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Peter James
- Department of Population Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Department of Population Medicine, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
| | - Lilah M Besser
- Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Brisa Sánchez
- Department of Epidemiology and Biostatistics, Drexel University, Philadelphia, Pennsylvania, USA
| | - Ana V Diez Roux
- Department of Epidemiology and Biostatistics, Drexel University, Philadelphia, Pennsylvania, USA
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7
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Chen YR, Hanazato M, Koga C, Ide K, Kondo K. The association between street connectivity and depression among older Japanese adults: the JAGES longitudinal study. Sci Rep 2022; 12:13533. [PMID: 35941206 PMCID: PMC9360019 DOI: 10.1038/s41598-022-17650-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 07/28/2022] [Indexed: 11/09/2022] Open
Abstract
Mental health is important in older age; neighborhood environment is considered a protective factor of depression. Research has established that a critical indicator of neighborhood environment, street connectivity, is related to older people's health. However, little is known about the relationship between street connectivity and depression. We examined the relationship between street connectivity and depression among older people. Using Japan Gerontological Evaluation Study 2013-2016, the target population comprised 24,141 independent older people without depression (Geriatric Depression Scale scores below 5) in 2013. The outcome variable was depression in 2016; the explanatory variable was street connectivity calculated by intersection density and space syntax within 800 m around the subject's neighborhood in 2013. We used logistic regression analysis to calculate the odds ratio and 95% confidence interval for the new occurrence of depression among participants in 2016. This analysis demonstrated incidence of new depression after 3 years that is 17% and 14% lower among participations living in high-intersection density and high-street-connectivity areas, respectively, than those living in low-intersection density and low-street-connectivity areas. The association held after adjusting for physical activities and social interaction. Given the established connection between street connectivity and mental health, the findings can contribute to healthy urban planning.
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Affiliation(s)
- Yu-Ru Chen
- Graduate School of Medical and Pharmaceutical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8672, Japan.
| | - Masamichi Hanazato
- Center for Preventive Medical Sciences, Chiba University, 1-33 Yayoi-cho, Inage-ku, Chiba-shi, Chiba, 263-8522, Japan
| | - Chie Koga
- Center for Preventive Medical Sciences, Chiba University, 1-33 Yayoi-cho, Inage-ku, Chiba-shi, Chiba, 263-8522, Japan
| | - Kazushige Ide
- Center for Preventive Medical Sciences, Chiba University, 1-33 Yayoi-cho, Inage-ku, Chiba-shi, Chiba, 263-8522, Japan
- Department of Community General Support, Hasegawa Hospital, Yachimata-shi, Chiba, 289-1103, Japan
| | - Katsunori Kondo
- Center for Preventive Medical Sciences, Chiba University, 1-33 Yayoi-cho, Inage-ku, Chiba-shi, Chiba, 263-8522, Japan
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430 Morikoka-cho, Obu-shi, Aichi, 474-8511, Japan
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8
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Garber MD, Flanders WD, Watkins KE, Lobelo RF, Kramer MR, McCullough LE. Have Paved Trails and Protected Bike Lanes Led to More Bicycling in Atlanta?: A Generalized Synthetic-Control Analysis. Epidemiology 2022; 33:493-504. [PMID: 35439778 PMCID: PMC9211442 DOI: 10.1097/ede.0000000000001483] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Bicycling is an important form of physical activity in populations. Research assessing the effect of infrastructure on bicycling with high-resolution smartphone data is emerging in several places, but it remains limited in low-bicycling US settings, including the Southeastern US. The Atlanta area has been expanding its bicycle infrastructure, including off-street paved trails such as the Atlanta BeltLine and some protected bike lanes. METHODS Using the generalized synthetic-control method, we estimated effects of five groups of off-street paved trails and protected bike lanes on bicycle ridership in their corresponding areas. To measure bicycling, we used 2 years (October 1, 2016 to September 30, 2018) of monthly Strava data in Atlanta's urban core along with data from 15 on-the-ground counters to adjust for spatiotemporal variation in app use. RESULTS Considering all infrastructure as one joint intervention, an estimated 1.10 (95% confidence interval [CI]: 0.99, 1.18) times more bicycle-distance was ridden than would have been expected in the same areas had the infrastructure not been built, when defining treatment areas by the narrower of two definitions (defined in text). The Atlanta BeltLine Westside Trail and Proctor Creek Greenway had especially strong effect estimates, e.g., ratios of 1.45 (95% CI: 1.12, 1.86) and 1.55 (1.10, 2.14) under each treatment-area definition, respectively. We estimated that other infrastructure had weaker positive or no effects on bicycle-distance ridden. CONCLUSIONS This study advances research on the topic because of its setting in the US Southeast, simultaneous assessment of several infrastructure groups, and data-driven approach to estimating effects. See video abstract at, http://links.lww.com/EDE/B936.
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Affiliation(s)
- Michael D. Garber
- Department of Epidemiology, Rollins School of Public
Health, Emory University, Atlanta, GA
| | - W. Dana Flanders
- Department of Epidemiology, Rollins School of Public
Health, Emory University, Atlanta, GA
- Department of Biostatistics and Bioinformatics, Rollins
School of Public Health, Emory University, Atlanta, GA
| | - Kari E. Watkins
- School of Civil and Environmental Engineering, Georgia
Institute of Technology, Atlanta, GA
| | - R.L. Felipe Lobelo
- Hubert Department of Global Health, Rollins School of
Public Health, Emory University, Atlanta, GA
| | - Michael R. Kramer
- Department of Epidemiology, Rollins School of Public
Health, Emory University, Atlanta, GA
| | - Lauren E. McCullough
- Department of Epidemiology, Rollins School of Public
Health, Emory University, Atlanta, GA
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Carlson JA, Sallis JF, Jankowska MM, Allison MA, Sotres-Alvarez D, Roesch SC, Steel C, Savin KL, Talavera GA, Castañeda SF, Llabre MM, Penedo FJ, Kaplan R, Mossavar-Rahmani Y, Daviglus M, Perreira KM, Gallo LC. Neighborhood built environments and Hispanic/Latino adults' physical activity in the U.S.: The Hispanic community health study/study of Latinos community and surrounding areas study. Prev Med 2022; 160:107073. [PMID: 35513129 PMCID: PMC9756587 DOI: 10.1016/j.ypmed.2022.107073] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 04/07/2022] [Accepted: 04/27/2022] [Indexed: 10/18/2022]
Abstract
Despite experiencing health inequities, less is known about neighborhood environments and physical activity among Hispanic/Latino adults compared to other populations. We investigated this topic in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Hispanic/Latino adults in the San Diego, California area of the U.S. completed measures of overall moderate-to-vigorous physical activity (MVPA) via accelerometry and domain-specific MVPA via questionnaire at Visits 1 (2008-2011; n = 4086) and 2 (2014-2017; n = 1776), ~6 years apart. 800-m home neighborhood buffers were used to create objective measures of residential, intersection, and retail density, bus/trolley stops, greenness, parks, and recreation area at Visit 1. Regression models tested the association of each neighborhood feature with MVPA at Visit 1 and over 6 years, adjusting for individual characteristics and neighborhood socioeconomic deprivation. At Visit 1, those in neighborhoods with higher vs. lower retail density or recreation area (+1 vs. -1 standard deviation from the mean) engaged in 10% more overall MVPA and 12-22% more active transportation. Those in neighborhoods with higher vs. lower residential density engaged in 22% more active transportation. Those in neighborhoods with higher vs. lower greenness and park count engaged in 14-16% more recreational MVPA. Neighborhood features were unassociated with changes in MVPA over 6 years. Although changes in MVPA over time were similar across neighborhoods, Hispanic/Latino adults living in neighborhoods with design features supportive of walking and recreational activity (e.g., greater residential and retail density, more parks and recreation facilities) were consistently more active. Improving neighborhood environments appears important for supporting physical activity among Hispanic/Latino adults.
