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Prince SA, Lang JJ, de Groh M, Badland H, Barnett A, Littlejohns LB, Brandon NC, Butler GP, Casu G, Cerin E, Colley RC, de Lannoy L, Demchenko I, Ellingwood HN, Evenson KR, Faulkner G, Fridman L, Friedenreich CM, Fuller DL, Fuselli P, Giangregorio LM, Gupta N, Hino AA, Hume C, Isernhagen B, Jalaludin B, Lakerveld J, Larouche R, Lemon SC, Loucaides CA, Maddock JE, McCormack GR, Mehta A, Milton K, Mota J, Ngo VD, Owen N, Oyeyemi AL, Palmeira AL, Rainham DG, Rhodes RE, Ridgers ND, Roosendaal I, Rosenberg DE, Schipperijn J, Slater SJ, Storey KE, Tremblay MS, Tully MA, Vanderloo LM, Veitch J, Vietinghoff C, Whiting S, Winters M, Yang L, Geneau R. Prioritizing a research agenda on built environments and physical activity: a twin panel Delphi consensus process with researchers and knowledge users. Int J Behav Nutr Phys Act 2023; 20:144. [PMID: 38062460 PMCID: PMC10704660 DOI: 10.1186/s12966-023-01533-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 10/31/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND The growth of urban dwelling populations globally has led to rapid increases of research and policy initiatives addressing associations between the built environment and physical activity (PA). Given this rapid proliferation, it is important to identify priority areas and research questions for moving the field forward. The objective of this study was to identify and compare research priorities on the built environment and PA among researchers and knowledge users (e.g., policy makers, practitioners). METHODS Between September 2022 and April 2023, a three-round, modified Delphi survey was conducted among two independent panels of international researchers (n = 38) and knowledge users (n = 23) to identify similarities and differences in perceived research priorities on the built environment and PA and generate twin 'top 10' lists of the most important research needs. RESULTS From a broad range of self-identified issues, both panels ranked in common the most pressing research priorities including stronger study designs such as natural experiments, research that examines inequalities and inequities, establishing the cost effectiveness of interventions, safety and injuries related to engagement in active transportation (AT), and considerations for climate change and climate adaptation. Additional priorities identified by researchers included: implementation science, research that incorporates Indigenous perspectives, land-use policies, built environments that support active aging, and participatory research. Additional priorities identified by knowledge users included: built environments and PA among people living with disabilities and a need for national data on trip chaining, multi-modal travel, and non-work or school-related AT. CONCLUSIONS Five common research priorities between the two groups emerged, including (1) to better understand causality, (2) interactions with the natural environment, (3) economic evaluations, (4) social disparities, and (5) preventable AT-related injuries. The findings may help set directions for future research, interdisciplinary and intersectoral collaborations, and funding opportunities.
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Affiliation(s)
- Stephanie A Prince
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, 785 Carling Avenue, Ottawa, K1A 0K9, Canada.
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada.
| | - Justin J Lang
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, 785 Carling Avenue, Ottawa, K1A 0K9, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, City East Campus, Adelaide, South Australia
| | - Margaret de Groh
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, 785 Carling Avenue, Ottawa, K1A 0K9, Canada
| | - Hannah Badland
- Social and Global Studies Centre, RMIT University, Melbourne, Australia
| | - Anthony Barnett
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Lori Baugh Littlejohns
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
- Population and Public Health, BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | | | - Gregory P Butler
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, 785 Carling Avenue, Ottawa, K1A 0K9, Canada
| | - Géna Casu
- Association pour la santé publique du Québec (ASPQ), Montréal, Québec, Canada
| | - Ester Cerin
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
- School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Rachel C Colley
- Health Analysis Division, Statistics Canada, Ottawa, Ontario, Canada
| | | | - Iryna Demchenko
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | | | - Kelly R Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Guy Faulkner
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Liraz Fridman
- Department of Mechanical and Industrial Engineering, Faculty of Applied Science and Engineering, University of Toronto, Toronto, Ontario, Canada
| | - Christine M Friedenreich
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Alberta, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Daniel L Fuller
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | | | - Lora M Giangregorio
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
- Schlegel-UW Research Institute for Aging, Waterloo, Ontario, Canada
| | - Neeru Gupta
- Department of Sociology, University of New Brunswick, Fredericton, New Brunswick, Canada
| | - Adriano A Hino
- Health Sciences Graduate Program, School of Medicine and Health Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
| | - Clare Hume
- School of Public Health, University of Adelaide, Adelaide, Australia
| | | | - Bin Jalaludin
- School of Population Health, University of New South Wales, Sydney, Australia
| | - Jeroen Lakerveld
- Department of Epidemiology and Data Science, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Health Behaviours and Chronic Diseases, Amsterdam Public Health, Amsterdam, the Netherlands
- Upstream Team, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Richard Larouche
- Faculty of Health Sciences, University of Lethbridge, Lethbridge, Alberta, Canada
| | - Stephenie C Lemon
- Prevention Research Center, UMass Chan Medical School, Worcester, Massachusetts, USA
| | | | - Jay E Maddock
- School of Public Health, Texas A&M University, College Station, Texas, USA
| | - Gavin R McCormack
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- School of Planning, Architecture, and Landscape, University of Calgary, Calgary, Alberta, Canada
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Aman Mehta
- Maroondah City Council, Victoria, Australia
| | - Karen Milton
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Jorge Mota
- Research Center in Physical Activity, health and Leisure (CIAFEL)-Faculty of Sports-University of Porto (FADEUP) and Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
| | - Victor D Ngo
- Canadian Institute of Planners, Ottawa, Ontario, Canada
| | - Neville Owen
