1
|
Zuo W, Cheng B, Feng X, Zhuang X. Relationship between urban green space and mental health in older adults: mediating role of relative deprivation, physical activity, and social trust. Front Public Health 2024; 12:1442560. [PMID: 39267636 PMCID: PMC11390600 DOI: 10.3389/fpubh.2024.1442560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2024] [Accepted: 08/12/2024] [Indexed: 09/15/2024] Open
Abstract
Introduction The importance of improving older adults' mental health is increasing worldwide with the rapid development of the aging process. Green space is an important part of the urban built environment, demonstrates a deep connection with the mental health of older adults, and its internal mechanisms have been widely studied. This study analyzed the influence of urban green spaces on the mental health of older adults via three factors: relative deprivation, physical activity, and social trust. Methods Based on the 2018 China Labor Dynamics Survey, a multi-level structural equation model was used to explore the mediating roles of relative deprivation, physical activity, social trust in urban green spaces, and the mental health of older adults. Results Urban green space was positively correlated with the mental health of older adults. Relative deprivation and physical activities played a mediating role between urban green space and the mental health of older adults. Discussion An increase in urban green spaces can help increase the number of older adults obtaining green space resources, and help them maintain good mental health. Secondly, older adults with a relatively homogeneous environment have more equal opportunities to obtain urban green space resources, which helps to reduce the comparison of older adults in access to green space resources and reduce the adverse impact of relative deprivation on their mental health. Additionally, increasing urban green spaces can encourage older adults to engage in physical activities and improve their mental health. Finally, we suggest improving the accessibility, fairness, and quality of green spaces, paying attention to the psychological needs of older adults, encouraging older adults to engage in physical activities in green spaces, and taking various measures to enhance the positive role of green space on the mental health of older adults.
Collapse
Affiliation(s)
- Wen Zuo
- School of Architecture and Urban Planning, Guangdong University of Technology, Guangzhou, China
| | - Bin Cheng
- School of Architecture and Urban Planning, Guangdong University of Technology, Guangzhou, China
| | - Xinyan Feng
- School of Business, Macau University of Science and Technology, Taipa, Macao SAR, China
| | - Xuefang Zhuang
- School of Architecture and Urban Planning, Guangdong University of Technology, Guangzhou, China
| |
Collapse
|
2
|
Zhu G. The effect of outdoor activities on the medical expenditure of older people: multiple chain mediating effects of health benefits. BMC Public Health 2024; 24:1227. [PMID: 38702631 PMCID: PMC11069142 DOI: 10.1186/s12889-024-18719-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 04/25/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND With the global aging population, attention to the health and medical issues of older adults is increasing. By analyzing the relationship between older people's participation in outdoor activities and medical expenditure, this study aims to provide a scientific basis for improving their quality of life and reducing the medical burden. METHODS Data on outdoor activity participation, medical expenditures, and relevant variables were collected through questionnaires and databases. A multi-chain mediation effect model was established to analyze the impact of outdoor activities on the medical expenditure of older people, considering mediation effects and heterogeneity. RESULTS Results revealed that increased participation in outdoor activities among older adults correlated with lower medical expenditures. Outdoor activities positively influenced their health by improving mental health, cognition, eating habits, and activities of daily living, resulting in reduced medical expenditures. Robustness tests confirmed the consistent effect of outdoor activities on older people's medical expenditure. CONCLUSION These findings contribute to understanding the relationship between outdoor activities, health, and medical expenditure in older people, guiding policy formulation and interventions. Encouraging and supporting older adults in outdoor activities can enhance their quality of life and alleviate medical resource strain. The study's conclusions can also inform health promotion measures for other populations and serve as a basis for future research in this area.
Collapse
Affiliation(s)
- Ge Zhu
- School of Economics, Trade and Management, Gansu University of Chinese Medicine, Lanzhou, Gansu, China.
| |
Collapse
|
3
|
Sharifi Y, Sobhani S, Ramezanghorbani N, Payab M, Ghoreshi B, Djalalinia S, Nouri Ghonbalani Z, Ebrahimpur M, Eslami M, Qorbani M. Association of greenspaces exposure with cardiometabolic risk factors: a systematic review and meta-analysis. BMC Cardiovasc Disord 2024; 24:170. [PMID: 38509487 PMCID: PMC10953288 DOI: 10.1186/s12872-024-03830-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 03/05/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Cardiometabolic conditions are major contributors to the global burden of disease. An emerging body of evidence has associated access to and surrounding public open spaces (POS) and greenspace with cardiometabolic risk factors, including obesity, body mass index (BMI), hypertension (HTN), blood glucose (BG), and lipid profiles. This systematic review aimed to synthesize this evidence. METHODS This systematic review was conducted based on the PRISMA guidelines. Four electronic databases including Web of Science, PubMed, Scopus, and Google Scholar were searched for eligible articles published until July 2023. All observational studies which assessed the association of greenspace and POS with cardiometabolic risk factors including obesity, BMI, HTN, BG, and lipid profiles were included and reviewed by two authors independently. Heterogeneity between studies was assessed using the I2 index and Cochrane's Q test. Random/fixed effect meta-analyses were used to combine the association between greenspace exposure with cardiometabolic risk factors. RESULTS Overall, 118 relevant articles were included in our review. The majority of the articles were conducted in North America or Europe. In qualitative synthesis, access or proximity to greenspaces or POS impacts BMI and blood pressure or HTN, BG, and lipid profiles via various mechanisms. According to the random effect meta-analysis, more access to greenspace was significantly associated with lower odds of HTN (odds ratio (OR): 0.81, 95% confidence intervals (CIs): 0.61-0.99), obesity (OR: 0.83, 95% CIs: 0.77-0.90), and diabetes (OR:0.79, 95% CI: 0.67,0.90). CONCLUSIONS Findings of this systematic review and meta-analysis suggested that greenspace accessibility is associated with some cardiometabolic risk factors. Improving greenspace accessibility could be considered as one of the main strategies to reduce cardiometabolic risk factors at population level.
