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Qi W, Zhang H, Han Y, Chen W, Teng Y, Chatzidiakou L, Barratt B, Jones R, Kelly F, Zhu T, Zhang J, Ji JS. Short-term air pollution and greenness exposures on oxidative stress in urban and peri-urban residents in Beijing: A part of AIRLESS study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 951:175148. [PMID: 39089388 DOI: 10.1016/j.scitotenv.2024.175148] [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: 01/31/2024] [Revised: 07/08/2024] [Accepted: 07/28/2024] [Indexed: 08/04/2024]
Abstract
BACKGROUND Exposure to air pollution has been associated with increased risks of cardiopulmonary diseases, cancer, and mortality, whereas residing near green spaces may reduce the risks. However, limited research explores their combined effect on oxidative stress. METHODS A total of 251 participants with multi-time measurements were included in the longitudinal-designed study. Personal gaseous air pollutants (CO, NO, NO2, and O3,) and particulate pollution (PM1, PM2.5, and PM10) were measured and followed in two 7-day windows while ambient exposure levels and urine samples were collected simultaneously. Participants' Normalized Difference Vegetation Index (NDVI) was estimated and used to represent greenness exposure. Urinary oxidative stress biomarkers include free malondialdehyde (MDA), total MDA, and 8-hydroxydeoxyguanosine (8-OHdG). Linear mixed-effects models were used to independently and jointly estimate the associations of greenness and air pollution with oxidative stress biomarkers. RESULTS We found consistent positive associations of personal ozone (O3) exposure with 8-OHdG percent changes, and this association was modified by gender and outdoor activity frequency. Consistent positive associations of personal lag 2-day carbon monoxide (CO) exposure with the percent changes of the three oxidative stress biomarkers were significant. We additionally observed that individuals who lived in greener areas had lower levels of urinary-free and total MDA. Participants in the highest NDVI tertile had 0.38 and 0.46 lower free and total MDA levels, [95 % CI: (-0.70, -0.05) and (-0.78, -0.13)], compared to the lowest NDVI tertile. There was also evidence indicating the modification effects by area, education, and outdoor activity frequency on associations between NDVI exposure and creatinine adjusted free MDA (all Pfor interaction < 0.05). Additional greenness modification effects on personal O3 exposure with urinary 8-OHdG was observed. CONCLUSION Our study provides biological evidence of the modification effect of the built environment on the impact of air pollution.
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Affiliation(s)
- Wenhao Qi
- Global Health Research Center, Duke Kunshan University, Duke University, Kunshan, China; State Key Laboratory of Genetic Engineering, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, China
| | - Hanbin Zhang
- Environmental Research Group, MRC Centre for Environment and Health, Imperial College London, London, UK; European Centre for Environment and Human Health, University of Exeter Medical School, Penryn, Cornwall, UK
| | - Yiqun Han
- Environmental Research Group, MRC Centre for Environment and Health, Imperial College London, London, UK; BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing, China
| | - Wu Chen
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing, China
| | - Yanbo Teng
- Global Health Research Center, Duke Kunshan University, Duke University, Kunshan, China
| | - Lia Chatzidiakou
- Centre for Atmospheric Science, Department of Chemistry, University of Cambridge, Cambridge, UK
| | - Benjamin Barratt
- Environmental Research Group, MRC Centre for Environment and Health, Imperial College London, London, UK
| | - Rod Jones
- Centre for Atmospheric Science, Department of Chemistry, University of Cambridge, Cambridge, UK
| | - Frank Kelly
- Environmental Research Group, MRC Centre for Environment and Health, Imperial College London, London, UK
| | - Tong Zhu
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing, China
| | - Junfeng Zhang
- Global Health Research Center, Duke Kunshan University, Duke University, Kunshan, China; Nicholas School of the Environment, Duke University, Durham, NC, United States; Duke Global Health Institute, Duke University, Durham, NC, United States
| | - John S Ji
- Vanke School of Public Health, Tsinghua University, Beijing, China.
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Jin Y, Yu Z, Yang G, Yao X, Hu M, Remme RP, van Bodegom PM, Morpurgo J, Huang Y, Wang J, Cui S. Quantifying physiological health efficiency and benefit threshold of greenspace exposure in typical urban landscapes. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 362:124726. [PMID: 39173868 DOI: 10.1016/j.envpol.2024.124726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 08/11/2024] [Accepted: 08/12/2024] [Indexed: 08/24/2024]
Abstract
Although greenspace exposure has physiological health benefits, there is insufficient research on the threshold effect of health benefits in typical urban landscapes. Here we selected five typical urban landscapes (open greenspace, semi-closed greenspace, closed greenspace, bluespace, grey space) in 15 urban parks in Xiamen, China, and applied the physiological health threshold model to calculate the efficiency threshold and benefit threshold of greenspace exposure by continuously monitoring the changes of two physiological indicators-electroencephalography (EEG) and heart rate (HR). (1) The EEG threshold results show that compared with greenspace exposure, bluespace exposure can reach the physiological health efficiency threshold faster (4-5 min) but does not show an advantage in terms of benefit threshold. The more open the greenspace, the faster it can reach the efficiency threshold (5-6 min), but the higher the canopy density of the (closed) greenspace, the shorter the time to reach the efficiency threshold (8-9 min). (2) The HR threshold shows that bluespace and open greenspace are the fastest to reach the efficiency threshold (1 min), with the remaining greenspace reaching it after 6-7 min. The benefit threshold was reached faster in the bluespace (11 min) than in the greenspace (18-21 min), and the degree of openness of the greenspace has no significant effect on the speed of benefit thresholds. (3) Combining the results of EEG and HR thresholds, it can be seen that bluespace is better at reducing stress, while open greenspace can reach efficiency thresholds more quickly. This study confirms the physiological health threshold model, offering a reference for urban greenspace planning to enhance residents' stress management and health.
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Affiliation(s)
- Yuenan Jin
- Xiamen Key Lab of Urban Metabolism, Institute of Urban Environment, Chinses Academy of Sciences, Xiamen, 361021, China; College of JunCao Science and Ecology (College of Carbon Neutrality), Fujian Agriculture and Forestry University, Fuzhou, Fujian Province, 350002, China
| | - Zhaowu Yu
- Department of Environmental Science and Engineering, Fudan University, Shanghai, 200438, China.
| | - Gaoyuan Yang
- School of Environmental and Geographical Sciences, Shanghai Normal University, Shanghai, 200234, China
| | - Xihan Yao
- Department of Environmental Science and Engineering, Fudan University, Shanghai, 200438, China
| | - Mingming Hu
- Institute of Environmental Sciences, Leiden University, Leiden, the Netherlands
| | - R P Remme
- Institute of Environmental Sciences, Leiden University, Leiden, the Netherlands
| | - P M van Bodegom
- Institute of Environmental Sciences, Leiden University, Leiden, the Netherlands
| | - Joeri Morpurgo
- Institute of Environmental Sciences, Leiden University, Leiden, the Netherlands
| | - Yunfeng Huang
- Environmental Engineering Department, Jimei University, Xiamen, 36102, China
| | - Jingyi Wang
- Xiamen Key Lab of Urban Metabolism, Institute of Urban Environment, Chinses Academy of Sciences, Xiamen, 361021, China
| | - Shenghui Cui
- Xiamen Key Lab of Urban Metabolism, Institute of Urban Environment, Chinses Academy of Sciences, Xiamen, 361021, China.
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Wang H, Gholami S, Xu W, Samavatekbatan A, Sleipness O, Tassinary LG. Where and how to invest in greenspace for optimal health benefits: a systematic review of greenspace morphology and human health relationships. Lancet Planet Health 2024; 8:e574-e587. [PMID: 39122326 DOI: 10.1016/s2542-5196(24)00140-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 05/22/2024] [Accepted: 06/04/2024] [Indexed: 08/12/2024]
Abstract
Research on the relationship between greenspace morphology and health is a growing field that informs the spatial design of greenspace to enhance health outcomes. This study reviews the current progress, methodologies, and knowledge gaps in this area. From a database search of 272 940 English articles and 39 053 Chinese articles up to April 18, 2024, we identified 22 and 7 studies on the topic for further evaluation. Predominantly cross-sectional and neighbourhood-scale analyses were conducted using land cover maps ranging from 0·25 to 100 meters in resolution. Six primary characteristics of greenspace morphology have been studied, including size, shape, fragmentation, connectedness, aggregation, and diversity. While associations between greenspace morphology and health outcomes have been observed, both their reliability and generalisability remain suggestive due to ecological study designs and heterogeneity among studies. Future research should prioritise individual-level prospective cohorts and intervention studies. Exploring mechanisms linking greenspace morphology and health, determining optimal map resolution, and distinguishing it from greenness magnitude in statistical analysis is essential. This evidence is crucial for health-promoting greenspace planning and should be routinely integrated into urban epidemiological research.
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Affiliation(s)
- Huaqing Wang
- Department of Landscape Architecture and Environmental Planning, Utah State University, Logan, UT, USA.
| | - Simin Gholami
- Department of Landscape Architecture and Environmental Planning, Utah State University, Logan, UT, USA
| | - Wenyan Xu
- Department of Landscape Architecture and Environmental Planning, Utah State University, Logan, UT, USA
| | | | - Ole Sleipness
- Department of Landscape Architecture and Environmental Planning, Utah State University, Logan, UT, USA
| | - Louis G Tassinary
- School of Performance, Visualization and Fine Arts, Texas A&M University, College Station, TX, USA
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Chen J, Hart JE, Fisher NDL, Yanosky JD, Roscoe C, James P, Laden F. Multiple Environmental Exposures and the Development of Hypertension in a Prospective US-Based Cohort of Female Nurses: A Mixture Analysis. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2024. [PMID: 39083359 DOI: 10.1021/acs.est.4c03722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/02/2024]
Abstract
We investigated the independent and joint associations between multiple environmental exposures and incident hypertension in a US nationwide prospective cohort of women: the Nurses' Health Study II. We followed 107,532 nonhypertensive participants from 1989 to diagnosis of hypertension, loss to follow-up, death, or end of follow-up in June 2019. We applied Cox proportional hazards models to assess associations of incident hypertension with time-varying residential exposure to air pollution, noise, surrounding greenness, temperature, and neighborhood socioeconomic status (nSES), adjusting for potential confounders and coexposures. We evaluated the joint association of simultaneous exposure using quantile g-computation. We observed 38,175 hypertension cases over 2,062,109 person-years. Increased hypertension incidence was consistently associated with lower nSES and higher levels of fine particles (PM2.5) and nighttime noise exposures: hazard ratio (HRs) and 95% confidence intervals (CIs) of 1.06 (1.04, 1.08), 1.04 (1.01, 1.07), and 1.01 (1.00, 1.03), respectively, per interquartile range change. Joint HR for a one-quartile change in simultaneous exposure to the mixture was 1.05 (95% CI: 1.02, 1.09), assuming additivity, or 1.13 (95% CI: 1.06, 1.20), considering potential interactions within the mixture. Hypertension prevention should focus on enhancing nSES and reducing PM2.5 and noise levels, recognizing that reducing the overall exposures may yield additional benefits.
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Affiliation(s)
- Jie Chen
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts 02115, United States
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115, United States
| | - Jaime E Hart
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts 02115, United States
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115, United States
| | - Naomi D L Fisher
- Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, Massachusetts 02115, United States
| | - Jeff D Yanosky
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania 17033, United States
| | - Charlotte Roscoe
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts 02115, United States
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115, United States
- Division of Population Sciences, Dana Faber Cancer Institute, Boston, Massachusetts 02215, United States
| | - Peter James
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts 02115, United States
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts 02215, United States
| | - Francine Laden
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts 02115, United States
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115, United States
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts 02115, United States
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5
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Bu Y, Zhang X, Song S, Su H, Yu Z, Guo Y. Association of greenspace with hypertension in adult: a systematic review and meta-analysis of epidemiological studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024; 34:2556-2577. [PMID: 37742118 DOI: 10.1080/09603123.2023.2259817] [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: 01/21/2023] [Accepted: 09/11/2023] [Indexed: 09/25/2023]
Abstract
BACKGROUND Several studies have investigated the relationship of greenspace with blood pressure (BP) and hypertension, but the results were inconsistent. We aimed to assess the relationship of greenspace with BP/hypertension. METHODS We searched PubMed, Embase and Web of Science on greenspace and BP/hypertension published before 5 April 2023. The methodological quality and risk of bias were evaluated. RESULTS Twenty-seven articles were included. Our results suggested that higher normalized difference vegetation index (NDVI) was associated with lower odds of hypertension and levels of SBP [for every 10% increase of NDVI 500-m and NDVI 1000-m, the ORs were 0.95 (95% CI: 0.90-0.99) and 0.95 (95% CI: 0.90-0.99), the ꞵwas -1.32 (95% CI: -2.18, -0.45) and -1.41 (95% CI: -2.57, -0.25), respectively]. CONCLUSION This study indicated that higher exposure to greenspace might be associated with lower levels of BP and risk of hypertension. Increase green spaces should be regarded as an important public health intervention..
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Affiliation(s)
- Yongjun Bu
- College of Public Health, Xinxiang Medical University, Xinxiang, China
| | - Xiaoyu Zhang
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Shuaixing Song
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Hexin Su
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Zengli Yu
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Yuewei Guo
- School of Management, Xinxiang Medical University, Xinxiang, China
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Zheng Y, Lin T, Hamm NAS, Liu J, Zhou T, Geng H, Zhang J, Ye H, Zhang G, Wang X, Chen T. Quantitative evaluation of urban green exposure and its impact on human health: A case study on the 3-30-300 green space rule. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 924:171461. [PMID: 38461976 DOI: 10.1016/j.scitotenv.2024.171461] [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: 07/16/2023] [Revised: 12/12/2023] [Accepted: 03/01/2024] [Indexed: 03/12/2024]
Abstract
BACKGROUND AND AIMS Urban green spaces offer various health benefits, yet the impact of comprehensive green exposure criteria on multidimensional health remains unclear. The 3-30-300 green space rule represents the green exposure indicators with specific thresholds. This study aims to quantitatively evaluate urban green exposure in cities and can support investigation of its relationship with human health. METHODS We conducted a cross-sectional study based on 902 investigated individuals in 261 residential locations aged 11-95 years from Xiamen City, China. 3-30-300 green exposure was calculated using field surveys, GIS, and Baidu Maps Application Programming Interface (API). Physical health data was based on Occupational Stress Indicator (OSI)-2. Mental health was from the 12-item General Health Questionnaire (GHQ-12). Social health was from a self-constructed evaluation questionnaire. Statistical analyses were conducted using Geographically Weighted Regression and Geographically Weighted Logistic Regression for global and local effects on green exposure and multidimensional health. RESULT Among the investigated individuals, only 3.55 % (32/902) fully meet the 3-30-300 rule in Xiamen. Global results show that individuals achieved at least 30 % vegetation coverage (Yes) is associated with better physical (β: 0.76, p < 0.01) and social (β: 0.5, p < 0.01) health. GWLR global results indicate that individuals can "see at least 3 trees from home" meeting one (OR = 0.46, 95%CI: 0.25-0.86, p < 0.05) or two (OR = 0.41, 95%CI: 0.22,0.78, p < 0.01; OR = 0.24, 95%CI: 0.07-0.77, p < 0.05) 3-30-300 rule components are significantly associated with reduced medical visits and hospitalizations refer to not met these criterias. In the GWR local analysis, achieved 30 % vegetation cover is significantly related to improved social health at all locations. Meeting any two indicators also contribute to improved social health (n = 511, β: 0.46-0.51, P < 0.05). CONCLUSION Green exposure indicators based on the 3-30-300 rule guiding healthy urban green space development. We observed multidimensional health benefits when 1/3 or 2/3 of the indicators were met.
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Affiliation(s)
- Yicheng Zheng
- Key Laboratory of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021, China; School of Geographical Sciences, Faculty of Science and Engineering, University of Nottingham, Ningbo 315100, China.
| | - Tao Lin
- Key Laboratory of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021, China; College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China; Fujian Key Laboratory of Digital Technology for Territorial Space Analysis and Simulation, Fuzhou 350108, China; CAS Haixi Industrial Technology Innovation Center in Beilun, Ningbo 315800, China.
| | - Nicholas A S Hamm
- School of Geographical Sciences, Faculty of Science and Engineering, University of Nottingham, Ningbo 315100, China.