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Affiliation(s)
- Jordan A Carlson
- Center for Children's Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, Kansas City, MO, USA; Department of Pediatrics, Children's Mercy Kansas City, University of Missouri Kansas City, Kansas City, MO, USA.
| | - James F Sallis
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA; Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Marta M Jankowska
- Population Sciences, Beckman Research Institute, City of Hope, Duarte, CA, USA
| | - Matthew A Allison
- Department of Family Medicine, University of California San Diego, La Jolla, CA, USA
| | - Daniela Sotres-Alvarez
- Collaborative Studies Coordinating Center, Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Scott C Roesch
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Chelsea Steel
- Center for Children's Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, Kansas City, MO, USA
| | - Kimberly L Savin
- Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California San Diego, San Diego, CA, USA
| | - Gregory A Talavera
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Sheila F Castañeda
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Maria M Llabre
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Frank J Penedo
- Department of Psychology, University of Miami, Coral Gables, FL, USA; Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA
| | - Robert Kaplan
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA; Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Yasmin Mossavar-Rahmani
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Martha Daviglus
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL, USA
| | - Krista M Perreira
- Department of Social Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, CA, USA
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10
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Conderino SE, Feldman JM, Spoer B, Gourevitch MN, Thorpe LE. Social and Economic Differences in Neighborhood Walkability Across 500 U.S. Cities. Am J Prev Med 2021; 61:394-401. [PMID: 34108111 DOI: 10.1016/j.amepre.2021.03.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 03/24/2021] [Accepted: 03/29/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Neighborhood walkability has been established as a potentially important determinant of various health outcomes that are distributed inequitably by race/ethnicity and sociodemographic status. The objective of this study is to assess the differences in walkability across major urban centers in the U.S. METHODS City- and census tract-level differences in walkability were assessed in 2020 using the 2019 Walk Score across 500 large cities in the U.S. RESULTS At both geographic levels, high-income and majority White geographic units had the lowest walkability overall. Walkability was lower with increasing tertile of median income among majority White, Latinx, and Asian American and Native Hawaiian and Pacific Islander neighborhoods. However, this association was reversed within majority Black neighborhoods, where tracts in lower-income tertiles had the lowest walkability. Associations varied substantially by region, with the strongest differences observed for cities located in the South. CONCLUSIONS Differences in neighborhood walkability across 500 U.S. cities provide evidence that both geographic unit and region meaningfully influence associations between sociodemographic factors and walkability. Structural interventions to the built environment may improve equity in urban environments, particularly in lower-income majority Black neighborhoods.
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Affiliation(s)
- Sarah E Conderino
- Department of Population Health, NYU Grossman School of Medicine, NYU Langone Health, New York, New York.
| | - Justin M Feldman
- FXB Center for Health and Human Rights, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Benjamin Spoer
- Department of Population Health, NYU Grossman School of Medicine, NYU Langone Health, New York, New York
| | - Marc N Gourevitch
- Department of Population Health, NYU Grossman School of Medicine, NYU Langone Health, New York, New York
| | - Lorna E Thorpe
- Department of Population Health, NYU Grossman School of Medicine, NYU Langone Health, New York, New York
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11
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Longitudinal association of built environment pattern with DXA-derived body fat in elderly Hong Kong Chinese: a latent profile analysis. Int J Obes (Lond) 2021; 45:2629-2637. [PMID: 34433908 DOI: 10.1038/s41366-021-00949-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 07/23/2021] [Accepted: 08/17/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND One major limitation of prior studies regarding the associations between built environment (BE) and obesity has been the use of anthropometric indices (e.g., body mass index [BMI]) for assessing obesity status, and there has been limited evidence of associations between BE and body fat. This study aimed to explore the longitudinal association between BE and body fat in a cohort of elderly Hong Kong Chinese and examine whether the BE-body fat associations differed by BMI categories. METHODS Between 2001 and 2003, 3944 participants aged 65-98 years were recruited and followed for a mean of 6.4 years. BE characteristics were assessed via Geographic Information System. Body fat (%) at whole body and regional areas (trunk, limbs, android, and gynoid) were assessed by dual energy X-ray absorptiometry at baseline and three follow-ups. Latent profile analysis was used to derive BE class, and linear mixed-effects models were used to investigate the associations of BE class with changes in body fat. Stratified analyses by BMI categories were also conducted. RESULTS Three BE classes were identified. Participants in Class 2 (characterized by greater open space and proportion of residential land use) had a slower increase in whole body fat (B = -0.403, 95% confidence interval [CI]: -0.780, -0.014) and limbs fat (-0.471, 95% CI: -0.870, -0.071) compared with participants in Class 1 (characterized by high proportion of commercial land use). There were significant interactions of BE class with BMI, and participants in Class 2 had a slower increase in whole body fat and regional fat compared with participants in Class 1 (B ranging from -0.987 [limbs] to -0.523 [gynoid]) among overweight and obese participants only. CONCLUSIONS We found that those who resided in the areas characterized by greater open space and proportion of residential land use had a slower body fat increase.
