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Schinasi LH, Lawrence JA. Everyday discrimination and satisfaction with nature experiences. FRONTIERS IN EPIDEMIOLOGY 2024; 4:1212114. [PMID: 38872717 PMCID: PMC11169619 DOI: 10.3389/fepid.2024.1212114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 05/07/2024] [Indexed: 06/15/2024]
Abstract
Introduction There is growing interest in creating public green spaces to promote health. Yet, discussions about these efforts often overlook how experiences of chronic discrimination-which may manifest as racism, sexism, or homophobia, and more-could undermine satisfaction with nature experiences. Methods Using data from the 2018 wave of the National Opinion Research Center (NORC) General Social Survey (GSS), we quantified associations of frequency of everyday discrimination, operationalized using the Everyday Discrimination Scale (EDS, the primary independent variable), with respondents' perceptions of nature experiences and with their reported time spent in nature. Specifically, we quantified associations with the following three variables: (1) dissatisfaction with day-to-day experiences of nature, (2) not spending as much time as they would like in natural environments, and (3) usually spending at least one day per week in nature. We used survey-weighted robust Poisson models to estimate overall associations, and also stratified analyses by racial/ethnic and gender identity categories. Results Of 768 GSS respondents, 14% reported dissatisfaction with nature experiences, 36% reported not spending as much time as they would like in nature, and 33% reported that they did not spend at least one day per week in nature. The median non-standardized EDS, coded such that a higher value indicates greater frequency of discrimination, was 11 (interquartile range: 8, 15). Prevalence of reporting dissatisfaction with day-to-day experiences in nature was 7% higher in association with every one unit increase in EDS score above the median (PR: 1.07, 95% CI: 1.02-1.11). The prevalence of reporting not spending as much time as one would like in nature was 2% higher for every unit increase in higher than median everyday discrimination frequency (PR: 1.02, 95% CI: 1.00-1.05). Higher than median frequency in everyday discrimination was not associated with spending less than one day per week in nature. Race/ethnicity and gender identity did not modify associations. Conclusion Greater frequency of everyday discrimination is associated with less satisfaction with experiences in nature. This relationship could undermine efforts to promote health equity through green interventions.
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Affiliation(s)
- Leah H. Schinasi
- Department of Environmental and Occupational Health, Drexel University, Philadelphia, PA, United States
- Urban Health Collaborative, Drexel University, Philadelphia, PA, United States
| | - Jourdyn A. Lawrence
- Department of Epidemiology and Biostatistics, Drexel University, Philadelphia, PA, United States
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2
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Lanfranco RC, Dos Santos Sousa F, Wessel PM, Rivera-Rei Á, Bekinschtein TA, Lucero B, Canales-Johnson A, Huepe D. Slow-wave brain connectivity predicts executive functioning and group belonging in socially vulnerable individuals. Cortex 2024; 174:201-214. [PMID: 38569258 DOI: 10.1016/j.cortex.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 01/19/2024] [Accepted: 03/05/2024] [Indexed: 04/05/2024]
Abstract
Important efforts have been made to describe the neural and cognitive features of healthy and clinical populations. However, the neural and cognitive features of socially vulnerable individuals remain largely unexplored, despite their proneness to developing neurocognitive disorders. Socially vulnerable individuals can be characterised as socially deprived, having a low socioeconomic status, suffering from chronic social stress, and exhibiting poor social adaptation. While it is known that such individuals are likely to perform worse than their peers on executive function tasks, studies on healthy but socially vulnerable groups are lacking. In the current study, we explore whether neural power and connectivity signatures can characterise executive function performance in healthy but socially vulnerable individuals, shedding light on the impairing effects that chronic stress and social disadvantages have on cognition. We measured resting-state electroencephalography and executive functioning in 38 socially vulnerable participants and 38 matched control participants. Our findings indicate that while neural power was uninformative, lower delta and theta phase synchrony are associated with worse executive function performance in all participants, whereas delta phase synchrony is higher in the socially vulnerable group compared to the control group. Finally, we found that delta phase synchrony and years of schooling are the best predictors for belonging to the socially vulnerable group. Overall, these findings suggest that exposure to chronic stress due to socioeconomic factors and a lack of education are associated with changes in slow-wave neural connectivity and executive functioning.
