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van de Geest JDS, Meijer P, Remmelzwaal S, Lakerveld J. Moderators and mediators of the association between the obesogenicity of neighbourhoods and weight status in Dutch adults. Health Place 2024; 90:103364. [PMID: 39357121 DOI: 10.1016/j.healthplace.2024.103364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 09/17/2024] [Accepted: 09/25/2024] [Indexed: 10/04/2024]
Abstract
This study aimed to assess sociodemographic, personality, and psychological moderators, and lifestyle behavioural mediators, of the association between obesogenicity of neighbourhoods and weight status in Dutch adults. This cross-sectional study used baseline data of 150,506 adult participants of the Lifelines study. To quantify obesogenicity of Dutch neighbourhoods, the Obesogenic Built Environment CharacterisTics (OBCT) index was used, calculated for 1000 m circular buffers around participant's residencies. Z-scores of components across food and physical activity (PA) environments were averaged, and rescaled from 0 to 100. Weight status was operationalised as objectively measured waist circumference. Stratified linear regression analyses by (self-reported) sociodemographic factors, perceived stress, impulsivity, self-discipline, and deliberation were conducted when interaction terms were significant (P < .01). Mediation by adherence to the Dutch PA guidelines and dietary behaviour was examined using the difference-in-coefficients approach. Every 10% increase in OBCT index was associated with a 0.65 (P < .001, 95%CI [0.59, 0.71]) centimetre larger waist circumference. The association was largest for respondents who were younger, had the lowest income, the highest educational level, the least self-discipline, the highest impulsivity scores and the most perceived stress. Adherence to PA guidelines and dietary behaviour mediated 13.3% of this association; however, the difference in coefficients was not statistically significant. Our findings enable to better target lifestyle interventions to individuals most vulnerable to obesogenic environments. Furthermore, they provide guidance for policymakers and urban planners in promoting health-enhancing environments.
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Affiliation(s)
- Jet D S van de Geest
- Epidemiology and Data Science, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081HV, Amsterdam, the Netherlands; Amsterdam Public Health Research Institute, 1105 AZ, Amsterdam, the Netherlands.
| | - Paul Meijer
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Str 6.131, PO Box 85500, 3508 GA, Utrecht, the Netherlands
| | - Sharon Remmelzwaal
- Epidemiology and Data Science, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081HV, Amsterdam, the Netherlands; Amsterdam Public Health Research Institute, 1105 AZ, Amsterdam, the Netherlands
| | - Jeroen Lakerveld
- Epidemiology and Data Science, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081HV, Amsterdam, the Netherlands; Amsterdam Public Health Research Institute, 1105 AZ, Amsterdam, the Netherlands
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Martin SS, Aday AW, Almarzooq ZI, Anderson CAM, Arora P, Avery CL, Baker-Smith CM, Barone Gibbs B, Beaton AZ, Boehme AK, Commodore-Mensah Y, Currie ME, Elkind MSV, Evenson KR, Generoso G, Heard DG, Hiremath S, Johansen MC, Kalani R, Kazi DS, Ko D, Liu J, Magnani JW, Michos ED, Mussolino ME, Navaneethan SD, Parikh NI, Perman SM, Poudel R, Rezk-Hanna M, Roth GA, Shah NS, St-Onge MP, Thacker EL, Tsao CW, Urbut SM, Van Spall HGC, Voeks JH, Wang NY, Wong ND, Wong SS, Yaffe K, Palaniappan LP. 2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association. Circulation 2024; 149:e347-e913. [PMID: 38264914 DOI: 10.1161/cir.0000000000001209] [Citation(s) in RCA: 182] [Impact Index Per Article: 182.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
BACKGROUND The American Heart Association (AHA), in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, nutrition, sleep, and obesity) and health factors (cholesterol, blood pressure, glucose control, and metabolic syndrome) that contribute to cardiovascular health. The AHA Heart Disease and Stroke Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, brain health, complications of pregnancy, kidney disease, congenital heart disease, rhythm disorders, sudden cardiac arrest, subclinical atherosclerosis, coronary heart disease, cardiomyopathy, heart failure, valvular disease, venous thromboembolism, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The AHA, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States and globally to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2024 AHA Statistical Update is the product of a full year's worth of effort in 2023 by dedicated volunteer clinicians and scientists, committed government professionals, and AHA staff members. The AHA strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year's edition includes additional global data, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains. RESULTS Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
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Kariuki JK, Rockette-Wagner B, Cheng J, Erickson KI, Gibbs BB, Sereika SM, Kline CE, Mendez DD, Wayan PI, Bizhanova Z, Saad MAB, Burke LE. Neighborhood Walkability Is Associated with Physical Activity and Prediabetes in a Behavioral Weight Loss Study: a Secondary Analysis. Int J Behav Med 2023; 30:486-496. [PMID: 35794410 PMCID: PMC11186594 DOI: 10.1007/s12529-022-10112-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Socio-environmental factors may affect uptake and utility of behavioral interventions targeting weight loss and cardiometabolic health. To evaluate the relation of neighborhood walkability to physical activity (PA) and glucose control in a sample of adults with overweight/obesity participating in a weight loss study. METHODS Secondary analysis of a 12-month behavioral weight loss intervention (2011-2015) using one-group pretest-posttest design. Neighborhood walkability was assessed via residential Walk Score (0-100) at study entry. Fasting plasma glucose (FPG) via phlebotomy and PA via waist-worn ActiGraph GT3X were assessed at baseline and end of study. Study variables included neighborhood walkability (car-dependent: Walk Score < 50 vs. walkable: Walk Score ≥ 50), prediabetes (FPG 100-125 mg/dL), and recommended PA (moderate to vigorous PA [MVPA] > 22 min/day). Generalized linear model with logit link results were reported as adjusted odds ratios (AOR) with 95% confidence intervals (CI). RESULTS The sample (N = 114) was mostly female (88.6%), white (83.3%), college educated (73.7%), and on average 51.4 ± 1.0 years of age. At baseline, persons residing in car-dependent neighborhoods tended to have higher income than those in walkable neighborhoods. Neighborhood walkability interacted with household income at study entry to predict participants' ability to meet the MVPA goal at 12 months (AOR = 13.52, 95% CI: 1.86-119.20). Those from walkable neighborhoods had 67% lower odds of having prediabetes compared to those from car-dependent neighborhoods (AOR = 0.33, 95% CI: 0.10-0.87) at 12 months. CONCLUSION Our findings corroborate previous research characterizing the relationship between neighborhood walkability, PA, and prediabetes status. Key drivers of this impact warrant further investigation in a study with a larger, more diverse sample.
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Affiliation(s)
- Jacob K Kariuki
- School of Nursing, University of Pittsburgh, 3500 Victoria Street, Pittsburgh, PA, 15261, USA.
| | | | - Jessica Cheng
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kirk I Erickson
- Dietrich School of Arts and Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| | - Bethany B Gibbs
- School of Education, University of Pittsburgh, Pittsburgh, PA, USA
| | - Susan M Sereika
- School of Nursing, University of Pittsburgh, 3500 Victoria Street, Pittsburgh, PA, 15261, USA
| | | | - Dara D Mendez
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Pulantara I Wayan
- University of Pittsburgh School of Health and Rehabilitation Sciences, Pittsburgh, PA, USA
| | - Zhadyra Bizhanova
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Mohammed A Bu Saad
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Lora E Burke
- School of Nursing, University of Pittsburgh, 3500 Victoria Street, Pittsburgh, PA, 15261, USA
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Zang P, Chen K, Zhang H, Qiu H, Yu Y, Huang J. Effect of built environment on BMI of older adults in regions of different socio-economic statuses. Front Public Health 2023; 11:1207975. [PMID: 37483934 PMCID: PMC10361068 DOI: 10.3389/fpubh.2023.1207975] [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: 04/18/2023] [Accepted: 06/20/2023] [Indexed: 07/25/2023] Open
Abstract
Background Numerous studies have ignored the influence of underdeveloped urban surroundings on the physical health of China's ageing population. Lanzhou is a typical representative of a less developed city in China. Methods This study investigated the relationship between body mass index (BMI) and built environment amongst older adults in regions of different socio-economic statuses (SES) using data from medical examinations of older adults in Lanzhou, as well as calculating community built environment indicators for regions of different SES based on multiple linear regression models. Results Results showed that age and underlying disease were negatively associated with overall older adult BMI in the study buffer zone. Land use mix, number of parks and streetscape greenery were positively associated with older adult BMI. Street design and distance to bus stops were negatively connected in low SES regions, but population density and street design were negatively correlated in high SES areas. Conclusion These findings indicate that the built environment of SES regions has varying impacts on the BMI of older persons and that planners may establish strategies to lower the incidence of obesity amongst older adults in different SES locations.
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Tsao CW, Aday AW, Almarzooq ZI, Anderson CAM, Arora P, Avery CL, Baker-Smith CM, Beaton AZ, Boehme AK, Buxton AE, Commodore-Mensah Y, Elkind MSV, Evenson KR, Eze-Nliam C, Fugar S, Generoso G, Heard DG, Hiremath S, Ho JE, Kalani R, Kazi DS, Ko D, Levine DA, Liu J, Ma J, Magnani JW, Michos ED, Mussolino ME, Navaneethan SD, Parikh NI, Poudel R, Rezk-Hanna M, Roth GA, Shah NS, St-Onge MP, Thacker EL, Virani SS, Voeks JH, Wang NY, Wong ND, Wong SS, Yaffe K, Martin SS. Heart Disease and Stroke Statistics-2023 Update: A Report From the American Heart Association. Circulation 2023; 147:e93-e621. [PMID: 36695182 DOI: 10.1161/cir.0000000000001123] [Citation(s) in RCA: 1433] [Impact Index Per Article: 1433.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The American Heart Association, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2023 Statistical Update is the product of a full year's worth of effort in 2022 by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. The American Heart Association strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year's edition includes additional COVID-19 (coronavirus disease 2019) publications, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains. RESULTS Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
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D’Hooghe S, Inaç Y, De Clercq E, Deforche B, Dury S, Vandevijvere S, Van de Weghe N, Van Dyck D, De Ridder K. The CIVISANO protocol: a mixed-method study about the role of objective and perceived environmental factors on physical activity and eating behavior among socioeconomically disadvantaged adults. Arch Public Health 2022; 80:219. [PMID: 36199109 PMCID: PMC9533259 DOI: 10.1186/s13690-022-00956-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 08/19/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Overweight and obesity have a strong socioeconomic profile. Unhealthy behaviors like insufficient physical activity and an unbalanced diet, which are causal factors of overweight and obesity, tend to be more pronounced in socioeconomically disadvantaged groups in high income countries. The CIVISANO project aims to identify objective and perceived environmental factors among different socioeconomic population groups that impede or facilitate physical activity and healthy eating behavior in the local context of two peri-urban Flemish municipalities in Belgium. We also aim to identify and discuss possible local interventions and evaluate the participatory processes of the project. METHODS This study (2020-2023) will use community-based participatory tools, involving collaborative partnerships with civic and stakeholder members of the community and regular exchanges among all partners to bridge knowledge development and health promotion for socioeconomically disadvantaged citizens. Furthermore, a mixed-methods approach will be used. A population survey and geographic analysis will explore potential associations between the physical activity and eating behaviors of socioeconomically disadvantaged adults (25-65 years old) and both their perceived and objective physical, food and social environments. Profound perceptive context information will be gathered from socioeconomically disadvantaged adults by using participatory methods like photovoice, walk-along, individual map creation and group model building. An evaluation of the participatory process will be conducted simultaneously. DISCUSSION The CIVISANO project will identify factors in the local environment that might provoke inequities in adopting a healthy lifestyle. The combination of perceived and objective measures using validated strategies will provide a robust assessment of the municipality environment. Through this analysis, the project will investigate to what extent community engagement can be a useful strategy to reduce health inequities. The strong knowledge exchange and capacity-building in a local setting is expected to contribute to our understanding of how to maximize research impact in this field and generate evidence about potential linkages between a health enhancing lifestyle among socioeconomically disadvantaged groups and their physical, food and social environments.