Collapse
Affiliation(s)
- Yasaman Sharifi
- Department of Radiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sahar Sobhani
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Nahid Ramezanghorbani
- Department of Development and Coordination Scientific Information and Publications, Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran
| | - Moloud Payab
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Behnaz Ghoreshi
- Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Shirin Djalalinia
- Development of Research & Technology Center, Ministry of Health and Medical Education, Tehran, Iran
| | - Zahra Nouri Ghonbalani
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Mahbube Ebrahimpur
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maysa Eslami
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.
| |
Collapse
|
4
|
Wang L, Md Sani N. The impact of outdoor blue spaces on the health of the elderly: A systematic review. Health Place 2024; 85:103168. [PMID: 38211359 DOI: 10.1016/j.healthplace.2023.103168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 12/06/2023] [Accepted: 12/11/2023] [Indexed: 01/13/2024]
Abstract
Research on natural health has identified the potential benefit of outdoor blue spaces for human health and wellbeing. However, the existing evidence has relatively limited attention to the elderly. This study aims to review the available evidence on outdoor blue spaces and health outcomes among older individuals and identify knowledge gaps. In accordance with the PRISMA guidelines, specific keywords were used to search for articles published in English from inception to October 2023. Five databases (Scopus, PubMed, Web of Science, CINAHL, and PsycINFO) were searched, and 22 studies were identified in this review. We classified articles based on elderly health as general health (e.g., self-reported, perceived health and wellbeing), physical health (e.g., physical activity, physical function index), and mental health and wellbeing (e.g., depression). The findings indicated a positive correlation between outdoor blue space and the health of the elderly. In terms of the characteristics of exposure to outdoor blue spaces, direct contact (e.g., sensory-based) has not been well documented compared to indirect contact (e.g., distance, percentage, region-based). Although encouraging, the available body of evidence is limited and lacks consistency. Future research is needed to provide complementary evidence between outdoor blue spaces and elderly health.
Collapse
Affiliation(s)
- Lixin Wang
- School of Housing, Building and Planning, Universiti Sains Malaysia, 11800, Pulau Pinang, Malaysia; Department of Life Sciences, Yuncheng University, Yuncheng, Shanxi, China.
| | - Norazmawati Md Sani
- School of Housing, Building and Planning, Universiti Sains Malaysia, 11800, Pulau Pinang, Malaysia
| |
Collapse
|
5
|
Xu J, Jing Y, Xu X, Zhang X, Liu Y, He H, Chen F, Liu Y. Spatial scale analysis for the relationships between the built environment and cardiovascular disease based on multi-source data. Health Place 2023; 83:103048. [PMID: 37348293 DOI: 10.1016/j.healthplace.2023.103048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 05/12/2023] [Accepted: 05/19/2023] [Indexed: 06/24/2023]
Abstract
To examine what built environment characteristics improve the health outcomes of human beings is always a hot issue. While a growing literature has analyzed the link between the built environment and health, few studies have investigated this relationship across different spatial scales. In this study, eighteen variables were selected from multi-source data and reduced to eight built environment attributes using principal component analysis. These attributes included socioeconomic deprivation, urban density, street walkability, land-use diversity, blue-green space, transportation convenience, ageing, and street insecurity. Multiscale geographically weighted regression was then employed to clarify how these attributes relate to cardiovascular disease at different scales. The results indicated that: (1) multiscale geographically weighted regression showed a better fit of the association between the built environment and cardiovascular diseases than other models (e.g., ordinary least squares and geographically weighted regression), and is thus an effective approach for multiscale analysis of the built environment and health associations; (2) built environment variables related to cardiovascular diseases can be divided into global variables with large scales (e.g., socioeconomic deprivation, street walkability, land-use diversity, blue-green space, transportation convenience, and ageing) and local variables with small scales (e.g., urban density and street insecurity); and (3) at specific spatial scales, global variables had trivial spatial variation across the area, while local variables showed significant gradients. These findings provide greater insight into the association between the built environment and lifestyle-related diseases in densely populated cities, emphasizing the significance of hierarchical and place-specific policy formation in health interventions.
