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Kahlmeier S, Wittowsky D, Fehr R. [Mobility and Urban Health]. DAS GESUNDHEITSWESEN 2023; 85:S304-S310. [PMID: 37972603 DOI: 10.1055/a-2160-2733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
Cities and communities form complex microcosms in which people with very different needs and opportunities live. The structural design and functionality of urban spaces have a significant impact on individual mobility and thus on the health and quality of life of the entire population. In recent decades, politicians and municipalities have accepted negative effects on people (especially vulnerable groups) and ecosystems as a price worth paying for ensuring mobility through car-friendly structures. The interconnection of health and sustainability aspects will be a central process component for the necessary transformation of urban structures in integrated urban and transport planning. Although there are many positive framework conditions and possible solutions in the international and national context, numerous processes need to be optimized and measures implemented on a large scale. In addition, the existing tools in urban and traffic planning must be further expanded to include health aspects more comprehensively. This requires readjustments in science, in municipal practice planning, in education and in interdisciplinary funding programs.
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Affiliation(s)
- Sonja Kahlmeier
- Departement Gesundheit, Fernfachhochschule Schweiz, Zürich, Switzerland
| | - Dirk Wittowsky
- Institut für Mobilitäts- und Stadtplanung, Universität Duisburg-Essen, Essen, Germany
| | - Rainer Fehr
- Sustainable Environmental Health Sciences, Medizinische Fakultät OWL, Universität Bielefeld, Bielefeld, Germany
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2
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Parrish S, Lavis A, Potter CM, Ulijaszek S, Nowicka P, Eli K. How active can preschoolers be at home? Parents' and grandparents' perceptions of children's day-to-day activity, with implications for physical activity policy. Soc Sci Med 2021; 292:114557. [PMID: 34837829 DOI: 10.1016/j.socscimed.2021.114557] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 09/21/2021] [Accepted: 11/05/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND The importance of physical activity in early childhood for establishing long-term health is well understood, yet with the exception of recent WHO guidelines, public health initiatives rarely focus on children below school age. Moreover, little is known about how domestic spaces and day-to-day caring activities influence preschool-age children's physical activity. To examine this, we explore caregivers' perceptions of young children's activities within and outside the home, and we consider how lived experiences of caregiving align (or not) with current physical activity policy. METHODS Semi-structured interviews with 49 parents and grandparents from 16 families were conducted in Oregon, USA; each family had a child aged 3-5 years. Questions focused on caregivers' perceptions of and involvement with children's body weights, activities, and food practices. The interviews were analysed using thematic analysis. Our analysis drew on a materialities framework, attending to relationships between children, caregivers, spaces in and around the home, and everyday activities. RESULTS Four themes were developed: appropriateness of outside versus inside spaces for physical activity; making accommodations for physical activity in the home; active spaces of care, referring to relationships among space, activity type, and caregiver attention; and mundane movement, or the low-intensity movement of everyday life. Together, the results highlight that children's day-to-day activities cut across a spectrum of movement, mediated by available spaces and caregiving affordances. CONCLUSIONS Attending to the full spectrum of children's movements highlights how children's activities interlink with family routines, available indoor and outdoor spaces, and the intended uses of these spaces. These interplays between space, care, and physical activity enacted at the household level should inform an integrated, systems-level public health approach to increasing health and well-being for preschool-age children. Suggestions for improvement include coordinating policy development across multiple fields (e.g., housing design, urban planning) that structure the activities of children and their caregivers across 'home' and 'outside' spaces.
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Affiliation(s)
- Sabine Parrish
- Unit for Biocultural Variation and Obesity, School of Anthropology and Museum Ethnography, University of Oxford, Oxford, UK; Centre for Food Policy, City, University of London, London, UK
| | - Anna Lavis
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Caroline M Potter
- Unit for Biocultural Variation and Obesity, School of Anthropology and Museum Ethnography, University of Oxford, Oxford, UK; Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Stanley Ulijaszek
- Unit for Biocultural Variation and Obesity, School of Anthropology and Museum Ethnography, University of Oxford, Oxford, UK
| | - Paulina Nowicka
- Department of Food Studies, Nutrition and Dietetics, University of Uppsala, Uppsala, Sweden.
| | - Karin Eli
- Unit for Biocultural Variation and Obesity, School of Anthropology and Museum Ethnography, University of Oxford, Oxford, UK; Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
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Phan L, Yu W, Keralis JM, Mukhija K, Dwivedi P, Brunisholz KD, Javanmardi M, Tasdizen T, Nguyen QC. Google Street View Derived Built Environment Indicators and Associations with State-Level Obesity, Physical Activity, and Chronic Disease Mortality in the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103659. [PMID: 32456114 PMCID: PMC7277659 DOI: 10.3390/ijerph17103659] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 05/17/2020] [Accepted: 05/20/2020] [Indexed: 11/21/2022]
Abstract
Previous studies have demonstrated that there is a high possibility that the presence of certain built environment characteristics can influence health outcomes, especially those related to obesity and physical activity. We examined the associations between select neighborhood built environment indicators (crosswalks, non-single family home buildings, single-lane roads, and visible wires), and health outcomes, including obesity, diabetes, cardiovascular disease, and premature mortality, at the state level. We utilized 31,247,167 images collected from Google Street View to create indicators for neighborhood built environment characteristics using deep learning techniques. Adjusted linear regression models were used to estimate the associations between aggregated built environment indicators and state-level health outcomes. Our results indicated that the presence of a crosswalk was associated with reductions in obesity and premature mortality. Visible wires were associated with increased obesity, decreased physical activity, and increases in premature mortality, diabetes mortality, and cardiovascular mortality (however, these results were not significant). Non-single family homes were associated with decreased diabetes and premature mortality, as well as increased physical activity and park and recreational access. Single-lane roads were associated with increased obesity and decreased park access. The findings of our study demonstrated that built environment features may be associated with a variety of adverse health outcomes.