- Swinburne University of Technology, Melbourne, Victoria, Australia
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Adewale L Oyeyemi
- College of Health Solutions, Arizona State University, Phoenix, Arizona, USA
| | | | - Daniel G Rainham
- Healthy Populations Institute, Dalhousie University, Halifax, Nova Scotia, Canada
- School of Health and Human Performance, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Ryan E Rhodes
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, British Columbia, Canada
| | - Nicola D Ridgers
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, City East Campus, Adelaide, South Australia
| | | | - Dori E Rosenberg
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington, USA
| | - Jasper Schipperijn
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Sandra J Slater
- Bachelor of Science in Public Health Program, School of Pharmacy, Concordia University Wisconsin, Mequon, Wisconsin, USA
| | - Kate E Storey
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Mark S Tremblay
- Outdoor Play Canada, Ottawa, Ontario, Canada
- Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada
- Department of Health Sciences, Carleton University, Ottawa, Ontario, Canada
| | - Mark A Tully
- School of Medicine, Ulster University, Londonberry, United Kingdom
| | - Leigh M Vanderloo
- ParticipACTION, Toronto, Ontario, Canada
- School of Occupational Therapy, Western University, London, Ontario, Canada
| | - Jenny Veitch
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | | | - Stephen Whiting
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Meghan Winters
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Linchuan Yang
- Department of Urban and Rural Planning, School of Architecture, Southwest Jiaotong University, Chengdu, China
| | - Robert Geneau
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, 785 Carling Avenue, Ottawa, K1A 0K9, Canada
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Lamb KE, Daniel M, Chaix B, Kestens Y, Coffee NT, Thornton LE. Socioeconomic differences in associations between living in a 20-min neighbourhood and diet, physical activity and self-rated health: Cross-sectional findings from ProjectPLAN. Health Place 2023; 84:103119. [PMID: 37742399 DOI: 10.1016/j.healthplace.2023.103119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 06/28/2023] [Accepted: 09/13/2023] [Indexed: 09/26/2023]
Abstract
The 20-min neighbourhood (20MN) concept aims to enable residents to meet daily needs using resources within a 20-min trip from home noting that there is no single definition of what services and amenities are required for daily needs nor what modes of transport constitute a 20 min trip. Whether 20MNs promote better health and whether associations differ by socio-economic status (SES) is unknown. Using cross-sectional data from adults randomly sampled in 2018-19 from Melbourne or Adelaide, Australia, we examined whether associations between neighbourhood type (20MN/non-20MN) and diet, physical activity or self-rated health vary according to individual- or area-level SES. We found no consistent patterns of interactions. The results do not consistently support the often assumed belief that 20MNs support more healthful behaviour and that these relationships vary by SES.
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Affiliation(s)
- Karen E Lamb
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.
| | - Mark Daniel
- Dasman Diabetes Institute, GeoHealth Laboratory, Kuwait City, Kuwait
| | - Basile Chaix
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Nemesis Research team, F75012, Paris, France
| | - Yan Kestens
- École de Santé Publique de l'Université de Montréal (ESPUM), Montreal, QC, Canada; Centre de Recherche en Santé Publique (CReSP), Montréal, QC, Canada
| | - Neil T Coffee
- Deakin Rural Health, Faculty of Health, Deakin University, Warrnambool, VIC, Australia
| | - Lukar E Thornton
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia; Department of Marketing, Faculty of Business Economics, University of Antwerp, Antwerp, Belgium
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Khoramrooz M, Zare F, Sadeghian F, Dadgari A, Chaman R, Mirrezaie SM. Socioeconomic inequalities in employees' health-enhancing physical activity: Evidence from the SHAHWAR cohort study in Iran. PLoS One 2023; 18:e0285620. [PMID: 37186583 PMCID: PMC10184902 DOI: 10.1371/journal.pone.0285620] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 04/26/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Increasing level of physical activity (PA) among working population is of particular importance, because of the high return of investment on employees' PA. This study was aimed to investigate socioeconomic inequalities in Health-Enhancing Physical Activity (HEPA) among employees of a Medical Sciences University in Iran. METHODS Data were extracted from the SHAHWAR Cohort study in Iran. Concentration index (C) and Wagstaff decomposition techniques were applied to determine socioeconomic inequality in the study outcomes and its contributors, respectively. RESULTS Nearly half of the university employees (44.6%) had poor HEPA, and employees with high socioeconomic status (SES) suffered more from it (C = 0.109; 95% CI: 0.075, 0.143). Also, we found while poor work-related PA (C = 0.175; 95% CI: 0.142, 0.209) and poor transport-related PA (C = 0.081, 95% CI: 0.047, 0.115) were more concentrated among high-SES employees, low-SES employees more affected by the poor PA at leisure time (C = -0.180; 95% CI: -0.213, -0.146). Shift working, and having higher SES and subjective social status were the main factors that positively contributed to the measured inequality in employees' poor HEPA by 33%, 31.7%, and 29%, respectively, whereas, having a married life had a negative contribution of -39.1%. The measured inequality in poor leisure-time PA was mainly attributable to SES, having a married life, urban residency, and female gender by 58.1%, 32.5%, 28.5%, and -32.6%, respectively. SES, urban residency, shift working, and female gender, with the contributions of 42%, 33.5%, 21.6%, and -17.3%, respectively, were the main contributors of poor work-related PA inequality. Urban residency, having a married life, SES, and subjective social status mainly contributed to the inequality of poor transport-related PA by 82.9%, -58.7%, 36.3%, and 33.5%, respectively, followed by using a personal car (12.3%) and female gender (11.3%). CONCLUSIONS To reduce the measured inequalities in employees' PA, workplace health promotion programs should aim to educate and support male, urban resident, high-SES, high-social-class, and non-shift work employees to increase their PA at workplace, and female, married, rural resident, and low-SES employees to increase their leisure-time PA. Active transportation can be promoted among female, married, urban resident, high-SES, and high-social-class employees and those use a personal car.