Collapse
Affiliation(s)
- Jiwei Xu
- School of Resource and Environmental Sciences, Wuhan University, Wuhan, 430079, PR China
| | - Ying Jing
- Business School, Ningbo Institute of Technology, Zhejiang University, Ningbo, 315100, PR China
| | - Xinkun Xu
- Fujian Provincial Expressway Information Technology Company Limited, Fuzhou, 350000, PR China
| | - Xinyi Zhang
- School of Resource and Environmental Sciences, Wuhan University, Wuhan, 430079, PR China
| | - Yanfang Liu
- School of Resource and Environmental Sciences, Wuhan University, Wuhan, 430079, PR China; Key Laboratory of Geographic Information System of Ministry of Education, Wuhan University, Wuhan, 430079, PR China; Collaborative Innovation Center of Geospatial Technology, Wuhan University, Wuhan, 430079, PR China
| | - Huagui He
- Guangzhou Urban Planning & Design Survey Research Institute, Guangzhou, 510060, PR China
| | - Fei Chen
- Guangzhou Urban Planning & Design Survey Research Institute, Guangzhou, 510060, PR China
| | - Yaolin Liu
- School of Resource and Environmental Sciences, Wuhan University, Wuhan, 430079, PR China; Key Laboratory of Geographic Information System of Ministry of Education, Wuhan University, Wuhan, 430079, PR China; Collaborative Innovation Center of Geospatial Technology, Wuhan University, Wuhan, 430079, PR China.
| |
Collapse
|
6
|
Job S, Heales L, Obst S. Tides of Change-Barriers and Facilitators to Beach Accessibility for Older People and People with Disability: An Australian Community Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20095651. [PMID: 37174170 PMCID: PMC10178453 DOI: 10.3390/ijerph20095651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 04/06/2023] [Accepted: 04/20/2023] [Indexed: 05/15/2023]
Abstract
The beach is Australia's most popular recreational destination with participation in beach-based activities associated with a wide range of health and wellbeing benefits. Unfortunately, access to beach environments is not possible for many older people and people with a disability. The purpose of this study was to investigate the barriers and facilitators of beach accessibility using a framework that recognises the complex interconnections between blue space, accessibility, physical activity, and health and wellbeing. A 39-item anonymous online cross-sectional survey was developed and administered to explore the perspectives of older people and people with a disability regarding beach accessibility. In total, 350 people completed the survey (69% female, age range 2-90 years (mean = 52)). Disability was reported by 88% of respondents, with 77% requiring a community mobility aid. Two-thirds (68%) of respondents were unable to visit the beach as often as they wanted, with 45% unable to visit at all. The most frequently reported barriers to beach access included difficulty moving on soft sand (87%), no specialised mobility equipment (75%), and inaccessible lead-up pathways (81%). If beach access was improved, respondents reported they would visit the beach more often (85%), for longer (83%), and have an improved experience (91%). The most frequently reported facilitators to beach access were the presence of accessible lead-up pathways (90%), sand walkways (89%), and parking (87%). Older people and people with disability have limited beach access, primarily due to a lack of accessible equipment, excluding them from the wide range of health benefits associated with visiting the beach.
Collapse
Affiliation(s)
- Sasha Job
- School of Health, Medical and Applied Sciences, College of Health Sciences, Central Queensland University, Bundaberg, QLD 4670, Australia
| | - Luke Heales
- School of Health, Medical and Applied Sciences, College of Health Sciences, Central Queensland University, Rockhampton, QLD 4701, Australia
| | - Steven Obst
- School of Health, Medical and Applied Sciences, College of Health Sciences, Central Queensland University, Bundaberg, QLD 4670, Australia
| |
Collapse
|
7
|
Rausch Osthoff AK, Nast I, Niedermann K. Understanding beliefs related to physical activity in people living with axial Spondyloarthritis: a theory-informed qualitative study. BMC Rheumatol 2022; 6:40. [PMID: 35871641 PMCID: PMC9310396 DOI: 10.1186/s41927-022-00270-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 04/12/2022] [Indexed: 11/28/2022] Open
Abstract
Background People living with axial Spondyloarthrtis (axSpA) have an increased risk of cardiovascular diseases, which can be reduced by regular physical activity (PA) and its subset of cardiorespiratory training (CRT). To fulfil their crucial role in PA promotion, physiotherapists and other health professionals need to understand the beliefs that people living with axSpA possess concerning general PA and CRT. The aim of this study is to explore these behavioural, normative and control beliefs.
Methods A qualitative descriptive design approach was chosen. Five semi-structured focus group interviews with 24 individuals living with axSpA were performed. Data was analysed using structured thematic qualitative content analysis.
Results People with axSpA possessed multifaceted behavioural, normative and control beliefs concerning general PA and CRT. Behavioural beliefs revealed a positive attitude towards general PA, with participants mentioning numerous physical, psychological, and social benefits and only few risks. However, the conceptual difference between general PA and CRT, and the relevance of CRT, was unclear to some participants. Normative beliefs were expressed as the beliefs of significant others that influenced their motivation to comply with such beliefs, e.g. spouses, other people living with axSpA, rheumatologists. Regarding control beliefs, general PA and CRT were both mentioned as effective self-management strategies to control the disease. From experience, a high level of self-discipline, as well as technology, were shown to be useful.
Conclusions General PA is understood to be an important self-management strategy for people with axSpA and most participants build general PA into their daily routines. They believe that general PA beneficially impacts personal health and wellbeing. However, some participants are unaware of the difference between general PA and CRT and the important impact that this difference could have on their health. The consequences of CRT promotion for people living with axSpA should be the subject of further research. Supplementary Information The online version contains supplementary material available at 10.1186/s41927-022-00270-2.