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Gullon P, Bilal U, Hirsch JA, Rundle AG, Judd S, Safford MM, Lovasi GS. Does a physical activity supportive environment ameliorate or exacerbate socioeconomic inequities in incident coronary heart disease? J Epidemiol Community Health 2021; 75:637-642. [PMID: 33318134 PMCID: PMC8200362 DOI: 10.1136/jech-2020-215239] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 10/30/2020] [Accepted: 11/29/2020] [Indexed: 11/03/2022]
Abstract
BACKGROUND Efforts to reduce socioeconomic inequities in cardiovascular disease include interventions to change the built environment. We aimed to explore whether socioeconomic inequities in coronary heart disease (CHD) incidence are ameliorated or exacerbated in environments supportive of physical activity (PA). METHODS We used data from the Reasons for Geographic and Racial Differences in Stroke study, which recruited US residents aged 45 or older between 2003 and 2007. Our analyses included participants at risk for incident CHD (n=20 808), followed until 31 December 2014. We categorised household income and treated it as ordinal: (1) US$75 000+, (2) US$35 000-US$74 000, (3) US$20 000-US$34 000 and (4) RESULTS We found a 25% (95% CI 1.17% to 1.34%) increased hazard of CHD per 1-category decrease in household income category. Adjusting for PA-supportive environments slightly reduced this association (HR=1.24). The income-CHD association was strongest in areas without walking destinations (HR=1.57), an interaction which reached statistical significance in analyses among men. In contrast, the income-CHD association showed a trend towards being strongest in areas with the highest percentage of green land cover. CONCLUSIONS Indicators of a PA supportive environment show divergent trends to modify socioeconomic inequities in CHD . Built environment interventions should measure the effect on socioeconomic inequities.
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Affiliation(s)
- Pedro Gullon
- Public Health and Epidemiology Research Group, Universidad de Alcala de Henares Facultad de Medicina y Ciencias de la Salud, Alcala de Henares, Spain
- Urban Health Collaborative, Drexel University School of Public Health, Philadelphia, Pennsylvania, USA
| | - Usama Bilal
- Urban Health Collaborative, Drexel University School of Public Health, Philadelphia, Pennsylvania, USA
- Epidemiology and Statistics, Drexel University School of Public Health, Philadelphia, Pennsylvania, USA
| | - Jana A Hirsch
- Urban Health Collaborative, Drexel University School of Public Health, Philadelphia, Pennsylvania, USA
- Epidemiology and Statistics, Drexel University School of Public Health, Philadelphia, Pennsylvania, USA
| | - Andrew G Rundle
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Suzanne Judd
- Department of Biostatistics, University of Alabama at Birmingham College of Arts and Sciences, Birmingham, Alabama, USA
| | - Monika M Safford
- Department of Medicine, Joan and Sanford I Weill Medical College of Cornell University, New York, New York, USA
| | - Gina S Lovasi
- Urban Health Collaborative, Drexel University School of Public Health, Philadelphia, Pennsylvania, USA
- Epidemiology and Statistics, Drexel University School of Public Health, Philadelphia, Pennsylvania, USA
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Lin J, Leung J, Yu B, Woo J, Kwok T, Ka-Lun Lau K. Socioeconomic status as an effect modifier of the association between built environment and mortality in elderly Hong Kong Chinese: A latent profile analysis. ENVIRONMENTAL RESEARCH 2021; 195:110830. [PMID: 33548297 DOI: 10.1016/j.envres.2021.110830] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 01/28/2021] [Accepted: 01/29/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Previous studies have focused on associations between individual built environment (BE) characteristics and mortality, and found the BE-mortality associations differed by socioeconomic status (SES). Different individual BE characteristics may have different impacts on health and thus could interact. Combinations of BE characteristics may be a better approach to explore the BE-mortality associations. OBJECTIVES This study aimed to investigate the associations of BE pattern with mortality in a prospective cohort of elderly Hong Kong Chinese (Mr. OS and Ms. OS Study), and assess whether the BE-mortality association differed by SES. METHODS Between 2001 and 2003, 3944 participants aged 65-98 years at baseline were included in the present analysis. BE characteristics were assessed via Geographic Information System. Data on all-cause and cause-specific mortality were obtained from the Hong Kong Government Death Registry. Latent profile analysis was used to derive BE class, and the Cox proportional hazards model was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS Three BE classes were identified. During a total of 53276 person-years of follow-up, 1632 deaths were observed. There were no significant associations of BE class with all-cause and cause-specific mortality. However, we found the associations of BE class with all-cause mortality were modified by SES. In comparison with Class 3 (characterized by greater green space), HRs (95%CIs) were 0.72 (0.54, 0.97) for Class 1 (characterized by greater commercial land use) and 0.77 (0.64, 0.94) for Class 2 (characterized by greater residential land use) among low-SES participants. The associations were stronger among high-SES participants, with 0.55 (0.33, 0.89) for Class 1 and 0.68 (0.48, 0.97) for Class 2. In contrast, Class 2 (HR 1.18, 95%CI 1.01-1.39) had a higher mortality risk compared with Class 3 among middle-SES participants. CONCLUSIONS Our findings provide new evidence on the role of SES as an effect modifier of BE pattern and mortality. BE pattern has a varied effect on mortality risk for different SES groups.
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Affiliation(s)
- Jiesheng Lin
- Institute of Future Cities, The Chinese University of Hong Kong, Hong Kong.
| | - Jason Leung
- Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Hong Kong
| | - Blanche Yu
- Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Hong Kong; Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Jean Woo
- CUHK Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Hong Kong; Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Timothy Kwok
- Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Hong Kong; Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Kevin Ka-Lun Lau
- Institute of Future Cities, The Chinese University of Hong Kong, Hong Kong; CUHK Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Hong Kong.
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Hirsch JA, Moore KA, Cahill J, Quinn J, Zhao Y, Bayer FJ, Rundle A, Lovasi GS. Business Data Categorization and Refinement for Application in Longitudinal Neighborhood Health Research: a Methodology. J Urban Health 2021; 98:271-284. [PMID: 33005987 PMCID: PMC8079597 DOI: 10.1007/s11524-020-00482-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/04/2020] [Indexed: 12/31/2022]
Abstract
Retail environments, such as healthcare locations, food stores, and recreation facilities, may be relevant to many health behaviors and outcomes. However, minimal guidance on how to collect, process, aggregate, and link these data results in inconsistent or incomplete measurement that can introduce misclassification bias and limit replication of existing research. We describe the following steps to leverage business data for longitudinal neighborhood health research: re-geolocating establishment addresses, preliminary classification using standard industrial codes, systematic checks to refine classifications, incorporation and integration of complementary data sources, documentation of a flexible hierarchical classification system and variable naming conventions, and linking to neighborhoods and participant residences. We show results of this classification from a dataset of locations (over 77 million establishment locations) across the contiguous U.S. from 1990 to 2014. By incorporating complementary data sources, through manual spot checks in Google StreetView and word and name searches, we enhanced a basic classification using only standard industrial codes. Ultimately, providing these enhanced longitudinal data and supplying detailed methods for researchers to replicate our work promotes consistency, replicability, and new opportunities in neighborhood health research.