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Affiliation(s)
- Lynn Phan
- Department of Public Health Science, University of Maryland School of Public Health, College Park, MA 20742, USA
- Correspondence: (L.P.); (Q.C.N.)
| | - Weijun Yu
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD 20742, USA; (W.Y.); (J.M.K.); (P.D.)
| | - Jessica M. Keralis
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD 20742, USA; (W.Y.); (J.M.K.); (P.D.)
| | | | - Pallavi Dwivedi
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD 20742, USA; (W.Y.); (J.M.K.); (P.D.)
| | - Kimberly D. Brunisholz
- Intermountain Healthcare Delivery Institute, Intermountain Healthcare, Murray, UT 4107, USA;
| | - Mehran Javanmardi
- Department of Electrical and Computer Engineering, Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT 84112, USA; (M.J.); (T.T.)
| | - Tolga Tasdizen
- Department of Electrical and Computer Engineering, Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT 84112, USA; (M.J.); (T.T.)
| | - Quynh C. Nguyen
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD 20742, USA; (W.Y.); (J.M.K.); (P.D.)
- Correspondence: (L.P.); (Q.C.N.)
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Drewnowski A, Buszkiewicz J, Aggarwal A, Rose C, Gupta S, Bradshaw A. Obesity and the Built Environment: A Reappraisal. Obesity (Silver Spring) 2020; 28:22-30. [PMID: 31782242 PMCID: PMC6986313 DOI: 10.1002/oby.22672] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 09/25/2019] [Indexed: 12/16/2022]
Abstract
The built environment (BE) has been viewed as an important determinant of health. Numerous studies have linked BE exposure, captured using a variety of methods, to diet quality and to area prevalence of obesity, diabetes, and cardiovascular disease. First-generation studies defined the neighborhood BE as the area around the home. Second-generation studies turned from home-centric to person-centric BE measures, capturing an individual's movements in space and time. Those studies made effective uses of global positioning system tracking devices and mobile phones, sometimes coupled with accelerometers and remote sensors. Activity space metrics explored travel paths, modes, and destinations to assess BE exposure that was both person and context specific. However, as measures of the contextual exposome have become ever more fine-grained and increasingly complex, connections to long-term chronic diseases with complex etiologies, such as obesity, are in danger of being lost. Furthermore, few studies on obesity and the BE have included intermediate energy balance behaviors, such as diet and physical activity, or explored the potential roles of social interactions or psychosocial pathways. Emerging survey-based applications that identify habitual destinations and associated travel patterns may become the third generation of tools to capture health-relevant BE exposures in the long term.
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Affiliation(s)
- Adam Drewnowski
- Center for Public Health Nutrition, School of Public Health, University of Washington
- Department of Epidemiology, School of Public Health, University of Washington
| | - James Buszkiewicz
- Department of Epidemiology, School of Public Health, University of Washington
| | - Anju Aggarwal
- Center for Public Health Nutrition, School of Public Health, University of Washington
- Department of Epidemiology, School of Public Health, University of Washington
| | - Chelsea Rose
- Center for Public Health Nutrition, School of Public Health, University of Washington
| | - Shilpi Gupta
- Center for Public Health Nutrition, School of Public Health, University of Washington
| | - Annie Bradshaw
- Department of Epidemiology, School of Public Health, University of Washington
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5
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Forberger S, Reisch L, Kampfmann T, Zeeb H. Nudging to move: a scoping review of the use of choice architecture interventions to promote physical activity in the general population. Int J Behav Nutr Phys Act 2019; 16:77. [PMID: 31481090 PMCID: PMC6724306 DOI: 10.1186/s12966-019-0844-z] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 08/23/2019] [Indexed: 11/10/2022] Open
Abstract
Background Nudges are used to alter lifestyles and thus curb the rise of non-communicable diseases. Physical activity is a core prevention strategy to reduce the burden of non-communicable diseases. This paper aims to (1) give an overview of the scope of interventions using choice architecture techniques to promote physical activity at the population levels and (2) identify research gaps by analysing the different approaches in terms of class and type of intervention used. Methods A systematic electronic database search was combined with snowball citation sampling of a starter set of publications to search for studies published through October 2018 reporting interventions to promote physical activity at the population level using choice architecture techniques. The methodology of the Joanna Briggs Institute for Scoping Reviews was applied. Results In all, 35 publications were included. Most of the interventions used point-of-choice prompts tested at railway stations, shopping malls and airports (N = 27). Eight studies were online studies. While all studies were aimed at the general population, details, if reported at all, were vague and basic. All studies focused on individual-level lifestyle behaviour. None of the studies attempted to alter population-based lifestyle behaviour. Online and “real-world” approaches were rarely combined. Neither, interventions targeting meso- and macro-level structures nor combinations of individual-level and specific meso- or macro-level interventions were found. Conclusion Nudging is in principle an effective approach to promote physical activity within the general population. However, there are large gaps in research. Available opportunities have not yet been exhausted. Further research is needed that is explicitly based on behavioural insights and covering the full range of nudging approaches, particularly focussing on theoretical developments, practical feasibility tests and scale-up activities. Electronic supplementary material The online version of this article (10.1186/s12966-019-0844-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- S Forberger
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, 28359, Bremen, Germany.