Collapse
|
8
|
Molina-Martínez MÁ, Marsillas S, Sánchez-Román M, del Barrio E. Friendly Residential Environments and Subjective Well-Being in Older People with and without Help Needs. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15832. [PMID: 36497900 PMCID: PMC9741280 DOI: 10.3390/ijerph192315832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 11/14/2022] [Accepted: 11/17/2022] [Indexed: 06/17/2023]
Abstract
Previous studies have shown that friendly environments are associated with well-being and higher quality of life in older people. This study aimed to investigate the relationship between friendly environments and subjective well-being by segmenting the population according to the need for help in performing activities of daily living (ADLs) in a representative sample of people over 55 years of age in the Basque Country (Spain) (n = 2760). To determine the predictive power of friendliness on subjective well-being, two separate linear regression models were obtained according to the need for help in ADLs. The results obtained show a greater explanatory power of the model in the case of people who required help. However, in the case of people who do not need help, subjective health had a greater weight in the predictions. This paper's findings support the greater importance of the characteristics of the physical and social environment, as people's functional status worsens, with friendliness being an explanatory factor for people's well-being as they age and their dependency increases.
Collapse
Affiliation(s)
- María Ángeles Molina-Martínez
- Faculty of Psychology, Universidad Nacional de Educación a Distancia (UNED), 28040 Madrid, Spain
- ENCAGEn-CM R&D Programme, Faculty of Education and Psychology, Francisco de Vitoria University, 28223 Madrid, Spain
| | | | - María Sánchez-Román
- ENCAGEn-CM R&D Programme, Research Group on Ageing (GIE-CSIC), Institute of Economics, Geography and Demography (IEGD-CSIC), Spanish National Research Council (CSIC), 28037 Madrid, Spain
| | | |
Collapse
|
9
|
Badin L, Alibran É, Pothier K, Bailly N. Effects of equine-assisted interventions on older adults' health: A systematic review. Int J Nurs Sci 2022; 9:542-552. [PMID: 36285074 PMCID: PMC9587396 DOI: 10.1016/j.ijnss.2022.09.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 08/30/2022] [Accepted: 09/14/2022] [Indexed: 11/25/2022] Open
Abstract
Objective Equine-assisted interventions (EAI) can improve a variety of health problems in older adults and thus promote their well-being. This systematic review aimed to synthesize studies on EAI to understand better their effects on the health of older adults. Method A systematic search guided by the PRISMA 2020 approach was performed on specific databases: Medline (PubMed), EMBASE, PsycINFO, and Cochrane Library. Peer-reviewed articles published in the English language from inception to June 2022 were retrieved. Methodological quality was established using the modified version of the Downs and Black checklist. Results A total of 244 studies were retrieved, and 13 eligible studies were finally included. Three health domains were investigated: physical (balance, gait, and muscular strength), psychological (quality of life and cognitive assessment), and physiological (hormonal measures, cerebral and muscular activity). Among the eight studies investigating the physical dimension, four studies highlighted a positive effect of EAI on balance, four for gait, and three for strength. Regarding the three studies investigating the psychological dimension, two studies showed a positive effect of EAI on quality of life. Lastly, the four studies investigating the physiological dimensions all demonstrated a positive effect of EAI on hormonal measures and cerebral and muscular activity. Conclusion Nevertheless, this systematic review provides promising findings regarding the positive effects of EAI on physical, psychological, and physiological health in older adults. Research on EAI should therefore be pursued rigorously to promote this non-pharmacological intervention in an older adult population.
Collapse
Affiliation(s)
- Léa Badin
- University of Tours, EA 2114 PAVEA Laboratory, Tours, France
| | - Émilie Alibran
- University of Tours, EA 2114 PAVEA Laboratory, Tours, France
| | | | - Nathalie Bailly
- University of Tours, EA 2114 PAVEA Laboratory, Tours, France
| |
Collapse
|
10
|
Liu XX, Ma XL, Huang WZ, Luo YN, He CJ, Zhong XM, Dadvand P, Browning MHEM, Li L, Zou XG, Dong GH, Yang BY. Green space and cardiovascular disease: A systematic review with meta-analysis. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 301:118990. [PMID: 35181451 DOI: 10.1016/j.envpol.2022.118990] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 01/15/2022] [Accepted: 02/10/2022] [Indexed: 06/14/2023]
Abstract
Exposure to green space has been proposed to be beneficially associated with cardiovascular morbidity and mortality. Many studies have explored this topic, but the results remain conflicting. We aimed to evaluate the epidemiological evidence on this topic by performing a systematic review with meta-analysis. We searched PubMed, Web of Science and Embase for studies on the association between green space and cardiovascular disease (CVD) that were published till January 2022. Two authors independently performed study selection, data extraction, quality assessment, and risk of bias assessment. For studies providing detailed numeric data, we also conducted quantitative meta-analyses and calculated the pooled odd ratios (ORs) for associations between the most commonly used exposure estimate (normalized difference vegetative index [NDVI]) and five CVD events: CVD mortality, ischemic heart disease (IHD) mortality, cerebrovascular disease (CBVD) mortality, and stroke incidence/prevalence. Additional analyses were conducted to explore the geographical scale effects of NDVI. Publication bias tests were also conducted. Of the 6787 records identified, 53 studies were eligible for inclusion. These studies covered 18 countries and included data from more than 100 million persons. Meta-analyses showed that a 0.1 increase in NDVI was significantly associated with 2-3% lower odds of CVD mortality (OR: 0.97, 95% CI: 0.96-0.99), IHD mortality (OR: 0.98, 95% CI: 0.96-1.00), CBVD mortality (OR: 0.98, 95% CI: 0.97-1.00), and stroke incidence/prevalence (OR: 0.98, 95% CI: 0.96-0.99). There was no significant difference between the pooled estimates for different buffer sizes. No evidence of publication bias was detected. We provide strong and robust evidence for the beneficial effects of green space exposure on cardiovascular health. More prospective studies and mechanistic studies, especially that conducted in low- and middle-income countries, are merited to strengthen our conclusions.