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Affiliation(s)
- Suzannah D’Hooghe
- grid.508031.fSciensano, Department of Epidemiology and Public Health, Brussels, Belgium ,grid.5342.00000 0001 2069 7798Ghent University, Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Ghent, Belgium ,grid.8767.e0000 0001 2290 8069Vrije Universiteit Brussel (VUB), Faculty of Psychology and Educational Sciences, Adult Educational Sciences, Brussels, Belgium
| | - Yasemin Inaç
- grid.508031.fSciensano, Department of Epidemiology and Public Health, Brussels, Belgium ,grid.8767.e0000 0001 2290 8069Vrije Universiteit Brussel (VUB), Faculty of Psychology and Educational Sciences, Adult Educational Sciences, Brussels, Belgium ,grid.5342.00000 0001 2069 7798Ghent University, Faculty of Sciences, Department of Geography, Ghent, Belgium
| | - Eva De Clercq
- grid.508031.fSciensano, Department of Chemical and Physical Health Risks, Brussels, Belgium
| | - Benedicte Deforche
- grid.5342.00000 0001 2069 7798Ghent University, Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Ghent, Belgium ,grid.8767.e0000 0001 2290 8069Vrije Universiteit Brussel (VUB), Faculty of Physical Education and Physiotherapy, Department of Movement and Sport Sciences, Brussels, Belgium
| | - Sarah Dury
- grid.8767.e0000 0001 2290 8069Vrije Universiteit Brussel (VUB), Faculty of Psychology and Educational Sciences, Adult Educational Sciences, Brussels, Belgium
| | - Stefanie Vandevijvere
- grid.508031.fSciensano, Department of Epidemiology and Public Health, Brussels, Belgium
| | - Nico Van de Weghe
- grid.5342.00000 0001 2069 7798Ghent University, Faculty of Sciences, Department of Geography, Ghent, Belgium
| | - Delfien Van Dyck
- grid.5342.00000 0001 2069 7798Ghent University, Faculty of Medicine and Health Sciences, Department of Movement and Sports Sciences, Brussels, Belgium
| | - Karin De Ridder
- grid.508031.fSciensano, Department of Epidemiology and Public Health, Brussels, Belgium
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Associations between neighborhood built environment, residential property values, and adult BMI change: The Seattle Obesity Study III. SSM Popul Health 2022; 19:101158. [PMID: 35813186 PMCID: PMC9260622 DOI: 10.1016/j.ssmph.2022.101158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 06/24/2022] [Accepted: 06/25/2022] [Indexed: 11/25/2022] Open
Abstract
Objective To examine associations between neighborhood built environment (BE) variables, residential property values, and longitudinal 1- and 2-year changes in body mass index (BMI). Methods The Seattle Obesity Study III was a prospective cohort study of adults with geocoded residential addresses, conducted in King, Pierce, and Yakima Counties in Washington State. Measured heights and weights were obtained at baseline (n = 879), year 1 (n = 727), and year 2 (n = 679). Tax parcel residential property values served as proxies for individual socioeconomic status. Residential unit and road intersection density were captured using Euclidean-based SmartMaps at 800 m buffers. Counts of supermarket (0 versus. 1+) and fast-food restaurant availability (0, 1–3, 4+) were measured using network based SmartMaps at 1600 m buffers. Density measures and residential property values were categorized into tertiles. Linear mixed-effects models tested whether baseline BE variables and property values were associated with differential changes in BMI at year 1 or year 2, adjusting for age, gender, race/ethnicity, education, home ownership, and county of residence. These associations were then tested for potential disparities by age group, gender, race/ethnicity, and education. Results Road intersection density, access to food sources, and residential property values were inversely associated with BMI at baseline. At year 1, participants in the 3rd tertile of density metrics and with 4+ fast-food restaurants nearby showed less BMI gain compared to those in the 1st tertile or with 0 restaurants. At year 2, higher residential property values were predictive of lower BMI gain. There was evidence of differential associations by age group, gender, and education but not race/ethnicity. Conclusion Inverse associations between BE metrics and residential property values at baseline demonstrated mixed associations with 1- and 2-year BMI change. More work is needed to understand how individual-level sociodemographic factors moderate associations between the BE, property values, and BMI change. Strong, inverse cross-sectional relationships between the built environment, residential property values (a proxy for individual socioeconomic status), and measured BMI were observed. Measures of the built environment and residential property values showed modest and inconsistent associations with 1- and 2-year BMI change. There was suggestive evidence that age may moderate the association between urban density and 1- and 2-year BMI change while education may moderate the association between residential property values and 2-year BMI change.
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Ahmed NH, Greaney ML, Cohen SA. Moderation of the Association between Primary Language and Health by Race and Gender: An Intersectional Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137750. [PMID: 35805412 PMCID: PMC9265264 DOI: 10.3390/ijerph19137750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 06/17/2022] [Accepted: 06/19/2022] [Indexed: 02/04/2023]
Abstract
In the United States (US), limited English proficiency is associated with a higher risk of obesity and diabetes. “Intersectionality”, or the interconnected nature of social categorizations, such as race/ethnicity and gender, creates interdependent systems of disadvantage, which impact health and create complex health inequities. How these patterns are associated with language-based health inequities is not well understood. The study objective was to assess the potential for race/ethnicity, gender, and socioeconomic status to jointly moderate the association between primary language (English/Spanish) and having obesity and diabetes. Using the 2018 Behavioral Risk Factor Surveillance System (n = 431,045), weighted generalized linear models with a logistic link were used to estimate the associations between primary language (English/Spanish) and obesity and diabetes status, adjusting for confounders using stratification for the intersections of gender and race/ethnicity (White, Black, Other). Respondents whose primary language was Spanish were 11.6% more likely to have obesity (95% CI 7.4%, 15.9%) and 15.1% more likely to have diabetes (95% CI 10.1%, 20.3%) compared to English speakers. Compared to English speakers, Spanish speakers were more likely to have both obesity (p < 0.001) and diabetes (p < 0.001) among White females. Spanish speakers were also more likely to have obesity among males and females of other races/ethnicities (p < 0.001 for both), and White females (p = 0.042). Among males of other racial/ethnic classifications, Spanish speakers were less likely to have both obesity (p = 0.011) and diabetes (p = 0.005) than English speakers. Health promotion efforts need to recognize these differences and critical systems−change efforts designed to fundamentally transform underlying conditions that lead to health inequities should also consider these critical sociodemographic factors to maximize their effectiveness.
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Affiliation(s)
- Neelam H. Ahmed
- Department of Biological Sciences, College of the Environment and Life Sciences, University of Rhode Island, Kingston, RI 02881, USA;
- Department of Health Studies, College of Health Sciences, University of Rhode Island, Kingston, RI 02881, USA;
| | - Mary L. Greaney
- Department of Health Studies, College of Health Sciences, University of Rhode Island, Kingston, RI 02881, USA;
| | - Steven A. Cohen
- Department of Health Studies, College of Health Sciences, University of Rhode Island, Kingston, RI 02881, USA;
- Correspondence: ; Tel.: +1-401-874-4301
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Suarez J, Makridis M, Anesiadou A, Komnos D, Ciuffo B, Fontaras G. Benchmarking the driver acceleration impact on vehicle energy consumption and CO 2 emissions. TRANSPORTATION RESEARCH. PART D, TRANSPORT AND ENVIRONMENT 2022. [PMID: 35784495 DOI: 10.1016/j.trd.2022.103228] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
The study proposes a methodology for quantifying the impact of real-world heterogeneous driving behavior on vehicle energy consumption, linking instantaneous acceleration heterogeneity and CO2 emissions. Data recorded from 20 different drivers under real driving are benchmarked against the Worldwide Harmonized Light Vehicle Test Cycle (WLTC), first by correlating the speed cycle with individual driver behavior and then by quantifying the CO2 emissions and consumption. The vehicle-Independent Driving Style metric (IDS) is used to quantify acceleration dynamicity, introducing driving style stochasticity by means of probability distribution functions. Results show that the WLTC cycle assumes a relatively smooth acceleration style compared to the observed ones. The method successfully associates acceleration dynamicity to CO2 emissions. We observe a 5% difference in the CO2 emissions between the most favourable and the least favourable case. The intra-driver variance reached 3%, while the inter-driver variance is below 2%. The approach can be used for quantifying the driving style induced emissions divergence.
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Affiliation(s)
- Jaime Suarez
- European Commission, Joint Research Centre (JRC), Ispra, Italy
| | - Michail Makridis
- ETH Zürich, Institute for Transport Planning and Systems (IVT), Zürich, Switzerland
| | | | | | - Biagio Ciuffo
- European Commission, Joint Research Centre (JRC), Ispra, Italy
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Bauer JM, Nielsen KS, Hofmann W, Reisch LA. Healthy eating in the wild: An experience-sampling study of how food environments and situational factors shape out-of-home dietary success. Soc Sci Med 2022; 299:114869. [PMID: 35278829 DOI: 10.1016/j.socscimed.2022.114869] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 02/17/2022] [Accepted: 02/24/2022] [Indexed: 01/09/2023]
Abstract
Across many parts of the world, people increasingly eat out-of-home. Simultaneously, many people strive to eat a healthier diet, but it remains unclear to what extent and how eating out helps or hinders people in achieving their dietary goals. The present study investigated how characteristics of the physical micro-environment in out-of-home food outlets (e.g., cafeterias, supermarkets, and restaurants) influence the healthiness of food choices among a sample of German adults with a goal to eat healthier. We used an experience sampling method to obtain detailed information about people's motivation for selecting a specific food outlet and the outlet's micro-environment. We further asked for people's mood, visceral state, and thoughts during their food choice and obtained evaluations of food choices reported near their occurrence and in externally valid conditions. The data was collected via a mobile app over a period of six to eleven days between November and December of 2018 in Germany with a sample of 409 participants (nobs = 6447). We find that even health-conscious people select food outlets and their respective micro-environments based on short-term goals, such as ease, taste, and speed of a consumption episode rather than long-term health outcomes. Using multiple regression, we show that micro-environments that promote healthy food, make such food more appealing and easier to select facilitate healthy food choices. We further identify some of the psychological mechanisms through which the micro-environment can affect food choices, as well as how individual characteristics moderate the relationship between specific micro-environmental factors and goal success. Taken together, our findings suggest the opportunity for, and arguably also necessity of, reshaping food environments to better facilitate healthier choices and support public health in the face of increasing out-of-home food consumption and the adverse consequences of unhealthy diets.