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing 100191, China; Department of Global Health and Population, Harvard TH Chan School of Public Health, 677 Huntington Avenue Boston, Boston, MA 02115, USA.
| | - Tongyu Zhou
- Department of Architecture and Built Environment, University of Nottingham Ningbo China, Ningbo 315100, China.
| | - Hongkai Geng
- Key Laboratory of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021, China; College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China.
| | - Junmao Zhang
- Key Laboratory of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021, China; College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China.
| | - Hong Ye
- Key Laboratory of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021, China; College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China; Fujian Key Laboratory of Digital Technology for Territorial Space Analysis and Simulation, Fuzhou 350108, China.
| | - Guoqin Zhang
- Key Laboratory of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021, China; College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China; Fujian Key Laboratory of Digital Technology for Territorial Space Analysis and Simulation, Fuzhou 350108, China.
| | - Xiaotong Wang
- Key Laboratory of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021, China; School of Geographical Sciences, Faculty of Science and Engineering, University of Nottingham, Ningbo 315100, China.
| | - Tianyi Chen
- Key Laboratory of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021, China; Fujian Key Laboratory of Digital Technology for Territorial Space Analysis and Simulation, Fuzhou 350108, China.
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Abstract
Accumulating evidence suggests that living in areas of high surrounding greenness or even brief exposures to areas of high greenery is conducive to cardiovascular health, which may be related to the environmental, social, psychological, and physiological benefits of greenspaces. Recent data from multiple cross-sectional, longitudinal, and cohort studies suggest that living in areas of high surrounding greenness is associated with a lower risk of all-cause and cardiovascular mortality. High levels of neighborhood greenery have been linked also to a decrease in the burden of cardiovascular disease risk factors as reflected by lower rates of hypertension, dyslipidemia, and diabetes. Those who live in greener environments report better mental health and more frequent social interactions, which can benefit cardiovascular health as well. In this narrative review, we discuss evidence linking greenspaces to cardiovascular health as well as the potential mechanisms underlying the beneficial effects of greenspaces, including the impact of vegetation on air, noise and light pollution, ambient temperature, physical activity, mental health, and biodiversity. We review literature on the beneficial effects of acute and chronic exposure to nature on cardiovascular disease risk factors, inflammation and immune function, and we highlight the potential cardiovascular effects of biogenic volatile organic compounds that are emitted by trees and shrubs. We identify current knowledge gaps in this area and underscore the need for additional population studies to understand more clearly and precisely the link between greenness and health. Such understanding is urgently needed to fully redeem the promise of greenspaces in preventing adverse environmental exposures, mitigating the effects of climate change, and creating healthier living environments.
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Affiliation(s)
- Rachel J Keith
- Christina Lee Brown Envirome Institute (R.J.K., J.L.H., A.B.)
- Department of Medicine (R.J.K., A.B.), University of Louisville
| | - Joy L Hart
- Christina Lee Brown Envirome Institute (R.J.K., J.L.H., A.B.)
- Department of Communication (J.L.H.), University of Louisville
| | - Aruni Bhatnagar
- Christina Lee Brown Envirome Institute (R.J.K., J.L.H., A.B.)
- Department of Medicine (R.J.K., A.B.), University of Louisville
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Cui Z, Pan R, Liu J, Yi W, Huang Y, Li M, Zhang Z, Kuang L, Liu L, Wei N, Song R, Yuan J, Li X, Yi X, Song J, Su H. Green space and its types can attenuate the associations of PM 2.5 and its components with prediabetes and diabetes-- a multicenter cross-sectional study from eastern China. ENVIRONMENTAL RESEARCH 2024; 245:117997. [PMID: 38157960 DOI: 10.1016/j.envres.2023.117997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 12/12/2023] [Accepted: 12/19/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND The effect of fine particulate matter (PM2.5) components on prediabetes and diabetes is of concern, but the evidence is limited and the specific role of different green space types remains unclear. This study aims to investigate the relationship of PM2.5 and its components with prediabetes and diabetes as well as the potential health benefits of different types and combinations of green spaces. METHODS A multicenter cross-sectional study was conducted in eastern China by using a multi-stage random sampling method. Health screening and questionnaires for 98,091 participants were performed during 2017-2020. PM2.5 and its five components were estimated by the inverse distance weighted method, and green space was reflected by the Normalized Difference Vegetation Index (NDVI), percentages of tree or grass cover. Multivariate logistic regression and quantile g-computing were used to explore the associations of PM2.5 and five components with prediabetes and diabetes and to elucidate the potential moderating role of green space and corresponding type combinations in these associations. RESULTS Each interquartile range (IQR) increment of PM2.5 was associated with both prediabetes (odds ratio [OR]: 1.15, 95%CI [confidence interval]: 1.10-1.20) and diabetes (OR: 1.18, 95% CI: 1.11-1.25), respectively. All five components of PM2.5 were related to prediabetes and diabetes. The ORs of PM2.5 on diabetes were 1.49 (1.35-1.63) in the low tree group and 0.90 (0.82-0.98) in the high tree group, respectively. In the high tree-high grass group, the harmful impacts of PM2.5 and five components were significantly lower than in the other groups. CONCLUSION Our study suggested that PM2.5 and its components were associated with the increased risk of prediabetes and diabetes, which could be diminished by green space. Furthermore, the coexistence of high levels of tree and grass cover provided greater benefits. These findings had critical implications for diabetes prevention and green space-based planning for healthy city.
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Affiliation(s)
- Zhiqian Cui
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, 230032, China
| | - Rubing Pan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, 230032, China
| | - Jintao Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, 230032, China
| | - Weizhuo Yi
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, 230032, China
| | - Yuxin Huang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, 230032, China
| | - Ming Li
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, 230032, China
| | - Zichen Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, 230032, China
| | - Lingmei Kuang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, 230032, China
| | - Li Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, 230032, China
| | - Ning Wei
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, 230032, China
| | - Rong Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, 230032, China
| | - Jiajun Yuan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, 230032, China
| | - Xuanxuan Li
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, 230032, China
| | - Xingxu Yi
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, 230032, China
| | - Jian Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, 230032, China
| | - Hong Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, 230032, China.
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Carver A, Beare R, Knibbs LD, Mavoa S, Grocott K, Wheeler AJ, Srikanth V, Andrew NE. Exploring associations of greenery, air pollution and walkability with cardiometabolic health in people at midlife and beyond. Geriatr Gerontol Int 2024; 24 Suppl 1:208-214. [PMID: 38115171 DOI: 10.1111/ggi.14743] [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: 08/31/2023] [Revised: 10/25/2023] [Accepted: 11/04/2023] [Indexed: 12/21/2023]
Abstract
AIM To examine associations of neighborhood greenery, air pollution and walkability with cardiometabolic disease in adults aged ≥45 years in the Frankston-Mornington Peninsula region, Victoria, Australia. METHODS A cross-sectional, ecological study design was used. We assessed mean annual neighborhood greenery using the Normalized Difference Vegetation Index; air pollution (fine particulate matter of diameter ≤2.5 μm [PM2.5] and NO2) using land-use regression models; and walkability using Walk Score (possible values 0-100). Medically diagnosed diabetes (~95% type-2), heart disease and stroke were self-reported in the Australian Census (2021). Multivariable regression was used to model associations between environmental exposures and area-level (neighborhood) cardiometabolic disease prevalence (age group ≥45 years), with socioeconomic status, age and sex as covariates. Air pollution was examined as a mediator of associations between greenery and disease prevalence. RESULTS Our sample comprised 699 neighborhoods with the following mean (SD) values: Normalized Difference Vegetation Index 0.47 (0.09), PM2.5, 8.5 (0.6) μg/m3 and NO2, 5.2 (1.6) ppb. Disease prevalences were: heart disease, mean 8.9% (4.5%); diabetes, mean 10.3% (4.7%); and stroke, median 1.2% (range 0-10.9%). Greenery was negatively associated with diabetes (β = -5.85, 95% CI -9.53, -2.17) and stroke prevalence (β = -1.26, 95% CI -2.11, -0.42). PM2.5 and NO2 were positively associated with diabetes (β = 1.59, 95% CI 1.00, 2.18; β = 0.42, 95% CI 0.22, 0.62) and stroke prevalence (β = 0.15, 95% CI 0.01, 0.29; β = 0.06, 95% CI 0.01, 0.10). The association between greenery and diabetes was partially mediated by PM2.5 (mediated effect -5.38, 95% CI -7.84, -3.03). CONCLUSIONS Greenery and air pollutants were associated with lower and higher prevalence, respectively, of self-reported diabetes and, to a lesser extent, stroke. These ecological findings require further exploration with stronger, longitudinal study designs to inform public health policy and directions. Geriatr Gerontol Int 2024; 24: 208-214.
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Affiliation(s)
- Alison Carver
- National Centre for Healthy Ageing, Melbourne, Victoria, Australia
- Peninsula Clinical School, Central Clinical school, Faculty of Medicine, Monash University, Melbourne, Victoria, Australia
- Peninsula Health, Melbourne, Victoria, Australia
| | - Richard Beare
- National Centre for Healthy Ageing, Melbourne, Victoria, Australia
- Peninsula Clinical School, Central Clinical school, Faculty of Medicine, Monash University, Melbourne, Victoria, Australia
- Peninsula Health, Melbourne, Victoria, Australia
- Developmental Imaging, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Luke D Knibbs
- School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
- Public Health Research Analytics and Methods for Evidence, Public Health Unit, Sydney Local Health District, Camperdown, New South Wales, Australia
| | - Suzanne Mavoa
- Environmental Protection Authority, Melbourne, Victoria, Australia
| | - Kaya Grocott
- University of Melbourne, Melbourne, Victoria, Australia
| | | | - Velandai Srikanth
- National Centre for Healthy Ageing, Melbourne, Victoria, Australia
- Peninsula Clinical School, Central Clinical school, Faculty of Medicine, Monash University, Melbourne, Victoria, Australia
- Peninsula Health, Melbourne, Victoria, Australia
| | - Nadine E Andrew
- National Centre for Healthy Ageing, Melbourne, Victoria, Australia
- Peninsula Clinical School, Central Clinical school, Faculty of Medicine, Monash University, Melbourne, Victoria, Australia
- Peninsula Health, Melbourne, Victoria, Australia
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Zeng YQ, Chong KC, Chang LY, Liang X, Guo LH, Dong G, Tam T, Lao XQ. Exposure to Neighborhood Greenness and Hypertension Incidence in Adults: A Longitudinal Cohort Study in Taiwan. ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:37001. [PMID: 38427031 PMCID: PMC10906659 DOI: 10.1289/ehp13071] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 01/11/2024] [Accepted: 02/01/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND There are few studies on the health effects of long-term exposure to neighborhood greenness in a longitudinal setting, especially in Asian countries with high population densities. OBJECTIVES This study investigates the association between long-term exposure to neighborhood greenness and hypertension among adults in Taiwan. METHODS We selected 125,537 participants (≥ 18 years of age) without hypertension from Taiwan who had joined the standard medical examination program between 2001 and 2016. Neighborhood greenness was estimated using the normalized difference vegetation index (NDVI), derived from satellite images at a resolution of 250 m 2 . The 2-y average NDVI value within a 500 -m circular buffer around participants' residences was calculated. A time-varying Cox regression model was used to investigate the association between neighborhood greenness and incident hypertension. Mediation analyses were performed to examine whether the association was explained by air pollution, leisure-time physical exercise, or body mass index (BMI). RESULTS Compared with living in areas within the first quartile of neighborhood greenness, living in areas within the second, third, and fourth quartiles of neighborhood greenness was found to be associated with a lower risk of hypertension, with hazard ratios (HRs) and 95% confidence intervals (CIs) of 0.95 (95% CI: 0.91, 1.00), 0.95 (95% CI: 0.90, 0.99), and 0.93 (95% CI: 0.88, 0.97), respectively. Each 0.1-unit increase in the NDVI was associated with a 24% lower risk of developing hypertension (HR = 0.76; 95% CI: 0.66, 0.87), with this associations being stronger among males and those with higher education levels. This association was slightly mediated by BMI but not by air pollution or leisure-time physical exercise. DISCUSSION Our findings suggest the protective effects of neighborhood greenness on hypertension development, especially in males and well-educated individuals. Our results reinforced the importance of neighborhood greenness for supporting health. https://doi.org/10.1289/EHP13071.
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Affiliation(s)
- Yi Qian Zeng
- Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ka Chun Chong
- Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China
- Centre for Health Systems and Policy Research, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ly-yun Chang
- Institute of Sociology, Academia Sinica, Taipei, Taiwan
| | - Xue Liang
- Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Li-Hao Guo
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Guanghui Dong
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Tony Tam
- Department of Sociology, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Xiang Qian Lao
- Department of Biomedical Sciences, City University of Hong Kong, Hong Kong SAR, China
- School of Public Health, Zhengzhou University, Zhengzhou, China
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11
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Browning MHEM, Locke DH, Konijnendijk C, Labib SM, Rigolon A, Yeager R, Bardhan M, Berland A, Dadvand P, Helbich M, Li F, Li H, James P, Klompmaker J, Reuben A, Roman LA, Tsai WL, Patwary M, O'Neil-Dunne J, Ossola A, Wang R, Yang B, Yi L, Zhang J, Nieuwenhuijsen M. Measuring the 3-30-300 rule to help cities meet nature access thresholds. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 907:167739. [PMID: 37832672 PMCID: PMC11090249 DOI: 10.1016/j.scitotenv.2023.167739] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 10/04/2023] [Accepted: 10/09/2023] [Indexed: 10/15/2023]
Abstract
The 3-30-300 rule offers benchmarks for cities to promote equitable nature access. It dictates that individuals should see three trees from their dwelling, have 30 % tree canopy in their neighborhood, and live within 300 m of a high-quality green space. Implementing this demands thorough measurement, monitoring, and evaluation methods, yet little guidance is currently available to pursue these actions. To overcome this gap, we employed an expert-based consensus approach to review the available ways to measure 3-30-300 as well as each measure's strengths and weaknesses. We described seven relevant data and processes: vegetation indices, street level analyses, tree inventories, questionnaires, window view analyses, land cover maps, and green space maps. Based on the reviewed strengths and weaknesses of each measure, we presented a suitability matrix to link recommended measures with each component of the rule. These recommendations included surveys and window-view analyses for the '3 component', high-resolution land cover maps for the '30 component', and green space maps with network analyses for the '300 component'. These methods, responsive to local situations and resources, not only implement the 3-30-300 rule but foster broader dialogue on local desires and requirements. Consequently, these techniques can guide strategic investments in urban greening for health, equity, biodiversity, and climate adaptation.