Collapse
Affiliation(s)
- Xiao-Xuan Liu
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Xin-Li Ma
- Department of Public Health, The First People's Hospital of Kashi (the Affiliated Kashi Hospital of Sun Yat-Sen University), Kashi, China
| | - Wen-Zhong Huang
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Ya-Na Luo
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Chuan-Jiang He
- Department of Clinical Laboratory, The First People's Hospital of Kashi (the Affiliated Kashi Hospital of Sun Yat-Sen University), Kashi, China
| | - Xue-Mei Zhong
- Department of Respiratory and Critical Care Medicine, The First People's Hospital of Kashi (the Affiliated Kashi Hospital of Sun Yat-Sen University), Kashi, China
| | - Payam Dadvand
- ISGlobal, Dr. Aiguader 88, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Matthew H E M Browning
- Department of Park, Recreation, and Tourism Management, Clemson University, Clemson, SC, 29634, USA
| | - Li Li
- Department of Respiratory and Critical Care Medicine, The First People's Hospital of Kashi (the Affiliated Kashi Hospital of Sun Yat-Sen University), Kashi, China
| | - Xiao-Guang Zou
- Department of Respiratory and Critical Care Medicine, The First People's Hospital of Kashi (the Affiliated Kashi Hospital of Sun Yat-Sen University), Kashi, China
| | - Guang-Hui Dong
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Bo-Yi Yang
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China; Department of Gynecology and Obstetrics, The First People's Hospital of Kashi Prefecture (the Affiliated Kashi Hospital of Sun Yat-Sen University), Kashi, 844000, China.
| |
Collapse
|
11
|
Zhang L, Luo Y, Zhang Y, Pan X, Zhao D, Wang Q. Green Space, Air Pollution, Weather, and Cognitive Function in Middle and Old Age in China. Front Public Health 2022; 10:871104. [PMID: 35586008 PMCID: PMC9108722 DOI: 10.3389/fpubh.2022.871104] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 03/09/2022] [Indexed: 11/13/2022] Open
Abstract
Prior research has shown that environmental hazards, such as limited green space, air pollution, and harmful weather, have the strong adverse impact on older adults' cognitive function; however, most of the studies were conducted in developed countries and limited to cross-sectional analyses. China has the largest aging population in the world so the research evidence from it can offer an insight to the study in other developing countries facing similar issues and inform future public health policy and disease control. This study examined the long-term impact of environmental factors, namely, green space coverage, air pollution, and weather conditions on cognitive function using a nationally representative sample consisting of adults aged 45 years and older selected from the China Health and Retirement Longitudinal Study (CHARLS 2011–2018), the China City Statistical Yearbook, and other sources. Multilevel growth curve models were utilized for analysis and the mediator effects of physical activity and social engagement on the relationship between environmental factors and cognitive function were examined. Findings of this study showed that after controlling for sociodemographic characteristics, annual precipitation of 80 cm or more, living in areas with July temperature of 28°C or higher, urban community, and green space coverage were positively associated with cognition score at the baseline and lower precipitation, urban community, and greater green space coverage were associated with slower cognitive decline over a 7-year period. The impact of gross domestic product (GDP) seemed to take into effect more and more over time. These effects did not substantially change after weekly total hours of physical activities and levels of social engagement were added. More research on the mechanisms of the effect of environmental factors on cognition is needed such as the subgroup analyses and/or with more aspects of environmental measures.
Collapse
Affiliation(s)
- Lingling Zhang
- Department of Nursing, University of Massachusetts Boston, Boston, MA, United States
| | - Ye Luo
- Department of Sociology, Anthropology and Criminal Justice, Clemson University, Clemson, SC, United States
- *Correspondence: Ye Luo
| | - Yao Zhang
- Department of Nursing, University of Massachusetts Boston, Boston, MA, United States
| | - Xi Pan
- Department of Sociology, Texas State University, San Marcos, TX, United States
| | - Dandan Zhao
- Department of Sociology, Anthropology and Criminal Justice, Clemson University, Clemson, SC, United States
| | - Qing Wang
- Department of Biostatistics, Shandong University, Jinan, China
| |
Collapse
|
12
|
Sun Y, Lin W, Li Y, Xu D. Dust deposition on vegetation leaves in Shanghai, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2021; 31:1001-1014. [PMID: 31941370 DOI: 10.1080/09603123.2020.1714559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 01/08/2020] [Indexed: 06/10/2023]
Abstract
Urban vegetation can deposit dust to reduce pollution, and dust retention capacity of vegetation has become an important indicator for urban ecological construction. We selected five representative vegetation in Shanghai to explore the regularity of dust deposition on vegetation leaves. Due to the influence of leaf area and surface characteristics, the amount of dust deposition was significantly different to each vegetation; Vegetation shows different dust retention capacity under different pollution intensity, before this capacity reaches its limit, and it will increase with the increase of dust content in the environment; Furthermore, water content of leaves was an important factor affecting dust retention capacity by vegetation. There was a linear positive correlation between the two variables. Our work suggests that the dust retention capacity of vegetation leaves was affected by various factors, but it showed certain regularity, which can provide a scientific basis for the configuration of urban green plant species.