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Affiliation(s)
- Jan M Bauer
- Department of Management, Society and Communication, Copenhagen Business School, Denmark.
| | | | | | - Lucia A Reisch
- El-Erian Institute for Behavioural Economics and Policy, Cambridge Judge Business School, University of Cambridge, UK.
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Tsao CW, Aday AW, Almarzooq ZI, Alonso A, Beaton AZ, Bittencourt MS, Boehme AK, Buxton AE, Carson AP, Commodore-Mensah Y, Elkind MSV, Evenson KR, Eze-Nliam C, Ferguson JF, Generoso G, Ho JE, Kalani R, Khan SS, Kissela BM, Knutson KL, Levine DA, Lewis TT, Liu J, Loop MS, Ma J, Mussolino ME, Navaneethan SD, Perak AM, Poudel R, Rezk-Hanna M, Roth GA, Schroeder EB, Shah SH, Thacker EL, VanWagner LB, Virani SS, Voecks JH, Wang NY, Yaffe K, Martin SS. Heart Disease and Stroke Statistics-2022 Update: A Report From the American Heart Association. Circulation 2022; 145:e153-e639. [PMID: 35078371 DOI: 10.1161/cir.0000000000001052] [Citation(s) in RCA: 2610] [Impact Index Per Article: 1305.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The American Heart Association, through its Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update. The 2022 Statistical Update is the product of a full year's worth of effort by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. This year's edition includes data on the monitoring and benefits of cardiovascular health in the population and an enhanced focus on social determinants of health, adverse pregnancy outcomes, vascular contributions to brain health, and the global burden of cardiovascular disease and healthy life expectancy. RESULTS Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
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Slater SJ, Leider J, Chriqui JF. Examining the Implementation of Activity-Friendly Zoning and Land Use Policies Through the Use of Google Street View Measures: A Pilot Study. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2022; 28:E127-E136. [PMID: 32487921 DOI: 10.1097/phh.0000000000001176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Pedestrian-oriented zoning and land use policies are being used by local jurisdictions as tools to implement population-level built environmental changes to create more walkable communities. There is a paucity of evidence examining whether these policies lead to actual changes in the built environment. We used Google Street View (GSV), an established, less expensive, alternative built environment data collection method, to conduct an exploratory pilot study of 19 jurisdictions to examine associations between variations in the presence of these adopted zoning policies and their corresponding specific street-level built environment features. METHODS Samples of 10 large and 9 small jurisdictions (18 municipalities and 1 county) were purposively selected on the basis of the presence of activity-friendly zoning policy provisions (sidewalks, crosswalks, bike-pedestrian connectivity, street connectivity, trails/paths, bike lanes, bike parking, and other items). Corresponding activity-friendly street-level built environment measures were constructed using GSV. Street segments in these jurisdictions were sampled using ArcGIS and stratified by type (residential and arterial) and income (high, medium, and low). RESULTS A total of 4363 street segments were audited across the 19 sampled jurisdictions. Results show significant differences in the presence of activity-friendly street features when the corresponding zoning policy element was addressed in New Urbanist zones/districts in the site's zoning code (eg, crosswalks, 24.48% vs 16.18%; and bike lanes, 12.60% vs 7.14%). Street segments in the middle- and high-income block groups were less likely to have activity-friendly features than low-income segments, except bike lanes. CONCLUSIONS Results show that having activity-friendly policy provisions embedded in a jurisdiction's (municipality/county) zoning codes was associated with a greater presence of the corresponding built environmental street feature on the ground. Results suggest that the methods tested in this article may be a useful policy tool for local governments to identify high need areas that should be prioritized for built environment improvements.
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Affiliation(s)
- Sandy J Slater
- School of Pharmacy, Concordia University Wisconsin, Mequon, Wisconsin (Dr Slater); Institute for Health Research and Policy (Mr Leider and Dr Chriqui), and Division of Health Policy and Administration, School of Public Health (Dr Chriqui), Institute for Health Research and Policy and School of Public Health, University of Illinois at Chicago, Chicago, Illinois
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Drivers to Obesity-A Study of the Association between Time Spent Commuting Daily and Obesity in the Nepean Blue Mountains Area. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:ijerph19010410. [PMID: 35010670 PMCID: PMC8744747 DOI: 10.3390/ijerph19010410] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 12/20/2021] [Accepted: 12/24/2021] [Indexed: 12/29/2022]
Abstract
Obesity has become a public health challenge in every country on this planet, with a substantial contribution to global mortality and morbidity. Studies of the built environment have shown some promise in understanding the drivers of this obesity pandemic. This paper contributes to this knowledge, by focusing on one aspect of the urban environment and asking whether there is an association between commuting and obesity in residents of the Nepean Blue Mountains area on the fringes of Sydney. This is a cross-sectional study with obesity being the dependent variable, and commuting the independent variable, where 45 min or less was defined as local and distant commute was more than 45 min. In the sample of 158 respondents, the risk of obesity was twice as likely in the distant commuters than in the local commuters (OR 2.04, 95% CI 1.051 to 3.962, p = 0.034). Investigation of possible mediators of this association was limited by sample size; however, mode of transport was found to be a significant mediator. The results support the design of cities to provide health supporting environments for all residents, including equitable access to employment at a reasonable distance and effective public transport.
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Buszkiewicz JH, Bobb JF, Kapos F, Hurvitz PM, Arterburn D, Moudon AV, Cook A, Mooney SJ, Cruz M, Gupta S, Lozano P, Rosenberg DE, Theis MK, Anau J, Drewnowski A. Differential associations of the built environment on weight gain by sex and race/ethnicity but not age. Int J Obes (Lond) 2021; 45:2648-2656. [PMID: 34453098 PMCID: PMC8608695 DOI: 10.1038/s41366-021-00937-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 07/19/2021] [Accepted: 08/04/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To explore the built environment (BE) and weight change relationship by age, sex, and racial/ethnic subgroups in adults. METHODS Weight trajectories were estimated using electronic health records for 115,260 insured Kaiser Permanente Washington members age 18-64 years. Member home addresses were geocoded using ArcGIS. Population, residential, and road intersection densities and counts of area supermarkets and fast food restaurants were measured with SmartMaps (800 and 5000-meter buffers) and categorized into tertiles. Linear mixed-effect models tested whether associations between BE features and weight gain at 1, 3, and 5 years differed by age, sex, and race/ethnicity, adjusting for demographics, baseline weight, and residential property values. RESULTS Denser urban form and greater availability of supermarkets and fast food restaurants were associated with differential weight change across sex and race/ethnicity. At 5 years, the mean difference in weight change comparing the 3rd versus 1st tertile of residential density was significantly different between males (-0.49 kg, 95% CI: -0.68, -0.30) and females (-0.17 kg, 95% CI: -0.33, -0.01) (P-value for interaction = 0.011). Across race/ethnicity, the mean difference in weight change at 5 years for residential density was significantly different among non-Hispanic (NH) Whites (-0.47 kg, 95% CI: -0.61, -0.32), NH Blacks (-0.86 kg, 95% CI: -1.37, -0.36), Hispanics (0.10 kg, 95% CI: -0.46, 0.65), and NH Asians (0.44 kg, 95% CI: 0.10, 0.78) (P-value for interaction <0.001). These findings were consistent for other BE measures. CONCLUSION The relationship between the built environment and weight change differs across demographic groups. Careful consideration of demographic differences in associations of BE and weight trajectories is warranted for investigating etiological mechanisms and guiding intervention development.
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Affiliation(s)
- James H Buszkiewicz
- Center for Public Health Nutrition, 305 Raitt Hall, #353410, University of Washington, Seattle, WA, USA.
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA.
| | - Jennifer F Bobb
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Flavia Kapos
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
| | - Philip M Hurvitz
- Urban Form Lab, Department of Urban Design and Planning, College of Built Environments, University of Washington, Seattle, WA, USA
- Center for Studies in Demography and Ecology, University of Washington, Raitt Hall, Seattle, WA, USA
| | - David Arterburn
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Anne Vernez Moudon
- Urban Form Lab, Department of Urban Design and Planning, College of Built Environments, University of Washington, Seattle, WA, USA
| | - Andrea Cook
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Stephen J Mooney
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
| | - Maricela Cruz
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Shilpi Gupta
- Center for Public Health Nutrition, 305 Raitt Hall, #353410, University of Washington, Seattle, WA, USA
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
| | - Paula Lozano
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Dori E Rosenberg
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Mary Kay Theis
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Jane Anau
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Adam Drewnowski
- Center for Public Health Nutrition, 305 Raitt Hall, #353410, University of Washington, Seattle, WA, USA
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
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Kan Z, Kwan M, Huang J, Wong M, Liu D. Comparing the space-time patterns of high-risk areas in different waves of COVID-19 in Hong Kong. TRANSACTIONS IN GIS : TG 2021; 25:2982-3001. [PMID: 34512106 PMCID: PMC8420231 DOI: 10.1111/tgis.12800] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
This study compares the space-time patterns and characteristics of high-risk areas of COVID-19 transmission in Hong Kong between January 23 and April 14 (the first and second waves) and between July 6 and August 29 (the third wave). Using space-time scan statistics and the contact tracing data of individual confirmed cases, we detect the clusters of residences of, and places visited by, both imported and local cases. We also identify the built-environment and demographic characteristics of the high-risk areas during different waves of COVID-19. We find considerable differences in the space-time patterns and characteristics of high-risk residential areas between waves. However, venues and buildings visited by the confirmed cases in different waves have similar characteristics. The results can inform policymakers to target mitigation measures in high-risk areas and at vulnerable groups, and provide guidance to the public to avoid visiting and conducting activities at high-risk places.
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Affiliation(s)
- Zihan Kan
- Institute of Space and Earth Information ScienceThe Chinese University of Hong KongShatinHong KongChina
| | - Mei‐Po Kwan
- Institute of Space and Earth Information ScienceThe Chinese University of Hong KongShatinHong KongChina
- Department of Geography and Resource ManagementThe Chinese University of Hong KongShatinHong KongChina
- Department of Human Geography and Spatial PlanningUtrecht UniversityUtrechtThe Netherlands
| | - Jianwei Huang
- Institute of Space and Earth Information ScienceThe Chinese University of Hong KongShatinHong KongChina
| | - Man Sing Wong
- Department of Land Surveying and Geo‐Informatics and Research Institute for Sustainable Urban DevelopmentThe Hong Kong Polytechnic UniversityHung HomHong KongChina
| | - Dong Liu
- Department of Geography and Geographic Information ScienceUniversity of Illinois at Urbana‐ChampaignUrbanaILUSA
- Human Environments Analysis LaboratoryThe University of Western OntarioLondonONCanada
- Department of Geography and EnvironmentThe University of Western OntarioLondonONCanada
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Buszkiewicz JH, Bobb JF, Hurvitz PM, Arterburn D, Moudon AV, Cook A, Mooney SJ, Cruz M, Gupta S, Lozano P, Rosenberg DE, Theis MK, Anau J, Drewnowski A. Does the built environment have independent obesogenic power? Urban form and trajectories of weight gain. Int J Obes (Lond) 2021; 45:1914-1924. [PMID: 33976378 PMCID: PMC8592117 DOI: 10.1038/s41366-021-00836-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 04/23/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To determine whether selected features of the built environment can predict weight gain in a large longitudinal cohort of adults. METHODS Weight trajectories over a 5-year period were obtained from electronic health records for 115,260 insured patients aged 18-64 years in the Kaiser Permanente Washington health care system. Home addresses were geocoded using ArcGIS. Built environment variables were population, residential unit, and road intersection densities captured using Euclidean-based SmartMaps at 800-m buffers. Counts of area supermarkets and fast food restaurants were obtained using network-based SmartMaps at 1600, and 5000-m buffers. Property values were a measure of socioeconomic status. Linear mixed effects models tested whether built environment variables at baseline were associated with long-term weight gain, adjusting for sex, age, race/ethnicity, Medicaid insurance, body weight, and residential property values. RESULTS Built environment variables at baseline were associated with differences in baseline obesity prevalence and body mass index but had limited impact on weight trajectories. Mean weight gain for the full cohort was 0.06 kg at 1 year (95% CI: 0.03, 0.10); 0.64 kg at 3 years (95% CI: 0.59, 0.68), and 0.95 kg at 5 years (95% CI: 0.90, 1.00). In adjusted regression models, the top tertile of density metrics and frequency counts were associated with lower weight gain at 5-years follow-up compared to the bottom tertiles, though the mean differences in weight change for each follow-up year (1, 3, and 5) did not exceed 0.5 kg. CONCLUSIONS Built environment variables that were associated with higher obesity prevalence at baseline had limited independent obesogenic power with respect to weight gain over time. Residential unit density had the strongest negative association with weight gain. Future work on the influence of built environment variables on health should also examine social context, including residential segregation and residential mobility.