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Affiliation(s)
- M H E M Browning
- Virtual Reality and Nature Lab, Department of Parks, Recreation and Tourism Management, Clemson University, Clemson, SC 29631, USA.
| | - D H Locke
- USDA Forest Service, Northern Research Station, Baltimore Field Station, Suite 350, 5523 Research Park Drive, Baltimore, MD 21228, USA.
| | - C Konijnendijk
- Nature Based Solutions Institute - Dutch Office, Zeist, the Netherlands
| | - S M Labib
- Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Utrecht, the Netherlands
| | - A Rigolon
- Department of City and Metropolitan Planning, The University of Utah, Salt Lake City, UT 84112, USA
| | - R Yeager
- Division of Environmental Medicine, School of Medicine, University of Louisville, Louisville, KY 40202, USA
| | - M Bardhan
- Virtual Reality and Nature Lab, Department of Parks, Recreation and Tourism Management, Clemson University, Clemson, SC 29631, USA; Environment and Sustainability Research Initiative, Khulna 9208, Bangladesh
| | - A Berland
- Department of Geography and Meteorology, Ball State University, Muncie, IN 47306, USA
| | - P Dadvand
- ISGlobal, Doctor Aiguader 88, 08003 Barcelona, Spain; Universitat Pompeu Fabra (UPF), Doctor Aiguader 88, 08003 Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Melchor Fernández Almagro, 3-5, 28029 Madrid, Spain
| | - M Helbich
- Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Utrecht, the Netherlands
| | - F Li
- Virtual Reality and Nature Lab, Department of Parks, Recreation and Tourism Management, Clemson University, Clemson, SC 29631, USA
| | - H Li
- College of Physical Education, Southwest University, Chongqing 400715, China
| | - P James
- Harvard T.H. Chan School of Public Health, Boston, MA, USA; Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - J Klompmaker
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - A Reuben
- Department of Psychology & Neuroscience, Duke University, Durham, NC, 27705, USA
| | - L A Roman
- USDA Forest Service, Pacific Southwest Research Station & Northern Research Station, 4995 Canyon Crest Dr., Riverside, CA 92507, USA
| | - W-L Tsai
- Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, NC, USA
| | - M Patwary
- Environment and Sustainability Research Initiative, Khulna 9208, Bangladesh; Environmental Science Discipline, Life Science School, Khulna University, Khulna 9208, Bangladesh
| | - J O'Neil-Dunne
- Spatial Analysis Lab, Rubenstein School of Environment and Natural Resources, University of Vermont, Burlington, VT, USA
| | - A Ossola
- Department of Plant Sciences, University of California Davis, Davis, CA, 95616, USA; School of Ecosystem and Forest Science, University of Melbourne, VIC, Australia
| | - R Wang
- Centre for Public Health, Queen's University Belfast, Northern Ireland, UK
| | - B Yang
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China
| | - L Yi
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - J Zhang
- College of Landscape Architecture, Nanjing Forestry University, Nanjing, China
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12
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Cerin E, Chan YK, Symmons M, Soloveva M, Martino E, Shaw JE, Knibbs LD, Jalaludin B, Barnett A. Associations of the neighbourhood built and natural environment with cardiometabolic health indicators: A cross-sectional analysis of environmental moderators and behavioural mediators. ENVIRONMENTAL RESEARCH 2024; 240:117524. [PMID: 37898226 DOI: 10.1016/j.envres.2023.117524] [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: 08/10/2023] [Revised: 10/12/2023] [Accepted: 10/25/2023] [Indexed: 10/30/2023]
Abstract
BACKGROUND Most studies examining the effects of neighbourhood urban design on cardiometabolic health focused solely on the built or natural environment. Also, they did not consider the roles of neighbourhood socio-economic status (SES) and ambient air pollution in the observed associations, and the extent to which these associations were mediated by physical activity and sedentary behaviours. METHODS We used data from the AusDiab3 study (N = 4141), a national cohort study of Australian adults to address the above-mentioned knowledge gaps. Spatial data were used to compute indices of neighbourhood walkability (population density, intersection density, non-commercial land use mix, commercial land use), natural environment (parkland and blue spaces) and air pollution (annual average concentrations of nitrogen dioxide (NO2) and fine particulate matter <2.5 μm in diameter (PM2.5)). Census indices were used to define neighbourhood SES. Clinical assessments collected data on adiposity, blood pressure, blood glucose and blood lipids. Generalised additive mixed models were used to estimate associations. RESULTS Neighbourhood walkability showed indirect beneficial associations with most indicators of cardiometabolic health via resistance training, walking and sitting for different purposes; indirect detrimental associations with the same indicators via vigorous gardening; and direct detrimental associations with blood pressure. The neighbourhood natural environment had beneficial indirect associations with most cardiometabolic health indicators via resistance training and leisure-time sitting, and beneficial direct associations with adiposity and blood lipids. Neighbourhood SES and air pollution moderated only a few associations of the neighbourhood environment with physical activity, blood lipids and blood pressure. CONCLUSIONS Within a low-density and low-pollution context, denser, walkable neighbourhoods with good access to nature may benefit residents' cardiometabolic health by facilitating the adoption of an active lifestyle. Possible disadvantages of living in denser neighbourhoods for older populations are having limited opportunities for gardening, higher levels of noise and less healthy dietary patterns associated with eating out.
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Affiliation(s)
- Ester Cerin
- Mary MacKillop Institute for Health Research, Australian Catholic University, 215 Spring St., Melbourne, VIC, Australia; School of Public Health, The University of Hong Kong, 7 Sassoon Rd., Sandy Bay, Hong Kong, Hong Kong SAR, China; Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.
| | - Yih-Kai Chan
- Mary MacKillop Institute for Health Research, Australian Catholic University, 215 Spring St., Melbourne, VIC, Australia.
| | - Mark Symmons
- Mary MacKillop Institute for Health Research, Australian Catholic University, 215 Spring St., Melbourne, VIC, Australia.
| | - Maria Soloveva
- Mary MacKillop Institute for Health Research, Australian Catholic University, 215 Spring St., Melbourne, VIC, Australia.
| | - Erika Martino
- School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.
| | - Jonathan E Shaw
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; School of Life Sciences, La Trobe University, Melbourne, VIC, Australia.
| | - Luke D Knibbs
- Sydney School of Public Health, The University of Sydney, Camperdown, NSW, Australia; Public Health Unit, Sydney Local Health District, Camperdown, NSW, Australia.
| | - Bin Jalaludin
- School of Population Health, University of New South Wales, Randwick, NSW, Australia.
| | - Anthony Barnett
- Mary MacKillop Institute for Health Research, Australian Catholic University, 215 Spring St., Melbourne, VIC, Australia.
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13
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Wang W, Yang C, Wang J, Wang F, Liang Z, Wang Y, Zhang F, Liang C, Li C, Lan Y, Li S, Li P, Zhou Y, Zhang L, Ding L. Lower regional urbanicity and socioeconomic status attenuate associations of green spaces with hypertension and diabetes mellitus: a national representative cross-sectional study in China. Environ Health Prev Med 2024; 29:47. [PMID: 39245566 PMCID: PMC11391273 DOI: 10.1265/ehpm.24-00121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/10/2024] Open
Abstract
BACKGROUND High blood pressure (HBP) and diabetes mellitus (DM) are two of the most prevalent cardiometabolic disorders globally, especially among individuals with lower socio-economic status (SES). Studies have linked residential greenness to decreased risks of HBP and DM. However, there has been limited evidence on whether SES may modify the associations of residential greenness with HBP and DM. METHODS Based on a national representative cross-sectional study among 44,876 adults, we generated the normalized difference vegetation index (NDVI) at 1 km spatial resolution to characterize individuals' residential greenness level. Administrative classification (urban/rural), nighttime light index (NLI), individual income, and educational levels were used to characterize regional urbanicity and individual SES levels. RESULTS We observed weaker inverse associations of NDVI with HBP and DM in rural regions compared to urban regions. For instance, along with per interquartile range (IQR, 0.26) increment in residential NDVI at 0∼5 year moving averages, the ORs of HBP were 1.04 (95%CI: 0.94, 1.15) in rural regions and 0.85 (95%CI: 0.79, 0.93) in urban regions (P = 0.003). Along with the decrease in NLI levels, there were continuously decreasing inverse associations of NDVI with DM prevalence (P for interaction <0.001). In addition, weaker inverse associations of residential NDVI with HBP and DM prevalence were found among individuals with lower income and lower education levels compared to their counterparts. CONCLUSIONS Lower regional urbanicity and individual SES could attenuate the associations of residential greenness with odds of HBP and DM prevalence.
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Affiliation(s)
- Wanzhou Wang
- National Institute of Health Data Science at Peking University
- Institute of Medical Technology, Peking University Health Science Center
| | - Chao Yang
- Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology
- Research Units of Diagnosis and Treatment of Immune-Mediated Kidney Diseases, Chinese Academy of Medical Sciences
- Advanced Institute of Information Technology, Peking University
| | - Jinwei Wang
- Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology
- Key Laboratory of Chronic Kidney Disease Prevention and Treatment, Peking University, Ministry of Education of the People's Republic of China
| | - Fulin Wang
- National Institute of Health Data Science at Peking University
- Institute of Medical Technology, Peking University Health Science Center
| | - Ze Liang
- Key Laboratory for Earth Surface Processes of the Ministry of Education, College of Urban and Environmental Sciences, Peking University
| | - Yueyao Wang
- Key Laboratory for Earth Surface Processes of the Ministry of Education, College of Urban and Environmental Sciences, Peking University
| | - Feifei Zhang
- National Institute of Health Data Science at Peking University
| | - Chenyu Liang
- Key Laboratory for Earth Surface Processes of the Ministry of Education, College of Urban and Environmental Sciences, Peking University
| | - Chenshuang Li
- Center for Smart and Healthy Buildings, Huazhong University of Science and Technology
| | - Yiqun Lan
- Center for Smart and Healthy Buildings, Huazhong University of Science and Technology
| | - Shuangcheng Li
- Key Laboratory for Earth Surface Processes of the Ministry of Education, College of Urban and Environmental Sciences, Peking University
| | - Pengfei Li
- Advanced Institute of Information Technology, Peking University
| | - Ying Zhou
- Center for Smart and Healthy Buildings, Huazhong University of Science and Technology
| | - Luxia Zhang
- National Institute of Health Data Science at Peking University
- Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology
- Research Units of Diagnosis and Treatment of Immune-Mediated Kidney Diseases, Chinese Academy of Medical Sciences
- Advanced Institute of Information Technology, Peking University
| | - Lieyun Ding
- Center for Smart and Healthy Buildings, Huazhong University of Science and Technology
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Fiffer MR, Li H, Iyer HS, Nethery RC, Sun Q, James P, Yanosky JD, Kaufman JD, Hart JE, Laden F. Associations between air pollution, residential greenness, and glycated hemoglobin (HbA1c) in three prospective cohorts of U.S. adults. ENVIRONMENTAL RESEARCH 2023; 239:117371. [PMID: 37839528 PMCID: PMC10873087 DOI: 10.1016/j.envres.2023.117371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 10/05/2023] [Accepted: 10/09/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND While studies suggest impacts of individual environmental exposures on type 2 diabetes (T2D) risk, mechanisms remain poorly characterized. Glycated hemoglobin (HbA1c) is a biomarker of glycemia and diagnostic criterion for prediabetes and T2D. We explored associations between multiple environmental exposures and HbA1c in non-diabetic adults. METHODS HbA1c was assessed once in 12,315 women and men in three U.S.-based prospective cohorts: the Nurses' Health Study (NHS), Nurses' Health Study II (NHSII), and Health Professionals Follow-up Study (HPFS). Residential greenness within 270 m and 1,230 m (normalized difference vegetation index, NDVI) was obtained from Landsat. Fine particulate matter (PM2.5) and nitrogen dioxide (NO2) were estimated from nationwide spatiotemporal models. Three-month and one-year averages prior to blood draw were assigned to participants' addresses. We assessed associations between single exposure, multi-exposure, and component scores from Principal Components Analysis (PCA) and HbA1c. Fully-adjusted models built on basic models of age and year at blood draw, BMI, alcohol use, and neighborhood socioeconomic status (nSES) to include diet quality, race, family history, smoking status, postmenopausal hormone use, population density, and season. We assessed interactions between environmental exposures, and effect modification by population density, nSES, and sex. RESULTS Based on HbA1c, 19% of participants had prediabetes. In single exposure fully-adjusted models, an IQR (0.14) higher 1-year 1,230 m NDVI was associated with a 0.27% (95% CI: 0.05%, 0.49%) lower HbA1c. In basic component score models, a SD increase in Component 1 (high loadings for 1-year NDVI) was associated with a 0.19% (95% CI: 0.04%, 0.34%) lower HbA1c. CI's crossed the null in multi-exposure and fully-adjusted component score models. There was little evidence of associations between air pollution and HbA1c, and no evidence of effect modification. CONCLUSIONS Among non-diabetic adults, environmental exposures were not consistently associated with HbA1c. More work is needed to elucidate biological pathways between the environment and prediabetes.
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Affiliation(s)
- Melissa R Fiffer
- Harvard T.H. Chan School of Public Health, Department of Environmental Health, Boston, MA, USA; University of Illinois Chicago, Children's Environmental Health Initiative, Chicago, IL, USA.
| | - Huichu Li
- Harvard T.H. Chan School of Public Health, Department of Environmental Health, Boston, MA, USA
| | - Hari S Iyer
- Harvard T.H. Chan School of Public Health, Department of Epidemiology, Boston, MA, USA; Dana-Farber Cancer Institute, Division of Population Sciences, Boston, MA, USA; Rutgers Cancer Institute of New Jersey, Section of Cancer Epidemiology and Health Outcomes, New Brunswick, NJ, USA
| | - Rachel C Nethery
- Harvard T.H. Chan School of Public Health, Department of Biostatistics, Boston, MA, USA
| | - Qi Sun
- Harvard T.H. Chan School of Public Health, Department of Epidemiology, Boston, MA, USA; Harvard T.H. Chan School of Public Health, Department of Nutrition, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Peter James
- Harvard T.H. Chan School of Public Health, Department of Environmental Health, Boston, MA, USA; Harvard Medical School and Harvard Pilgrim Health Care Institute, Department of Population Medicine, Boston, MA, USA
| | - Jeff D Yanosky
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, USA
| | - Joel D Kaufman
- Department of Epidemiology, University of Washington, Seattle, USA; Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, USA
| | - Jaime E Hart
- Harvard T.H. Chan School of Public Health, Department of Environmental Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Francine Laden
- Harvard T.H. Chan School of Public Health, Department of Environmental Health, Boston, MA, USA; Harvard T.H. Chan School of Public Health, Department of Epidemiology, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
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15
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Chen X, Wen J, Wu W, Peng Q, Cui X, He L. A review of factors influencing sensitive skin: an emphasis on built environment characteristics. Front Public Health 2023; 11:1269314. [PMID: 38111482 PMCID: PMC10726041 DOI: 10.3389/fpubh.2023.1269314] [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: 07/29/2023] [Accepted: 11/20/2023] [Indexed: 12/20/2023] Open
Abstract
Background Sensitive skin (SS) is a condition characterized by hyperreactivity. Impacting around 37 percent of the worldwide population and exerting an influence on the quality of life for affected individuals. Its prevalence rate has increased due to factors such as elevating stress levels and deteriorating environmental conditions. The exposome factors influencing SS have extended from demographic, biological attributes, and lifestyle to external environments. Built environments (BEs) have demonstrated as root drivers for changes in behaviors and environmental exposure which have the potential to trigger SS, but the review of the associations between BEs and SS is currently lacking. Objective This review aims to achieve two primary objectives: (1) Examine exposome factors that exert influence on SS at the individual and environmental levels. (2) Develop a theoretical framework that establishes a connection between BEs and SS, thereby offering valuable insights into the impact of the built environment on this condition. Methods An extensive literature search was carried out across multiple fields, including sociology, epidemiology, basic medicine, clinical medicine, and environmental research, with a focus on SS. To identify pertinent references, renowned databases such as PubMed, Web of Science, and CNKI were utilized. Results SS is the outcome of interactions between individual attributes and environmental factors. These influencing factors can be categorized into five distinct classes: (1) demographic and socioeconomic characteristics including age, gender, and race; (2) physiological and biological attributes such as emotional changes, skin types, sleep disorders, and menstrual cycles in women; (3) behavioral factors, such as spicy diet, cosmetic use, alcohol consumption, and physical exercise; (4) natural environmental features, including climate conditions and air pollution; (5) built environmental features such as population density, green space availability, road network density, and access to public transportation, also have the potential to affect the condition. Conclusion The importance of interdisciplinary integration lies in its ability to ascertain whether and how BEs are impacting SS. By elucidating the role of BEs in conjunction with other factors in the onset of SS, we can provide guidance for future research endeavors and the formulation of interventions aimed at mitigating the prevalence of SS.