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Affiliation(s)
- Maryam Khoramrooz
- Department of Health Management and Economics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Fariba Zare
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Farideh Sadeghian
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Ali Dadgari
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
- School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Reza Chaman
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
- Department of Epidemiology, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Seyed Mohammad Mirrezaie
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
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4
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DeVille NV, Iyer HS, Holland I, Bhupathiraju SN, Chai B, James P, Kawachi I, Laden F, Hart JE. Neighborhood socioeconomic status and mortality in the nurses' health study (NHS) and the nurses' health study II (NHSII). Environ Epidemiol 2023; 7:e235. [PMID: 36777531 PMCID: PMC9916023 DOI: 10.1097/ee9.0000000000000235] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 11/12/2022] [Indexed: 12/24/2022] Open
Abstract
Few studies have prospectively examined long-term associations between neighborhood socioeconomic status (nSES) and mortality risk, independent of demographic and lifestyle risk factors. Methods We assessed associations between nSES and all-cause, nonaccidental mortality among women in the Nurses' Health Study (NHS) 1986-2014 (N = 101,701) and Nurses' Health Study II (NHSII) 1989-2015 (N = 101,230). Mortality was ascertained from the National Death Index (NHS: 19,228 deaths; NHSII: 1556 deaths). Time-varying nSES was determined for the Census tract of each residential address. We used principal component analysis (PCA) to identify nSES variable groups. Multivariable Cox proportional hazards models were conditioned on age and calendar period and included time-varying demographic, lifestyle, and individual SES factors. Results For NHS, hazard ratios (HRs) comparing the fifth to first nSES quintiles ranged from 0.89 (95% confidence interval [CI] = 0.84, 0.94) for percent of households receiving interest/dividends, to 1.11 (95% CI = 1.06, 1.17) for percent of households receiving public assistance income. In NHSII, HRs ranged from 0.72 (95% CI: 0.58, 0.88) for the percent of households receiving interest/dividends, to 1.27 (95% CI: 1.07, 1.49) for the proportion of households headed by a single female. PCA revealed three constructs: education/income, poverty/wealth, and racial composition. The racial composition construct was associated with mortality (HRNHS: 1.03; 95% CI = 1.01, 1.04). Conclusion In two cohorts with extensive follow-up, individual nSES variables and PCA component scores were associated with mortality. nSES is an important population-level predictor of mortality, even among a cohort of women with little individual-level variability in SES.
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Affiliation(s)
- Nicole V. DeVille
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology and Biostatistics, University of Nevada, Las Vegas School of Public Health, Las Vegas, Naveda
| | - Hari S. Iyer
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Division of Population Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Isabel Holland
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Shilpa N. Bhupathiraju
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Boyang Chai
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Peter James
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Francine Laden
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Jaime E. Hart
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Barnhart S, Bode M, Gearhart MC, Maguire-Jack K. Supportive Neighborhoods, Family Resilience and Flourishing in Childhood and Adolescence. CHILDREN 2022; 9:children9040495. [PMID: 35455539 PMCID: PMC9030551 DOI: 10.3390/children9040495] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/21/2022] [Accepted: 03/25/2022] [Indexed: 11/30/2022]
Abstract
Flourishing is linked with health and well-being in childhood and adulthood. This study applied a promotive factors model to examine how neighborhood assets might benefit child and adolescent flourishing by promoting family resilience. Using data from the combined 2018 and 2019 National Survey of Children’s Health, structural equation models tested direct and indirect relationships between neighborhood physical environment, neighborhood social cohesion, family resilience, and flourishing among 18,396 children and 24,817 adolescents. After controlling for multiple covariates that may influence flourishing, the models supported that higher levels of neighborhood social cohesion were directly associated with higher levels of flourishing adolescents, and indirectly by positive associations with family resilience for both children and adolescents. No indirect effects between neighborhood physical environments and flourishing were supported by the data for either children or adolescents. However, neighborhood physical environments were positively associated with adolescent flourishing. Understanding social environmental factors that strengthen and enhance child and adolescent flourishing are critical toward designing prevention, intervention, and policy efforts that can build on the existing strengths of families and their communities.
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Affiliation(s)
- Sheila Barnhart
- College of Social Work, University of Kentucky, Lexington, KY 40506, USA;
- Correspondence:
| | - Molly Bode
- College of Social Work, University of Kentucky, Lexington, KY 40506, USA;
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Schwartz J, Oh P, Perotto MB, Rhodes RE, Firth W, Bredin SSD, Gaytán-González A, Warburton DER. A Critical Review on New Approaches for Chronic Disease Prevention in Brazil and Canada: From Wholistic Dietary Guidelines to Physical Activity Security. Front Cardiovasc Med 2021; 8:730373. [PMID: 34527714 PMCID: PMC8435680 DOI: 10.3389/fcvm.2021.730373] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 08/10/2021] [Indexed: 01/12/2023] Open
Abstract
In light of new evidence on the prevention of chronic diseases and the elevated rates of overweight and obesity in Brazil and Canada, this critical review aims to interpret and synthesize current aspects regarding dietary and physical activity initiatives in both countries and make future recommendations. The pioneering work presented in the last Brazilian dietary guidelines has been called a model that can be applied globally, given its conceptualization of healthy eating that translates easily to practical guidance. The new Canadian Food Guide has incorporated similar aspects, also putting the country as a leader in dietary guidance. With these new recommendations, citizens in both Brazil and Canada have access to impactful evidence-informed nutritional guidelines. Both documents propose eating patterns that focus not only on health benefits, such as chronic disease prevention, but also incorporate well-being concerning cultural, economic, sociodemographic, biological, and ecological dimensions. A similar approach is required for physical activity to allow individuals to have attainable health and life goals and thereby fully enjoy their lives, regardless of geographical location, health status, and socioeconomic condition, a concept recently described as physical activity security. The wholistic dietary guidelines from both countries represent a change in paradigm in public health. Likewise, national evidence-based policies are warranted to reduce disparities in physical activity, allowing healthier and more active lifestyles for everyone.