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Affiliation(s)
- James H. Buszkiewicz
- Center for Public Health Nutrition, 305 Raitt Hall, #353410, University of Washington, Seattle, WA, 98195-3410, USA,Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, 98195, USA
| | - Jennifer F. Bobb
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave. Suite 1600, Seattle, WA, 98101, USA
| | - Philip M Hurvitz
- Urban Form Lab, Department of Urban Design and Planning, College of Built Environments, University of Washington, 4333 Brooklyn Ave NE, Seattle, Washington 98195, USA,Center for Studies in Demography and Ecology, University of Washington, Seattle, WA, 98195-3410, USA
| | - David Arterburn
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave. Suite 1600, Seattle, WA, 98101, USA
| | - Anne Vernez Moudon
- Urban Form Lab, Department of Urban Design and Planning, College of Built Environments, University of Washington, 4333 Brooklyn Ave NE, Seattle, Washington 98195, USA
| | - Andrea Cook
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave. Suite 1600, Seattle, WA, 98101, USA
| | - Stephen J. Mooney
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, 98195, USA
| | - Maricela Cruz
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave. Suite 1600, Seattle, WA, 98101, USA
| | - Shilpi Gupta
- Center for Public Health Nutrition, 305 Raitt Hall, #353410, University of Washington, Seattle, WA, 98195-3410, USA,Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, 98195, USA
| | - Paula Lozano
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave. Suite 1600, Seattle, WA, 98101, USA
| | - Dori E. Rosenberg
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave. Suite 1600, Seattle, WA, 98101, USA
| | - Mary Kay Theis
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave. Suite 1600, Seattle, WA, 98101, USA
| | - Jane Anau
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave. Suite 1600, Seattle, WA, 98101, USA
| | - Adam Drewnowski
- Center for Public Health Nutrition, 305 Raitt Hall, #353410, University of Washington, Seattle, WA, 98195-3410, USA,Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, 98195, USA
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Kan Z, Kwan MP, Wong MS, Huang J, Liu D. Identifying the space-time patterns of COVID-19 risk and their associations with different built environment features in Hong Kong. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 772:145379. [PMID: 33578150 PMCID: PMC7839428 DOI: 10.1016/j.scitotenv.2021.145379] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 01/11/2021] [Accepted: 01/19/2021] [Indexed: 05/07/2023]
Abstract
Identifying the space-time patterns of areas with a higher risk of transmission and the associated built environment and demographic characteristics during the COVID-19 pandemic is critical for developing targeted intervention measures in response to the pandemic. This study aims to identify areas with a higher risk of COVID-19 transmission in different periods in Hong Kong and analyze the associated built environment and demographic factors using data of individual confirmed cases. We detect statistically significant space-time clusters of COVID-19 at the Large Street Block Group (LSBG) level in Hong Kong between January 23 and April 14, 2020. Two types of high-risk areas are identified (residences of and places visited by confirmed cases) and two types of cases (imported and local cases) are considered. The demographic and built environment features for the identified high-risk areas are further examined. The results indicate that high transport accessibility, dense and high-rise buildings, a higher density of commercial land and higher land-use mix are associated with a higher risk for places visited by confirmed cases. More green spaces, higher median household income, lower commercial land density are linked to a higher risk for the residences of confirmed cases. The results in this study not only can inform policymakers to improve resource allocation and intervention strategies but also can provide guidance to the public to avoid conducting high-risk activities and visiting high-risk places.
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Affiliation(s)
- Zihan Kan
- Institute of Space and Earth Information Science, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Mei-Po Kwan
- Institute of Space and Earth Information Science, The Chinese University of Hong Kong, Shatin, Hong Kong, China; Department of Geography and Resource Management, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
| | - Man Sing Wong
- Department of Land Surveying and Geo-Informatics, & Research Institute for Sustainable Urban Development, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China
| | - Jianwei Huang
- Institute of Space and Earth Information Science, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Dong Liu
- Department of Geography and Geographic Information Science, University of Illinois at Urbana-Champaign, 1301 W Green St, Urbana, IL 61801, United States
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Yin C, Sun B. Does Compact Built Environment Help to Reduce Obesity? Influence of Population Density on Waist-Hip Ratio in Chinese Cities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217746. [PMID: 33113970 PMCID: PMC7660192 DOI: 10.3390/ijerph17217746] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 10/17/2020] [Accepted: 10/20/2020] [Indexed: 11/16/2022]
Abstract
This study aimed to identify the non-linear association between population density and obesity in China and to provide empirical evidence for the public health orientated guideline of urban planning. By conducting a longitudinal study with data collected from the China Health and Nutrition Survey (CHNS) between 2004 and 2011, we applied fixed-effect models to assess the non-linear association between the compact built environment and waist–hip ratio (WHR), controlling for sex, age, nationality, education, employment status, marital status, household size, household income, and residents’ attitudes. Our findings reveal that the built environment is one of the key determinants of obesity. The U-shaped influence of population density on WHR was observed. Moreover, influence differs according to sex and weight status. Our findings indicate healthy city planning has the potential to improve the built environment to reduce obesity risk and promote public health.
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Affiliation(s)
- Chun Yin
- Research Center for China Administrative Division, East China Normal University, Shanghai 200241, China;
- Institute of Eco-Chongming, Shanghai 202162, China
- Future City Lab, East China Normal University, Shanghai 200241, China
| | - Bindong Sun
- Research Center for China Administrative Division, East China Normal University, Shanghai 200241, China;
- Institute of Eco-Chongming, Shanghai 202162, China
- Future City Lab, East China Normal University, Shanghai 200241, China
- Correspondence:
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Abstract
Background. The salutogenicity of urban environments is significantly affected by their ergonomics, i.e., by the quality of the interactions between citizens and the elements of the built environment. Measuring and modelling urban ergonomics is thus a key issue to provide urban policy makers with planning solutions to increase the well-being, usability and safety of the urban environment. However, this is a difficult task due to the complexity of the interrelations between the urban environment and human activities. The paper contributes to the definition of a generalized model of urban ergonomics and salutogenicity, focusing on walkability, by discussing the relevant parameters from the large and variegated sets proposed in the literature, by discussing the emerging model structure from a data mining process, by considering the background of the relevant functional dependency already established in the literature, and by providing evidence of the solutions’ effectiveness. The methodology is developed for a case study in central Italy, with a focus on the mobility issue, which is a catalyst to generate more salutogenic and sustainable behaviors.
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James KA, Calanan R, Macaluso F, Li Y, Levinson AH. Convenience and corner store fruit and vegetable access: attitudes and intentions among Colorado adults, 2014. J Public Health (Oxf) 2020; 30:871-878. [PMID: 37868935 PMCID: PMC10588133 DOI: 10.1007/s10389-020-01358-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 07/01/2020] [Indexed: 11/27/2022] Open
Abstract
Aim The term food desert generally refers to areas where healthy food options, such as fresh fruits and vegetables, are unavailable within a certain number of miles. However, other factors besides distance may affect the ability to purchase healthier foods. The goal of this study was to understand Colorado adults' perceptions of their access to healthy food options and to assess how other structural and socio-demographic factors may affect that access. Subject and methods Colorado adults were asked questions about self-reported access to healthy food, likelihood of buying fresh fruits and vegetables from convenience/corner stores if available, perceived characteristics of fruits and vegetables available for purchase near respondents' residence, and demographics. Results A majority of Colorado adults in 2013-14 reported wanting fresh fruits and vegetables to be more available, more varied, higher quality, and/or less expensive. Socioeconomic status, race/ethnicity, and regular shopping habits were significantly associated with reported likelihood of purchasing fruits and vegetables from a convenience/corner store if available. Conclusion Factors other than proximity to a grocery store affect Colorado adults' perceived access to healthy food options and should be considered in the development and implementation of public health programs and policies geared toward improving healthy food access.
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Affiliation(s)
- Katherine A James
- School of Public Health, University of Colorado Anschutz Medical Campus, 13001 E 17th PL, MS B119, Bldg 500 3rd FLR, Aurora, CO 80045, USA
| | - Renee Calanan
- Colorado Department of Public Health and Environment, 4300 Cherry Creek Drive South, Denver, CO 80246, USA
- Present address: National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway NE, Atlanta, GA 30341, USA
| | - Francesca Macaluso
- School of Public Health, University of Colorado Anschutz Medical Campus, 13001 E 17th PL, MS B119, Bldg 500 3rd FLR, Aurora, CO 80045, USA
| | - Yaqiang Li
- School of Public Health, University of Colorado Anschutz Medical Campus, 13001 E 17th PL, MS B119, Bldg 500 3rd FLR, Aurora, CO 80045, USA
| | - Arnold H Levinson
- School of Public Health, University of Colorado Anschutz Medical Campus, 13001 E 17th PL, MS B119, Bldg 500 3rd FLR, Aurora, CO 80045, USA
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Kartschmit N, Sutcliffe R, Sheldon MP, Moebus S, Greiser KH, Hartwig S, Thürkow D, Stentzel U, van den Berg N, Wolf K, Maier W, Peters A, Ahmed S, Köhnke C, Mikolajczyk R, Wienke A, Kluttig A, Rudge G. Walkability and its association with walking/cycling and body mass index among adults in different regions of Germany: a cross-sectional analysis of pooled data from five German cohorts. BMJ Open 2020; 10:e033941. [PMID: 32350013 PMCID: PMC7213856 DOI: 10.1136/bmjopen-2019-033941] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES To examine three walkability measures (points of interest (POI), transit stations and impedance (restrictions to walking) within 640 m of participant's addresses) in different regions in Germany and assess the relationships between walkability, walking/cycling and body mass index (BMI) using generalised additive models. SETTING Five different regions and cities of Germany using data from five cohort studies. PARTICIPANTS For analysing walking/cycling behaviour, there were 6269 participants of a pooled sample from three cohorts with a mean age of 59.2 years (SD: 14.3) and of them 48.9% were male. For analysing BMI, there were 9441 participants of a pooled sample of five cohorts with a mean age of 62.3 years (SD: 12.8) and of them 48.5% were male. OUTCOMES (1) Self-reported walking/cycling (dichotomised into more than 30 min and 30 min and less per day; (2) BMI calculated with anthropological measures from weight and height. RESULTS Higher impedance was associated with lower prevalence of walking/cycling more than 30 min/day (prevalence ratio (PR): 0.95; 95% CI 0.93 to 0.97), while higher number of POI and transit stations were associated with higher prevalence (PR 1.03; 95% CI 1.02 to 1.05 for both measures). Higher impedance was associated with higher BMI (ß: 0.15; 95% CI 0.04 to 0.25) and a higher number of POI with lower BMI (ß: -0.14; 95% CI -0.24 to 0.04). No association was found between transit stations and BMI (ß: 0.005, 95% CI -0.11 to 0.12). Stratified by cohort we observed heterogeneous associations between BMI and transit stations and impedance. CONCLUSION We found evidence for associations of walking/cycling with walkability measures. Associations for BMI differed across cohorts.