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Affiliation(s)
- Jana A. Hirsch
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, PA Philadelphia, USA
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA USA
| | - Kari A. Moore
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA USA
| | - Jesse Cahill
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City, NY USA
| | - James Quinn
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City, NY USA
| | - Yuzhe Zhao
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA USA
| | - Felicia J. Bayer
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA USA
| | - Andrew Rundle
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City, NY USA
| | - Gina S. Lovasi
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, PA Philadelphia, USA
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA USA
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Majercak KR, Magder LS, Villalonga-Olives E. Social capital and cost-related medication nonadherence (CRN): A retrospective longitudinal cohort study using the Health and Retirement Study data, 2006-2016. SSM Popul Health 2020; 12:100671. [PMID: 33088892 PMCID: PMC7559535 DOI: 10.1016/j.ssmph.2020.100671] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 09/21/2020] [Accepted: 09/26/2020] [Indexed: 11/17/2022] Open
Abstract
Prescription drug spending and other financial factors (e.g., out-of-pocket costs) partially explain variation in cost-related medication nonadherence (CRN). Indicators of social capital such as neighborhood factors and social support may influence the health and well-being of older adults as they may rely on community resources and support from family and peers to manage conditions. Previous research on the relationship of social capital and CRN has limited evidence and contradictory findings. Hence, our objective is to assess the relationship of social capital indicators (neighborhood social cohesion, neighborhood physical disorder, positive social support, and negative social support) and CRN using a longitudinal design, 2006 to 2016, in a nationally representative sample of older adults in the United States (US). The Health and Retirement Study is a prospective panel study of US adults aged ≥ 50 years evaluated every two years. Data was pooled to create three waves and fitted using Generalized Estimating Equation modelling adjusting for both baseline and timevarying covariates (age, sex, education, race, total household income, and perceived health status). The three waves consisted of 11,791, 12,336, and 9,491 participants. Higher levels of neighborhood social cohesion and positive social support were related with lower CRN (OR 0.92, 95% CI 0.88-0.95 and OR 0.77, 95% CI 0.70-0.84, p<0.01). In contrast, higher levels of neighborhood physical disorder and negative social support were related to higher CRN (OR 1.07, 95% CI 1.03-1.11 and OR 1.46, 95% CI 1.32-1.62, p<0.01). Interventions targeting social capital are needed, reinforcing positive social support and neighborhood social cohesion and diminishing neighborhood physical disorder and negative social support for older adults.
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Affiliation(s)
- Kayleigh R. Majercak
- University of Maryland Baltimore, School of Pharmacy, Department of Pharmaceutical Health Services Research, 220 Arch Street, 12th Floor, Baltimore, MD 21201, Baltimore, MD, USA
| | - Laurence S. Magder
- University of Maryland Baltimore, School of Medicine, Department of Epidemiology and Public Health, 660 W. Redwood Street, Baltimore, MD 21201, Baltimore, MD, USA
| | - Ester Villalonga-Olives
- University of Maryland Baltimore, School of Pharmacy, Department of Pharmaceutical Health Services Research, 220 Arch Street, 12th Floor, Baltimore, MD 21201, Baltimore, MD, USA
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Lin JS, Chan FYF, Leung J, Yu B, Lu ZH, Woo J, Kwok T, Lau KKL. Longitudinal Association of Built Environment Pattern with Physical Activity in a Community-Based Cohort of Elderly Hong Kong Chinese: A Latent Profile Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124275. [PMID: 32549289 PMCID: PMC7344458 DOI: 10.3390/ijerph17124275] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 06/11/2020] [Accepted: 06/12/2020] [Indexed: 12/12/2022]
Abstract
A large number of studies have focused on the associations between single built environment (BE) characteristics and physical activity (PA). Combinations of BE characteristics offer a more comprehensive approach to identify the BE–PA associations. We aimed to examine the BE–PA associations in a cohort of elderly Hong Kong Chinese. Between 2001 and 2003, 3944 participants (65–98 years of age) were recruited and followed for a mean of 7.8 years. BE characteristics were assessed via geographic information system. PA levels were obtained using the Physical Activity Scale for the Elderly questionnaire at baseline and three follow-ups. Latent profile analysis was first conducted to classify the BE characteristics, and linear mixed-effects models were then used to explore the longitudinal associations between the BE classes and changes in the PA levels. Three classes of BE were identified. Class 3 (characterized by greater green space and sky view factor) demonstrated a significant decline in household PA (β = −1.26, 95% confidence interval: −2.20, −0.33) during the study period, and a slower decline in walking PA (1.19 (0.42, 1.95)) compared with Class 2 (characterized by a greater proportion of residential land use). Our results indicate that BE patterns characterized by high green space and a sky view factor may help promote the walking PA level.
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Affiliation(s)
- Jie-Sheng Lin
- Institute of Future Cities, The Chinese University of Hong Kong, Hong Kong 99077, China;
- Correspondence: (J.-S.L.); (K.K.-L.L.); Tel.: +852-39435399 (J.-S.L.); +852-39435398 (K.K.-L.L.)
| | - Faye Ya-Fen Chan
- Institute of Future Cities, The Chinese University of Hong Kong, Hong Kong 99077, China;
| | - Jason Leung
- Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Hong Kong 99077, China; (J.L.); (B.Y.); (T.K.)
| | - Blanche Yu
- Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Hong Kong 99077, China; (J.L.); (B.Y.); (T.K.)
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 99077, China; (Z.-H.L.); (J.W.)
| | - Zhi-Hui Lu
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 99077, China; (Z.-H.L.); (J.W.)
| | - Jean Woo
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 99077, China; (Z.-H.L.); (J.W.)
- CUHK Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Hong Kong 99077, China
| | - Timothy Kwok
- Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Hong Kong 99077, China; (J.L.); (B.Y.); (T.K.)
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 99077, China; (Z.-H.L.); (J.W.)
| | - Kevin Ka-Lun Lau
- Institute of Future Cities, The Chinese University of Hong Kong, Hong Kong 99077, China;
- CUHK Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Hong Kong 99077, China
- Correspondence: (J.-S.L.); (K.K.-L.L.); Tel.: +852-39435399 (J.-S.L.); +852-39435398 (K.K.-L.L.)