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Affiliation(s)
- Juliano Schwartz
- Physical Activity Promotion and Chronic Disease Prevention Unit, University of British Columbia, Vancouver, BC, Canada
- Experimental Medicine Program, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Paul Oh
- Cardiovascular Prevention and Rehabilitation Program, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Maira B. Perotto
- West Toronto Diabetes Education Program, LAMP Community Health Centre, Toronto, ON, Canada
| | - Ryan E. Rhodes
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada
| | - Wanda Firth
- Hearts & Health in Motion Program, Nova Scotia Health, QEII Health Sciences Centre, Halifax, NS, Canada
| | - Shannon S. D. Bredin
- Physical Activity Promotion and Chronic Disease Prevention Unit, University of British Columbia, Vancouver, BC, Canada
- School of Kinesiology, Faculty of Education, University of British Columbia, Vancouver, BC, Canada
| | - Alejandro Gaytán-González
- Physical Activity Promotion and Chronic Disease Prevention Unit, University of British Columbia, Vancouver, BC, Canada
- School of Kinesiology, Faculty of Education, University of British Columbia, Vancouver, BC, Canada
- Institute of Applied Sciences for Physical Activity and Sport, University of Guadalajara, Guadalajara, Mexico
| | - Darren E. R. Warburton
- Physical Activity Promotion and Chronic Disease Prevention Unit, University of British Columbia, Vancouver, BC, Canada
- Experimental Medicine Program, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- School of Kinesiology, Faculty of Education, University of British Columbia, Vancouver, BC, Canada
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7
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The Relationship between Physical Activity and the Objectively-Measured Built Environment in Low- and High-Income South African Communities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18083853. [PMID: 33916926 PMCID: PMC8067549 DOI: 10.3390/ijerph18083853] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 03/04/2021] [Accepted: 03/07/2021] [Indexed: 11/30/2022]
Abstract
There is limited data concerning the built environment and physical activity (PA) in a country with a history of sociopolitically motivated, spatial and economic disparities. We explored the extent to which objectively measured attributes of the built environment were associated with self-report or device-measured PA in low- and high-socioeconomic status (SES) communities. Methods: In a convenient sample of residents (n = 52, aged 18–65 years) from four urban suburbs in low- and high-income settings near Cape Town, South Africa, self-reported transport- and leisure-time PA, and device-measured moderate-to-vigorous PA (MVPA) data were collected. Built environment constructs derived from individual-level street network measures (1000 m buffer, ArcGIS, 10.51) were obtained. We assessed PA between four groups, based on income and GIS walkability (derived by a median split, low or high SES and low or high walkable). Results: No relationships between self-reported MVPA and GIS-measured walkability were found. Only intersection density was significantly, inversely associated with moderate and total MVPA (rho = −0.29 and rho = −0.31, respectively, p < 0.05). In the high SES group, vigorous PA was inversely associated with intersection density (rho = −0.39, p < 0.05). Self-report transport PA differed between groups (p < 0.013). Conclusions: Results suggest that the construct of walkability may relate to volitional (leisure) and utilitarian (transport) PA differently, in highly inequitable settings.
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8
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Lukic R, Olstad DL, Doyle-Baker PK, Potestio ML, McCormack GR. Associations between neighbourhood street pattern, neighbourhood socioeconomic status and sleep in adults. Prev Med Rep 2021; 22:101345. [PMID: 33850695 PMCID: PMC8022243 DOI: 10.1016/j.pmedr.2021.101345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 01/22/2021] [Accepted: 02/22/2021] [Indexed: 12/05/2022] Open
Abstract
Sleep duration is a risk factor for poor health and all-cause mortality. Evidence suggests that neighbourhood characteristics such as built environment and socioeconomic status (SES) may affect sleep duration in adults. This study examined the relationship between neighbourhood built environment (i.e., measured via the street pattern) and SES with sleep duration in adults (n = 797) from 12 neighbourhoods in Calgary (Canada). Covariate adjusted linear and multinomial logistic regression models estimated the associations between street pattern (grid, warped-grid, curvilinear), SES and sleep duration. We also tested if the interaction between street pattern and SES was associated with sleep duration. Although neighbourhood street pattern and neighbourhood SES were not independently associated with sleep, the interaction between street pattern and neighbourhood SES, was associated with mean sleep duration. Individuals living in curvilinear low SES neighbourhoods had the shortest sleep duration (6.93 h per day; 95% CI 6.68, 7.18), while those living in curvilinear high SES neighbourhoods slept the longest (7.43 h per day; 95% CI 7.29, 7.57). Neighbourhood street pattern and SES, as well as their interaction, were not associated with the odds of sleeping shorter or longer than 7 to 8 h per day. Our findings suggest that the combined effect of the neighbourhood built environment and SES is potentially important for influencing sleep duration. More research is needed to understand the complex interrelationships between the built environment, SES, and sleep.
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Affiliation(s)
- R Lukic
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Canada
| | - D L Olstad
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Canada
| | - P K Doyle-Baker
- Faculty of Kinesiology, University of Calgary, Canada.,School of Planning, Architecture, and Landscape, University of Calgary, Canada
| | - M L Potestio
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Canada
| | - G R McCormack
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Canada.,Faculty of Kinesiology, University of Calgary, Canada.,School of Planning, Architecture, and Landscape, University of Calgary, Canada.,Faculty of Sport Sciences, Waseda University, Japan
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Budd EL, Giuliani NR, Kelly NR. Perceived Neighborhood Crime Safety Moderates the Association Between Racial Discrimination Stress and Chronic Health Conditions Among Hispanic/Latino Adults. Front Public Health 2021; 9:585157. [PMID: 33659230 PMCID: PMC7917115 DOI: 10.3389/fpubh.2021.585157] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 01/18/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Little is known about the link between perceived neighborhood walkability and prevalence of chronic disease. Even less is known regarding this association among Hispanic/Latino adults, despite exhibiting high rates of chronic diseases. Stress due to racial discrimination is a harmful social determinant of health in Hispanics/Latinos. Having both low perceived neighborhood walkability and high racial discrimination stress may exacerbate the chronic disease status of Hispanics/Latinos. Among a U.S. national sample of Hispanic/Latino adults, this cross-sectional study aims to examine (1) the associations among overall perceived neighborhood walkability, racial discrimination stress, and having a chronic health condition; and (2) whether overall perceived neighborhood walkability moderates the hypothesized association between racial discrimination stress and having a chronic health condition. Methods: In January 2018, 798 Hispanic/Latino adults (M age = 39.7 years, SD = 15.1; 58.6% female; 70.0% U.S. born; 52.0% Mexican/Mexican American) responded to a survey via Qualtrics Panels. Surveys included the Neighborhood Environment Walkability Scale-Abbreviated, Hispanic Stress Inventory-2, and self-reported presence/absence of chronic health conditions (e.g., hypertension, heart disease). A logistic regression was conducted testing for the moderation of the main effect of racial discrimination stress on the presence of a chronic health condition by overall perceived neighborhood walkability. Results: After controlling for age, body mass index, and income, racial discrimination stress was inversely associated with overall perceived neighborhood walkability (b = -0.18, p < 0.001) and positively associated with having a chronic health condition (OR = 1.02; 95% CI [1.00, 1.03]). While overall perceived neighborhood walkability was not associated with having a chronic health condition, perceived crime safety was inversely associated with having a chronic health condition (OR = 0.94; 95% CI [0.89, 0.99]). Perceived crime safety moderated the positive association between discrimination stress and having a chronic health condition, such that the association was only significant among those who perceived their neighborhood to be less safe (β = -0.004, 95% CI [-0.01, -0.00]). Conclusions: Overall perceived neighborhood walkability was inversely associated with racial discrimination stress, but not associated with having a chronic health condition. Perceived neighborhood crime safety, but not infrastructure or aesthetics, matters when it comes to the link between racial discrimination stress and having a chronic health condition among Hispanics/Latinos.