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Affiliation(s)
- Nadja Kartschmit
- Institute of Med. Epidemiology, Biometrics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Robynne Sutcliffe
- Centre for Urban Epidemiology, University Clinics Essen, Essen, Germany
| | | | - Susanne Moebus
- Centre for Urban Epidemiology, University Clinics Essen, Essen, Germany
| | - Karin Halina Greiser
- Institute of Med. Epidemiology, Biometrics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany
- German Cancer Research Centre, Heidelberg, Baden-Württemberg, Germany
| | - Saskia Hartwig
- Institute of Med. Epidemiology, Biometrics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Detlef Thürkow
- Institute of Geosciences and Geography, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Ulrike Stentzel
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Neeltje van den Berg
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Kathrin Wolf
- German Center for Diabetes Research (DZD), Neuherberg, Germany
- Institute of Epidemiology II, Helmholtz Zentrum München, Neuherberg, Germany
| | - Werner Maier
- German Center for Diabetes Research (DZD), Neuherberg, Germany
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Health Economics and Health Care Management, Neuherberg, Germany
| | - Annette Peters
- German Center for Diabetes Research (DZD), Neuherberg, Germany
- Institute of Epidemiology II, Helmholtz Zentrum München, Neuherberg, Germany
| | - Salman Ahmed
- Centre for Urban Epidemiology, University Clinics Essen, Essen, Germany
| | - Corinna Köhnke
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Nordrhein-Westfalen, Germany
| | - Rafael Mikolajczyk
- Institute of Med. Epidemiology, Biometrics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Andreas Wienke
- Institute of Med. Epidemiology, Biometrics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Alexander Kluttig
- Institute of Med. Epidemiology, Biometrics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Gavin Rudge
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
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22
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Jones A, Mamudu HM, Squires GD. Mortgage possessions, spatial inequality, and obesity in large US metropolitan areas. Public Health 2020; 181:86-93. [PMID: 31978778 DOI: 10.1016/j.puhe.2019.11.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 10/29/2019] [Accepted: 11/27/2019] [Indexed: 11/24/2022]
Abstract
OBJECTIVES As social determinants of health, mortgage possessions (primarily foreclosures in the US context) and housing instability have been associated with certain mental and physical health outcomes at the individual level. However, individual risks of foreclosure and of poor health are spatially patterned. The objective of this study is to examine the extent to which area-specific social and economic characteristics help explain the relationship between mortgage possessions and obesity prevalence in 75 of the 100 most populous US metropolitan areas. STUDY DESIGN This is a cross-sectional study. METHODS The study relies on three sources of data: the Selected Metropolitan/Micropolitan Area Risk Trends (SMART) project, RealtyTrac foreclosure data, and the American Community Survey. Focal social and economic characteristics include foreclosure rates, levels of racial residential segregation, and poverty. Obesity prevalence and several control measures for each metropolitan area are also used. Ordinary least squares regression, weighted using the SMART project data, is used, and statistical significance is set at 0.05. RESULTS The results suggest that mortgage possessions are independently associated with higher obesity prevalence and that foreclosures operate through the specific channel of racial residential segregation and its tie to the racial composition of a metropolitan area. Socio-economic status of an area, and not poverty, is related to foreclosures and obesity prevalence. CONCLUSION Mortgage possessions not only are socio-economic but also have negative health consequences, such as obesity. The findings provide an empirical base for other researchers to uncover the relationships between segregation, mortgage possessions, and obesity at the individual level of analysis. The public health community should be engaged in addressing the issue of foreclosures in the US because the failure to engage may have broad financial and health consequences across large cities.
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Affiliation(s)
- A Jones
- Department of Sociology, The George Washington University, USA; Department of Epidemiology, Department of Biostatistics and Bioinformatics, The George Washington University, USA.
| | - H M Mamudu
- College of Public Health, East Tennessee State University, USA
| | - G D Squires
- Department of Sociology, The George Washington University, USA
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23
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Kartschmit N, Sutcliffe R, Sheldon MP, Moebus S, Greiser KH, Hartwig S, Thürkow D, Stentzel U, van den Berg N, Wolf K, Maier W, Peters A, Ahmed S, Köhnke C, Mikolajczyk R, Wienke A, Kluttig A, Rudge G. Walkability and its association with prevalent and incident diabetes among adults in different regions of Germany: results of pooled data from five German cohorts. BMC Endocr Disord 2020; 20:7. [PMID: 31931801 PMCID: PMC6958624 DOI: 10.1186/s12902-019-0485-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 12/27/2019] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Highly walkable neighbourhoods may increase transport-related and leisure-time physical activity and thus decrease the risk for obesity and obesity-related diseases, such as type 2 diabetes (T2D). METHODS We investigated the association between walkability and prevalent/incident T2D in a pooled sample from five German cohorts. Three walkability measures were assigned to participant's addresses: number of transit stations, points of interest, and impedance (restrictions to walking due to absence of intersections and physical barriers) within 640 m. We estimated associations between walkability and prevalent/incident T2D with modified Poisson regressions and adjusted for education, sex, age at baseline, and cohort. RESULTS Of the baseline 16,008 participants, 1256 participants had prevalent T2D. Participants free from T2D at baseline were followed over a mean of 9.2 years (SD: 3.5, minimum: 1.6, maximum: 14.8 years). Of these, 1032 participants developed T2D. The three walkability measures were not associated with T2D. The estimates pointed toward a zero effect or were within 7% relative risk increase per 1 standard deviation with 95% confidence intervals including 1. CONCLUSION In the studied German settings, walkability differences might not explain differences in T2D.
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Affiliation(s)
- Nadja Kartschmit
- Institute of Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University Halle-Wittenberg, Magdeburger Straße 8, 06112, Halle (Saale), Germany
- German Center for Diabetes Research (Deutsches Zentrum für Diabetesforschung DZD), Ingolstädter Landstraße 1, 85764, Neuherberg, Germany
| | - Robynne Sutcliffe
- Centre for Urban Epidemiology, University Clinics Essen, Hufelandstr. 55, 45122, Essen, Germany
| | - Mark Patrick Sheldon
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Susanne Moebus
- Centre for Urban Epidemiology, University Clinics Essen, Hufelandstr. 55, 45122, Essen, Germany
| | - Karin Halina Greiser
- Institute of Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University Halle-Wittenberg, Magdeburger Straße 8, 06112, Halle (Saale), Germany
- German Cancer Research Center DKFZ (Deutsches Krebsforschungszentrum) Heidelberg, Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - Saskia Hartwig
- Institute of Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University Halle-Wittenberg, Magdeburger Straße 8, 06112, Halle (Saale), Germany
- German Center for Diabetes Research (Deutsches Zentrum für Diabetesforschung DZD), Ingolstädter Landstraße 1, 85764, Neuherberg, Germany
| | - Detlef Thürkow
- Institute of Geosciences and Geography, Martin-Luther-University Halle-Wittenberg, 06099, Halle (Saale), Germany
| | - Ulrike Stentzel
- Institute for Community Medicine, University Medicine Greifswald, Ellernholzstr. 1-2, 17487, Greifswald, Germany
| | - Neeltje van den Berg
- Institute for Community Medicine, University Medicine Greifswald, Ellernholzstr. 1-2, 17487, Greifswald, Germany
| | - Kathrin Wolf
- German Center for Diabetes Research (Deutsches Zentrum für Diabetesforschung DZD), Ingolstädter Landstraße 1, 85764, Neuherberg, Germany
- Institute of Epidemiology, Helmholtz Zentrum München, Ingolstädter Landstr. 1, 85764, Neuherberg, Germany
| | - Werner Maier
- German Center for Diabetes Research (Deutsches Zentrum für Diabetesforschung DZD), Ingolstädter Landstraße 1, 85764, Neuherberg, Germany
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, Ingolstädter Landstraße 1, 85764, Neuherberg, Germany
| | - Annette Peters
- German Center for Diabetes Research (Deutsches Zentrum für Diabetesforschung DZD), Ingolstädter Landstraße 1, 85764, Neuherberg, Germany
- Institute of Epidemiology, Helmholtz Zentrum München, Ingolstädter Landstr. 1, 85764, Neuherberg, Germany
| | - Salman Ahmed
- Centre for Urban Epidemiology, University Clinics Essen, Hufelandstr. 55, 45122, Essen, Germany
| | - Corinna Köhnke
- Institute of Epidemiology and Social Medicine, University of Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany
| | - Rafael Mikolajczyk
- Institute of Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University Halle-Wittenberg, Magdeburger Straße 8, 06112, Halle (Saale), Germany
| | - Andreas Wienke
- Institute of Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University Halle-Wittenberg, Magdeburger Straße 8, 06112, Halle (Saale), Germany
| | - Alexander Kluttig
- Institute of Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University Halle-Wittenberg, Magdeburger Straße 8, 06112, Halle (Saale), Germany.
- German Center for Diabetes Research (Deutsches Zentrum für Diabetesforschung DZD), Ingolstädter Landstraße 1, 85764, Neuherberg, Germany.
| | - Gavin Rudge
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
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24
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McKenzie S, Lev-Tov H, Shi V, Hsiao J. Clinical Pearls for Managing Hidradenitis Suppurativa Patients of Low Socioeconomic Status. Dermatology 2020; 236:439-444. [DOI: 10.1159/000505149] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Accepted: 11/29/2019] [Indexed: 11/19/2022] Open
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25
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Tarlov E, Silva A, Wing C, Slater S, Matthews SA, Jones KK, Zenk SN. Neighborhood Walkability and BMI Change: A National Study of Veterans in Large Urban Areas. Obesity (Silver Spring) 2020; 28:46-54. [PMID: 31804004 PMCID: PMC6925327 DOI: 10.1002/oby.22611] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Accepted: 07/15/2019] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Improving neighborhood walkability has been proposed as a policy intervention to reduce obesity. The objective of this study was to evaluate longitudinal relationships between neighborhood walkability and body weight among adults living in large urban areas. METHODS In this retrospective longitudinal study of United States military veterans using Department of Veterans Affairs health care, Veterans Affairs clinical and administrative data (2007-2014) were linked to environmental measures constructed from public (2006-2014) and proprietary (2008-2014) sources, and linear regression models with person fixed effects were used to estimate associations between walkability and BMI among 758,434 men and 70,319 women aged 20 to 80 years in 2009 to 2014. RESULTS Neighborhood walkability was associated with small reductions in BMI. Effects were most pronounced among men aged 30 to 49 and 50 to 64. For women, differences were largest in the two youngest age groups, 20 to 29 and 30 to 49, though only estimates for all women combined were statistically significant. For women aged 30 to 49, effect sizes grew when the sample was limited to those who remained in the same neighborhood during the entire follow-up period. CONCLUSIONS Investments in the built environment to improve walkability may be a useful strategy for weight control in some segments of the adult population.