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17
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Shvetsov YB, Shariff-Marco S, Yang J, Conroy SM, Canchola AJ, Albright CL, Park SY, Monroe KR, Le Marchand L, Gomez SL, Wilkens LR, Cheng I. Association of change in the neighborhood obesogenic environment with colorectal cancer risk: The Multiethnic Cohort Study. SSM Popul Health 2020; 10:100532. [PMID: 31909167 PMCID: PMC6940713 DOI: 10.1016/j.ssmph.2019.100532] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 12/11/2019] [Accepted: 12/19/2019] [Indexed: 12/13/2022] Open
Abstract
Background Neighborhood environment has been associated with health behaviors. Despite the evidence of the influence of neighborhood social and physical factors on cancer risk, no research has evaluated whether changes in the neighborhood obesogenic environment, either by physical moves to different neighborhoods or experiencing neighborhood redevelopment or neglect, affect cancer risk. Methods The association of change in neighborhood environment attributes (socioeconomic status, population density, restaurant and retail food environments, numbers of recreational facilities and businesses, commute patterns, traffic density, and street connectivity) with colorectal cancer (CRC) risk was examined among 95,472 Los Angeles, CA, Multiethnic Cohort participants, including 2295 invasive CRC cases diagnosed between 1993 and 2010 using Cox proportional hazards regression, adjusting for age, race/ethnicity, other risk factors including BMI and physical activity, and baseline levels of neighborhood attributes. Stratified analyses were conducted by racial/ethnic group and moving status. Results 40% of participants moved (changed physical residence) during follow-up. Across all races/ethnicities, upward change in population density was statistically significantly associated with higher CRC risk among male and female non-movers (HR: 1.35 and 1.41, respectively). The same association was also observed separately among female African American and Japanese American non-movers, male Latino non-movers, female African American and male White movers. Downward change in population density was significantly related to higher CRC risk among female non-movers (HR: 1.33). Downward change in traffic density was associated with lower CRC risk among male non-movers but with higher CRC risk among female movers (HR: 0.66 and 1.43, respectively). Downward changes in street connectivity or the number of recreational facilities were associated with higher CRC risk (HR: 1.34 and 1.54, respectively). Upward change in the number of recreational facilities was associated with lower CRC risk among female non-movers (HR: 0.70). Changes in the other neighborhood attributes did not exhibit significant associations with CRC risk within more than one racial/ethnic group. Conclusion Changes over time in neighborhood attributes have an effect on the risk of colorectal cancer, which is separate from the baseline levels of the same attributes and individual-level risk factors, and differs between sexes, movers and non-movers and across racial/ethnic groups. A person's neighborhood environment can change due to physical moves or neighborhood redevelopment. Association of change in neighborhood environment with colorectal cancer risk was examined. The California part of the Multiethnic Cohort was used for the analysis. Upward change in population density was associated with higher colorectal cancer risk among non-movers.
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Affiliation(s)
| | - Salma Shariff-Marco
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Juan Yang
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Shannon M Conroy
- Department of Public Health Sciences, School of Medicine, University of California, Davis, Davis, CA, USA
| | - Alison J Canchola
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Cheryl L Albright
- University of Hawaii Cancer Center, Honolulu, HI, USA.,University of Hawaii at Manoa, School of Nursing and Dental Hygiene, Honolulu, HI, USA
| | - Song-Yi Park
- University of Hawaii Cancer Center, Honolulu, HI, USA
| | | | | | - Scarlett Lin Gomez
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | | | - Iona Cheng
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
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Chandrabose M, Cerin E, Mavoa S, Dunstan D, Carver A, Turrell G, Owen N, Giles-Corti B, Sugiyama T. Neighborhood walkability and 12-year changes in cardio-metabolic risk: the mediating role of physical activity. Int J Behav Nutr Phys Act 2019; 16:86. [PMID: 31615522 PMCID: PMC6792258 DOI: 10.1186/s12966-019-0849-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 09/16/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Living in walkable neighborhoods may provide long-term cardio-metabolic health benefits to residents. Little empirical research has examined the behavioral mechanisms in this relationship. In this longitudinal study, we examined the potential mediating role of physical activity (baseline and 12-year change) in the relationships of neighborhood walkability with 12-year changes in cardio-metabolic risk markers. METHODS The Australian Diabetes, Obesity and Lifestyle study collected data from adults, initially aged 25+ years, in 1999-2000, 2004-05, and 2011-12. We used 12-year follow-up data from 2023 participants who did not change their address during the study period. Outcomes were 12-year changes in waist circumference, weight, systolic and diastolic blood pressure, fasting and 2-h postload plasma glucose, high-density lipoprotein cholesterol, and triglycerides. A walkability index was calculated, using dwelling density, intersection density, and destination density, within 1 km street-network buffers around participants' homes. Spatial data for calculating these measures were sourced around the second follow-up period. Physical activity was assessed by self-reported time spent in moderate-to-vigorous physical activity (including walking). Multilevel models, adjusting for potential confounders, were used to examine the total and indirect relationships. The joint-significance test was used to assess mediation. RESULTS There was evidence for relationships of higher walkability with smaller increases in weight (P = 0.020), systolic blood pressure (P < 0.001), and high-density lipoprotein cholesterol (P = 0.002); and, for relationships of higher walkability with higher baseline physical activity (P = 0.020), which, in turn, related to smaller increases in waist circumference (P = 0.006), weight (P = 0.020), and a greater increase in high-density lipoprotein cholesterol (P = 0.005). There was no evidence for a relationship of a higher walkability with a change in physical activity during the study period (P = 0.590). CONCLUSIONS Our mediation analysis has shown that the protective effects of walkable neighborhoods against obesity risk may be in part attributable to higher baseline physical activity levels. However, there was no evidence of mediation by increases in physical activity during the study period. Further research is needed to understand other behavioral pathways between walkability and cardio-metabolic health, and to investigate any effects of changes in walkability.
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Affiliation(s)
- Manoj Chandrabose
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia. .,Centre for Urban Transitions, Swinburne University of Technology, Melbourne, Australia.
| | - Ester Cerin
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia.,Baker Heart and Diabetes Institute, Melbourne, Australia.,School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Suzanne Mavoa
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia.,Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - David Dunstan
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia.,Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Alison Carver
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Gavin Turrell
- Centre for Urban Research, RMIT University, Melbourne, Australia.,School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Neville Owen
- Centre for Urban Transitions, Swinburne University of Technology, Melbourne, Australia.,Baker Heart and Diabetes Institute, Melbourne, Australia.,Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.,School of Public Health, The University of Queensland, Brisbane, Australia.,Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.,Institute for Resilient Regions, University of Southern Queensland, Toowoomba, Australia
| | | | - Takemi Sugiyama
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia.,Centre for Urban Transitions, Swinburne University of Technology, Melbourne, Australia.,Baker Heart and Diabetes Institute, Melbourne, Australia
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19
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Berger N, Kaufman TK, Bader MDM, Rundle AG, Mooney SJ, Neckerman KM, Lovasi GS. Disparities in trajectories of changes in the unhealthy food environment in New York City: A latent class growth analysis, 1990-2010. Soc Sci Med 2019; 234:112362. [PMID: 31247345 DOI: 10.1016/j.socscimed.2019.112362] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 04/08/2019] [Accepted: 06/10/2019] [Indexed: 11/27/2022]
Abstract
Disparities in availability of food retailers in the residential environment may help explain racial/ethnic and socio-economic differences in obesity risk. Research is needed that describes whether food environment dynamics may contribute to equalizing conditions across neighborhoods or to amplifying existing inequalities over time. This study improves the understanding of how the BMI-unhealthy food environment has evolved over time in New York City. We use longitudinal census tract-level data from the National Establishment Time-Series (NETS) for New York City in the period 1990-2010 and implement latent class growth analysis (LCGA) to (1) examine trajectories of change in the number of unhealthy food outlets (characterized as selling calorie-dense foods such as pizza and pastries) at the census tract-level, and (2) examine how trajectories are related to socio-demographic characteristics of the census tract. Overall, the number of BMI-unhealthy food outlets increased between 1990 and 2010. We summarized trajectories of evolutions with a 5-class model that indicates a pattern of fanning out, such that census tracts with a higher initial number of BMI-unhealthy food outlets in 1990 experienced a more rapid increase over time. Finally, fully adjusted logistic regression models reveal a greater increase in BMI-unhealthy food outlets in census tracts with: higher baseline population size, lower baseline income, and lower proportion of Black residents. Greater BMI-unhealthy food outlet increases were also noted in the context of census tracts change suggestive of urbanization (increasing population density) or increasing purchasing power (increasing income).