Collapse
Affiliation(s)
- Yue Sun
- School of Environmental and Geographical Sciences, Shanghai Normal University, Shanghai, P.R. China
| | - Wenpeng Lin
- School of Environmental and Geographical Sciences, Shanghai Normal University, Shanghai, P.R. China
| | - Yuan Li
- College of Life Sciences, Shanghai Normal University, Shanghai, P.R. China
| | - Dan Xu
- College of Life Sciences, Shanghai Normal University, Shanghai, P.R. China
| |
Collapse
|
13
|
Zhang X, Zhang Y, Zhai J, Wu Y, Mao A. Waterscapes for Promoting Mental Health in the General Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11792. [PMID: 34831547 PMCID: PMC8618438 DOI: 10.3390/ijerph182211792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 11/06/2021] [Accepted: 11/08/2021] [Indexed: 11/17/2022]
Abstract
The WHO estimates that, with the development of urbanization, 25% of the population is suffering from psychological and mental distress. Preliminary evidence has suggested that aquatic environments and riparian areas, i.e., waterscapes, can benefit psychological and mental wellbeing. The aim of this study was to identify the processes of waterscape psychological and mental health promotion through aliterature review. We propose a design framework of waterscapes for achieving psychological and mental health in the general population that often visits waterscapes, which has the function of therapeutic landscapes through values of accessibility, versatility, habitats, and biodiversity. According to theories, waterscapes can improve psychological and mental health to divert negative emotions through mitigation (e.g., reduced urban heat island), instoration (e.g., physical activity and state of nature connectedness), and restoration (e.g., reduced anxiety/attentional fatigue). By accessing water (e.g., streams, rivers, lakes, wetlands, and the coast) and riparian areas, people can get in close contact with nature and spend more time in activities (e.g., walking, exploring, talking, and relaxing). Waterscapes with healing effects can enhance psychological resilience to promote people's psychological and mental health. Future research should focus on ensuring an adequate supply of waterscapes and promoting the efficiency of waterscape ecosystem services on mental health. Moreover, fora deep understanding of the complexity of nature-human health associations, it is necessary to explore more consistent evidence for therapeutic waterscapes considering the characteristics and functional mechanisms of waterscape quality, in terms of freshness, luminescence, rippling or fluidity, and cultural value, to benefit public health and biodiversity conservation.
Collapse
Affiliation(s)
- Xindi Zhang
- Department of Landscape Architecture, Gold Mantis School of Architecture, Soochow University, Suzhou 215123, China; (X.Z.); (J.Z.); (A.M.)
| | - Yixin Zhang
- Department of Landscape Architecture, Gold Mantis School of Architecture, Soochow University, Suzhou 215123, China; (X.Z.); (J.Z.); (A.M.)
- China-Portugal Belt and Road Cooperation Laboratory of Cultural Heritage Conservation Science, Research Center of Landscape Protection and Ecological Restoration, Soochow University, Suzhou 215123, China;
- Collaborative Innovation Center of Architecture and Urban Environment of Soochow University-Suzhou Yuanke, Soochow University, Suzhou 215123, China
| | - Jun Zhai
- Department of Landscape Architecture, Gold Mantis School of Architecture, Soochow University, Suzhou 215123, China; (X.Z.); (J.Z.); (A.M.)
- Collaborative Innovation Center of Architecture and Urban Environment of Soochow University-Suzhou Yuanke, Soochow University, Suzhou 215123, China
| | - Yongfa Wu
- China-Portugal Belt and Road Cooperation Laboratory of Cultural Heritage Conservation Science, Research Center of Landscape Protection and Ecological Restoration, Soochow University, Suzhou 215123, China;
- Collaborative Innovation Center of Architecture and Urban Environment of Soochow University-Suzhou Yuanke, Soochow University, Suzhou 215123, China
| | - Anyuan Mao
- Department of Landscape Architecture, Gold Mantis School of Architecture, Soochow University, Suzhou 215123, China; (X.Z.); (J.Z.); (A.M.)
- Collaborative Innovation Center of Architecture and Urban Environment of Soochow University-Suzhou Yuanke, Soochow University, Suzhou 215123, China
| |
Collapse
|
14
|
How Does Urban Green Space Impact Residents' Mental Health: A Literature Review of Mediators. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182211746. [PMID: 34831512 PMCID: PMC8621109 DOI: 10.3390/ijerph182211746] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 11/05/2021] [Indexed: 11/17/2022]
Abstract
In recent years, the interest in the relationship between urban green space and residents’ mental health has gradually risen. A number of researchers have investigated the causal relationship and possible mediators between the two, although few have summarized these mediators. For this reason, we searched for relevant studies and filtered them by criteria and quality score, and analyzed the mediators and paths of the impact of urban green space on residents’ mental health. The mediators can be divided into environmental factors, outdoor activity, and social cohesion. From the perspective of heterogeneity, both individual characteristics (e.g., age and gender) and group characteristics (e.g., level of urban development and urban density) of residents are considered to be the cause of various mediating effects. Types of urban green space tend to affect residents’ mental health through different paths. Furthermore, this review discusses the details of each part under the influence paths. Finally, the policy implications for urban green space planning from three mediator levels are put forward based on an analysis of the situation in different countries.