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Affiliation(s)
- Elizabeth Tarlov
- College of Nursing, University of Illinois at Chicago, Illinois, USA
- Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr. VA Hospital, Hines, IL, USA
| | - Abigail Silva
- Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr. VA Hospital, Hines, IL, USA
- Department of Public Health Sciences, Loyola University Chicago, Maywood, IL, USA
| | - Coady Wing
- School of Public and Environmental Affairs, Indiana University, Bloomington, IN, USA
| | - Sandy Slater
- School of Pharmacy, Concordia University Wisconsin, Mequon, WI, USA
| | - Stephen A. Matthews
- Department of Sociology and Criminology, Department of Anthropology, The Pennsylvania State University, University Park, PA, USA
| | - Kelly K. Jones
- National Socio-Environmental Synthesis Center, Annapolis, MD, USA
| | - Shannon N. Zenk
- College of Nursing, University of Illinois at Chicago, Illinois, USA
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26
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Buck C, Eiben G, Lauria F, Konstabel K, Page A, Ahrens W, Pigeot I. Urban Moveability and physical activity in children: longitudinal results from the IDEFICS and I.Family cohort. Int J Behav Nutr Phys Act 2019; 16:128. [PMID: 31829198 PMCID: PMC6907228 DOI: 10.1186/s12966-019-0886-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 11/15/2019] [Indexed: 01/29/2023] Open
Abstract
Background Physical activity (PA) is one of the major protective behaviours to prevent non-communicable diseases. Positive effects of the built environment on PA are well investigated, although evidence of this association is mostly based on cross-sectional studies. The present study aims to investigate the longitudinal effects of built environment characteristics in terms of a moveability index on PA of children in their transition phase to adolescence using data of the IDEFICS/I.Family cohort. Methods We used data on 3394 accelerometer measurements of 2488 children and adolescents aged 3 to 15 years old from survey centres of three countries, Germany, Italy, and Sweden, who participated in up to three surveys over 6 years. In network-dependent home neighbourhoods, a moveability index was calculated based on residential density, land use mix, street connectivity, availability of public transport and public open spaces such as green spaces and public playgrounds in order to quantify opportunities for PA of children and adolescents. Linear trajectories of light PA (LPA) and moderate-to-vigorous PA (MVPA) were estimated using linear mixed models accounting for repeated measurements nested within individuals. Least squares means were estimated to quantify differences in trajectories over age. Results LPA and MVPA declined annually with age by approximately 20 min/day and 2 min/day respectively. In girls, the moveability index showed a consistent significantly positive effect on MVPA (\documentclass[12pt]{minimal}
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\begin{document}$$ \hat{\beta} $$\end{document}β^ = 2.14, 95% CI: (0.11; 4.16)) for all ages, while in boys the index significantly lessened the decline in LPA with age for each year. (\documentclass[12pt]{minimal}
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\begin{document}$$ \hat{\beta} $$\end{document}β^ = 2.68, 95% CI: (0.46; 4.90)). Availability of public open spaces was more relevant for MVPA in girls and LPA in boys during childhood, whereas in adolescence, residential density and intersection density became more important. Conclusion Built environment characteristics are important determinants of PA and were found to have a supportive effect that ameliorates the decline in PA during the transition phase from childhood to adolescence. In childhood environmental support for leisure time PA through public open spaces was found to be the most protective factor whereas in adolescence the positive influence of street connectivity and residential density was most supportive of physical activity.
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Affiliation(s)
- Christoph Buck
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, 28359, Bremen, Germany.
| | - Gabriele Eiben
- Section for Epidemiology and Social Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Biomedicine and Public Health, School of Health and Education, University of Skövde, Skövde, Sweden
| | - Fabio Lauria
- National Research Council, Institute of Food Sciences, Avellino, Italy
| | - Kenn Konstabel
- National Institute for Health Development, Tallinn, Estonia
| | - Angie Page
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, Bristol, UK.,NIHR Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, 28359, Bremen, Germany.,Faculty of Mathematics/Computer Science, University of Bremen, Bremen, Germany
| | - Iris Pigeot
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, 28359, Bremen, Germany.,Faculty of Mathematics/Computer Science, University of Bremen, Bremen, Germany
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27
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Cuberek R, Pelclová J, Gába A, Pechová J, Svozilová Z, Přidalová M, Štefelová N, Hron K. Adiposity and changes in movement-related behaviors in older adult women in the context of the built environment: a protocol for a prospective cohort study. BMC Public Health 2019; 19:1522. [PMID: 31727040 PMCID: PMC6857272 DOI: 10.1186/s12889-019-7905-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 11/05/2019] [Indexed: 12/21/2022] Open
Abstract
Background In older adults, sedentary behaviors increase while physical activity decreases over time following the compositional nature of 24-h behaviors. These changes in movement-related behaviors (MRBs) might be associated with unhealthy weight gain and several health comorbidities. However, information is lacking on how obesity influences longitudinal changes in the composition of MRBs in older adults. Furthermore, the moderating effect of the built environment on prospective associations between obesity and MRBs in older adults is not fully understood. Therefore, using an integrated time-use approach, this study aims to identify prospective associations between obesity and MRBs together with an assessment of the moderating effect of the built environment in elderly women. Methods The study was designed as a prospective 7-year follow-up study. It is based on two previous cross-sectional studies that enable the use of participant data (women aged 60+ years, n = 409) as a baseline dataset in the current study. All methods designed for 7-year follow-up are based on previous studies. The data collection comprises device-based measurement of MRBs (ActiGraph GT1M accelerometer), objective assessment of body adiposity (multi-frequency bioelectrical impedance analysis), subjective assessment of the built environment (NEWS-A questionnaire), and other possible confounding factors. Time spent in sedentary behavior, light physical activity, and moderate-to-vigorous physical activity will be used as three components in a composition reflecting individual MRBs. In linear multiple compositional regression analysis assessing the prospective association between obesity and MRBs, the 7-year follow-up composition of the three mentioned components represents the dependent variable. The 7-year changes in the percentage of body fat (body adiposity), baseline composition of MRBs, and parameters of the built environment represent regressors. Discussion This study will use an integrated time-use approach to explore causality from obesity to device-measured behaviors in older women. The design and respective analysis consider the compositional nature of MRBs data and the potential moderating effects of various factors. A comprehensive assessment of causality may help to develop multilevel interventional models that enhance physical activity in older adults.
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Affiliation(s)
- Roman Cuberek
- Institute of active lifestyle, Faculty of Physical Culture, Palacký University Olomouc, třída Míru 117, 771 11, Olomouc, Czech Republic.
| | - Jana Pelclová
- Institute of active lifestyle, Faculty of Physical Culture, Palacký University Olomouc, třída Míru 117, 771 11, Olomouc, Czech Republic
| | - Aleš Gába
- Institute of active lifestyle, Faculty of Physical Culture, Palacký University Olomouc, třída Míru 117, 771 11, Olomouc, Czech Republic
| | - Jana Pechová
- Institute of active lifestyle, Faculty of Physical Culture, Palacký University Olomouc, třída Míru 117, 771 11, Olomouc, Czech Republic
| | - Zuzana Svozilová
- Institute of active lifestyle, Faculty of Physical Culture, Palacký University Olomouc, třída Míru 117, 771 11, Olomouc, Czech Republic
| | - Miroslava Přidalová
- Institute of active lifestyle, Faculty of Physical Culture, Palacký University Olomouc, třída Míru 117, 771 11, Olomouc, Czech Republic
| | - Nikola Štefelová
- Department of Mathematical Analysis and Applications of Mathematics, Faculty of Science, 17. listopadu 1192/12, 771 46, Olomouc, Czech Republic
| | - Karel Hron
- Department of Mathematical Analysis and Applications of Mathematics, Faculty of Science, 17. listopadu 1192/12, 771 46, Olomouc, Czech Republic
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Paulo Dos Anjos Souza Barbosa J, Henrique Guerra P, de Oliveira Santos C, de Oliveira Barbosa Nunes AP, Turrell G, Antonio Florindo A. Walkability, Overweight, and Obesity in Adults: A Systematic Review of Observational Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16173135. [PMID: 31466371 PMCID: PMC6747269 DOI: 10.3390/ijerph16173135] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Revised: 07/13/2019] [Accepted: 07/13/2019] [Indexed: 11/16/2022]
Abstract
We conducted a systematic review to describe and summarize possible associations between the walkability index, overweight, and obesity. Systematic searches using seven electronic databases and reference lists were conducted to identify papers published until December 2017. Observational studies, describing associations using regression-based statistical methods, published in English and Portuguese, reporting markers of overweight and obesity, and involving adults (≥18 years) were included. Of the 2469 references initially retrieved, ten were used for the descriptive synthesis. Seven studies showed significant inverse associations between walkability and overweight and obesity, however, all were cross-sectional studies. High risk of bias scores were observed in "selection bias" and "withdrawals and dropouts". All studies were published in high-income countries with sample sizes ranging among 75 to 649,513 participants. Weight and height as measures for determining BMI tended to be self-reported. Indicators of walkability, such as land-use mix, street connectivity and residential density were used as components of the indices. Based on this review, more studies should be conducted in low, middle, and middle-high income countries, using longitudinal designs that control neighborhood self-selection; other indicators of the neighborhood environment, such as food access, physical activity facilities, sidewalks, and safety and crime prevention should be considered.
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Affiliation(s)
- João Paulo Dos Anjos Souza Barbosa
- Nutrition Department, Graduate Program in Public Health Nutrition, School of Public Health, University of São Paulo, Sao Paulo City 01246-904, Brazil.
- Physical Activity Epidemiology Group, University of Sao Paulo, Sao Paulo City 03828-000, Brazil.
| | - Paulo Henrique Guerra
- Physical Activity Epidemiology Group, University of Sao Paulo, Sao Paulo City 03828-000, Brazil
- Federal University of Fronteira Sul, Chapecó Campus, Chapecó 89815-899, Brazil
| | - Crislaine de Oliveira Santos
- Physical Activity Epidemiology Group, University of Sao Paulo, Sao Paulo City 03828-000, Brazil
- School of Arts, Sciences and Humanities, Graduate Program in Physical Activity Sciences, University of Sao Paulo, Sao Paulo City 03828-000, Brazil
| | | | - Gavin Turrell
- Centre for Urban Research, School of Global, Urban and Social Studies, RMIT University, Melbourne, VIC 3000, Australia
| | - Alex Antonio Florindo
- Nutrition Department, Graduate Program in Public Health Nutrition, School of Public Health, University of São Paulo, Sao Paulo City 01246-904, Brazil
- Physical Activity Epidemiology Group, University of Sao Paulo, Sao Paulo City 03828-000, Brazil
- School of Arts, Sciences and Humanities, Graduate Program in Physical Activity Sciences, University of Sao Paulo, Sao Paulo City 03828-000, Brazil
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Low FM, Gluckman PD, Hanson MA. Niche Modification, Human Cultural Evolution and the Anthropocene. Trends Ecol Evol 2019; 34:883-885. [PMID: 31422891 DOI: 10.1016/j.tree.2019.07.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 07/04/2019] [Accepted: 07/11/2019] [Indexed: 12/01/2022]
Abstract
Niche-constructing organisms actively modify their environments with adaptive consequences, sustaining a new equilibrium. Modern humans are instead niche modifiers, continually changing their environments irrespective of adaptive pressures. The nature, scale, and speed of such modifications have potential ill effects that need to be addressed with multilevel societal initiatives.