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Affiliation(s)
- Nicolas Berger
- Population Health Innovation Lab, Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom.
| | - Tanya K Kaufman
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States.
| | - Michael D M Bader
- Center on Health, Risk, and Society, American University, Washington, DC, United States.
| | - Andrew G Rundle
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States.
| | - Stephen J Mooney
- Harborview Injury Prevention & Research Center, University of Washington, Seattle, WA, United States.
| | - Kathryn M Neckerman
- Columbia Population Research Center, Columbia University, New York, NY, United States.
| | - Gina S Lovasi
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States.
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20
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The Relationships between Adolescents' Obesity and the Built Environment: Are They City Dependent? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16091579. [PMID: 31064107 PMCID: PMC6539234 DOI: 10.3390/ijerph16091579] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 04/25/2019] [Accepted: 04/26/2019] [Indexed: 12/28/2022]
Abstract
There is evidence that the built environment can promote unhealthy habits which may increase the risk for obesity among adolescents. However, the majority of evidence is from North America, Europe and Australia, and less is known about other world regions. The purpose of this study was to examine how the number of overweight and obese adolescents may vary in relation to the built environment, area socioeconomic status (SES), physical activity (PA) and nutritional home environment. We performed a telephone survey of 904 adolescents ages 15-18 from three different cities in Israel. The questionnaire included: reported PA, sedentary behaviors and nutritional home environment. Body Mass Index (BMI) was attained from records of Maccabi Healthcare Services (MHS). The built environment measures were calculated by Geographic Information System (GIS). Multivariable logistic regression analysis was performed to identify variables associated with adolescents' overweight and obesity. The highest level of overweight and obese adolescents was in Beer Sheva (29.2%). The three cities did not differ in built environment characteristics, PA and sedentary behaviors. In Haifa, a more positive nutritional home environment was reported (p = 0.001). Boys, in all three cities presented higher rates of overweight and obesity (29%). After adjusting for covariates, adolescents' overweight and obesity was associated with built environment measures only in a low SES peripheral city (OR = 0.72; 95% CI: 0.56-0.92), and positively associated with higher level of sedentary behavior in the total sample (OR = 1.23; 95% CI:1.03-1.47). This may imply a much more complex causal pathway between the built environment, SES and obesity than suggested in previous literature.
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21
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Jacobs J, Alston L, Needham C, Backholer K, Strugnell C, Allender S, Nichols M. Variation in the physical activity environment according to area-level socio-economic position-A systematic review. Obes Rev 2019; 20:686-700. [PMID: 30624854 DOI: 10.1111/obr.12818] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 11/07/2018] [Accepted: 11/11/2018] [Indexed: 01/29/2023]
Abstract
Physical inactivity is a major contributing factor to obesity, and both follow a socio-economic gradient. This systematic review aims to identify whether the physical activity environment varies by socio-economic position (SEP), which may contribute to socio-economic patterning of physical activity behaviours, and in turn, obesity levels. Six databases were searched. Studies were included if they compared an objectively measured aspect of the physical activity environment between areas of differing SEP in a high-income country. Two independent reviewers screened all papers. Results were classified according to the physical activity environment analysed: walkability/bikeability, green space, and recreational facilities. Fifty-nine studies met the inclusion criteria. A greater number of positive compared with negative associations were found between SEP and green space, whereas there were marginally more negative than positive associations between SEP and walkability/bikeability and recreational facilities. A high number of mixed and null results were found across all categories. With a high number of mixed and null results, clear socio-economic patterning in the presence of physical activity environments in high-income countries was not evident in this systematic review. Heterogeneity across studies in the measures used for both SEP and physical activity environments may have contributed to this result.
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Affiliation(s)
- Jane Jacobs
- Global Obesity Centre, Centre for Population Health Research, Deakin University, Geelong, Victoria, Australia
| | - Laura Alston
- Global Obesity Centre, Centre for Population Health Research, Deakin University, Geelong, Victoria, Australia
| | - Cindy Needham
- Global Obesity Centre, Centre for Population Health Research, Deakin University, Geelong, Victoria, Australia
| | - Kathryn Backholer
- Global Obesity Centre, Centre for Population Health Research, Deakin University, Geelong, Victoria, Australia
| | - Claudia Strugnell
- Global Obesity Centre, Centre for Population Health Research, Deakin University, Geelong, Victoria, Australia
| | - Steven Allender
- Global Obesity Centre, Centre for Population Health Research, Deakin University, Geelong, Victoria, Australia
| | - Melanie Nichols
- Global Obesity Centre, Centre for Population Health Research, Deakin University, Geelong, Victoria, Australia
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22
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Kelly C, Callaghan M, Molcho M, Nic Gabhainn S, Alforque Thomas A. Food environments in and around post-primary schools in Ireland: Associations with youth dietary habits. Appetite 2019; 132:182-189. [DOI: 10.1016/j.appet.2018.08.021] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 07/09/2018] [Accepted: 08/13/2018] [Indexed: 12/16/2022]
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23
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Xiao Q, Berrigan D, Powell-Wiley TM, Matthews CE. Ten-Year Change in Neighborhood Socioeconomic Deprivation and Rates of Total, Cardiovascular Disease, and Cancer Mortality in Older US Adults. Am J Epidemiol 2018; 187:2642-2650. [PMID: 30137194 DOI: 10.1093/aje/kwy181] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 08/14/2018] [Indexed: 12/24/2022] Open
Abstract
Low neighborhood socioeconomic status has been linked to adverse health outcomes. However, it is unclear whether changing the neighborhood may influence health. We examined 10-year change in neighborhood socioeconomic deprivation in relation to mortality rate among 288,555 participants aged 51-70 years who enrolled in the National Institutes of Health-AARP Diet and Health Study in 1995-1996 (baseline) and did not move during the study. Changes in neighborhood socioeconomic deprivation between 1990 and 2000 were measured by US Census data at the census tract level. All-cause, cardiovascular disease, and cancer deaths were ascertained through annual linkage to the Social Security Administration Death Master File between 2000 and 2011. Overall, our results suggested that improvement in neighborhood socioeconomic status was associated with a lower mortality rate, while deterioration was associated with a higher mortality rate. More specially, a 30-percentile-point reduction in neighborhood deprivation among more deprived neighborhoods was associated with 11% and 19% reductions in the total mortality rate among men and women, respectively. On the other hand, a 30-point increase in neighborhood deprivation in less deprived neighborhoods was associated with an 11% increase in the mortality rate among men. Our findings support a longitudinal association between changing neighborhood conditions and mortality.