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Affiliation(s)
- Renzo C Lanfranco
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden; Center for Research in Cognition & Neurosciences, Université libre de Bruxelles, Brussels, Belgium
| | | | - Pierre Musa Wessel
- Department of Criminology, University of Cambridge, Cambridge, United Kingdom
| | - Álvaro Rivera-Rei
- Center for Social and Cognitive Neuroscience (SCN), School of Psychology, Universidad Adolfo Ibáñez, Santiago, Chile
| | - Tristán A Bekinschtein
- Cambridge Consciousness and Cognition Lab, Department of Psychology, University of Cambridge, Cambridge, United Kingdom
| | - Boris Lucero
- The Neuropsychology and Cognitive Neurosciences Research Center, Faculty of Health Sciences, Universidad Católica del Maule, Talca, Chile
| | - Andrés Canales-Johnson
- Cambridge Consciousness and Cognition Lab, Department of Psychology, University of Cambridge, Cambridge, United Kingdom; The Neuropsychology and Cognitive Neurosciences Research Center, Faculty of Health Sciences, Universidad Católica del Maule, Talca, Chile.
| | - David Huepe
- Center for Social and Cognitive Neuroscience (SCN), School of Psychology, Universidad Adolfo Ibáñez, Santiago, Chile.
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Hazlehurst MF, Hajat A, Szpiro AA, Tandon PS, Kaufman JD, Loftus CT, Bush NR, LeWinn KZ, Hare ME, Sathyanarayana S, Karr CJ. Individual and Neighborhood Level Predictors of Children's Exposure to Residential Greenspace. J Urban Health 2024; 101:349-363. [PMID: 38485845 PMCID: PMC11052952 DOI: 10.1007/s11524-024-00829-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/17/2024] [Indexed: 04/28/2024]
Abstract
Inequities in urban greenspace have been identified, though patterns by race and socioeconomic status vary across US settings. We estimated the magnitude of the relationship between a broad mixture of neighborhood-level factors and residential greenspace using weighted quantile sum (WQS) regression, and compared predictive models of greenspace using only neighborhood-level, only individual-level, or multi-level predictors. Greenspace measures included the Normalized Difference Vegetation Index (NDVI), tree canopy, and proximity of the nearest park, for residential locations in Shelby County, Tennessee of children in the CANDLE cohort. Neighborhood measures include socioeconomic and education resources, as well as racial composition and racial residential segregation. In this sample of 1012 mother-child dyads, neighborhood factors were associated with higher NDVI and tree canopy (0.021 unit higher NDVI [95% CI: 0.014, 0.028] per quintile increase in WQS index); homeownership rate, proximity of and enrollment at early childhood education centers, and racial composition, were highly weighted in the WQS index. In models constrained in the opposite direction (0.028 unit lower NDVI [95% CI: - 0.036, - 0.020]), high school graduation rate and teacher experience were highly weighted. In prediction models, adding individual-level predictors to the suite of neighborhood characteristics did not meaningfully improve prediction accuracy for greenspace measures. Our findings highlight disparities in greenspace for families by neighborhood socioeconomic and early education factors, and by race, suggesting several neighborhood indicators for consideration both as potential confounders in studies of greenspace and pediatric health as well as in the development of policies and programs to improve equity in greenspace access.
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Affiliation(s)
- Marnie F Hazlehurst
- Department of Environmental & Occupational Health Sciences, University of Washington School of Public Health, Seattle, WA, USA.