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Affiliation(s)
- Elizabeth L. Budd
- Counseling Psychology and Human Services, College of Education, University of Oregon, Eugene, OR, United States
- Prevention Science Institute, University of Oregon, Eugene, OR, United States
| | - Nicole R. Giuliani
- Prevention Science Institute, University of Oregon, Eugene, OR, United States
- Special Education and Clinical Sciences, College of Education, University of Oregon, Eugene, OR, United States
| | - Nichole R. Kelly
- Counseling Psychology and Human Services, College of Education, University of Oregon, Eugene, OR, United States
- Prevention Science Institute, University of Oregon, Eugene, OR, United States
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Christie CD, Consoli A, Ronksley PE, Vena JE, Friedenreich CM, McCormack GR. Associations between the built environment and physical activity among adults with low socio-economic status in Canada: a systematic review. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2021; 112:152-165. [PMID: 32833139 PMCID: PMC7851286 DOI: 10.17269/s41997-020-00364-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 06/08/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To synthesize literature on the associations between the built environment and physical activity among adults with low socio-economic status (SES) in Canada. METHODS Using a pre-specified study protocol (PROSPERO ID: CRD42019117894), we searched seven databases from inception to November 2018, for peer-reviewed quantitative studies that (1) included adults with low SES living in Canada and (2) estimated the association between self-reported or objectively measured built characteristics and self-reported or objectively measured physical activity. Study quality was assessed using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Findings were synthesized using a narrative approach. SYNTHESIS Of the 8338 citations identified by our search, seven studies met the inclusion criteria. Most studies included adults living in one province (Alberta, British Columbia, Ontario, or Quebec), with one study including a national sample. All studies were cross-sectional, and none controlled for residential self-selection. Sampling designs and data collection strategies were heterogeneous. Sample sizes ranged between 78 and 37,241 participants. Most studies measured SES using household income. Street connectivity, greenness, destination density, and walkability were positively associated with physical activity. Relative to the objectively measured built environment, associations between the self-reported built environment and physical activity were less consistent. Studies were of fair to good quality. CONCLUSION Findings suggest that the neighbourhood built environment is associated with physical activity among adults with low SES in Canada. More rigorous study designs are needed to determine whether or not the built environment and physical activity are causally related within this vulnerable population.
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Affiliation(s)
- Chelsea D Christie
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, TRW 3rd floor, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada.
| | - Anna Consoli
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, TRW 3rd floor, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada
| | - Paul E Ronksley
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, TRW 3rd floor, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada
| | - Jennifer E Vena
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, TRW 3rd floor, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada
- CancerControl Alberta, Alberta Health Services, Richmond Road Diagnostic and Treatment Centre, 1820 Richmond Road SW, Calgary, Alberta, T2T 5C7, Canada
| | - Christine M Friedenreich
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, TRW 3rd floor, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, 2210 2nd St SW, Calgary, Alberta, T2S 3C3, Canada
| | - Gavin R McCormack
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, TRW 3rd floor, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada
- School of Architecture, Planning and Landscape, University of Calgary, 2500 University Dr NW, Calgary, Alberta, T2N 4N1, Canada
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Steinmetz-Wood M, El-Geneidy A, Ross NA. Moving to policy-amenable options for built environment research: The role of micro-scale neighborhood environment in promoting walking. Health Place 2020; 66:102462. [PMID: 33120068 DOI: 10.1016/j.healthplace.2020.102462] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 09/28/2020] [Accepted: 10/02/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Altering micro-scale features of neighborhoods (e.g., the presence and condition of benches, sidewalks, trees, crossing signals, walking paths) could be a relatively cost-effective method of creating environments that are conducive to physical activity. The Virtual Systematic Tool for Evaluating Pedestrian Streetscapes (Virtual-STEPS) was created to virtually audit the microscale environment of cities using Google Street View (GSV). The objective of this study was to evaluate the collective influence of items from the Virtual-STEPS tool on walking outcomes (utilitarian walking and walking for leisure), while accounting for self-selection of walkers into walking-friendly neighborhoods. METHODS Adults (N = 1403) were recruited from Montreal and Toronto from neighborhoods stratified by their level of macro-scale walking-friendliness and walking rates. The micro-scale environment of 5% of street segments from the selected neighborhoods was audited using the Virtual-STEPS tool and a micro-scale environment score was assigned. The scores were then linked to each respondent from the survey. A multilevel logistic regression analysis was used to model the relationship between the micro-scale environment score and odds of both utilitarian walking (i.e., walking for purpose such as to go shopping or go to work or school) and walking for leisure for at least 150 min per week, while accounting for environmental and demographic covariates as well as self-selection. RESULTS Micro-scale neighborhood features were associated with elevated odds of walking for leisure (OR: 1.14, CI: 1.04-1.25). The association between micro-scale neighborhood features and walking for utilitarian purposes was, however, inconclusive (OR: 1.01, CI: 0.90-1.13). On the other hand, macro-scale walk-friendliness was associated with elevated odds of walking for utilitarian purposes (OR: 2.01, CI:1.42-2.84) and the association between macro-scale features and leisure walking was inconclusive (OR: 1.02, CI: 0.78-1.34). CONCLUSIONS Our results imply that micro-scale features of neighborhoods collectively promote leisure walking but not necessarily utilitarian walking, even after accounting for self-selection. In contrast, macro-scale features may collectively promote utilitarian walking, but not leisure walking. Micro scale features of neighborhoods fall within the budget of local jurisdictions and our results suggest that jurisdictions that improve micro-scale features may expect increased leisure walking in populations.
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Affiliation(s)
| | - Ahmed El-Geneidy
- School of Urban Planning, McGill University, 815 Rue Sherbrooke St W, Montreal, QC, H3A 0C2, Canada.
| | - Nancy A Ross
- Department of Geography, McGill University, 805 Sherbrooke St W, Montreal, QC, H3A 0B9, Canada.