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Affiliation(s)
- Xiangfeng Chen
- Department of Dermatology, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Jing Wen
- The Centre for Modern Chinese City Studies, East China Normal University, Shanghai, China
| | - Wenjuan Wu
- Department of Dermatology, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Qiuzhi Peng
- Faculty of Land Resources Engineering, Kunming University of Science and Technology, Kunming, China
| | - Xiangfen Cui
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming, China
| | - Li He
- Department of Dermatology, First Affiliated Hospital of Kunming Medical University, Kunming, China
- Yunnan Institute of Skin Health, Kunming, China
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16
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Baheti B, Chen G, Ding Z, Wu R, Zhang C, Zhou L, Liu X, Song X, Wang C. Residential greenness alleviated the adverse associations of long-term exposure to ambient PM 1 with cardiac conduction abnormalities in rural adults. ENVIRONMENTAL RESEARCH 2023; 237:116862. [PMID: 37574100 DOI: 10.1016/j.envres.2023.116862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/27/2023] [Accepted: 08/08/2023] [Indexed: 08/15/2023]
Abstract
BACKGROUND Ambient air pollution was linked to elevated risks of adverse cardiovascular events, and alterations in electrophysiological properties of the heart might be potential pathways. However, there is still lacking research exploring the associations between PM1 exposure and cardiac conduction parameters. Additionally, the interactive effects of PM1 and residential greenness on cardiac conduction parameters in resource-limited areas remain unknown. METHODS A total of 27483 individuals were enrolled from the Henan Rural Cohort study. Cardiac conduction parameters were tested by 12-lead electrocardiograms. Concentrations of PM1 were evaluated by satellite-based spatiotemporal models. Levels of residential greenness were assessed using Enhanced Vegetation Index (EVI) and Normalized difference vegetation index (NDVI). Logistic regression models and restricted cubic splines were fitted to explore the associations of PM1 and residential greenness exposure with cardiac conduction abnormalities risk, and the interaction plot method was performed to visualize their interaction effects. RESULTS The 3-year median concentration of PM1 was 56.47 (2.55) μg/m3, the adjusted odds rate (ORs) and 95% confidence intervals (CIs) for abnormal HR, PR, QRS, and QTc interval risk in response to 1 μg/m3 increase in PM1 were 1.064 (1.044, 1.085), 1.037 (1.002, 1.074), 1.061 (1.044, 1.077) and 1.046 (1.028, 1.065), respectively. Participants exposure to higher levels of PM1 had increased risks of abnormal HR (OR = 1.221, 95%CI: 1.144, 1.303), PR (OR = 1.061, 95%CI: 0.940, 1.196), QRS (OR = 1.225, 95%CI: 1.161, 1.294) and QTc interval (OR = 1.193, 95%CI: 1.121, 1.271) compared with lower levels of PM1. Negative interactive effects of exposure to PM1 and residential greenness on abnormal HR, QRS, and QTc intervals were observed (Pfor interaction < 0.05). CONCLUSION Long-term PM1 exposure was associated with elevated cardiac conduction abnormalities risks, and this adverse association might be mitigated by residential greenness to some extent. These findings emphasize that controlling PM1 pollution and increasing greenness levels might be effective strategies to reduce cardiovascular disease burdens in resource-limited areas.
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Affiliation(s)
- Bota Baheti
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Gongbo Chen
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Zhongao Ding
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Ruiyu Wu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Caiyun Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Lue Zhou
- NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Diseases, Zhengzhou, Henan, PR China
| | - Xiaotian Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Xiaoqin Song
- Physical Examination Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, PR China.
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China; NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Diseases, Zhengzhou, Henan, PR China.
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17
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Vranken A, Bijnens E, Horemans C, Leclercq A, Kestens W, Karakaya G, Vandenthoren L, Trimpeneers E, Vanpoucke C, Fierens F, Nawrot T, Cox B, Bruyneel L. Association of air pollution and green space with all-cause general practitioner and emergency room visits: A cross-sectional study of young people and adults living in Belgium. ENVIRONMENTAL RESEARCH 2023; 236:116713. [PMID: 37481061 DOI: 10.1016/j.envres.2023.116713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 07/17/2023] [Accepted: 07/19/2023] [Indexed: 07/24/2023]
Abstract
BACKGROUND Residing in areas with lower levels of air pollution and higher green space is beneficial to physical and mental health. We investigated associations of PM2.5, tree cover and grass cover with in-hours and out-of-hours GP visits and ER visits, for young people and adults. We estimated potential cost savings of GP visits attributable to high PM2.5. METHODS We linked individual-level health insurance claims data of 315,123 young people (10-24 years) and 885,988 adults (25-64 years) with census tract-level PM2.5, tree cover and grass cover. Deploying negative binomial generalized linear mixed models, we estimated associations between quartile exposures and the three outcome measures. RESULTS For in-hours and out-of-hours GP visits, among young people as well as adults, statistically significant pairwise differences between quartiles suggested increasing beneficial effects with lower PM2.5. The same outcomes were statistically significantly less frequent in quartiles with highest tree cover (>30.00%) compared to quartiles with lower tree cover, but otherwise pairwise differences were not statistically significant. These associations largely persisted in rural and urban areas. Among adults living in urban areas lower grass cover was associated with increased in-hours GP visits and ER visits. Assuming causality, reducing PM2.5 levels to the lowest quartile (4.91-7.49 μg/m³), among adults, 195,964 in-hours and 74,042 out-of-hours GP visits could be avoided annually. Among young people, 27,457 in-hours and 22,423 out-of-hours GP visits could be avoided annually. Nationally, this amounts to an annual potential cost saving of €43 million (€5.7 million in out-of-pocket payments and €37.2 million in compulsory health insurance). CONCLUSION Higher ambient PM2.5 and lower tree cover show associations with higher non-urgent and urgent medical care utilization. These findings confirm the importance of reducing air pollution and fostering green zones, and that such policies may contribute positively to economic growth.
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Affiliation(s)
- Arthur Vranken
- Independent Health Insurance Funds, Lenniksebaan 788a, 1070, Anderlecht, Belgium; Institute for Healthcare Policy, KU Leuven, Kapucijnenvoer 35, Leuven, Belgium
| | - Esmée Bijnens
- Centre for Environmental Sciences, Hasselt University, Agoralaan Building D, 3590, Diepenbeek, Belgium; Department of Environmental Sciences, Open University Heerlen, Valkenburgerweg 177, 6419, AT Heerlen, the Netherlands
| | - Christian Horemans
- Independent Health Insurance Funds, Lenniksebaan 788a, 1070, Anderlecht, Belgium
| | - Agnès Leclercq
- Independent Health Insurance Funds, Lenniksebaan 788a, 1070, Anderlecht, Belgium
| | - Wies Kestens
- Independent Health Insurance Funds, Lenniksebaan 788a, 1070, Anderlecht, Belgium
| | - Güngör Karakaya
- Independent Health Insurance Funds, Lenniksebaan 788a, 1070, Anderlecht, Belgium
| | - Ludo Vandenthoren
- Independent Health Insurance Funds, Lenniksebaan 788a, 1070, Anderlecht, Belgium
| | | | | | - Frans Fierens
- Belgian Interregional Environment Agency, Brussels, Belgium
| | - Tim Nawrot
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium; Centre for Environment and Health, KU Leuven, Leuven, Belgium
| | - Bianca Cox
- VITO Health, Flemish Institute for Technological Research (VITO), Mol, Belgium
| | - Luk Bruyneel
- Independent Health Insurance Funds, Lenniksebaan 788a, 1070, Anderlecht, Belgium; Institute for Healthcare Policy, KU Leuven, Kapucijnenvoer 35, Leuven, Belgium.
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18
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Woodward A, Hinwood A, Bennett D, Grear B, Vardoulakis S, Lalchandani N, Lyne K, Williams C. Trees, Climate Change, and Health: An Urban Planning, Greening and Implementation Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6798. [PMID: 37754657 PMCID: PMC10530629 DOI: 10.3390/ijerph20186798] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 09/09/2023] [Accepted: 09/13/2023] [Indexed: 09/28/2023]
Abstract
The In Conversation: Boundary, Spanners, Thinkers and Policy Actors Round Table Series provides a platform for researchers, policy actors, and implementation experts to elevate discussion on emerging issues, present new and upcoming research, and facilitate conversations around impacts and possible solutions. This brief report, on trees, climate change, and health, reflects a conversation between the authors of this paper, along with supporting literature. It explores the potential of green spaces and trees as a viable strategy to address climate change challenges and simultaneously improve population health, well-being, and health equity. In particular, it highlights the public health benefits of trees and green space, the challenges faced in urban areas, and opportunities for the protection, maintenance and regeneration of urban green space.
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Affiliation(s)
- Alistair Woodward
- School of Population Health, University of Auckland, Auckland 1010, New Zealand
| | - Andrea Hinwood
- United Nations Environment Programme, Nairobi 00100, Kenya
| | - Daniel Bennett
- Australian Institute of Landscape Architects, Adelaide 5001, Australia
| | - Brenton Grear
- Green Adelaide, Department for Environment and Water, Adelaide 5000, Australia
| | - Sotiris Vardoulakis
- Healthy Environments and Lives (HEAL) Network, Australian National University, Canberra 0200, Australia
| | - Neha Lalchandani
- School of Public Health, The University of Adelaide, Adelaide 5005, Australia
| | - Katrina Lyne
- Centre for Health in All Policies Research Translation, Health Translation SA, SAHMRI, Adelaide 5000, Australia
| | - Carmel Williams
- School of Public Health, The University of Adelaide, Adelaide 5005, Australia
- Centre for Health in All Policies Research Translation, Health Translation SA, SAHMRI, Adelaide 5000, Australia
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19
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Mujahid MS, Maddali SR, Gao X, Oo KH, Benjamin LA, Lewis TT. The Impact of Neighborhoods on Diabetes Risk and Outcomes: Centering Health Equity. Diabetes Care 2023; 46:1609-1618. [PMID: 37354326 PMCID: PMC10465989 DOI: 10.2337/dci23-0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 06/05/2023] [Indexed: 06/26/2023]
Abstract
Neighborhood environments significantly influence the development of diabetes risk factors, morbidity, and mortality throughout an individual's life. The social, economic, and physical environments of a neighborhood all affect the health risks of individuals and communities and also affect population health inequities. Factors such as access to healthy food, green spaces, safe housing, and transportation options can impact the health outcomes of residents. Social factors, including social cohesion and neighborhood safety, also play an important role in shaping neighborhood environments and can influence the development of diabetes. Therefore, understanding the complex relationships between neighborhood environments and diabetes is crucial for developing effective strategies to address health disparities and promote health equity. This review presents landmark findings from studies that examined associations between neighborhood socioeconomic, built and physical, and social environmental factors and diabetes-related risk and outcomes. Our framework emphasizes the historical context and structural and institutional racism as the key drivers of neighborhood environments that ultimately shape diabetes risk and outcomes. To address health inequities in diabetes, we propose future research areas that incorporate health equity principles and place-based interventions.
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Affiliation(s)
- Mahasin S. Mujahid
- Division of Epidemiology, School of Public Health, University of California Berkeley, Berkeley, CA
| | - Sai Ramya Maddali
- Division of Epidemiology, School of Public Health, University of California Berkeley, Berkeley, CA
| | - Xing Gao
- Division of Epidemiology, School of Public Health, University of California Berkeley, Berkeley, CA
| | - Khin H. Oo
- Division of Epidemiology, School of Public Health, University of California Berkeley, Berkeley, CA
| | - Larissa A. Benjamin
- Division of Epidemiology, School of Public Health, University of California Berkeley, Berkeley, CA
| | - Tené T. Lewis
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
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20
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Astell-Burt T, Navakatikyan MA, Feng X. Why might urban tree canopy reduce dementia risk? A causal mediation analysis of 109,688 adults with 11 years of hospital and mortality records. Health Place 2023; 82:103028. [PMID: 37182375 DOI: 10.1016/j.healthplace.2023.103028] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 04/11/2023] [Accepted: 04/12/2023] [Indexed: 05/16/2023]
Abstract
Urban tree canopy is associated with lower dementia risk, but no mediation analysis has been attempted to reveal potential mechanisms. We examined 3,639 dementia diagnoses in 109,688 participants of the Sax Institute's 45 and Up Study. Adjusted models indicated ≥20% tree canopy lowered the odds of developing dementia by 14% over 11 years (Odds Ratio = 0.86, 95%CI = 0.79-0.93). Association between tree canopy and dementia was partially mediated by physical activity (4.5%) and absences of psychological distress (5.7%), social support (2.9%), sleep duration (2.3%) and diabetes (1.8%). Social loneliness and absence of heart disease or hypertension did not mediate the tree canopy-dementia association.
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Affiliation(s)
- Thomas Astell-Burt
- Population Wellbeing and Environment Research Lab (PowerLab), NSW, Australia; School of Health and Society, University of Wollongong, Northfields Avenue, Wollongong, Australia.
| | - Michael A Navakatikyan
- Population Wellbeing and Environment Research Lab (PowerLab), NSW, Australia; School of Health and Society, University of Wollongong, Northfields Avenue, Wollongong, Australia
| | - Xiaoqi Feng
- Population Wellbeing and Environment Research Lab (PowerLab), NSW, Australia; School of Population Health, University of New South Wales, Sydney, Australia; The George Institute of Global Health, Sydney, NSW, Australia
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21
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Ccami-Bernal F, Soriano-Moreno DR, Fernandez-Guzman D, Tuco KG, Castro-Díaz SD, Esparza-Varas AL, Medina-Ramirez SA, Caira-Chuquineyra B, Cortez-Soto AG, Yovera-Aldana M, Rojas-Rueda D. Green space exposure and type 2 diabetes mellitus incidence: A systematic review. Health Place 2023; 82:103045. [PMID: 37159977 DOI: 10.1016/j.healthplace.2023.103045] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 04/04/2023] [Accepted: 05/03/2023] [Indexed: 05/11/2023]
Abstract
INTRODUCTION Epidemiological studies have suggested that exposure to green spaces is associated with a lower prevalence of diabetes. The aim of this systematic review was to summarize the evidence on green spaces and diabetes mellitus II (T2DM) in longitudinal studies. METHODS We searched PubMed, SCOPUS, Web of Science (WoS)/Core Collection, WoS/MEDLINE, and EMBASE until February 2023. We included cohort studies that assessed the incidence of T2DM according to the level of exposure to green spaces. Two authors independently performed study selection, data extraction, and analysis of risk of bias. No meta-analysis was performed due to clinical heterogeneity between studies. RESULTS We included 13 cohort studies with a sample size ranging from 1700 to 1 922 545 participants. Studies presented different ways of defining (quartiles, percentages) and measuring (tools, buffers) green spaces. Similarly, the definition of T2DM was heterogeneous (self-reports, medical records, clinical criteria). Twelve studies showed that individuals with higher exposure to green spaces had a decreased incidence of T2DM. Out of these 12 studies, 10 revealed statistically significant differences. All studies were of high methodological quality, except for one. CONCLUSION Our findings suggest that exposure to green space could be a protective factor for the development of T2DM. Promoting policies to preserve and increase green space could help to reduce T2DM at the community level. More standardization of green space exposure definition is needed in studies on green space and T2DM.
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Affiliation(s)
- Fabricio Ccami-Bernal
- Facultad de Medicina, Universidad Nacional de San Agustín de Arequipa, 04000, Arequipa, Peru.
| | - David R Soriano-Moreno
- Unidad de Investigación Clínica y Epidemiológica, Universidad Peruana Unión, 15464, Lima, Peru.
| | | | - Kimberly G Tuco
- Unidad de Investigación Clínica y Epidemiológica, Universidad Peruana Unión, 15464, Lima, Peru.
| | - Sharong D Castro-Díaz
- Unidad de Investigación Clínica y Epidemiológica, Universidad Peruana Unión, 15464, Lima, Peru.
| | - Analis L Esparza-Varas
- Sociedad Científica de Estudiantes de Medicina de la Universidad Nacional de Trujillo, 13011, Trujillo, Peru.
| | | | | | - Andrea G Cortez-Soto
- Sociedad Científica de Estudiantes de Medicina Humana de Ica (SOCEMI), 11004, Ica, Peru.
| | - Marlon Yovera-Aldana
- Grupo de Investigación Neurociencia, Efectividad Clínica y Salud Pública, Universidad Científica del Sur, 15067, Lima, Peru.
| | - David Rojas-Rueda
- Department of Environmental and Radiological Health Sciences, Colorado State University, 80523, Fort Collins, CO, USA; Colorado School of Public Health, Colorado State University, Fort Collins, CO, USA.
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22
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Masdor NA, Abu Bakar MF, Hod R, Mohammed Nawi A. Green space exposure and colorectal cancer: A systematic review. Heliyon 2023; 9:e15572. [PMID: 37153430 PMCID: PMC10160744 DOI: 10.1016/j.heliyon.2023.e15572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 04/14/2023] [Accepted: 04/14/2023] [Indexed: 05/09/2023] Open
Abstract
Green space has been linked to colorectal cancer, but the evidence is still limited and inconclusive. This review aimed to investigate the relationship between green space and CRC. The studies were searched using three primary journal databases: PubMed, Scopus, and Web of Science. The retrieved citations were screened, and data from articles about GS exposure and CRC were extracted. The Newcastle-Ottawa Quality Assessment Form for Cohort Studies was used to evaluate the studies' quality. Five of the 1792 articles identified were eligible for the final review, which included five cohort studies published between 2017 and 2022. Each one article from the United States, the United Kingdom, France, Belgium, and Germany and All studies are of high quality. Four studies reported CRC incidence and one study reported CRC mortality from GS exposure. There was no significant association between GS attributes (Normalized Difference Vegetation Index (NDVI), surrounding greenness, surrounding green area, proximity to GS (agricultural lands, urban GSs, and forests), and count of recreational facilities and parks) with CRC. Only one study discovered that a healthier ecosystem was linked to a lower CRC risk. Although the evidence is still limited, the findings may indicate the presence of other factors in the relationship between GS and CRC. Future research should continue to focus on the variation of GS and the factors that influence it. Specific attention to the development of GS has the potential to produce benefits while mitigating cancer risk.