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Affiliation(s)
- Felicia M Low
- Centre for Science in Policy, Diplomacy and Society, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand; Liggins Institute, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
| | - Peter D Gluckman
- Centre for Science in Policy, Diplomacy and Society, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand; Liggins Institute, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand.
| | - Mark A Hanson
- Institute of Developmental Sciences, Faculty of Medicine, University Hospital Southampton, Mailpoint 887, Tremona Road, Southampton SO16 6YD, UK
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30
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Präger M, Kurz C, Böhm J, Laxy M, Maier W. Using data from online geocoding services for the assessment of environmental obesogenic factors: a feasibility study. Int J Health Geogr 2019; 18:13. [PMID: 31174531 PMCID: PMC6555943 DOI: 10.1186/s12942-019-0177-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 05/29/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The increasing prevalence of obesity is a major public health problem in many countries. Built environment factors are known to be associated with obesity, which is an important risk factor for type 2 diabetes. Online geocoding services could be used to identify regions with a high concentration of obesogenic factors. The aim of our study was to examine the feasibility of integrating information from online geocoding services for the assessment of obesogenic environments. METHODS We identified environmental factors associated with obesity from the literature and translated these factors into variables from the online geocoding services Google Maps and OpenStreetMap (OSM). We tested whether spatial data points can be downloaded from these services and processed and visualized on maps. True- and false-positive values, false-negative values, sensitivities and positive predictive values of the processed data were determined using search engines and in-field inspections within four pilot areas in Bavaria, Germany. RESULTS Several environmental factors could be identified from the literature that were either positively or negatively correlated with weight outcomes in previous studies. The diversity of query variables was higher in OSM compared with Google Maps. In each pilot area, query results from Google showed a higher absolute number of true-positive hits and of false-positive hits, but a lower number of false-negative hits during the validation process. The positive predictive value of database hits was higher in OSM and ranged between 81 and 100% compared with a range of 63-89% for Google Maps. In contrast, sensitivities were higher in Google Maps (between 59 and 98%) than in OSM (between 20 and 64%). CONCLUSIONS It was possible to operationalize obesogenic factors identified from the literature with data and variables available from geocoding services. The validity of Google Maps and OSM was reasonable. The assessment of environmental obesogenic factors via geocoding services could potentially be applied in diabetes surveillance.
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Affiliation(s)
- Maximilian Präger
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München – German Research Center for Environmental Health (GmbH), Ingolstädter Landstraße 1, 85758 Neuherberg, Germany
- German Center for Diabetes Research, Neuherberg, Germany
| | - Christoph Kurz
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München – German Research Center for Environmental Health (GmbH), Ingolstädter Landstraße 1, 85758 Neuherberg, Germany
- German Center for Diabetes Research, Neuherberg, Germany
| | - Julian Böhm
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München – German Research Center for Environmental Health (GmbH), Ingolstädter Landstraße 1, 85758 Neuherberg, Germany
- German Center for Diabetes Research, Neuherberg, Germany
| | - Michael Laxy
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München – German Research Center for Environmental Health (GmbH), Ingolstädter Landstraße 1, 85758 Neuherberg, Germany
- German Center for Diabetes Research, Neuherberg, Germany
| | - Werner Maier
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München – German Research Center for Environmental Health (GmbH), Ingolstädter Landstraße 1, 85758 Neuherberg, Germany
- German Center for Diabetes Research, Neuherberg, Germany
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Abstract
PURPOSE OF REVIEW To explore the relationship between the built environment and type 2 diabetes, considering both risk factors and policies to reduce risk. The built environment refers to the physical characteristics of the areas in which people live including buildings, streets, open spaces, and infrastructure. RECENT FINDINGS A review of current literature suggests an association between the built environment and type 2 diabetes, likely driven by two key pathways-physical activity and the food environment. Other hypothesized mechanisms linking the built environment and type 2 diabetes include housing policy, but evidence in these areas is underdeveloped. Policies designed to enhance the built environment for diabetes risk reduction are mechanistically plausible, but as of yet, little direct evidence supports their effectiveness in reducing in type 2 diabetes risk. Future work should rigorously evaluate policies meant to reduce type 2 diabetes via the built environment.
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Affiliation(s)
- Aisha T Amuda
- University of North Carolina School of Medicine, 1001 Bondurant Hall, CB 9535, Chapel Hill, NC, 27599, USA
| | - Seth A Berkowitz
- Division of General Medicine and Clinical Epidemiology, Department of Medicine, Chapel Hill School of Medicine, University of North Carolina, 5034 Old Clinic Bldg. CB 7110, Chapel Hill, NC, 27599, USA.
- Cecil G. Sheps Center for Health Services Research, Chapel Hill, University of North Carolina, Chapel Hill, NC, USA.
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Examining the Relationship between Urban Design Qualities and Walking Behavior: Empirical Evidence from Dallas, TX. SUSTAINABILITY 2019. [DOI: 10.3390/su11102720] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study examines the relationship between street-level urban design perceptual qualities and walking behavior in the City of Dallas. While the city has the potential to experience growth in pedestrian activities, it exhibits a very low level of walking activity, placing it as one of the least walkable cities in the nation. To assess the impact of urban design qualities on walkability, we collected data on 23 features related to urban design, 11 built environment variables characterized as D variables comprising diversity, density, design, distance to transit, and destination accessibility. The sample included 402 street block faces in Dallas Downtown Improvement District. Accounting for spatial autocorrelation, we found that two urban design qualities, among five, including image-ability—such as a memorable quality of a place, and transparency—as to what degree people can see beyond the street’s edge—significantly influence pedestrian volume in downtown streets. These findings are in agreement with the two previous studies that used the same methodology in different cities (New York City, NYC and Salt Lake City, UT). According to the findings of these three studies, the other urban design qualities including human scale, complexity, as well as enclosure, are not playing a significant role in walkability, despite the theoretical justification and the extensive operationalization efforts. The findings of this study draw policy makers’ attention to creating more appealing and walkable places through the implementation of these urban design qualities.
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Pereira M, Nogueira H, Padez C. The role of urban design in childhood obesity: A case study in Lisbon, Portugal. Am J Hum Biol 2019; 31:e23220. [PMID: 30869821 DOI: 10.1002/ajhb.23220] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 11/08/2018] [Accepted: 12/28/2018] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE We hypothesize that physical features of the urban environment might enhance or prevent childhood obesity. Thus, this study's main goal was to verify if there is an association between the neighborhood urban design and childhood obesity-independent of well-known childhood obesity determinants, such as, father's level of schooling (as a proxy for socioeconomic status), and parent's weight status. METHODS This study classifies neighborhoods according to land use and building features using hierarchical clusters analysis and examines their association with childhood obesity through logistic regression models. RESULTS Four clusters resulted from the analysis: Cluster 1 represents areas with older buildings and mixed land use, cluster 2 is an area with small rented buildings and urban areas, cluster 3 comprises newer buildings with parking and urban green space, and cluster 4 is a forest area. Living in cluster 3 protects from childhood obesity, even when adjusting for father's level of schooling or parent's weight status. CONCLUSIONS There are distinct urban configurations in Lisbon's municipality and children who live in Cluster 3 (more recent and greener neighborhoods) seem to be protected from obesity. Therefore, public policy should focus on healthy urban planning at the neighborhood level, to promote positive impacts on peoples' health.
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Affiliation(s)
- Margarida Pereira
- Department of Life Sciences, Research Centre for Anthropology and Health, University of Coimbra, Portugal Calçada Martim de Freitas, Edifício de São bento, 3000-456 Coimbra, Portugal
| | - Helena Nogueira
- Department of Life Sciences, Research Centre for Anthropology and Health, University of Coimbra, Portugal Calçada Martim de Freitas, Edifício de São bento, 3000-456 Coimbra, Portugal
| | - Cristina Padez
- Department of Life Sciences, Research Centre for Anthropology and Health, University of Coimbra, Portugal Calçada Martim de Freitas, Edifício de São bento, 3000-456 Coimbra, Portugal
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34
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Bell CN, Kerr J, Young JL. Associations between Obesity, Obesogenic Environments, and Structural Racism Vary by County-Level Racial Composition. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16050861. [PMID: 30857286 PMCID: PMC6427384 DOI: 10.3390/ijerph16050861] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 02/14/2019] [Accepted: 02/28/2019] [Indexed: 11/29/2022]
Abstract
Obesity rates in the U.S. are associated with area-level, food-related characteristics. Studies have previously examined the role of structural racism (policies/practices that advantaged White Americans and deprived other racial/ethnic minority groups), but racial inequalities in socioeconomic status (SES) is a novel indicator. The aim of this study is to determine the associations between racial inequalities in SES with obesity and obesogenic environments. Data from 2007–2014 County Health Rankings and 2012–2016 County Business Patterns were combined to assess the associations between relative SES comparing Blacks to Whites with obesity, and number of grocery stores and fast food restaurants in U.S. counties. Random effects linear and Poisson regressions were used and stratified by county racial composition. Racial inequality in poverty, unemployment, and homeownership were associated with higher obesity rates. Racial inequality in median income, college graduates, and unemployment were associated with fewer grocery stores and more fast food restaurants. Associations varied by county racial composition. The results demonstrate that a novel indicator of structural racism on the county-level is associated with obesity and obesogenic environments. Associations vary by SES measure and county racial composition, suggesting the ability for targeted interventions to improve obesogenic environments and policies to eliminate racial inequalities in SES.
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Affiliation(s)
- Caryn N Bell
- Department of African American Studies, University of Maryland, College Park, MD 20724, USA.
| | - Jordan Kerr
- School of Public Health, University of Maryland, College Park, MD 20724, USA.
| | - Jessica L Young
- Department of Health Studies, American University, Washington, DC 20016, USA.
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35
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Slater SJ, Tarlov E, Jones K, Matthews SA, Wing C, Zenk SN. Would increasing access to recreational places promote healthier weights and a healthier nation? Health Place 2019; 56:127-134. [PMID: 30738347 PMCID: PMC6878109 DOI: 10.1016/j.healthplace.2019.01.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 12/23/2018] [Accepted: 01/15/2019] [Indexed: 11/22/2022]
Abstract
Addressing gaps in evidence on causal associations, this study tested the hypothesis that better access to recreational places close to home helps people to maintain lower body mass index (BMI) using a retrospective longitudinal study design and up to 6 years of data for the same individuals (1,522,803 men and 183,618 women). Participants were military veterans aged 20-64 who received healthcare through the U.S. Department of Veterans Affairs in 2009-2014 and lived in a metropolitan area. Although there were cross-sectional associations, we found no longitudinal evidence that access to parks and fitness facilities was associated with BMI for either men or women in the full sample or in subgroups of residential movers and stayers. Our findings suggest that simply increasing the number of parks and fitness facilities may not be enough to achieve needed population-level reductions in weight.