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Molina-García J, Menescardi C, Estevan I, Martínez-Bello V, Queralt A. Neighborhood Built Environment and Socioeconomic Status are Associated with Active Commuting and Sedentary Behavior, but not with Leisure-Time Physical Activity, in University Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16173176. [PMID: 31480418 PMCID: PMC6747177 DOI: 10.3390/ijerph16173176] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 08/23/2019] [Accepted: 08/29/2019] [Indexed: 12/18/2022]
Abstract
The role of neighborhood characteristics in promoting physical activity and sedentary behaviors (SB) has not been extensively studied in university students. The study purpose was to analyze the associations of neighborhood built environment and neighborhood socioeconomic status (SES) with active commuting, leisure-time physical activity (LTPA), and SB among university students. This is a cross-sectional study of 308 undergraduate students from two urban universities in Valencia, Spain. Participants' residential neighborhoods were classified according to walkability and SES levels. Walkability was defined as an index of three built environment attributes (i.e., residential density, land-use mix, and street connectivity) based on geographical information system data. Active commuting to and from university (ACU), active commuting in the neighborhood, LTPA, and SB were evaluated through a questionnaire. Mixed model regression analyses were performed. There were no significant SES-walkability interactions for any of the outcomes analyzed. However, university students living in more walkable areas reported two more ACU trips per week compared to those living in less walkable neighborhoods (p < 0.01). University students living in lower-SES neighborhoods reported more ACU trips per week than those living in higher-SES neighborhoods (p < 0.05). Regarding LTPA, there were no significant SES or walkability main effects. Neighborhood SES was negatively related to active commuting in the neighborhood and to time spent in SB (all p < 0.05). Participants living in lower-SES neighborhoods reported more active commuting per week and had the highest average minutes spent in SB. This study highlights the relevance of assessing university's residential environment when active transportation and SB are analyzed.
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Affiliation(s)
- Javier Molina-García
- Department of Teaching of Musical, Visual and Corporal Expression, University of Valencia, Avda. dels Tarongers, 4, 46022 Valencia, Spain.
- AFIPS research group, University of Valencia, 46022 Valencia, Spain.
| | - Cristina Menescardi
- Department of Teaching of Musical, Visual and Corporal Expression, University of Valencia, Avda. dels Tarongers, 4, 46022 Valencia, Spain
- AFIPS research group, University of Valencia, 46022 Valencia, Spain
| | - Isaac Estevan
- Department of Teaching of Musical, Visual and Corporal Expression, University of Valencia, Avda. dels Tarongers, 4, 46022 Valencia, Spain
- AFIPS research group, University of Valencia, 46022 Valencia, Spain
| | - Vladimir Martínez-Bello
- Department of Teaching of Musical, Visual and Corporal Expression, University of Valencia, Avda. dels Tarongers, 4, 46022 Valencia, Spain
- COS research group, University of Valencia, 46022 Valencia, Spain
| | - Ana Queralt
- AFIPS research group, University of Valencia, 46022 Valencia, Spain
- Department of Nursing, University of Valencia, Jaume Roig, s/n, 46010 Valencia, Spain
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Abstract
BACKGROUND Recent studies have linked urban environmental factors and body mass index (BMI); however, such factors are often examined in isolation, ignoring correlations across exposures. METHODS Using data on Nurses' Health Study participants living in the Northeastern United States in 2006, we estimated associations between neighborhood walkability (a composite of population density, street connectivity, and business access), greenness (from satellite imagery), and ambient air pollution (from satellite-based spatiotemporally resolved PM2.5 predictions and weighted monthly average concentrations of NO2 from up to five nearest monitors) and self-reported BMI using generalized additive models, allowing for deviations from linearity using penalized splines. RESULTS Among 23,435 women aged 60-87 years, we observed nonlinear associations between walkability and BMI and between PM2.5 and BMI in single-exposure models adjusted for age, race, and individual- and area-level socioeconomic status. When modeling all exposures simultaneously, only the association between walkability and BMI remained nonlinear and nonmonotonic. Increasing walkability was associated with increasing BMI at lower levels of walkability (walkability index <1.8), while increasing walkability was linked to lower BMI in areas of higher walkability (walkability index >1.8). A 10 percentile increase in walkability, right above 1.8 was associated with a 0.84% decrease in log BMI. The relationship between walkability and BMI existed only among younger participants (<71 years old). CONCLUSIONS Neighborhood walkability was nonlinearly linked to lower BMI independent of air pollution and greenness. Our findings highlight the importance of accounting for nonlinear confounding by interrelated urban environmental factors when investigating associations between the environment and BMI.
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Integrating activity spaces in health research: Comparing the VERITAS activity space questionnaire with 7-day GPS tracking and prompted recall. Spat Spatiotemporal Epidemiol 2018; 25:1-9. [PMID: 29751887 DOI: 10.1016/j.sste.2017.12.003] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 12/06/2017] [Accepted: 12/22/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Accounting for daily mobility allows assessment of multiple exposure to environments. This study compares spatial data obtained (i) from an interactive map-based questionnaire on regular activity locations (VERITAS) and (ii) from GPS tracking. METHODS 234 participants of the RECORD GPS Study completed the VERITAS questionnaire and wore a GPS tracker for 7 days. Analyses illustrate the spatial match between both datasets. RESULTS For half of the sample, 85.5% of GPS data fell within 500 m of a VERITAS location. The median minimum distance between a VERITAS location and a GPS coordinate ranged from 0.4 m for home to slightly over 100 m for a recreational destination. CONCLUSIONS There is a spatial correspondence between destinations collected through VERITAS and 7-day GPS tracking. Both collection methods offer complementary ways to assess daily mobilities, useful to study environmental determinants of health and health inequities.