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23
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Tharrey M, Klein O, Bohn T, Malisoux L, Perchoux C. Nine-year exposure to residential greenness and the risk of metabolic syndrome among Luxembourgish adults: A longitudinal analysis of the ORISCAV-Lux cohort study. Health Place 2023; 81:103020. [PMID: 37028115 DOI: 10.1016/j.healthplace.2023.103020] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 03/20/2023] [Accepted: 03/21/2023] [Indexed: 04/09/2023]
Abstract
Growing evidence shows a beneficial effect of exposure to greenspace on cardiometabolic health, although limited by the cross-sectional design of most studies. This study examined the long-term associations of residential greenness exposure with metabolic syndrome (MetS) and MetS components within the ORISCAV-LUX study (Wave 1: 2007-2009, Wave 2: 2016-2017, n = 395 adults). Objective exposure to residential greenness was measured in both waves by the Soil-Adjusted Vegetation Index (SAVI) and by Tree Cover Density (TCD). Linear mixed models were fitted to estimate the effect of baseline levels and change in residential greenness on MetS (continuous score: siMS score) and its components (waist circumference, triglycerides, HDL-cholesterol, fasting plasma glucose and systolic blood pressure), respectively. This study provides evidence that an increase in SAVI, but not TCD, may play a role in preventing MetS, as well as improving HDL-cholesterol and fasting plasma glucose levels. Greater baseline SAVI was also associated with lower fasting plasma glucose levels in women and participants living in municipalities with intermediate housing price, and greater baseline TCD was associated with larger waist circumference. Overall, findings suggest a mixed impact of increased greenness on cardiometabolic outcomes. Further longitudinal research is needed to better understand the potential effects of different types of greenness exposure on cardiometabolic outcomes.
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Affiliation(s)
- Marion Tharrey
- Department of Urban Development and Mobility, Luxembourg Institute of Socio-Economic Research, Esch/Alzette, Luxembourg; Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg.
| | - Olivier Klein
- Department of Urban Development and Mobility, Luxembourg Institute of Socio-Economic Research, Esch/Alzette, Luxembourg
| | - Torsten Bohn
- Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Laurent Malisoux
- Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Camille Perchoux
- Department of Urban Development and Mobility, Luxembourg Institute of Socio-Economic Research, Esch/Alzette, Luxembourg
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24
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Nguyen PY, Astell-Burt T, Rahimi-Ardabili H, Feng X. Effect of nature prescriptions on cardiometabolic and mental health, and physical activity: a systematic review. Lancet Planet Health 2023; 7:e313-e328. [PMID: 37019572 DOI: 10.1016/s2542-5196(23)00025-6] [Citation(s) in RCA: 35] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 01/31/2023] [Accepted: 02/01/2023] [Indexed: 06/19/2023]
Abstract
Nature prescriptions are gaining popularity as a form of social prescribing in support of sustainable health care. This systematic review and meta-analysis aims to synthesise evidence on the effectiveness of nature prescriptions and determine the factors important for their success. We searched five databases from inception up to July 25, 2021. Randomised and non-randomised controlled studies featuring a nature prescription (ie, a referral or an organised programme, by a health or social professional, to encourage spending time in nature) were included. Two reviewers independently conducted all steps of study selection; one reviewer collected summary data from published reports and conducted the risk of bias assessment. Random-effect DerSimonian-Laird meta-analyses were conducted for five key outcomes. We identified 92 unique studies (122 reports), of which 28 studies contributed data to meta-analyses. Compared with control conditions, nature prescription programmes resulted in a greater reduction in systolic blood pressure (mean difference -4·82 mm Hg [-8·92 to -0·72]) and diastolic blood pressure (mean difference -3·82 mm Hg [-6·47 to -1·16). Nature prescriptions also had a moderate to large effect on depression scores (post-intervention standardised mean difference -0·50 [-0·84 to -0·16]; change from baseline standardised mean difference -0·42 [-0·82 to -0·03]) and anxiety scores (post-intervention standardised mean difference -0·57 [-1·12 to -0·03]; change from baseline standardised mean difference -1·27 [-2·20 to -0·33]). Nature prescriptions resulted in a greater increase in daily step counts than control conditions (mean difference 900 steps [790 to 1010]) but did not improve weekly time of moderate physical activity (mean difference 25·90 min [-10·26 to 62·06]). A subgroup analysis restricted to studies featuring a referring institution showed stronger effects on depression scores, daily step counts, and weekly time of moderate physical activity than the general analysis. Beneficial effects on anxiety and depression scores were mainly provided by interventions involving social professionals whereas beneficial effects on blood pressures and daily step counts were provided mainly by interventions involving health professionals. Most studies have a moderate to high risk of bias. Nature prescription programmes showed evidence of cardiometabolic and mental health benefits and increases in walking. Effective nature prescription programmes can involve a range of natural settings and activities and can be implemented via social and community channels, in addition to health professionals.
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Affiliation(s)
- Phi-Yen Nguyen
- School of Population Health, University of New South Wales, Sydney, NSW, Australia; Population Wellbeing and Environment Research Lab (PowerLab), Sydney, NSW, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Thomas Astell-Burt
- Population Wellbeing and Environment Research Lab (PowerLab), Sydney, NSW, Australia; School of Health and Society, Faculty of Arts, Social Sciences, and Humanities, University of Wollongong, Wollongong, NSW, Australia
| | - Hania Rahimi-Ardabili
- School of Population Health, University of New South Wales, Sydney, NSW, Australia; Population Wellbeing and Environment Research Lab (PowerLab), Sydney, NSW, Australia; Centre for Health Informatics, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia
| | - Xiaoqi Feng
- School of Population Health, University of New South Wales, Sydney, NSW, Australia; Population Wellbeing and Environment Research Lab (PowerLab), Sydney, NSW, Australia; The George Institute of Global Health, Sydnet, NSW, Australia.
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25
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Zhuang Y, Xie D, Yu X. Urban Tree Canopy and Environmental Justice: Examining the Distributional Equity of Urban Tree Canopy in Guangzhou, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4050. [PMID: 36901064 PMCID: PMC10001874 DOI: 10.3390/ijerph20054050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 02/21/2023] [Accepted: 02/22/2023] [Indexed: 06/18/2023]
Abstract
Rapid urbanization has led to a series of environmental problems that are harmful to the physical and mental health of residents. Not only can increasing urban tree canopy (UTC) improve sustainable city development, but it can also effectively promote the quality of life for residents; however, the uneven spatial distribution of UTC can also bring about social justice problems. Currently, there are few studies related to the justice of UTC distribution in China. Based on this, the paper adopts object-oriented image classification technology to interpret and extract UTC data from satellite images, and it uses house price to explore the justice of the spatial distribution of UTC in the main urban area of Guangzhou from the perspective of environmental justice by ANOVA, Pearson correlation coefficient, and bivariate local spatial autocorrelation. The results show that: (1) There is a significant positive correlation between UTC and house price in the main urban area of Guangzhou, and there are regional differences in the distribution of UTC, with the UTC in the "very high" house price group being significantly higher than that in other groups. (2) The spatial clustering of UTC and house price in the main urban area of Guangzhou is found to be "low-low" and "high-high"; thus, it can be concluded that the spatial distribution of UTC in the main urban area of Guangzhou is uneven. This is an environmental injustice, as the areas with low UTC are spatially clustered in old residential areas, while the areas with high UTC are spatially clustered in commercial housing estates with high house prices. The study shows that urban tree planting should not only focus on quantitative improvement but also on equitable spatial layouts to promote social equity and justice thereby improving the urban ecological environment and promoting healthy urban development.
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Affiliation(s)
- Yutian Zhuang
- School of Architecture and Urban Planning, Guangdong University of Technology, Guangzhou 510090, China
| | - Dixiang Xie
- School of Architecture and Urban Planning, Guangdong University of Technology, Guangzhou 510090, China
| | - Xijun Yu
- South China Institute for Environmental Science, Ministry of Ecology and Environment, Guangzhou 510655, China
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26
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Iungman T, Cirach M, Marando F, Pereira Barboza E, Khomenko S, Masselot P, Quijal-Zamorano M, Mueller N, Gasparrini A, Urquiza J, Heris M, Thondoo M, Nieuwenhuijsen M. Cooling cities through urban green infrastructure: a health impact assessment of European cities. Lancet 2023; 401:577-589. [PMID: 36736334 DOI: 10.1016/s0140-6736(22)02585-5] [Citation(s) in RCA: 57] [Impact Index Per Article: 57.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 10/14/2022] [Accepted: 12/07/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND High ambient temperatures are associated with many health effects, including premature mortality. The combination of global warming due to climate change and the expansion of the global built environment mean that the intensification of urban heat islands (UHIs) is expected, accompanied by adverse effects on population health. Urban green infrastructure can reduce local temperatures. We aimed to estimate the mortality burden that could be attributed to UHIs and the mortality burden that would be prevented by increasing urban tree coverage in 93 European cities. METHODS We did a quantitative health impact assessment for summer (June 1-Aug 31), 2015, of the effect of UHIs on all-cause mortality for adults aged 20 years or older in 93 European cities. We also estimated the temperature reductions that would result from increasing tree coverage to 30% for each city and estimated the number of deaths that could be potentially prevented as a result. We did all analyses at a high-resolution grid-cell level (250 × 250 m). We propagated uncertainties in input analyses by using Monte Carlo simulations to obtain point estimates and 95% CIs. We also did sensitivity analyses to test the robustness of our estimates. FINDINGS The population-weighted mean city temperature increase due to UHI effects was 1·5°C (SD 0·5; range 0·5-3·0). Overall, 6700 (95% CI 5254-8162) premature deaths could be attributable to the effects of UHIs (corresponding to around 4·33% [95% CI 3·37-5·28] of all summer deaths). We estimated that increasing tree coverage to 30% would cool cities by a mean of 0·4°C (SD 0·2; range 0·0-1·3). We also estimated that 2644 (95% CI 2444-2824) premature deaths could be prevented by increasing city tree coverage to 30%, corresponding to 1·84% (1·69-1·97) of all summer deaths. INTERPRETATION Our results showed the deleterious effects of UHIs on mortality and highlighted the health benefits of increasing tree coverage to cool urban environments, which would also result in more sustainable and climate-resilient cities. FUNDING GoGreenRoutes, Spanish Ministry of Science and Innovation, Institute for Global Health, UK Medical Research Council, European Union's Horizon 2020 Project Exhaustion.
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Affiliation(s)
- Tamara Iungman
- Institute for Global Health, Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Marta Cirach
- Institute for Global Health, Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - Evelise Pereira Barboza
- Institute for Global Health, Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Sasha Khomenko
- Institute for Global Health, Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Pierre Masselot
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Marcos Quijal-Zamorano
- Institute for Global Health, Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Natalie Mueller
- Institute for Global Health, Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Antonio Gasparrini
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK; Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK; Centre for Statistical Methodology, London School of Hygiene & Tropical Medicine, London, UK
| | - José Urquiza
- Institute for Global Health, Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Mehdi Heris
- Hunter College, City University of New York, New York, NY, USA
| | - Meelan Thondoo
- Institute for Global Health, Barcelona, Spain; MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Mark Nieuwenhuijsen
- Institute for Global Health, Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
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Feng X, Navakatikyan MA, Toms R, Astell-Burt T. Leafier Communities, Healthier Hearts: An Australian Cohort Study of 104,725 Adults Tracking Cardiovascular Events and Mortality Across 10 Years of Linked Health Data. Heart Lung Circ 2023; 32:105-113. [PMID: 36586794 DOI: 10.1016/j.hlc.2022.10.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 10/11/2022] [Accepted: 10/19/2022] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Green space reduces cardiovascular disease (CVD) risk, but few studies examine what types of green space matter, which is an important consideration as cities densify and apartments become more common. METHOD Participants were 86,727 in houses and 17,998 in apartments from the 45 and Up Study (Sax Institute) baseline survey with 10 years of linked hospitalisation and death data used to define: (i) all-cause; and (ii) CVD-mortality; (iii) fatal and non-fatal CVD events; and (iv) acute myocardial infarction (AMI). Associations with total green space, tree canopy cover and open grass within 1.6 km buffers were assessed using survival analysis adjusted for potential confounders. RESULTS Mean percentage green space indicators were all higher among participants in houses than in apartments. Among residents of houses, a 10% increase in total green space was associated with reduced risk of CVD mortality (HR 0.97, 95%CI 0.95-1.00). A 10% increase in tree canopy cover was associated with reduced risks of all-cause mortality (HR 0.97, 95%CI 0.95-0.99), CVD mortality (HR 0.96, 95%CI 0.93-0.98), and fatal or non-fatal AMI (HR 0.93, 95%CI 0.89-0.96). In contrast, a 10% increase in open grass was associated with an increased risk of fatal or non-fatal AMI (HR 1.15, 95%CI 1.09-1.20) in residents of houses. Among residents of apartments, a 10% increase in total green space was associated with increased risk of all-cause mortality (HR 1.04, 95%CI 1.00-1.08) and CVD mortality (HR 1.03, 95%CI 1.00-1.08). CONCLUSIONS Urban reforestation may be a population-level intervention to protect cardiovascular health, especially for people living in houses. The intersection of urban greening and cardiovascular health among residents of apartments warrants further investigation.
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Affiliation(s)
- Xiaoqi Feng
- School of Population Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia; School of Health and Society, Faculty of Arts, Social Sciences, and Humanities, University of Wollongong, Wollongong, NSW, Australia; Population Wellbeing and Environment Research Lab (PowerLab), Sydney, NSW, Australia; The George Institute for Global Health, UNSW Sydney, Sydney, NSW, Australia.
| | - Michael A Navakatikyan
- School of Health and Society, Faculty of Arts, Social Sciences, and Humanities, University of Wollongong, Wollongong, NSW, Australia; Population Wellbeing and Environment Research Lab (PowerLab), Sydney, NSW, Australia
| | - Renin Toms
- School of Population Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia; School of Health and Society, Faculty of Arts, Social Sciences, and Humanities, University of Wollongong, Wollongong, NSW, Australia; Population Wellbeing and Environment Research Lab (PowerLab), Sydney, NSW, Australia
| | - Thomas Astell-Burt
- School of Population Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia; School of Health and Society, Faculty of Arts, Social Sciences, and Humanities, University of Wollongong, Wollongong, NSW, Australia; Population Wellbeing and Environment Research Lab (PowerLab), Sydney, NSW, Australia.
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Fernández Núñez MB, Campos Suzman L, Maneja R, Bach A, Marquet O, Anguelovski I, Knobel P. The Differences by Sex and Gender in the Relationship Between Urban Greenness and Cardiometabolic Health: A Systematic Review. J Urban Health 2022; 99:1054-1067. [PMID: 36180810 PMCID: PMC9727044 DOI: 10.1007/s11524-022-00685-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
In an increasingly urbanized world, where cardiometabolic issues in cities have raised public health concerns, urban greenness is known to be beneficial for some of the most common health issues. However, the examination of the contribution of sex and gender regarding the benefits of urban greenness for people's cardiometabolic health is lacking. For that reason, we conducted a systematic review of previous literature on the topic following the PRISMA methodology. Additionally, we assessed the quality of the included articles, which we found satisfactory as most papers were of very good or good quality. We explored the relationship between urban greenness exposure and cardiovascular risk factors, cardiovascular diseases, and mortality from cardiovascular diseases. Results suggest that urban greenness is protective against cardiovascular risk factors, diseases, and mortality. When stratifying results by sex and gender, findings point to urban greenness being more beneficial for women and females in stroke and cardiovascular risk factors, except for hypertension and lipid accumulation product. On the other hand, males were more protected by urban greenness in terms of cardiovascular diseases and CVD-related mortality, thus proving that sex and gender health inequalities exist. Furthermore, looking towards the future, research needs to use the proper terminology for sex and gender and policy makers should design urban greenness with a gender perspective.