Collapse
|
15
|
Pathak N, McKinney A. Planetary Health, Climate Change, and Lifestyle Medicine: Threats and Opportunities. Am J Lifestyle Med 2021; 15:541-552. [PMID: 34646104 PMCID: PMC8504332 DOI: 10.1177/15598276211008127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Global environmental degradation and climate change threaten the foundation of human health and well-being. In a confluence of crises, the accelerating pace of climate change and other environmental disruptions pose an additional, preventable danger to a global population that is both aging and carrying a growing burden of noncommunicable diseases (NCDs). Climate change and environmental disruption function as "threat multipliers," especially for those with NCDs, worsening the potential health impacts on those with suboptimal health. At the same time, these environmental factors threaten the basic pillars of health and prevention, increasing the risk of developing chronic disease. In the face of these threats, the core competencies of lifestyle medicine (LM) present crucial opportunities to mitigate climate change and human health impacts while also allowing individuals and communities to build resilience. LM health professionals are uniquely positioned to coach patients toward climate-healthy behavior changes that heal both people and the planet.
Collapse
Affiliation(s)
- Neha Pathak
- American College of Lifestyle Medicine, Global Sustainability Committee, Atlanta, Georgia
| | - Amanda McKinney
- Institute for Human and Planetary Health-Doane University, Crete, Nebraska
| |
Collapse
|
16
|
Yuan Y, Huang F, Lin F, Zhu P, Zhu P. Green space exposure on mortality and cardiovascular outcomes in older adults: a systematic review and meta-analysis of observational studies. Aging Clin Exp Res 2021; 33:1783-1797. [PMID: 32951189 DOI: 10.1007/s40520-020-01710-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 09/03/2020] [Indexed: 01/11/2023]
Abstract
BACKGROUND With the launch of the "Global Age-Friendly Cities project", increasing emphasis has been placed on the effects of green spaces on health in the elderly. The previous literature has shown that green spaces are beneficial to a range of health-related outcomes in adults. However, associations of greenness with mortality and cardiovascular outcomes are less certain, which may differ depending on the age class. This review aimed to synthesize current evidence from observational studies to assess relationships of green space exposure with mortality and cardiovascular outcomes in older individuals. METHODS Five databases were searched. Qualitative evaluation and meta-analyses of included studies were conducted. This review is registered with PROSPERO, CRD42020160366. RESULTS Of the 8,143 records identified, we finally included 22 studies. In a narrative systematic review, we observed that the majority of studies showed reductions in the risk of all-cause mortality and total cardiovascular disease. Further meta-analyses which included eight cohort studies, indicated that greater greenness exposure (per 0.1 unit increase of normalized difference vegetation index (NDVI)) was associated with a reduced risk of all-cause mortality (pooled hazard ratios (HR) (95% confidence interval (CI) = 0.99 (0.97, 1.00)) and stroke mortality (pooled HR (95% CI) = 0.77 (0.59, 1.00)) in older individuals. CONCLUSIONS This review supports increasing green space exposure in terms of the prevention of death and cardiovascular outcomes in older individuals. Effective measures to increase or preserve greenspaces should therefore be considered as important public health interventions.
Collapse
Affiliation(s)
- Yin Yuan
- The Shengli Clinical Medical College, Fujian Medical University, Fuzhou, China
- Department of Geriatric Medicine, Fujian Provincial Hospital, Fuzhou, China
- Fujian Provincial Institute of Clinical Geriatrics, Fuzhou, China
- Fujian Provincial Key Laboratory of Geriatrics, Fuzhou, China
| | - Feng Huang
- The Shengli Clinical Medical College, Fujian Medical University, Fuzhou, China
- Department of Geriatric Medicine, Fujian Provincial Hospital, Fuzhou, China
- Fujian Provincial Institute of Clinical Geriatrics, Fuzhou, China
- Fujian Provincial Key Laboratory of Geriatrics, Fuzhou, China
| | - Fan Lin
- The Shengli Clinical Medical College, Fujian Medical University, Fuzhou, China
- Department of Geriatric Medicine, Fujian Provincial Hospital, Fuzhou, China
- Fujian Provincial Institute of Clinical Geriatrics, Fuzhou, China
- Fujian Provincial Key Laboratory of Geriatrics, Fuzhou, China
| | - Pengyi Zhu
- School of Economics, Fujian Normal University, Fuzhou, China.
| | - Pengli Zhu
- The Shengli Clinical Medical College, Fujian Medical University, Fuzhou, China.
- Department of Geriatric Medicine, Fujian Provincial Hospital, Fuzhou, China.
- Fujian Provincial Institute of Clinical Geriatrics, Fuzhou, China.