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Associations of Neighborhood Environmental Attributes with Walking in Japan: Moderating Effects of Area-Level Socioeconomic Status. J Urban Health 2017; 94:847-854. [PMID: 28900893 PMCID: PMC5722731 DOI: 10.1007/s11524-017-0199-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Several studies have examined how the associations of built environment attributes with walking behaviors may be moderated by socioeconomic status (SES). Such understanding is important to address socioeconomic inequalities in health through urban design initiatives. However, to date, there is no study examining the moderation effects of SES in the relationships of environmental attributes and walking in non-Western countries. The current study aims to examine associations of environmental attributes with walking behaviors among Japanese adults, and to test whether these associations were moderated by area-level SES. Data on walking were collected from Japanese adults using a nationwide Internet survey (N = 4605). Built environment measures including population density, street density, distance to the nearest public open space, and distance to the nearest commercial destination were calculated using geographic information systems software. An index of neighborhood deprivation was used as an area-level indicator of SES. Logistic regression models adjusted for clustering and sociodemographic variables were used. It was found that more residents in high SES areas walked for commuting, for errands, and for exercise compared with those who lived in low SES areas. When the whole sample was examined, all environmental attributes were associated with walking behaviors (except for street density not being associated with walking for exercise). Associations of environmental attributes with walking behaviors were moderated by area-level SES only in walking for exercise. Walking for exercise was associated with higher population density, higher street density (marginally significant), and shorter distance to the nearest commercial destination only in high SES areas. Our findings showed that the associations of these environmental attributes and walking behaviors were largely consistent across different SES levels. Therefore, urban design interventions focusing on low SES areas may help to reduce socioeconomic disparities in walking.
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Molina-García J, Queralt A, Adams MA, Conway TL, Sallis JF. Neighborhood built environment and socio-economic status in relation to multiple health outcomes in adolescents. Prev Med 2017; 105:88-94. [PMID: 28863871 DOI: 10.1016/j.ypmed.2017.08.026] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 08/19/2017] [Accepted: 08/27/2017] [Indexed: 12/01/2022]
Abstract
The study aim was to examine associations of neighborhood built environment and neighborhood socio-economic status (SES) with multiple physical activity (PA) behaviors, sedentary time, and obesity indicators among adolescents. Cross-sectional study of 325 adolescents aged 14-18years recruited from schools in Valencia, Spain. Participants' home neighborhoods were classified according to walkability and SES levels. Walkability was defined as an index of three built environment characteristics (i.e., residential density, land use mix, and street connectivity) based on geographic information system data. Moderate-vigorous PA (MVPA) and sedentary time were assessed using accelerometers. Active commuting to school, leisure-time PA, and time in specific sedentary activities were evaluated by questionnaire. Objectively measured weight and height were used to calculate body mass index, and percent body fat was analyzed by bioelectrical impedance. Data were collected in 2013-15. Mixed model regression analyses were performed. Analyses showed an SES-by-walkability interaction for MVPA on weekends. MVPA was highest in high-SES/high-walkable neighborhoods. Another SES-by-walkability interaction was found for sedentary minutes per weekend day. The lowest average sedentary minutes were found in high-SES/high-walkable areas. Neighborhood SES was positively related to participation in sports teams/PA classes and, negatively to time spent in sedentary behaviors. Adolescents living in lower-SES neighborhoods spent more time watching TV and had more obesity and body fat. Present findings strengthen the rationale for targeting neighborhood built and SES environments as health promotion interventions for adolescents.
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Affiliation(s)
- Javier Molina-García
- Department of Teaching of Musical, Visual and Corporal Expression, University of Valencia, Avda. dels Tarongers, 4, 46022, Valencia, Spain; AFIPS Research Group, University of Valencia, Valencia, Spain.
| | - Ana Queralt
- AFIPS Research Group, University of Valencia, Valencia, Spain; Department of Nursing, University of Valencia, Jaume Roig, s/n, 46010, Valencia, Spain.
| | - Marc A Adams
- Exercise Science and Health Promotion, School of Nutrition and Health Promotion, Arizona State University, 500 N Third St, Mail Code 3020, Phoenix, AZ 85004, USA.
| | - Terry L Conway
- Department of Family Medicine and Public Health, School of Medicine, University of California, San Diego, CA 92093, USA.
| | - James F Sallis
- Department of Family Medicine and Public Health, School of Medicine, University of California, San Diego, CA 92093, USA.
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Neighborhood Built Environment and Socioeconomic Status in Relation to Active Commuting to School in Children. J Phys Act Health 2017; 14:761-765. [DOI: 10.1123/jpah.2017-0033] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background:The role of neighborhood type in active commuting to school (ACS) has not been extensively studied in children. The purpose of this study was to analyze the association between neighborhood built environment (walkability) and neighborhood socioeconomic status (SES) with ACS among children.Methods:A cross-sectional study of 310 Spanish children (aged 10–12 y; 51% male) was conducted in 2015. Walkability was defined as an index of 3 built environment characteristics (ie, residential density, land-use mix, and street connectivity) based on geographical information system data. Children’s home and school neighborhoods were evaluated. ACS was evaluated by questionnaire. Mixed model regression analyses evaluated ACS in relation to neighborhood walkability and SES.Results:There were no significant SES–walkability interactions for ACS. Children living in more walkable neighborhoods reported 2.5 more trips per week compared with those living in less walkable neighborhoods (P < .001). Children attending schools located in lower SES neighborhoods reported more ACS trips per week than those attending schools in higher SES neighborhoods (P < .05).Conclusions:Home-neighborhood walkability and school-neighborhood SES were associated with ACS. This study highlights the importance of assessing children’s home environment and school environment when ACS behavior is analyzed.
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“Contextualizing Context”: Reconciling Environmental Exposures, Social Networks, and Location Preferences in Health Research. Curr Environ Health Rep 2017; 4:51-60. [DOI: 10.1007/s40572-017-0121-8] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Adkins A, Makarewicz C, Scanze M, Ingram M, Luhr G. Contextualizing Walkability: Do Relationships Between Built Environments and Walking Vary by Socioeconomic Context? JOURNAL OF THE AMERICAN PLANNING ASSOCIATION. AMERICAN PLANNING ASSOCIATION 2017; 83:296-314. [PMID: 31762526 PMCID: PMC6873812 DOI: 10.1080/01944363.2017.1322527] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
PROBLEM RESEARCH STRATEGY AND FINDINGS Supportive built environments for walking are linked to higher rates of walking and physical activity, but little is known about this relationship for socioeconomically disadvantaged (e.g., low-income and racial/ethnic minority) populations. We review 17 articles and find that most show that the built environment has weaker effects on walking and physical activity for disadvantaged than advantaged groups. Those who lived in supportive built environments walked more and were more physically active than those who did not, but the effect was about twice as large for advantaged groups. We see this difference because disadvantaged groups walked more in unsupportive built environments and less in supportive built environments, though the latter appears more influential. TAKEAWAY FOR PRACTICE Defining walkability entirely in built environment terms may fail to account for important social and individual/household characteristics and other non-built environment factors that challenge disadvantaged groups, including fear of crime and lack of social support. Planners must be sensitive to these findings and to community concerns about gentrification and displacement in the face of planned built environment improvements that may benefit more advantaged populations. We recommend five planning responses: Recognize that the effects of the built environment may vary by socioeconomics; use holistic approaches to improve walkability; expand walkability definitions to address a range of social and physical barriers; partner across agencies, disciplines, and professions; and evaluate interventions in different socioeconomic environments.