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Affiliation(s)
| | - Lia Campos Suzman
- Environmental Science and Technology Institute (ICTA), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Roser Maneja
- Forest Science and Technology Center of Catalonia, Ctra. de St. Llorenç de Morunys, km 2, 25280, Solsona, Spain
- Environment and Human Health Laboratory (EH2 Lab), Ctra. de St. Llorenç de Morunys, km 2, 25280, Solsona, Spain
- Geography Department, Autonomous University of Barcelona, Barcelona, Spain
| | - Albert Bach
- Forest Science and Technology Center of Catalonia, Ctra. de St. Llorenç de Morunys, km 2, 25280, Solsona, Spain
- Environment and Human Health Laboratory (EH2 Lab), Ctra. de St. Llorenç de Morunys, km 2, 25280, Solsona, Spain
| | - Oriol Marquet
- Geography Department, Autonomous University of Barcelona, Barcelona, Spain
| | - Isabelle Anguelovski
- Environmental Science and Technology Institute (ICTA), Universitat Autònoma de Barcelona, Barcelona, Spain
- ICREA, Institució Catalana de Recerca I Estudis Avançats, Barcelona, Spain
| | - Pablo Knobel
- Icahn School of Medicine at Mount Sinai, Department of Environmental Medicine and Public Health, 1 Gustave L. Levy Place, Box 1057, New York, NY, 10029, USA.
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Nieuwenhuijsen MJ, Dadvand P, Márquez S, Bartoll X, Barboza EP, Cirach M, Borrell C, Zijlema WL. The evaluation of the 3-30-300 green space rule and mental health. ENVIRONMENTAL RESEARCH 2022; 215:114387. [PMID: 36162472 DOI: 10.1016/j.envres.2022.114387] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 09/15/2022] [Accepted: 09/17/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND AND AIMS Urban green space has many health benefits, but it is still unclear how much actually is needed for better health. Recently a new 3-30-300 rule of thumb for urban forestry and urban greening has been proposed, but this rule has not been evaluated for benefits on health. The rule requires that every citizen should be able to see at least three trees from their home, have 30 percent tree canopy cover in their neighbourhood and not live more than 300 m away from the nearest park or green space. The aim of this study was to evaluate the relationship between the 3-30-300 green space rule and its components in relation to mental health. METHODS We conducted a cross-sectional study based on a population-based sample of 3145 individuals aged 15-97 years from in Barcelona, Spain who participated in the Barcelona Health Survey (2016-2017). We created 3-30-300 green space indicators using questionnaire data, GIS, remote sensing and land cover maps. Mental health status was assessed with the 12-item General Health Questionnaire (GHQ-12) and also the use of tranquilizer/sedatives or antidepressants and psychiatrist or psychologist visits. Analyses were conducted using mixed effects logistic regression models with districts as the random effect, adjusted for relevant covariates. RESULTS We found that people in Barcelona had relatively little exposure to green space, whether through window view, living in an area with sufficient greenness, or access to a major green space, and only 4.7% met a surrogate 3-30-300 green space rule. Residential surrounding greenness, but not tree window view or access to major green space, was significantly associated with better mental health, less medication use, and fewer psychologist or psychiatrist visits. Meeting the full surrogate 3-30-300 green space rule was associated with better mental health, less medication use, and fewer psychologist or psychiatrist visits, but only for the latter combined the association was statistically significant (Odds ratio = 0.31, 95% CI: 0.11, 0.91). CONCLUSION Few people achieved the 3-30-300 green space in Barcelona and we used a surrogate measure. We observed health benefits when the full surrogate rule was met.
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Affiliation(s)
- Mark J Nieuwenhuijsen
- Barcelona Institute for Global Health (ISGlobal), Doctor Aiguader 88, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Doctor Aiguader 88, 08003, Barcelona, Spain; CIBER Epidemioloǵıa y Salud Pública (CIBERESP), Melchor Ferńandez Almagro, 3-5, 28029, Madrid, Spain.
| | - Payam Dadvand
- Barcelona Institute for Global Health (ISGlobal), Doctor Aiguader 88, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Doctor Aiguader 88, 08003, Barcelona, Spain; CIBER Epidemioloǵıa y Salud Pública (CIBERESP), Melchor Ferńandez Almagro, 3-5, 28029, Madrid, Spain
| | - Sandra Márquez
- Barcelona Institute for Global Health (ISGlobal), Doctor Aiguader 88, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Doctor Aiguader 88, 08003, Barcelona, Spain; CIBER Epidemioloǵıa y Salud Pública (CIBERESP), Melchor Ferńandez Almagro, 3-5, 28029, Madrid, Spain
| | - Xavier Bartoll
- Agència de Salut Pública de Barcelona, Avinguda Pŕıncep D'Astúries, 63 (1-1), 08012, Barcelona, Spain; Institut de Recerca Biomèdica Sant Pau (IIB-Sant Pau), 08041, Barcelona, Spain
| | - Evelise Pereira Barboza
- Barcelona Institute for Global Health (ISGlobal), Doctor Aiguader 88, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Doctor Aiguader 88, 08003, Barcelona, Spain; CIBER Epidemioloǵıa y Salud Pública (CIBERESP), Melchor Ferńandez Almagro, 3-5, 28029, Madrid, Spain
| | - Marta Cirach
- Barcelona Institute for Global Health (ISGlobal), Doctor Aiguader 88, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Doctor Aiguader 88, 08003, Barcelona, Spain; CIBER Epidemioloǵıa y Salud Pública (CIBERESP), Melchor Ferńandez Almagro, 3-5, 28029, Madrid, Spain
| | - Carme Borrell
- Universitat Pompeu Fabra (UPF), Doctor Aiguader 88, 08003, Barcelona, Spain; CIBER Epidemioloǵıa y Salud Pública (CIBERESP), Melchor Ferńandez Almagro, 3-5, 28029, Madrid, Spain; Agència de Salut Pública de Barcelona, Avinguda Pŕıncep D'Astúries, 63 (1-1), 08012, Barcelona, Spain; Institut de Recerca Biomèdica Sant Pau (IIB-Sant Pau), 08041, Barcelona, Spain
| | - Wilma L Zijlema
- Barcelona Institute for Global Health (ISGlobal), Doctor Aiguader 88, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Doctor Aiguader 88, 08003, Barcelona, Spain; CIBER Epidemioloǵıa y Salud Pública (CIBERESP), Melchor Ferńandez Almagro, 3-5, 28029, Madrid, Spain
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Abstract
In recent decades, the prevalence of obesity and diabetes has risen substantially in North America and worldwide. To address these dual epidemics, researchers and policymakers alike have been searching for effective means to promote healthy lifestyles at a population level. As a consequence, there has been a proliferation of research examining how the "built" environment in which we live influences physical activity levels, by promoting active forms of transportation, such as walking and cycling, over passive ones, such as car use. Shifting the transportation choices of local residents may mean that more members of the population can participate in physical activity during their daily routine without structured exercise programs. Increasingly, this line of research has considered the downstream metabolic consequences of the environment in which we live, raising the possibility that "healthier" community designs could help mitigate the rise in obesity and diabetes prevalence. This review discusses the evidence examining the relationship between the built environment, physical activity, and obesity-related diseases. We also consider how other environmental factors may interact with the built environment to influence metabolic health, highlighting challenges in understanding causal relationships in this area of research.
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Affiliation(s)
| | - Gillian L Booth
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- ICES, Toronto, ON, Canada
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Chen Q, Ma X, Geng Y, Liao J, Ma L. Association between smoking and hypertension under different PM 2.5 and green space exposure: A nationwide cross-sectional study. Front Public Health 2022; 10:1026648. [PMID: 36466446 PMCID: PMC9712966 DOI: 10.3389/fpubh.2022.1026648] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 10/24/2022] [Indexed: 11/19/2022] Open
Abstract
Background Smoking has been widely reported to have a significant relationship with hypertension, but the past description of this relationship has not been uniform. In addition, there has been a lack of research to discuss the impact of environmental exposure on the relationship between smoking and hypertension. Therefore, this study estimates the association between smoking and hypertension in middle aged and elderly people in China under different PM2.5 (fine particulate matter) concentrations and the green space exposure conditions. Methods Individual sample data from the China Health and Retirement Longitudinal Study in 2018 and the long-term average exposure concentration of fine particles and green space exposure for all participants were used with a multilevel binary logistic mixed effects model. Adjustments were made for sociodemographic characteristics and other health behaviors including drinking, physical activity, and social activity. The normalized difference vegetation index (NDVI) and PM2.5 concentration stratification were assigned with the median of the population exposure concentration as the dividing line, and the dual environmental factor stratification was assigned in combination with the two types of environmental exposure. The analysis was also stratified using age groups. Results A total of 10,600 participants over the age of 45 were included in the study. The effects of smoking on hypertension were diverse under different environmental exposure conditions. There was a significant relationship between smoking behavior and hypertension in the Low-NDVI group, and the effect value of this relationship was significantly different from that in the High-NDVI group. Furthermore, for respondents exposed to low green spaces and high PM2.5 environments at the same time (Low-NDVI/High-PM2.5 group), their smoking behavior may lead to an increase in the risk of hypertension. In addition, the risk of hypertension caused by smoking in the middle-aged (45-64) was significant under low green space exposure, but the effect difference between the different age groups was not significant. Conclusions The relationship between smoking and hypertension was different under different environmental exposure conditions. Exposure to low green spaces may strengthen the association between smoking and hypertension risk. When participants were exposed to both low green spaces and high PM2.5 concentrations, the risk of hypertension caused by smoking was significantly higher than that of those who were exposed to high green spaces and low PM2.5 concentrations.
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Affiliation(s)
- Qihao Chen
- Department of Biostatistics, School of Public Health, Wuhan University, Wuhan, China
| | - Xuxi Ma
- Department of Global Health, School of Public Health, Wuhan University, Wuhan, China
| | - Yan Geng
- Department of Global Health, School of Public Health, Wuhan University, Wuhan, China
| | - Jingling Liao
- Department of Nutrition and Food Hygiene, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan, China
| | - Lu Ma
- Department of Biostatistics, School of Public Health, Wuhan University, Wuhan, China,*Correspondence: Lu Ma
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Spatial and socioeconomic inequities in liveability in Australia’s 21 largest cities: Does city size matter? Health Place 2022; 78:102899. [DOI: 10.1016/j.healthplace.2022.102899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 08/11/2022] [Accepted: 08/12/2022] [Indexed: 11/16/2022]
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Cao M, Guan T, Tong M, Li J, Lu H, Yang X, Wang R, Liu H, Chao B, Liu Y, Xue T. Greenspace exposure and poststroke disability: A nationwide longitudinal study. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 246:114195. [PMID: 36265403 DOI: 10.1016/j.ecoenv.2022.114195] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 10/12/2022] [Accepted: 10/13/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Exposure to greenspace has been reported to reduce stroke mortality, but there is a lack of evidence regarding poststroke disability. This study aimed to investigate the association between long-term greenspace exposure and the risk of poststroke disability. METHODS Based on the China National Stroke Screening Survey from 2013 to 2019, a total of 65,892 visits from 28,085 stroke survivors with ≥ 2 visits were included in this longitudinal study. Long-term greenspace exposure was assessed by a 3-year average of the Normalized Difference Vegetation Index (NDVI) and the proportion of green land cover according to participants' residential communities. Poststroke functional status was assessed with the modified Ranking Score (mRS) at each visit; a cutoff score > 2 indicated disability. Fixed effects regressions were used to examine the association of greenspace exposure with continuous mRS scores or binary indicators for disability. RESULTS The annual mean NDVI value was 0.369 (standard deviation = 0.120) for all visits among stroke survivors. With full adjustments, each 0.05 increase in NDVI was associated with a 0.056-unit (95 % confidence interval (CI): 0.034, 0.079) decrease in the mRS score and a 46.6 % (95 % CI: 10.0 %, 68.3 %) lower risk of poststroke disability. An L-shaped curve was observed for the nonlinear associations between NDVI and mRS score or disability. Additionally, each 1 % increase in grasslands, savannas, forest, and croplands was associated with 0.008- (95 % CI: 0.002, 0.014), 0.003- (95 % CI: 0.001, 0.005), 0.001- (95 % CI: -0.015, 0.018), and 0.002-unit (95 % CI: -0.003, 0.007) decreases in the mRS score, respectively. CONCLUSIONS Increasing greenspace was inversely associated with mRS score. Greenspace planning can be a potential intervention to prevent poststroke disability.
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Affiliation(s)
- Man Cao
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Tianjia Guan
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Mingkun Tong
- Institute of Reproductive and Child Health / National Health Commission Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Jiajianghui Li
- Institute of Reproductive and Child Health / National Health Commission Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Hong Lu
- Institute of Reproductive and Child Health / National Health Commission Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Xinyue Yang
- College of Environmental Sciences and Engineering, Peking University, Beijing, China
| | - Ruohan Wang
- Institute of Reproductive and Child Health / National Health Commission Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Hengyi Liu
- Institute of Reproductive and Child Health / National Health Commission Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Baohua Chao
- The General Office of Stroke Prevention Project Committee, National Health Commission of the People's Republic of China, Beijing, China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
| | - Tao Xue
- Institute of Reproductive and Child Health / National Health Commission Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.
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Wang R, Dong P, Dong G, Xiao X, Huang J, Yang L, Yu Y, Dong GH. Exploring the impacts of street-level greenspace on stroke and cardiovascular diseases in Chinese adults. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 243:113974. [PMID: 35988381 DOI: 10.1016/j.ecoenv.2022.113974] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 08/09/2022] [Accepted: 08/11/2022] [Indexed: 05/22/2023]
Abstract
In recent years, cardiovascular diseases (CVDs) have become the primary cause of death in the world. Existing studies have found that greenspace is important for the prevention of CVDs and stroke. However, since they only focus on large green infrastructure (e.g., urban parks) or the general greenspace (usually being evaluated through normalized difference vegetation index), little information exists regarding the association between street-level greenspace and CVDs (stroke). In this study, the CVDs and stroke data of participants were retrieved from the 33 Chinese Community Health Study. We measured participants' exposure to street-level greenspace exposure using street view images and machine learning technique. Multilevel logistic regressions were applied. While controlling for confounders, we found that higher level of street-level greenspace exposure was associated with lower CVDs prevalence. However, street-level greenspace exposure was associated with stroke prevalence only for females. The associations were stronger among females, younger adults, participants with educational attainment above high school, physically active participants and participants who were not overweight. None of the mediators (air pollution, physical exercise, and BMI) can explain the associations between street-level greenspace exposure and CVDs (stroke) prevalence. Our findings suggest that street-level vegetation should be increased to cope with the rapid growth of the CVDs burdens. Also, the differences between the effect of street-level trees and grasses should be noted before formulating specific urban planning policies.
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Affiliation(s)
- Ruoyu Wang
- UKCRC Centre of Excellence for Public Health/Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland, United Kingdom.
| | - Pengxin Dong
- Nursing College, Guangxi Medical University, Nanning 530021, China.
| | - Guoping Dong
- School of Accounting, Guangzhou Huashang College, Guangzhou 511300, China.
| | - Xiang Xiao
- Department of Geography, Hong Kong Baptist University, Hong Kong, China.
| | - Jingwen Huang
- 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.
| | - Linchuan Yang
- Department of Urban and Rural Planning, School of Architecture and Design, Southwest Jiaotong University, Chengdu, China.
| | - Yunjiang Yu
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou 510655, 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.