| | - Anjum Hajat
- Department of Epidemiology, University of Washington School of Public Health, Seattle, WA, USA
| | - Adam A Szpiro
- Department of Biostatistics, University of Washington School of Public Health, Seattle, WA, USA
| | - Pooja S Tandon
- Seattle Children's Research Institute, Seattle, WA, USA
- Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA, USA
| | - Joel D Kaufman
- Department of Environmental & Occupational Health Sciences, University of Washington School of Public Health, Seattle, WA, USA
- Department of Epidemiology, University of Washington School of Public Health, Seattle, WA, USA
- Division of General Internal Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Christine T Loftus
- Department of Environmental & Occupational Health Sciences, University of Washington School of Public Health, Seattle, WA, USA
| | - Nicole R Bush
- Department of Pediatrics, School of Medicine, University of California, San Francisco, CA, USA
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, San Francisco, CA, USA
| | - Kaja Z LeWinn
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, San Francisco, CA, USA
| | - Marion E Hare
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Sheela Sathyanarayana
- Seattle Children's Research Institute, Seattle, WA, USA
- Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA, USA
| | - Catherine J Karr
- Department of Environmental & Occupational Health Sciences, University of Washington School of Public Health, Seattle, WA, USA
- Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA, USA
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4
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Wilkerson AD, Gentle CK, Ortega C, Al-Hilli Z. Disparities in Breast Cancer Care-How Factors Related to Prevention, Diagnosis, and Treatment Drive Inequity. Healthcare (Basel) 2024; 12:462. [PMID: 38391837 PMCID: PMC10887556 DOI: 10.3390/healthcare12040462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 02/05/2024] [Accepted: 02/07/2024] [Indexed: 02/24/2024] Open
Abstract
Breast cancer survival has increased significantly over the last few decades due to more effective strategies for prevention and risk modification, advancements in imaging detection, screening, and multimodal treatment algorithms. However, many have observed disparities in benefits derived from such improvements across populations and demographic groups. This review summarizes published works that contextualize modern disparities in breast cancer prevention, diagnosis, and treatment and presents potential strategies for reducing disparities. We conducted searches for studies that directly investigated and/or reported disparities in breast cancer prevention, detection, or treatment. Demographic factors, social determinants of health, and inequitable healthcare delivery may impede the ability of individuals and communities to employ risk-mitigating behaviors and prevention strategies. The disparate access to quality screening and timely diagnosis experienced by various groups poses significant hurdles to optimal care and survival. Finally, barriers to access and inequitable healthcare delivery patterns reinforce inequitable application of standards of care. Cumulatively, these disparities underlie notable differences in the incidence, severity, and survival of breast cancers. Efforts toward mitigation will require collaborative approaches and partnerships between communities, governments, and healthcare organizations, which must be considered equal stakeholders in the fight for equity in breast cancer care and outcomes.
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Affiliation(s)
- Avia D Wilkerson
- Department of General Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Corey K Gentle
- Department of General Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Camila Ortega
- Department of General Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Zahraa Al-Hilli
- Department of General Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH 44195, USA
- Breast Center, Integrated Surgical Institute, Cleveland Clinic, Cleveland, OH 44195, USA
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5
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Hallum SH, Wende ME, Hesam Shariati F, Thomas KM, Chupak AL, Witherspoon E, Kaczynski AT. Unearthing Inequities in the Relationship between Multiple Sociodemographic Factors and Diverse Elements of Park Availability and Quality in a Major Southern Metropolitan Region. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:204. [PMID: 38397693 PMCID: PMC10888646 DOI: 10.3390/ijerph21020204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 01/18/2024] [Accepted: 01/29/2024] [Indexed: 02/25/2024]
Abstract
Parks are critical components of healthy communities. This study explored neighborhood socioeconomic and racial/ethnic inequalities in park access and quality in a large U.S. southeastern metropolitan region. A total of 241 block groups were examined, including 77 parks. For each block group, we obtained multiple sociodemographic indicators, including unemployment rate, education level, renter-occupied housing, poverty rate, and racial/ethnic minority composition. All parks were mapped using geographical information systems and audited via the Community Park Audit Tool to evaluate their features and quality. We analyzed seven diverse elements of park quality (transportation access, facility availability, facility quality, amenity availability, park aesthetics, park quality concerns, and neighborhood quality concerns), as well as an overall park quality score by calculating the mean for all parks within each block group. The mean percent of residents below 125% of the poverty level and the percentage of renter-occupied housing units were significantly higher among block groups with any parks in comparison to block groups with no parks. In addition, there were significant positive associations between park transportation access scores and both the percentage of residents with less than high school education and the percent identifying as non-Hispanic white. Moreover, there was a significant negative association between park amenity availability and the block group's unemployed population. Further, a significant negative association between park aesthetics and the population with a lower than high school education percentage was observed. Revealed differences in park availability, park acreage, and park quality dimensions emphasized the need for targeted policy, programmatic, and infrastructure interventions to improve park access and quality and address health disparities.
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Affiliation(s)
- Shirelle H. Hallum
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (S.H.H.); (F.H.S.); (K.M.T.); (A.L.C.); (E.W.)
| | - Marilyn E. Wende
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, FL 32608, USA;
| | - Farnaz Hesam Shariati
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (S.H.H.); (F.H.S.); (K.M.T.); (A.L.C.); (E.W.)
| | - Kelsey M. Thomas
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (S.H.H.); (F.H.S.); (K.M.T.); (A.L.C.); (E.W.)
| | - Anna L. Chupak
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (S.H.H.); (F.H.S.); (K.M.T.); (A.L.C.); (E.W.)
| | - Eleanor Witherspoon
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (S.H.H.); (F.H.S.); (K.M.T.); (A.L.C.); (E.W.)
| | - Andrew T. Kaczynski
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (S.H.H.); (F.H.S.); (K.M.T.); (A.L.C.); (E.W.)