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Affiliation(s)
- Sandy J Slater
- Department of Pharmaceutical Sciences Concordia University Wisconsin School of Pharmacy, 12800 N. Lake Shore Drive, Mequon, WI 53097, United States.
| | - Elizabeth Tarlov
- Department of Health Systems Science, College of Nursing, University of Illinois at Chicago, United States
| | - Kelly Jones
- Department of Health Systems Science, College of Nursing, University of Illinois at Chicago, United States
| | - Stephen A Matthews
- Department of Sociology & Criminology, Department of Anthropology, Pennsylvania State University, United States
| | - Coady Wing
- School of Public and Environmental Affairs, Indiana University, United States
| | - Shannon N Zenk
- Department of Health Systems Science, College of Nursing, University of Illinois at Chicago, United States
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36
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Mayne DJ, Morgan GG, Jalaludin BB, Bauman AE. Area-Level Walkability and the Geographic Distribution of High Body Mass in Sydney, Australia: A Spatial Analysis Using the 45 and Up Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16040664. [PMID: 30813499 PMCID: PMC6406292 DOI: 10.3390/ijerph16040664] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 02/07/2019] [Accepted: 02/19/2019] [Indexed: 12/12/2022]
Abstract
Improving the walkability of built environments to promote healthy lifestyles and reduce high body mass is increasingly considered in regional development plans. Walkability indexes have the potential to inform, benchmark and monitor these plans if they are associated with variation in body mass outcomes at spatial scales used for health and urban planning. We assessed relationships between area-level walkability and prevalence and geographic variation in overweight and obesity using an Australian population-based cohort comprising 92,157 Sydney respondents to the 45 and Up Study baseline survey between January 2006 and April 2009. Individual-level data on overweight and obesity were aggregated to 2006 Australian postal areas and analysed as a function of area-level Sydney Walkability Index quartiles using conditional auto regression spatial models adjusted for demographic, social, economic, health and socioeconomic factors. Both overweight and obesity were highly clustered with higher-than-expected prevalence concentrated in the urban sprawl region of western Sydney, and lower-than-expected prevalence in central and eastern Sydney. In fully adjusted spatial models, prevalence of overweight and obesity was 6% and 11% lower in medium-high versus low, and 10% and 15% lower in high versus low walkability postcodes, respectively. Postal area walkability explained approximately 20% and 9% of the excess spatial variation in overweight and obesity that remained after accounting for other individual- and area-level factors. These findings provide support for the potential of area-level walkability indexes to inform, benchmark and monitor regional plans aimed at targeted approaches to reducing population-levels of high body mass through environmental interventions. Future research should consider potential confounding due to neighbourhood self-selection on area-level walkability relations.
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Affiliation(s)
- Darren J Mayne
- The University of Sydney, School of Public Health, Sydney, NSW 2006, Australia.
- Illawarra Shoalhaven Local Health District, Public Health Unit, Warrawong, NSW 2502, Australia.
- University of Wollongong, School of Medicine, Wollongong, NSW 2522, Australia.
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW 2522, Australia.
| | - Geoffrey G Morgan
- The University of Sydney, School of Public Health, Sydney, NSW 2006, Australia.
- The University of Sydney, University Centre for Rural Health, Rural Clinical School-Northern Rivers, Sydney, NSW 2006, Australia.
| | - Bin B Jalaludin
- Ingham Institute, University of New South Wales, Sydney, NSW 2052, Australia.
- Epidemiology, Healthy People and Places Unit, Population Health, South Western Sydney Local Health District, Liverpool, NSW 1871, Australia.
| | - Adrian E Bauman
- The University of Sydney, School of Public Health, Sydney, NSW 2006, Australia.
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37
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Poulsen MN, Knapp EA, Hirsch AG, Bailey-Davis L, Pollak J, Schwartz BS. Comparing objective measures of the built environment in their associations with youth physical activity and sedentary behavior across heterogeneous geographies. Health Place 2017; 49:30-38. [PMID: 29161656 DOI: 10.1016/j.healthplace.2017.11.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 09/18/2017] [Accepted: 11/06/2017] [Indexed: 10/18/2022]
Abstract
We compared two strategies for measuring built environment features in their associations with youth physical activity and sedentary behavior across heterogeneous geographies of Pennsylvania. Physical activity environments of communities representing a rural-to-urban gradient were characterized through direct observation and spatially referenced archival data subjected to confirmatory factor analysis. Stratified regression analyses assessed associations between environmental measures and behavioral outcomes by community type. Neither strategy was consistently associated with behavior across communities. Findings highlight the importance of differentiating community type in evaluating associations of the built environment, and the challenge of measuring meaningful differences that influence youth behavior across heterogeneous geographies.
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Affiliation(s)
- Melissa N Poulsen
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA; Department of Epidemiology and Health Services Research, Geisinger Health System, 100 North Academy Avenue, MC 44-00, Danville, PA 17822, USA.
| | - Emily A Knapp
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA.
| | - Annemarie G Hirsch
- Department of Epidemiology and Health Services Research, Geisinger Health System, 100 North Academy Avenue, MC 44-00, Danville, PA 17822, USA.
| | - Lisa Bailey-Davis
- Department of Epidemiology and Health Services Research, Geisinger Health System, 100 North Academy Avenue, MC 44-00, Danville, PA 17822, USA.
| | - Jonathan Pollak
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA.
| | - Brian S Schwartz
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA; Department of Epidemiology and Health Services Research, Geisinger Health System, 100 North Academy Avenue, MC 44-00, Danville, PA 17822, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA; Department of Medicine, Johns Hopkins School of Medicine, 733 N. Broadway, Baltimore, MD 21205, USA.
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Joseph P, Leong D, McKee M, Anand SS, Schwalm JD, Teo K, Mente A, Yusuf S. Reducing the Global Burden of Cardiovascular Disease, Part 1: The Epidemiology and Risk Factors. Circ Res 2017; 121:677-694. [PMID: 28860318 DOI: 10.1161/circresaha.117.308903] [Citation(s) in RCA: 583] [Impact Index Per Article: 83.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Current global health policy goals include a 25% reduction in premature mortality from noncommunicable diseases by 2025. In this 2-part review, we provide an overview of the current epidemiological data on cardiovascular diseases (CVD), its risk factors, and describe strategies aimed at reducing its burden. In part 1, we examine the global epidemiology of cardiac conditions that have the greatest impact on CVD mortality; the predominant risk factors; and the impact of upstream, societal health determinants (eg, environmental factors, health policy, and health systems) on CVD. Although age-standardized mortality from CVD has decreased in many regions of the world, the absolute number of deaths continues to increase, with the majority now occurring in middle- and low-income countries. It is evident that multiple factors are causally related to CVD, including traditional individual level risk factors (mainly tobacco use, lipids, and elevated blood pressure) and societal level health determinants (eg, health systems, health policies, and barriers to CVD prevention and care). Both individual and societal risk factors vary considerably between different regions of the world and economic settings. However, reliable data to estimate CVD burden are lacking in many regions of the world, which hampers the establishment of nationwide prevention and management strategies. A 25% reduction in premature CVD mortality globally is feasible but will require better implementation of evidence-based policies (particularly tobacco control) and integrated health systems strategies that improve CVD prevention and management. In addition, there is a need for better health information to monitor progress and guide health policy decisions.
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Affiliation(s)
- Philip Joseph
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Ontario, Canada (P.J., D.L., S.S.A., J.-D.S., K.T., A.M., S.Y.); and London School of Hygiene and Tropical Medicine, United Kingdom (M.M.).
| | - Darryl Leong
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Ontario, Canada (P.J., D.L., S.S.A., J.-D.S., K.T., A.M., S.Y.); and London School of Hygiene and Tropical Medicine, United Kingdom (M.M.)
| | - Martin McKee
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Ontario, Canada (P.J., D.L., S.S.A., J.-D.S., K.T., A.M., S.Y.); and London School of Hygiene and Tropical Medicine, United Kingdom (M.M.)
| | - Sonia S Anand
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Ontario, Canada (P.J., D.L., S.S.A., J.-D.S., K.T., A.M., S.Y.); and London School of Hygiene and Tropical Medicine, United Kingdom (M.M.)
| | - Jon-David Schwalm
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Ontario, Canada (P.J., D.L., S.S.A., J.-D.S., K.T., A.M., S.Y.); and London School of Hygiene and Tropical Medicine, United Kingdom (M.M.)
| | - Koon Teo
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Ontario, Canada (P.J., D.L., S.S.A., J.-D.S., K.T., A.M., S.Y.); and London School of Hygiene and Tropical Medicine, United Kingdom (M.M.)
| | - Andrew Mente
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Ontario, Canada (P.J., D.L., S.S.A., J.-D.S., K.T., A.M., S.Y.); and London School of Hygiene and Tropical Medicine, United Kingdom (M.M.)
| | - Salim Yusuf
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Ontario, Canada (P.J., D.L., S.S.A., J.-D.S., K.T., A.M., S.Y.); and London School of Hygiene and Tropical Medicine, United Kingdom (M.M.)
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Aguilar-Salinas CA, Bourges-Rodriguez H, Polo-Oteyza E. Prevention of diabetes in Mexico: summary of evidence on preventive interventions presented at the 2014 Nestle Nutrition Conference. Nutr Rev 2017; 75:1-3. [PMID: 28049744 DOI: 10.1093/nutrit/nuw050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Carlos A Aguilar-Salinas
- C.A. Aguilar-Salinas is with the Department of Endocrinology and Metabolism, Instituto Nacional de Ciencias Medicas y Nutrición, Salvador Zubiran, Mexico City, Mexico. H. Bourges-Rodriguez is with the Direction of Nutrition, Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubiran, Mexico City, Mexico. E. Polo-Oteyza is with the Fondo Nestlé para la Nutrición, Fundacion Mexicana para la Salud, Mexico City, Mexico.
| | - Hector Bourges-Rodriguez
- C.A. Aguilar-Salinas is with the Department of Endocrinology and Metabolism, Instituto Nacional de Ciencias Medicas y Nutrición, Salvador Zubiran, Mexico City, Mexico. H. Bourges-Rodriguez is with the Direction of Nutrition, Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubiran, Mexico City, Mexico. E. Polo-Oteyza is with the Fondo Nestlé para la Nutrición, Fundacion Mexicana para la Salud, Mexico City, Mexico
| | - Ernestina Polo-Oteyza
- C.A. Aguilar-Salinas is with the Department of Endocrinology and Metabolism, Instituto Nacional de Ciencias Medicas y Nutrición, Salvador Zubiran, Mexico City, Mexico. H. Bourges-Rodriguez is with the Direction of Nutrition, Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubiran, Mexico City, Mexico. E. Polo-Oteyza is with the Fondo Nestlé para la Nutrición, Fundacion Mexicana para la Salud, Mexico City, Mexico
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