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Affiliation(s)
- Qian Xiao
- Department of Health and Human Physiology, College of Liberal Arts and Sciences, University of Iowa, Iowa City, Iowa
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa
| | - David Berrigan
- Applied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
| | - Tiffany M Powell-Wiley
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, Bethesda, Maryland
- Intramural Research Program of the National Institute of Minority Health and Health Disparities, Bethesda, Maryland
| | - Charles E Matthews
- Metabolic Epidemiological Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
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24
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Arthur KN, Spencer-Hwang R, Knutsen SF, Shavlik D, Soret S, Montgomery S. Are perceptions of community safety associated with respiratory illness among a low-income, minority adult population? BMC Public Health 2018; 18:1089. [PMID: 30176823 PMCID: PMC6122647 DOI: 10.1186/s12889-018-5933-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 08/03/2018] [Indexed: 12/11/2022] Open
Abstract
Background Growing evidence suggests social disadvantage magnifies the harmful health effects of environmental hazards; however, there is limited research related to perceptions of risk among individuals who live near such environmental hazard sites. We explored the association between individual-level perception of community safety and respiratory illness among low-income, minority adults who live in a region with routine poor air quality exacerbated by the emissions of a nearby freight railyard. Methods Interview-administered household surveys were collected (87% response rate; n = 965) in English/Spanish from varying distances surrounding a freight railyard (analytic total n = 792: nearest region n = 215, middle n = 289, farthest n = 288). Illness outcome was an affirmative response to doctor-diagnosed asthma, bronchial condition, emphysema, COPD, or prescribed-inhaler usage. Respiratory symptoms outcome was an affirmative response to chronic cough, chronic mucus, or wheezing. The independent variable was perceived community safety. Results Outcome prevalences were similar across environmental hazard regions; 205 (25.9%) were diagnosed-illness cases and 166 (21.0%) diagnosis-free participants reported symptoms. Nearly half (47.5%) of participants reported lack of perceived community safety, which was associated with environmental hazard region (p < 0.0001). In multivariable log-binomial regression models adjusting for covariables (age, gender, race/ethnicity, smoking status, smoke exposure, residential duration, and distance from the railyard) respiratory illness diagnosis was associated with lack of perceived community safety (PR = 1.39; 95% CI 1.09, 1.76). Sensitivity analyses showed a non-significant but increasing trend in the strength of association between safety perceptions and illness diagnoses with closer proximity to the railyard. Conclusions Our findings contribute to the literature that individuals’ perceptions of community safety are associated with adverse respiratory health among a population living in high air pollution exposure areas. Electronic supplementary material The online version of this article (10.1186/s12889-018-5933-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kristen N Arthur
- School of Public Health, Center for Community Resilience, Loma Linda University, 24951 N. Circle Drive, Nichol Hall, room 1401, Loma Linda, CA, 92350, USA.
| | - Rhonda Spencer-Hwang
- School of Public Health, Center for Community Resilience, Loma Linda University, 24951 N. Circle Drive, Nichol Hall, room 1401, Loma Linda, CA, 92350, USA
| | - Synnøve F Knutsen
- School of Public Health, Center for Nutrition, Health Lifestyle and Disease Prevention, Loma Linda University, Loma Linda, USA
| | - David Shavlik
- School of Public Health, Center for Community Resilience, Loma Linda University, 24951 N. Circle Drive, Nichol Hall, room 1401, Loma Linda, CA, 92350, USA
| | - Samuel Soret
- School of Public Health, Center for Community Resilience, Loma Linda University, 24951 N. Circle Drive, Nichol Hall, room 1401, Loma Linda, CA, 92350, USA
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25
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Hawkesworth S, Silverwood RJ, Armstrong B, Pliakas T, Nanchalal K, Jefferis BJ, Sartini C, Amuzu AA, Wannamethee SG, Ramsay SE, Casas JP, Morris RW, Whincup PH, Lock K. Investigating associations between the built environment and physical activity among older people in 20 UK towns. J Epidemiol Community Health 2017; 72:121-131. [PMID: 29175864 PMCID: PMC5800350 DOI: 10.1136/jech-2017-209440] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 09/25/2017] [Accepted: 10/29/2017] [Indexed: 12/23/2022]
Abstract
Background Policy initiatives such as WHO Age Friendly Cities recognise the importance of the urban environment for improving health of older people, who have both low physical activity (PA) levels and greater dependence on local neighbourhoods. Previous research in this age group is limited and rarely uses objective measures of either PA or the environment. Methods We investigated the association between objectively measured PA (Actigraph GT3x accelerometers) and multiple dimensions of the built environment, using a cross-sectional multilevel linear regression analysis. Exposures were captured by a novel foot-based audit tool that recorded fine-detail neighbourhood features relevant to PA in older adults, and routine data. Results 795 men and 638 women aged 69–92 years from two national cohorts, covering 20 British towns, were included in the analysis. Median time in moderate to vigorous PA (MVPA) was 27.9 (lower quartile: 13.8, upper quartile: 50.4) minutes per day. There was little evidence of associations between any of the physical environmental domains (eg, road and path quality defined by latent class analysis; number of bus stops; area aesthetics; density of shops and services; amount of green space) and MVPA. However, analysis of area-level income deprivation suggests that the social environment may be associated with PA in this age group. Conclusions Although small effect sizes cannot be discounted, this study suggests that older individuals are less affected by their local physical environment and more by social environmental factors, reflecting both the functional heterogeneity of this age group and the varying nature of their activity spaces.