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Affiliation(s)
- Arlie Adkins
- Arlie Adkins is an assistant professor of planning in the School of Landscape Architecture and Planning at the University of Arizona. Carrie Makarewicz is an assistant professor in the College of Architecture and Planning at the University of Colorado, Denver. Michele Scanze is a recent graduate of the planning master's program at the University of Arizona. Maia Ingram is the codirector of the Arizona Prevention Research Center at the University of Arizona. Gretchen Luhr is a research associate at the Institute on Aging at Portland State University
| | - Carrie Makarewicz
- Arlie Adkins is an assistant professor of planning in the School of Landscape Architecture and Planning at the University of Arizona. Carrie Makarewicz is an assistant professor in the College of Architecture and Planning at the University of Colorado, Denver. Michele Scanze is a recent graduate of the planning master's program at the University of Arizona. Maia Ingram is the codirector of the Arizona Prevention Research Center at the University of Arizona. Gretchen Luhr is a research associate at the Institute on Aging at Portland State University
| | - Michele Scanze
- Arlie Adkins is an assistant professor of planning in the School of Landscape Architecture and Planning at the University of Arizona. Carrie Makarewicz is an assistant professor in the College of Architecture and Planning at the University of Colorado, Denver. Michele Scanze is a recent graduate of the planning master's program at the University of Arizona. Maia Ingram is the codirector of the Arizona Prevention Research Center at the University of Arizona. Gretchen Luhr is a research associate at the Institute on Aging at Portland State University
| | - Maia Ingram
- Arlie Adkins is an assistant professor of planning in the School of Landscape Architecture and Planning at the University of Arizona. Carrie Makarewicz is an assistant professor in the College of Architecture and Planning at the University of Colorado, Denver. Michele Scanze is a recent graduate of the planning master's program at the University of Arizona. Maia Ingram is the codirector of the Arizona Prevention Research Center at the University of Arizona. Gretchen Luhr is a research associate at the Institute on Aging at Portland State University
| | - Gretchen Luhr
- Arlie Adkins is an assistant professor of planning in the School of Landscape Architecture and Planning at the University of Arizona. Carrie Makarewicz is an assistant professor in the College of Architecture and Planning at the University of Colorado, Denver. Michele Scanze is a recent graduate of the planning master's program at the University of Arizona. Maia Ingram is the codirector of the Arizona Prevention Research Center at the University of Arizona. Gretchen Luhr is a research associate at the Institute on Aging at Portland State University
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Demoury C, Thierry B, Richard H, Sigler B, Kestens Y, Parent ME. Residential greenness and risk of prostate cancer: A case-control study in Montreal, Canada. ENVIRONMENT INTERNATIONAL 2017; 98:129-136. [PMID: 27823799 DOI: 10.1016/j.envint.2016.10.024] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 10/27/2016] [Accepted: 10/27/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Recent studies suggest that exposure to greenness favors several health outcomes. We assessed whether living in the proximity of greener areas was related to prostate cancer incidence in a population-based case-control study in Montreal, Canada. MATERIALS AND METHODS Interviews eliciting lifetime addresses were conducted with 1933 prostate cancer cases diagnosed in 2005-2009 and 1994 population controls. Odds ratios (OR) and 95% confidence intervals (CI) estimated the association between residential greenness, both at recruitment (2005-2009) and about ten years prior (1996), defined by the normalized difference vegetation index (NDVI) around the home, and prostate cancer risk. Three models were developed adjusting for age, individual characteristics, and individual and ecological characteristics, estimating relative risk in relation to an interquartile range (IQR) increase of the NDVI. RESULTS We observed inverse associations between greenness measured within home buffers of 150m, 300m, 500m and 1000m, at both time points, and risk of prostate cancer, independently of individual and ecological characteristics. For instance, using a buffer of 300m, the OR for an IQR increase of 0.11 in NDVI at the time of recruitment was 0.82 (95%CI 0.74-0.92). The corresponding OR for an IQR increase of 0.15 in NDVI in 1996 was 0.86 (95%CI 0.74-1.00). There were little differences in risks according to buffer size, the time point of exposure, when considering prostate cancer aggressiveness, or when restricting controls to men recently screened for prostate cancer to reduce the likelihood of undiagnosed cancer among them. CONCLUSION Men living in greener areas, either recently or about a decade earlier, had lower risks of prostate cancer, independently of socio-demographic and lifestyle factors. These observations are novel and require confirmation.
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Affiliation(s)
- Claire Demoury
- Epidemiology and Biostatistics Unit, INRS-Institut Armand-Frappier, Institut national de la recherche scientifique, Université du Québec, Laval, Québec, Canada.
| | - Benoît Thierry
- University of Montreal Hospital Research Centre (CRCHUM), Montréal, Québec, Canada.
| | - Hugues Richard
- Epidemiology and Biostatistics Unit, INRS-Institut Armand-Frappier, Institut national de la recherche scientifique, Université du Québec, Laval, Québec, Canada.
| | - Brittany Sigler
- Epidemiology and Biostatistics Unit, INRS-Institut Armand-Frappier, Institut national de la recherche scientifique, Université du Québec, Laval, Québec, Canada.
| | - Yan Kestens
- University of Montreal Hospital Research Centre (CRCHUM), Montréal, Québec, Canada; School of Public Health, Department of Social and Preventive Medicine, Université de Montréal, Montréal, Québec, Canada.
| | - Marie-Elise Parent
- Epidemiology and Biostatistics Unit, INRS-Institut Armand-Frappier, Institut national de la recherche scientifique, Université du Québec, Laval, Québec, Canada; University of Montreal Hospital Research Centre (CRCHUM), Montréal, Québec, Canada; School of Public Health, Department of Social and Preventive Medicine, Université de Montréal, Montréal, Québec, Canada.
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