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Zhang J, Cui J, Astell-Burt T, Shi W, Peng J, Lei L, Xin X, Zhang J, Feng X, Jiang Y, Ma J. Weekly green space visit duration is positively associated with favorable health outcomes in people with hypertension: Evidence from Shenzhen, China. ENVIRONMENTAL RESEARCH 2022; 212:113228. [PMID: 35398313 DOI: 10.1016/j.envres.2022.113228] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 03/04/2022] [Accepted: 03/29/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Studies from high income 'western' countries indicate that green space visit duration is associated with better health. However, scant comparable research has been done in developing countries with rapid urbanization and on the potential health impacts of specific green infrastructure. OBJECTIVE Associations between green space visit duration, green infrastructure and various health outcomes were assessed in hypertensive patients. METHODS A stratified multi-stage cluster random sampling method was applied to select 1116 patients with hypertension aged 35 years or older in Shenzhen, China. Face-to-face survey, physical examination and laboratory biochemical tests were applied to obtain information. Binary logistic regressions with restricted cubic splines were used to explore the degree of linearity in associations between green space visit duration and the following health outcomes: central obesity; diabetes; blood pressure; dyslipidemia; poor physical health; poor mental health. Models were adjusted for age, sex, education, marital status, occupation, and socioeconomic status. Further analysis was made for presence of the following health promoting green infrastructure: health knowledge promotion areas; walking trails; fitness areas; group exercise venues. RESULTS Each additional 30 min green space visitation was linearly associated with lower odds of self-reported poor mental health [OR (95%CI): 0.937 (0.891-0.985)], self-reported poor physical health [OR (95%CI): 0.918 (0.872-0.966)], and central obesity [OR (95%CI): 0.951 (0.907-0.997)]. Odds of poor mental health [OR (95%CI): 0.886 (0.788-0.997)], poor physical health [OR (95%CI): 0.882 (0.782-0.996)] and central obesity [OR (95%CI): 0.855 (0.765-0.955)] were founded to decrease with a greater number of health promoting green infrastructure. CONCLUSION More time spent in green space and with more types of green infrastructure were favourably associated with central obesity, and physical and mental health in people with hypertension.
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Affiliation(s)
- Jingwen Zhang
- School of Population Medicine and Public Health, Peking Union Medical College and the Chinese Academy of Medical Sciences, Beijing, China; Shijiazhuang Municipal Bureau of Statistics, Shijiazhuang, Hebei Province, China
| | - Jia Cui
- School of Population Medicine and Public Health, Peking Union Medical College and the Chinese Academy of Medical Sciences, Beijing, China
| | - Thomas Astell-Burt
- School of Population Medicine and Public Health, Peking Union Medical College and the Chinese Academy of Medical Sciences, Beijing, China; Population Wellbeing and Environment Research Lab (PowerLab), School of Health and Society, Faculty of Arts, Social Sciences, and Humanities, University of Wollongong, Wollongong, Australia; Menzies Centre for Health Policy, University of Sydney, Sydney, Australia; National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Wenhui Shi
- Division of Non-communicable Disease and Aging Health Management, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ji Peng
- Department of Chronic Non-communication Disease Control and Prevention, Shenzhen Center for Chronic Disease Control, Shenzhen, China
| | - Lin Lei
- Department of Chronic Non-communication Disease Control and Prevention, Shenzhen Center for Chronic Disease Control, Shenzhen, China
| | - Xin Xin
- Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Juan Zhang
- School of Population Medicine and Public Health, Peking Union Medical College and the Chinese Academy of Medical Sciences, Beijing, China.
| | - Xiaoqi Feng
- Population Wellbeing and Environment Research Lab (PowerLab), School of Health and Society, Faculty of Arts, Social Sciences, and Humanities, University of Wollongong, Wollongong, Australia; Menzies Centre for Health Policy, University of Sydney, Sydney, Australia; National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
| | - Yu Jiang
- School of Population Medicine and Public Health, Peking Union Medical College and the Chinese Academy of Medical Sciences, Beijing, China
| | - Jixiang Ma
- Shandong Center for Disease Control and Prevention, Shandong, China
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Konijnendijk CC. Evidence-based guidelines for greener, healthier, more resilient neighbourhoods: Introducing the 3-30-300 rule. JOURNAL OF FORESTRY RESEARCH 2022; 34:821-830. [PMID: 36042873 PMCID: PMC9415244 DOI: 10.1007/s11676-022-01523-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 08/07/2022] [Indexed: 05/05/2023]
Abstract
The important contributions of urban trees and green spaces to for example, climate moderation and public health have been recognized. This paper discusses guidelines and norms that promote the benefits of viewing green, living amongst green, and having easy access to green spaces for recreational use. Having trees and other vegetation in sight from one's home, place of work, or school has important mental health and performance benefits. Local tree canopy cover is positively associated with cooling and other aspects of climate moderation. With public green spaces in proximity to one's home stimulates regular use of these areas and results in positive impacts on mental, physical, and social health. After analyzing existing guidelines and rules for urban green space planning and provision, a new, comprehensive guideline is presented, known as the '3-30-300 rule' for urban forestry. This guideline aims to provide equitable access to trees and green spaces and their benefits by setting the thresholds of having at least 3 well-established trees in view from every home, school, and place of work, no less than a 30% tree canopy in every neighbourhood; and no more than 300 m to the nearest public green space from every residence. Current implementation of this new guideline is discussed, as well as the advantages and disadvantages of using this evidence-based but also clear and simple rules.
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Grigsby-Toussaint DS, Shin JC. COVID-19, green space exposure, and mask mandates. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 836:155302. [PMID: 35447167 PMCID: PMC9015714 DOI: 10.1016/j.scitotenv.2022.155302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 04/11/2022] [Accepted: 04/11/2022] [Indexed: 05/07/2023]
Abstract
INTRODUCTION Mask-wearing and social distancing are critical prevention measures that have been implemented to stem the spread of COVID-19. The degree to which these measures are adhered to in the US, however, may be influenced by access to outdoor resources such as green space, as well as mask mandates that may vary by state. PURPOSE To examine the association between the presence or absence of statewide mask mandates and green space exposure with COVID-19 cumulative incidence in the US. METHODS In October 2020, COVID-19 case data for each US county was downloaded from USA Facts, in addition to statewide mask mandates from a database maintained by the American Association of Retired Persons. The Normalized Difference Vegetation Index from the US Geological Survey (USGS), was used as a measure of greenspace, while the 2016 National Land Cover Database was used to assess tree canopy exposure as an alternative measure of greenspace. We performed generalized linear regression to evaluate associations with COVID-19 incidence, adjusting for potential confounders such as other environmental factors (i.e., air pollution and climate) and socio-economic factors derived from the CDC social vulnerability index. In addition, we also performed spatial regression analyses to account for spatial autocorrelation across counties. RESULTS Counties with mandatory mask-wearing policies had a lower cumulative incidence of COVID-19 (B = -0.299, SE = 0.038). Among environmental factors, precipitation (B = 0.005, SE = 0.001) and PM 2.5 (B = 0.072, SE = 0.012) were associated with a higher incidence of COVID-19, while tree canopy (B = -0.501, SE = 0.129) was associated with a lower risk of COVID-19. COVID-19 incidence was higher in counties with socially vulnerable populations regarding socioeconomic status, minority status, and housing and transportation. CONCLUSION Mandatory mask regulation, exposure to green space, and reduced exposure to air pollution may reduce COVID-19 incidence in the US. Additional public health policies should consider ways to mitigate environmental conditions that may contribute to the risk of COVID-19, especially for vulnerable populations.
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Affiliation(s)
- Diana S Grigsby-Toussaint
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island, United States of America; Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, United States of America.
| | - Jong Cheol Shin
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island, United States of America; Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, United States of America.
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Nature prescriptions for community and planetary health: unrealised potential to improve compliance and outcomes in physiotherapy. J Physiother 2022; 68:151-152. [PMID: 35753967 DOI: 10.1016/j.jphys.2022.05.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 05/30/2022] [Indexed: 11/24/2022] Open
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Putra IGNE, Astell-Burt T, Feng X. Perceived green space quality, child biomarkers and health-related outcomes: A longitudinal study. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 303:119075. [PMID: 35240270 DOI: 10.1016/j.envpol.2022.119075] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 01/24/2022] [Accepted: 02/26/2022] [Indexed: 06/14/2023]
Abstract
Accumulating exposure to quality green space over time is posited to influence child health, yet longitudinal studies are scarce. This study aimed to examine the associations between trajectories of perceived green space quality and child health-related outcomes. We used data from 1874 childrenin the B-cohort of the Longitudinal Study of Australian Children who participated in the Child Health Checkpoint module at 11-12 years. Data on caregiver perceived green space quality measured biennially was assessed using discrete trajectory mixture models to group children by contrasting distributions in green space quality over time. Examination of associations between trajectory groups of perceived green space quality and child biomarkers (i.e., albumin-to-creatinine ratio, total, cholesterol, total triglycerides, and glucose), physical health and behavioural assessments (i.e., anthropometric measurements, blood pressure, sedentary behaviour, physical activity, sleep, aerobic work capacity, and general wellbeing), and health care use were assessed using multilevel models, adjusted for sociodemographic variables. Four perceived green space quality trajectories were identified: "decreasing quality from high to moderate"; "increasing quality from low to high"; "consistently high quality"; "consistently low quality". Compared with consistently low levels of quality green space, adjusted models indicated consistently high-quality green space was associated with lower total triglycerides (β -0.13; 95%CI -0.25, -0.01). Lower odds of hospital admission was observed among children who accumulated quality green space over time (OR 0.45; 95%CI 0.23, 0.87). These associations were observed in boys only in sex-stratified analyses. Moreover, boys accumulating quality green space through time tended to have lower diastolic blood pressure (β -2.76; 95%CI -5.17, -0.35) and girls who experienced loss in quality green space tended to have a higher percentage of body fat (β 2.81; 95%CI 0.43, 5.20). Accumulating quality green space over time is important for various aspects of child health, with contrasting benefits by sex.
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Affiliation(s)
- I Gusti Ngurah Edi Putra
- Population Wellbeing and Environment Research Lab (PowerLab), NSW, Australia; School of Health and Society, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, NSW, Australia
| | - Thomas Astell-Burt
- Population Wellbeing and Environment Research Lab (PowerLab), NSW, Australia; School of Health and Society, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, NSW, Australia
| | - Xiaoqi Feng
- Population Wellbeing and Environment Research Lab (PowerLab), NSW, Australia; School of Health and Society, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, NSW, Australia; School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia.
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Perceived Qualities, Visitation and Felt Benefits of Preferred Nature Spaces during the COVID-19 Pandemic in Australia: A Nationally-Representative Cross-Sectional Study of 2940 Adults. LAND 2022. [DOI: 10.3390/land11060904] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
We investigated how the perceived quality of natural spaces influenced levels of visitation and felt benefits during the COVID-19 pandemic in Australia via a nationally representative online and telephone survey conducted on 12–26 October (Social Research Centre’s Life in AustraliaTM panel aged > 18 years, 78.8% response, n = 3043). Our sample was restricted to those with complete information (n = 2940). Likert scale responses to 18 statements regarding the quality of local natural spaces that participants preferred to visit were classified into eight quality domains: access; aesthetics; amenities; facilities; incivilities; potential usage; safety; and social. These domains were then summed into an overall nature quality score (mean = 5.8, range = 0–16). Associations between these quality variables and a range of nature visitation and felt benefits were tested using weighted multilevel models, adjusted for demographic and socioeconomic confounders. Compared with participants in the lowest perceived nature quality quintile, those in the highest quality quintile had higher odds of spending at least 2 h in their preferred local nature space in the past week (Odds Ratio [OR] = 3.40; 95% Confidence Interval [95%CI] = 2.38–4.86), of visiting their preferred nature space almost every day in the past four weeks (OR = 3.90; 2.77–5.47), and of reporting increased levels of nature visitation in comparison with before the COVID-19 pandemic (OR = 3.90; 2.54–6.00). Participants in the highest versus lowest perceived nature quality quintile also reported higher odds of feeling their visits to nature enabled them to take solace and respite during the pandemic (OR = 9.49; 6.73–13.39), to keep connected with their communities (OR = 5.30; 3.46–8.11), and to exercise more often than they did before the pandemic (OR = 3.88; 2.57–5.86). Further analyses of each quality domain indicated time in and frequency of visiting nature spaces were most affected by potential usage and safety (time in nature was also influenced by the level of amenity). Feelings of connection and solace were most affected by potential usage and social domains. Exercise was most influenced by potential usage, social and access domains. In conclusion, evidence reported in this study indicates that visits to nature and various health-related benefits associated with it during the COVID-19 pandemic were highly contingent upon numerous qualities of green and blue spaces.
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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.
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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.
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Cirino DW, Tambosi LR, Mauad T, Freitas SR, Metzger JP. Balanced spatial distribution of green areas creates healthier urban landscapes. J Appl Ecol 2022. [DOI: 10.1111/1365-2664.14195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | | | - Thais Mauad
- Faculdade de Medicina Universidade de São Paulo (FMUSP)
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Van Den Eeden SK, H E M Browning M, Becker DA, Shan J, Alexeeff SE, Thomas Ray G, Quesenberry CP, Kuo M. Association between residential green cover and direct healthcare costs in Northern California: An individual level analysis of 5 million persons. ENVIRONMENT INTERNATIONAL 2022; 163:107174. [PMID: 35306251 DOI: 10.1016/j.envint.2022.107174] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 02/17/2022] [Accepted: 03/07/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND AND OBJECTIVE Prior studies have shown higher green cover levels are associated with beneficial health outcomes. We sought to determine if residential green cover was also associated with direct healthcare costs. METHODS We linked residential Normalized Difference Vegetation Index (NDVI) satellite data for 5,189,303 members of Kaiser Permanente Northern California (KPNC) to direct individual healthcare costs for 2003-2015. Using generalized linear regression to adjust for confounding, we examined the association between direct healthcare costs and green cover within250, 500, and 1000 meters (m) of an individual's residence. Costs were determined from an internal cost accounting system that captures administrative and patient care costs for each clinical encounter. Sensitivity analyses included adjustments for comorbidity and an alternative measure of green cover, tree canopy. RESULTS We observed a significant inverse association between higher levels of residential green cover and lower direct healthcare costs. The relative rate of total cost for the highest compared to the lowest decile of NDVI was 0.92 (95% CI 0.90-0.93) for the 500 m buffer. The association was robust to adjustment from a broad array of confounders, found at each buffer size, and largely driven by hospitalization, and emergency department visits. Individuals in the top decile of residential green cover had adjusted healthcare costs of $374.04 (95% CI $307.31-$439.41) per person per year less than individuals living in the bottom or least green decile. Sensitivity analyses including tree canopy cover as the green space measure yielded similar findings. Analyses that included adjustment for comorbidity were consistent with the hypothesis that green cover reduces healthcare costs by improving health status. CONCLUSION Green cover was associated with lower direct healthcare costs, raising the possibility that residential greening can have a significant healthcare cost impact across the population.
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Affiliation(s)
| | - Matthew H E M Browning
- Department of Parks, Recreation and Tourism Management, Clemson University, Clemson, SC, USA
| | - Douglas A Becker
- Natural Resources and Environmental Sciences, University of Illinois, Urbana-Champaign, IL, USA
| | - Jun Shan
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Stacey E Alexeeff
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - G Thomas Ray
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | | | - Ming Kuo
- Natural Resources and Environmental Sciences, University of Illinois, Urbana-Champaign, IL, USA
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Chi D, Aerts R, Van Nieuwenhuyse A, Bauwelinck M, Demoury C, Plusquin M, Nawrot TS, Casas L, Somers B. Residential Exposure to Urban Trees and Medication Sales for Mood Disorders and Cardiovascular Disease in Brussels, Belgium: An Ecological Study. ENVIRONMENTAL HEALTH PERSPECTIVES 2022; 130:57003. [PMID: 35543508 PMCID: PMC9093162 DOI: 10.1289/ehp9924] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 03/31/2022] [Accepted: 04/04/2022] [Indexed: 05/21/2023]
Abstract
BACKGROUND The available evidence for positive associations between urban trees and human health is mixed, partly because the assessment of exposure to trees is often imprecise because of, for instance, exclusion of trees in private areas and the lack of three-dimensional (3D) exposure indicators (e.g., crown volume). OBJECTIVES We aimed to quantify all trees and relevant 3D structural traits in Brussels (Belgium) and to investigate associations between the number of trees, tree traits, and sales of medication commonly prescribed for mood disorders and cardiovascular disease. METHODS We developed a workflow to automatically isolate all individual trees from airborne light detection and ranging (LiDAR) data collected in 2012. Trait data were subsequently extracted for 309,757 trees in 604 census tracts. We used the average annual age-standardized rate of medication sales in Brussels for the period 2006 to 2014, calculated from reimbursement information on medication prescribed to adults (19-64 years of age). The medication sales data were provided by sex at the census tract level. Generalized log-linear models were used to investigate associations between the number of trees, the crown volume, tree structural variation, and medication sales. Models were run separately for mood disorder and cardiovascular medication and for men and women. All models were adjusted for indicators of area-level socioeconomic status. RESULTS Single-factor models showed that higher stem densities and higher crown volumes are both associated with lower medication sales, but opposing associations emerged in multifactor models. Higher crown volume [an increase by one interquartile range (IQR) of 1.4×104 m³/ha] was associated with 34% lower mood disorder medication sales [women, β=-0.341 (95% CI: -0.379, -0.303); men, β=-0.340 (95% CI: -0.378, -0.303)] and with 21-25% lower cardiovascular medication sales [women, β=-0.214 (95% CI: -0.246, -0.182); men, β=-0.252 (95% CI: -0.285, -0.219)]. Conversely, a higher stem density (an increase by one IQR of 21.8 trees/ha) was associated with 28-32% higher mood disorder medication sales [women, β=0.322 (95% CI: 0.284, 0.361); men, β=0.281 (95% CI: 0.243, 0.319)] and with 20-24% higher cardiovascular medication sales [women, β=0.202 (95% CI: 0.169, 0.236); men, β=0.240 (95% CI: 0.206, 0.273)]. DISCUSSION We found a trade-off between the number of trees and the crown volumes of those trees for human health benefits in an urban environment. Our results demonstrate that conserving large trees in urban environments may not only support conservation of biodiversity but also human health. https://doi.org/10.1289/EHP9924.