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Affiliation(s)
- Sophie Hawkesworth
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Richard J Silverwood
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Ben Armstrong
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Triantafyllos Pliakas
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Kiran Nanchalal
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Barbara J Jefferis
- UCL Department of Primary Care & Population Health, UCL Medical School, London, UK.,UCL Physical Activity Research Group, London, UK
| | - Claudio Sartini
- UCL Department of Primary Care & Population Health, UCL Medical School, London, UK.,UCL Physical Activity Research Group, London, UK
| | - Antoinette A Amuzu
- Farr Institute of Health Informatics, Faculty of Population Health Sciences, London, UK
| | - S Goya Wannamethee
- UCL Department of Primary Care & Population Health, UCL Medical School, London, UK
| | - Sheena E Ramsay
- UCL Department of Primary Care & Population Health, UCL Medical School, London, UK
| | - Juan-Pablo Casas
- Farr Institute of Health Informatics, Faculty of Population Health Sciences, London, UK
| | - Richard W Morris
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Peter H Whincup
- Population Health Research Institute, St George's, University of London, London, UK
| | - Karen Lock
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
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26
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Hawkesworth S, Silverwood R, Armstrong B, Pliakas T, Nanchahal K, Sartini C, Amuzu A, Wannamethee G, Atkins J, Ramsay S, Casas J, Morris R, Whincup P, Lock K. Investigating the importance of the local food environment for fruit and vegetable intake in older men and women in 20 UK towns: a cross-sectional analysis of two national cohorts using novel methods. Int J Behav Nutr Phys Act 2017; 14:128. [PMID: 28923064 PMCID: PMC5604417 DOI: 10.1186/s12966-017-0581-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Accepted: 09/03/2017] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Local neighbourhood environments can influence dietary behavior. There is limited evidence focused on older people who are likely to have greater dependence on local areas and may suffer functional limitations that amplify any neighbourhood impact. METHODS Using multi-level ordinal regression analysis we investigated the association between multiple dimensions of neighbourhood food environments (captured by fine-detail, foot-based environmental audits and secondary data) and self-reported frequency of fruit and vegetable intake. The study was a cross-sectional analysis nested within two nationally representative cohorts in the UK: the British Regional Heart Study and the British Women's Heart and Health Study. Main exposures of interest were density of food retail outlets selling fruits and vegetables, the density of fast food outlets and a novel measure of diversity of the food retail environment. RESULTS A total of 1124 men and 883 women, aged 69 - 92 years, living in 20 British towns were included in the analysis. There was strong evidence of an association between area income deprivation and fruit and vegetable consumption, with study members in the most deprived areas estimated to have 27% (95% CI: 7, 42) lower odds of being in a higher fruit and vegetable consumption category relative to those in the least deprived areas. We found no consistent evidence for an association between fruit and vegetable consumption and a range of other food environment domains, including density of shops selling fruits and vegetables, density of premises selling fast food, the area food retail diversity, area walkability, transport accessibility, or the local food marketing environment. For example, individuals living in areas with greatest fruit and vegetable outlet density had 2% (95% CI: -22, 21) lower odds of being in a higher fruit and vegetable consumption category relative to those in areas with no shops. CONCLUSIONS Although small effect sizes in environment-diet relationships cannot be discounted, this study suggests that older people are less influenced by physical characteristics of neighbourhood food environments than is suggested in the literature. The association between area income deprivation and diet may be capturing an important social aspect of neighbourhoods that influence food intake in older adults and warrants further research.
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Affiliation(s)
- S. Hawkesworth
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, WC1E 7HT UK
| | - R.J. Silverwood
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, WC1E 7HT UK
| | - B. Armstrong
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, WC1E 7HT UK
| | - T. Pliakas
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, WC1E 7HT UK
| | - K. Nanchahal
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, WC1E 7HT UK
| | - C. Sartini
- UCL Department of Primary Care & Population Health, UCL Medical School, Rowland Hill Street, London, NW3 2PF UK
| | - A. Amuzu
- University of Exeter Medical School, Wonford Barrack Road, Exeter, EX2 5DW UK
| | - G. Wannamethee
- UCL Department of Primary Care & Population Health, UCL Medical School, Rowland Hill Street, London, NW3 2PF UK
| | - J. Atkins
- University of Exeter Medical School, Wonford Barrack Road, Exeter, EX2 5DW UK
| | - S.E. Ramsay
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, NE2 4AX UK
| | - J.P. Casas
- Farr Institute of Health Informatics, Faculty of Population Health Sciences, 222 Euston Road, London, NW1 2DA UK
| | - R.W. Morris
- School of Social and Community Medicine, University of Bristol, Bristol, BS8 2PS UK
| | - P.H. Whincup
- Population Health Research Institute, St George’s, University of London, London, SW17 0RE UK
| | - Karen Lock
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, WC1E 7HT UK
- London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, UK
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27
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Gullón P, Bilal U, Cebrecos A, Badland HM, Galán I, Franco M. Intersection of neighborhood dynamics and socioeconomic status in small-area walkability: the Heart Healthy Hoods project. Int J Health Geogr 2017; 16:21. [PMID: 28587623 PMCID: PMC5461703 DOI: 10.1186/s12942-017-0095-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 05/31/2017] [Indexed: 11/29/2022] Open
Abstract
Background Previous studies found a complex relationship between area-level socioeconomic status (SES) and walkability. These studies did not include neighborhood dynamics. Our aim was to study the association between area-level SES and walkability in the city of Madrid (Spain) evaluating the potential effect modification of neighborhood dynamics. Methods All census sections of the city of Madrid (n = 2415) were included. Area-level SES was measured using a composite index of 7 indicators in 4 domains (education, wealth, occupation and living conditions). Two neighborhood dynamics factors were computed: gentrification, proxied by change in education levels in the previous 10 years, and neighborhood age, proxied by median year of construction of housing units in the area. Walkability was measured using a composite index of 4 indicators (Residential Density, Population Density, Retail Destinations and Street Connectivity). We modeled the association using linear mixed models with random intercepts. Results Area-level SES and walkability were inversely and significantly associated. Areas with lower SES showed the highest walkability. This pattern did not hold for areas with an increase in education level, where the association was flat (no decrease in walkability with higher SES). Moreover, the association was attenuated in newly built areas: the association was stronger in areas built before 1975, weaker in areas built between 1975 and 1990 and flat in areas built from 1990 on. Conclusion Areas with higher neighborhood socioeconomic status had lower walkability in Madrid. This disadvantage in walkability was not present in recently built or gentrified areas. Electronic supplementary material The online version of this article (doi:10.1186/s12942-017-0095-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Pedro Gullón
- Social and Cardiovascular Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, 28871, Spain.,Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Madrid, 28029, Spain
| | - Usama Bilal
- Social and Cardiovascular Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, 28871, Spain.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, 21205, MD, USA
| | - Alba Cebrecos
- Social and Cardiovascular Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, 28871, Spain.,Department of Geology, Geography and Environmental Sciences, University of Alcalá, Alcalá de Henares, Madrid, 28871, Spain
| | - Hannah M Badland
- Center for Urban Research, RMIT University, Melbourne, 3000, VIC, Australia
| | - Iñaki Galán
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, 28029, Spain
| | - Manuel Franco
- Social and Cardiovascular Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, 28871, Spain. .,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, 21205, MD, USA.
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