- Fujian Provincial Key Laboratory of Geriatrics, Fuzhou, China.
| |
Collapse
|
17
|
Nawrath M, Guenat S, Elsey H, Dallimer M. Exploring uncharted territory: Do urban greenspaces support mental health in low- and middle-income countries? ENVIRONMENTAL RESEARCH 2021; 194:110625. [PMID: 33338487 DOI: 10.1016/j.envres.2020.110625] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 11/29/2020] [Accepted: 12/11/2020] [Indexed: 05/27/2023]
Abstract
Exposure to urban greenspaces promotes an array of mental health benefits. Understanding these benefits is of paramount importance, particularly in low- and middle-income countries (LMICs), where cities are expanding at an unprecedented rate. However, the existing evidence-base for the health benefits of greenspaces has a strong bias towards high-income countries. Here we systematically assess the emerging evidence regarding the mental health benefits provided by urban greenspaces in LMICs. We carried out a scoping review to assess the extent, type and quality of evidence investigating the relationship between greenspaces and mental health in LMICs. We systematically searched the literature databases Web of Science, Medline, Embase and CAB Abstracts using key terms related to greenspaces and mental health in LMICs. We analysed the resulting studies using a narrative synthesis approach, taking into account study quality, to assess the overall effects on mental health. 36 studies met the inclusion criteria and were included in the narrative synthesis. Studies were heterogeneous in design, study population, greenspace and mental health assessment. While more than 90% of LMICs remain unstudied, we found that eight out of ten studies using validated mental health screening tools detected positive associations between greenspaces and one or more mental health outcomes. These studies mostly took place in upper-middle-income countries. However, there still is a lack of evidence from regions with the highest levels of urbanisation, and only four studies assessed lower-middle and low-income countries. Furthermore, the analysis of mediating and moderating factors indicates that the relationship between greenspaces and mental health in LMICs is context dependent and needs to be assessed in relation to locally relevant environmental and cultural settings. Based on the evidence reviewed here, exposure to urban greenspaces can support multiple mental health outcomes in upper-middle-income countries. However, we still know little about poorer, rapidly urbanising countries. Our findings highlight the need for high-quality, context specific research in those urban areas with the highest levels of urbanisation, and the need to address specific challenges regarding mediating and moderating factors. Future studies should combine robust ecological assessments of greenspaces with validated mental health screening tools.
Collapse
Affiliation(s)
- Maximilian Nawrath
- Sustainability Research Institute, School of Earth and Environment, University of Leeds, Leeds, LS2 9JT, UK.
| | - Solène Guenat
- Sustainability Research Institute, School of Earth and Environment, University of Leeds, Leeds, LS2 9JT, UK.
| | - Helen Elsey
- Department of Health Sciences, University of York, York, YO10 5NG, UK.
| | - Martin Dallimer
- Sustainability Research Institute, School of Earth and Environment, University of Leeds, Leeds, LS2 9JT, UK.
| |
Collapse
|
18
|
Carreño A, Gascon M, Vert C, Lloret J. The Beneficial Effects of Short-Term Exposure to Scuba Diving on Human Mental Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17197238. [PMID: 33022983 PMCID: PMC7579011 DOI: 10.3390/ijerph17197238] [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: 07/17/2020] [Revised: 09/28/2020] [Accepted: 10/01/2020] [Indexed: 12/17/2022]
Abstract
Exposure to outdoor blue spaces can help improve human health by reducing stress, promoting social relationships, and physical activity. While most studies have focused on the adverse health effects of scuba diving, very few have assessed its health benefits. Moreover, when scuba diving is done in large groups with no diving instructor or pre-dive briefing, negative environmental impacts are generated and negative impacts on human health may also occur due to overcrowding, which may create stress. This is the first study to evaluate the effects of scuba diving on divers' mental health using their diving practices to estimate the impacts on the ecosystem. In the marine-protected area of Cap de Creus and adjacent areas, we assessed the mental health of 176 divers and 70 beach users (control group) by employing a 29-item version of Profile of Mood State (POMS) questionnaires. According to the parameters associated with reduced environmental impacts, two scuba diving experiences were established. Poisson regression models were performed to assess both the contribution of the activity and diving experiences to POMS scores. Both groups (scuba divers and beach goers) reduced their POMS scores after carrying out the activities. Although no significant differences were found between beach and scuba diving activities, nor between the two different scuba diving experiences, our results showed that subjects with regular medication intake due to a chronic or psychiatric illness had a POMS reduction score significantly higher than other subjects. We conclude that both beach and scuba diving activities have positive effects for human mental health, particularly among subjects with regular medication intake.
Collapse
Affiliation(s)
- Arnau Carreño
- Oceans & Human Health Chair, Institute of Aquatic Ecology, University of Girona, 17003 Girona, Spain;
- Correspondence: or
| | - Mireia Gascon
- ISGlobal (Global Health Institute Barcelona), Campus Mar, 08003 Barcelona, Spain; (M.G.); (C.V.)
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), 08003 Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - Cristina Vert
- ISGlobal (Global Health Institute Barcelona), Campus Mar, 08003 Barcelona, Spain; (M.G.); (C.V.)
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), 08003 Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - Josep Lloret
- Oceans & Human Health Chair, Institute of Aquatic Ecology, University of Girona, 17003 Girona, Spain;
| |
Collapse
|