| | - L Reisch
- Leibniz-Chair, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, 28359, Bremen, Germany.,Copenhagen Business School, MSC, Dalgas Have 15, 2000, Frederiksberg, Denmark
| | - T Kampfmann
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, 28359, Bremen, Germany
| | - H Zeeb
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, 28359, Bremen, Germany.,Health Sciences Bremen, University of Bremen, Bremen, Germany
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Hills AP, Farpour-Lambert NJ, Byrne NM. Precision medicine and healthy living: The importance of the built environment. Prog Cardiovasc Dis 2019; 62:34-38. [PMID: 30639136 DOI: 10.1016/j.pcad.2018.12.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Accepted: 12/31/2018] [Indexed: 12/28/2022]
Abstract
The built environment encompasses the major physical spaces, including buildings, streets, homes, schools, parks, playgrounds and other infrastructure in which we live, work and play. In an ideal world, the built environment should support and facilitate a healthy engagement in physical activity across the lifespan. However, in the context of an environment characterized by increased mechanization and urbanization, physical inactivity and higher levels of overweight and obesity, too many settings are not conducive to physical activity and/or are not safe and walkable. In the knowledge that there are multiple challenges to redress the low levels of physical activity seen in many parts of the world, this paper provides some examples of opportunities for healthy living (HL) in a built environment characteristic of an increasingly urbanized world. Particular foci include opportunities for HL fostered in child-friendly cities, in which walkability is high, and active transport is encouraged and supported.
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Affiliation(s)
- Andrew P Hills
- School of Health Sciences, College of Health and Medicine, University of Tasmania, TAS, Australia.
| | - Nathalie J Farpour-Lambert
- Obesity Prevention and Care Program "Contrepoids," Service of Therapeutic Education for Chronic Diseases, Department of Community Medicine, Primary Care and Emergency, Geneva University Hospitals and University of Geneva, Geneva, Switzerland; Pediatric Sports Medicine Consultation, Service of General Pediatrics, Department of Child and Adolescent, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Nuala M Byrne
- School of Health Sciences, College of Health and Medicine, University of Tasmania, TAS, Australia
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Dulloo AG, Miles-Chan J, Schutz Y, Montani JP. Targeting lifestyle energy expenditure in the management of obesity and health: from biology to built environment. Obes Rev 2018; 19 Suppl 1:3-7. [PMID: 30511502 DOI: 10.1111/obr.12786] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 09/11/2018] [Indexed: 12/01/2022]
Abstract
Increasing lifestyle energy expenditure has long been advocated in the prevention and treatment of obesity, as embodied in the ancient prescription of Hippocrates (the 'father of modern medicine') that people with obesity should eat less and exercise more. However, the long-term outcome of exercise alone or in combination with dieting in obesity management is poor. To understand the reasons underlying these failures and to develop novel strategies that target lifestyle energy expenditure in both prevention and treatment of obesity, research over the past decades has focused on (i) the interactions between physical activity and body weight (and its composition) throughout the lifespan; (ii) the influence of biology and potential compensatory changes in energy expenditure, food intake and food assimilation in response to energy deficits; and (iii) the impact of the built environment (outdoor and indoor) and smart technology on physical activity behaviours, thermoregulatory thermogenesis and metabolic health. It is against this background that recent advances relevant to the theme of 'Targeting Lifestyle Energy Expenditure in the Management of Obesity and Health: From Biology to Built Environment' are addressed in this overview and the nine review articles in this supplement, reporting the proceedings of the 9th Fribourg Obesity Research Conference.
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Affiliation(s)
- A G Dulloo
- Department of Endocrinology, Metabolism and Cardiovascular System, Faculty of Sciences and Medicine, University of Fribourg, Fribourg, Switzerland
| | - J Miles-Chan
- Human Nutrition Unit, School of Biological Sciences, University of Auckland, Auckland, New Zealand
| | - Y Schutz
- Department of Endocrinology, Metabolism and Cardiovascular System, Faculty of Sciences and Medicine, University of Fribourg, Fribourg, Switzerland
| | - J-P Montani
- Department of Endocrinology, Metabolism and Cardiovascular System, Faculty of Sciences and Medicine, University of Fribourg, Fribourg, Switzerland
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