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Affiliation(s)
- Dengkai Chi
- Division of Forest, Nature and Landscape, University of Leuven (KU Leuven), Leuven, Belgium
- KU Leuven Plant Institute, KU Leuven, Leuven, Belgium
- KU Leuven Urban Studies Institute, KU Leuven, Leuven, Belgium
| | - Raf Aerts
- KU Leuven Plant Institute, KU Leuven, Leuven, Belgium
- Risk and Health Impact Assessment, Sciensano (Belgian Institute of Health), Brussels, Belgium
- Division of Ecology, Evolution and Biodiversity Conservation, KU Leuven, Leuven, Belgium
- Center for Environmental Sciences, University of Hasselt, Hasselt, Belgium
| | - An Van Nieuwenhuyse
- Risk and Health Impact Assessment, Sciensano (Belgian Institute of Health), Brussels, Belgium
- Center for Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Mariska Bauwelinck
- Interface Demography, Department of Sociology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Claire Demoury
- Risk and Health Impact Assessment, Sciensano (Belgian Institute of Health), Brussels, Belgium
| | - Michelle Plusquin
- Center for Environmental Sciences, University of Hasselt, Hasselt, Belgium
| | - Tim S. Nawrot
- Center for Environmental Sciences, University of Hasselt, Hasselt, Belgium
- Center for Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Lidia Casas
- Social Epidemiology and Health Policy, Department Family Medicine and Population Health, University of Antwerp, Wilrijk, Belgium
| | - Ben Somers
- Division of Forest, Nature and Landscape, University of Leuven (KU Leuven), Leuven, Belgium
- KU Leuven Plant Institute, KU Leuven, Leuven, Belgium
- KU Leuven Urban Studies Institute, KU Leuven, Leuven, Belgium
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Zhao Y, Bao WW, Yang BY, Liang JH, Gui ZH, Huang S, Chen YC, Dong GH, Chen YJ. Association between greenspace and blood pressure: A systematic review and meta-analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 817:152513. [PMID: 35016929 DOI: 10.1016/j.scitotenv.2021.152513] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 12/08/2021] [Accepted: 12/14/2021] [Indexed: 06/14/2023]
Abstract
Many studies have investigated the association between greenspaces and blood pressure (BP), but the results remain mixed. We conducted a systematic review and meta-analysis to comprehensively evaluate the evidence concerning greenspaces with BP levels and prevalent hypertension. Systematic literature searches were performed in Web of Science, PubMed, and Embase up to 25 April 2021. Combined effect estimates were calculated using random-effect models for each greenspace exposure assessment method that had been examined in ≥3 studies. Sensitivity analysis, subgroup analysis, and publication bias were also conducted. Of 38 articles (including 52 analyses, 5.2 million participants in total) examining the effects of normalized difference vegetation index (NDVI) (n = 23), proportion of greenspace (n = 11), distance to greenspace (n = 9), and others (n = 9) were identified. Most studies (65%) reported beneficial associations between greenspaces and BP levels/hypertension. Our results of meta-analyses showed that higher NDVI500m was significantly associated with lower levels of systolic blood pressure (SBP = -0.77 mmHg, 95%CI: -1.23 to -0.32) and diastolic blood pressure (DBP = -0.32 mmHg, 95%CI: -0.57 to -0.07). We also found that NDVI in different buffers and the proportion of greenspaces were significantly associated with lower odds (1-9%) of hypertension. However, no significant effect was found for distance to greenspaces. In summary, our results indicate the beneficial effects of greenspace exposure on BP and hypertension. However, future better-designed studies, preferably longitudinal, are needed to confirm and better quantify the observed benefits in BP and/or hypertension.
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Affiliation(s)
- Yu Zhao
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Wen-Wen Bao
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Bo-Yi Yang
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Jing-Hong Liang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Zhao-Huan Gui
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Shan Huang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Yi-Can Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Guang-Hui Dong
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Ya-Jun Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
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Feng X, Astell-Burt T, Standl M, Flexeder C, Heinrich J, Markevych I. Green space quality and adolescent mental health: do personality traits matter? ENVIRONMENTAL RESEARCH 2022; 206:112591. [PMID: 34932980 DOI: 10.1016/j.envres.2021.112591] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 12/16/2021] [Accepted: 12/16/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Adolescents, especially females, tend to experience poorer mental health if they are higher in introversion and neuroticism. As a result, they also may have more to gain from having quality green space (e.g. parks) nearby to enable restoration, but this remains tested. METHOD Cross-sectional data on 2946 adolescents aged 16-17y were extracted from the Longitudinal Study of Australian Children. Multilevel linear regressions assessed association between parent/caregiver green space quality perception with self-reported Strengths and Difficulties Questionnaire Total Difficulties Scores (TDS) and internalising (e.g. anxiety) and externalising (e.g. fidgetiness) subscales. Models were weighted for representativeness, accounted for spatial clustering within postcodes, and adjusted for geographic stratum and socioeconomic confounders. This was followed by adjustment for introversion and neuroticism, and then three-way interaction terms between each trait, green space quality and sex to assess for potential effect modification. RESULTS Quality green spaces was associated with higher TDS (β = 1.506; SE = 0.371), internalising (β = 0.982; SE = 0.220) and externalising (β = 0.518; SE = 0.234) scores (i.e. poorer mental health). Introversion was associated with higher TDS (β = 1.416; SE = 0.089), higher internalising (β = 1.233; SE = 0.050) and higher externalising scores (β = 0.181; SE = 0.056). Similar associations were observed for neuroticism and TDS (β = 2.283; SE = 0.084), internalising (β = 1.627; SE = 0.046) and externalising scores (β = 0.656; SE = 0.056). Mean levels of introversion were similar for girls and boys (1.73 vs 1.76, p = 0.6573), but mean levels of neuroticism were notably higher in girls than boys (2.42 and 1.67, p < 0.0001). Likelihood ratio tests indicated three-way interactions improved models analysing the internalising subscale outcome only. Green space quality made no difference to associations between introversion or neuroticism and internalising scores in males. Quality green space was associated with 3.2 and 2.1 reductions in mean internalising scores among females with the highest levels of introversion or neuroticism, respectively. CONCLUSIONS Individual differences in psychological traits may predispose some adolescents, and females especially, to restoration from green space.
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Affiliation(s)
- Xiaoqi Feng
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia; Population Wellbeing and Environment Research Lab (PowerLab), NSW, Australia; School of Health and Society, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, NSW, Australia.
| | - Thomas Astell-Burt
- Population Wellbeing and Environment Research Lab (PowerLab), NSW, Australia; School of Health and Society, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, NSW, Australia; Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia; Menzies Centre for Health Policy, University of Sydney, Sydney, NSW, Australia
| | - Marie Standl
- Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany
| | - Claudia Flexeder
- Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany
| | - Joachim Heinrich
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Iana Markevych
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany; Institute of Psychology, Jagiellonian University, Krakow, Poland
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Dzhambov AM, Lercher P, Markevych I, Browning MHEM, Rüdisser J. Natural and built environments and blood pressure of Alpine schoolchildren. ENVIRONMENTAL RESEARCH 2022; 204:111925. [PMID: 34437849 DOI: 10.1016/j.envres.2021.111925] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 08/18/2021] [Accepted: 08/19/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Early life environments may influence children's blood pressure (BP), but evidence on the combined effects of natural and built environment exposures is scarce. The present study investigates the associations of natural and built environment indicators, traffic noise, and air pollution with BP in children living in Alpine valleys. METHODS In 2004/2005, 1251 school children (8-12 years old) were sampled for a cross-sectional survey in several Austrian and Italian mountain valleys. Children's mothers completed a questionnaire. The outcomes of interest were systolic and diastolic BP measured with a calibrated oscillometric device. Indicators of land cover assigned to the residential and school coordinates within 100 and 1000 m included normalized difference vegetation index (NDVI), tree canopy cover, and a broader naturalness indicator titled distance to nature (D2N). The presence of a home garden was also measured via self-report. Imperviousness density served as a proxy for the built environment. Residential air pollution (NO2) and noise (Lden) from traffic were calculated using bespoke modeling. NO2, Lden, physical activity, and body mass index (BMI) were treated as mediating pathways. RESULTS Higher NDVI and tree cover levels in residential and school surroundings and home gardens were consistently associated with lower BP. The built environment was associated with higher BP. Counterintuitive inverse associations between NO2 and Lden and BP were also found. Structural equation modeling showed that higher levels of greenspace and presence of a home garden were weakly associated with more outdoor play spaces, and in turn with lower BMI, and ultimately with lower BP. CONCLUSIONS Exposure to natural environments may help maintain normal BP in children, while built environment may increase children's BP. Outdoor play and less adiposity in greener areas may mediate some of these associations. Evidence on air pollution and noise remains controversial and difficult to explain.
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Affiliation(s)
- Angel M Dzhambov
- Department of Hygiene, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria; Institute for Highway Engineering and Transport Planning, Graz University of Technology, Graz, Austria.
| | - Peter Lercher
- Institute for Highway Engineering and Transport Planning, Graz University of Technology, Graz, Austria
| | - Iana Markevych
- Institute of Psychology, Jagiellonian University, Krakow, Poland
| | - Matthew H E M Browning
- Department of Park, Recreation, and Tourism Management, Clemson University, Clemson, USA
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Bikomeye JC, Beyer AM, Kwarteng JL, Beyer KMM. Greenspace, Inflammation, Cardiovascular Health, and Cancer: A Review and Conceptual Framework for Greenspace in Cardio-Oncology Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:2426. [PMID: 35206610 PMCID: PMC8872601 DOI: 10.3390/ijerph19042426] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 02/12/2022] [Accepted: 02/17/2022] [Indexed: 02/04/2023]
Abstract
Cardiovascular disease (CVD) is a leading cause of global morbidity and mortality. Cancer survivors have significantly elevated risk of poor cardiovascular (CV) health outcomes due to close co-morbid linkages and shared risk factors between CVD and cancer, as well as adverse effects of cancer treatment-related cardiotoxicity. CVD and cancer-related outcomes are exacerbated by increased risk of inflammation. Results from different pharmacological interventions aimed at reducing inflammation and risk of major adverse cardiovascular events (MACEs) have been largely mixed to date. Greenspaces have been shown to reduce inflammation and have been associated with CV health benefits, including reduced CVD behavioral risk factors and overall improvement in CV outcomes. Greenspace may, thus, serve to alleviate the CVD burden among cancer survivors. To understand pathways through which greenspace can prevent or reduce adverse CV outcomes among cancer survivors, we review the state of knowledge on associations among inflammation, CVD, cancer, and existing pharmacological interventions. We then discuss greenspace benefits for CV health from ecological to multilevel studies and a few existing experimental studies. Furthermore, we review the relationship between greenspace and inflammation, and we highlight forest bathing in Asian-based studies while presenting existing research gaps in the US literature. Then, we use the socioecological model of health to present an expanded conceptual framework to help fill this US literature gap. Lastly, we present a way forward, including implications for translational science and a brief discussion on necessities for virtual nature and/or exposure to nature images due to the increasing human-nature disconnect; we also offer guidance for greenspace research in cardio-oncology to improve CV health outcomes among cancer survivors.
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Affiliation(s)
- Jean C. Bikomeye
- Institute for Health and Equity, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA; (J.C.B.); (J.L.K.)
- PhD Program in Public and Community Health, Division of Epidemiology & Social Sciences, Institute for Health and Equity, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA
| | - Andreas M. Beyer
- Department of Medicine, Division of Cardiology, Cardiovascular and Cancer Center, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA
| | - Jamila L. Kwarteng
- Institute for Health and Equity, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA; (J.C.B.); (J.L.K.)
- MCW Cancer Center, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA
| | - Kirsten M. M. Beyer
- Institute for Health and Equity, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA; (J.C.B.); (J.L.K.)
- PhD Program in Public and Community Health, Division of Epidemiology & Social Sciences, Institute for Health and Equity, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA
- MCW Cancer Center, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA
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Abstract
Peri-urban and urban green are considered among the basic priorities of the local government’s regional policy agenda, in line with the principles of spatial planning. This agenda is promoted at both the national and European levels through a variety of technical and institutional measures. Green spaces in urban and suburban areas are directly linked to the quality of life of urban residents and their environment. In this context, the purpose of this study is to investigate and identify the characteristics and factors that influence the residents of a small Greek city in terms of the value they attach to urban and suburban green spaces. These factors are identified through the residents’ willingness to pay (WTP) using the contingent valuation method (CVM). In general, the analysis aims to document the value of environmental economic methods as a tool in the management of natural heritage. According to the research, income and knowledge of environmental issues (global and local) as well as the benefits of green spaces (urban and suburban) are the key factors that drive residents to place a higher value on them. Future work may explore whether or how the COVID-19 pandemic affected city residents’ willingness to pay for green spaces.
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Koh C, Kondo MC, Rollins H, Bilal U. Socioeconomic Disparities in Hypertension by Levels of Green Space Availability: A Cross-Sectional Study in Philadelphia, PA. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042037. [PMID: 35206224 PMCID: PMC8872624 DOI: 10.3390/ijerph19042037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 02/08/2022] [Accepted: 02/08/2022] [Indexed: 01/18/2023]
Abstract
Green spaces have been proposed as equigenic factors, potentially mitigating health disparities. We used data from the 3887 participants residing in Philadelphia who participated in the Public Health Management Corporation’s Southeastern Pennsylvania Household Health Survey in 2014–2015 to assess whether socioeconomic disparities in hypertension are modified by availability of neighborhood-level green spaces. Socioeconomic status (SES) was measured using individual-level education and neighborhood-level median household income. Green space availability was measured using surrounding percent tree canopy cover, mean normalized difference vegetation index (NDVI), and proximity to nearest park. Using logistic regression models adjusted for age, sex, and race/ethnicity, we found that adults with higher educational attainment had significantly lower levels of hypertension (OR = 0.63, 0.57, and 0.36 for high school, some college, and college graduates, respectively, as compared to those with less than high school education), and this pattern was similar for median household income (higher prevalence in lower income areas). We found no significant interaction between education and percent tree canopy cover (p = 0.83), meaning that educational disparities in hypertension were similar across all levels of green space availability. These results held when using mean NDVI or distance to nearest park as availability measures, or when considering neighborhood-level median household income as the socioeconomic measure, although the specific patterns and significance of interactions varied by exposure and modifier. While socioeconomic disparities in hypertension are strong for adults residing in Philadelphia, green spaces did not seem to modify them.
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Affiliation(s)
- Celina Koh
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, 3215 Market St., Philadelphia, PA 19104, USA;
- Urban Health Collaborative, Drexel University Dornsife School of Public Health, 3600 Market St., Philadelphia, PA 19104, USA;
| | - Michelle C. Kondo
- Northern Research Station, United States Department of Agriculture–Forest Service, 100 N. St., Ste 205, Philadelphia, PA 19103, USA;
| | - Heather Rollins
- Urban Health Collaborative, Drexel University Dornsife School of Public Health, 3600 Market St., Philadelphia, PA 19104, USA;
| | - Usama Bilal
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, 3215 Market St., Philadelphia, PA 19104, USA;
- Urban Health Collaborative, Drexel University Dornsife School of Public Health, 3600 Market St., Philadelphia, PA 19104, USA;
- Correspondence: ; Tel.: +1-267-359-6378
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