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6
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McCormack M, Pratt M, Conway TL, Cain KL, Frank LD, Saelens BE, Glanz K, Larsen BA, Bloss CS, Fox EH, Sallis JF. Availability of Recreation Facilities and Parks In Relation to Adolescent Participation in Organized Sports and Activity Programs. JOURNAL OF HEALTHY EATING AND ACTIVE LIVING 2023; 3:19-35. [PMID: 37794920 PMCID: PMC10546936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
Most adolescents do not meet physical activity guidelines, so understanding facilitators and barriers is important. This study used surveys and geocoded location data to examine associations of availability of parks and recreation facilities with adolescent-reported participation in organized team sports and physical activity classes. The study was conducted with 928 adolescents aged 12-17 years, plus one parent/caretaker, recruited from two regions of the US. Adolescents' participation in teams and classes was positively associated with parents' perceptions of multiple available recreation environments, but not with objectively-measured availability. Having multiple nearby parks and recreation facilities may provide adolescents with more options for participating in preferred organized team sports and activity classes.
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Affiliation(s)
- Marisa McCormack
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, U.S.A
| | - Michael Pratt
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, U.S.A
| | - Terry L Conway
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, U.S.A
| | - Kelli L Cain
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, U.S.A
| | - Lawrence D Frank
- Department of Urban Studies and Planning, University of California San Diego, U.S.A
- Urban Design 4 Health, Inc., Rochester, NY U.S.A
| | - Brian E Saelens
- Departments of Pediatrics and Psychiatry and Behavioral Sciences, University of Washington, U.S.A
| | - Karen Glanz
- Department of Biostatistics and Epidemiology, University of Pennsylvania, U.S.A
| | - Britta A Larsen
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, U.S.A
| | - Cinnamon S Bloss
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, U.S.A
| | - Eric H Fox
- Urban Design 4 Health, Inc., Rochester, NY U.S.A
| | - James F Sallis
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, U.S.A
- Department of Biostatistics and Epidemiology, University of Pennsylvania, U.S.A
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7
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Stewart MT, Verma M, Rajbhandari A, Antonakos CL, Colabianchi N. Park Area and Physical Activity Among Children and Adolescents: Findings From the Healthy Communities Study. J Phys Act Health 2023; 20:792-798. [PMID: 37290766 PMCID: PMC10897581 DOI: 10.1123/jpah.2022-0420] [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] [Received: 08/03/2022] [Revised: 02/26/2023] [Accepted: 04/17/2023] [Indexed: 06/10/2023]
Abstract
BACKGROUND There is currently a nationwide effort to bring parks and green spaces within a 10-minute walk of the home. We examined the association between park area within 1 km of a child's residence and self-reported park-specific physical activity (PA) along with accelerometer-derived moderate to vigorous physical activity (MVPA). METHODS A subsample of K through eighth-grade youth (n = 493) from the Healthy Communities Study reported whether they engaged in park-specific PA during the last 24 hours and wore an accelerometer for up to 7 days. Park area was defined as the percentage of park land in a 1 km Euclidean buffer around the participant's residence, categorized into quintiles. Analysis consisted of logistic and linear regression modeling with interaction effects that controlled for clustering within communities. RESULTS Regression models estimated greater park-specific PA for participants in the fourth and fifth quintiles of park land. Age, sex, race ethnicity, and family income were unrelated to park-specific PA. Accelerometer analysis indicated that total MVPA was unrelated to park area. Older children (β = -8.73, P < .001) and girls (β = -13.44, P < .001) engaged in less MVPA. Seasonality significantly predicted both park-specific PA and total MVPA. CONCLUSION Increasing park area is likely to improve youth PA patterns, lending support for the 10-minute walk initiative.
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Affiliation(s)
| | - Manish Verma
- Consulting for Statistics, Computing & Analytics Research, University of Michigan, Ann Arbor, MI,USA
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Larson N, Tavernier RE, Berge JM, Barr-Anderson DJ, Neumark-Sztainer D. Implications of the COVID-19 Pandemic for the Well-Being of Emerging Adult Populations: A Synthesis of Findings From the COVID-19 Eating and Activity Over Time (C-EAT) Study. EMERGING ADULTHOOD (PRINT) 2023; 11:779-796. [PMID: 37832141 PMCID: PMC10064195 DOI: 10.1177/21676968231166034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/15/2023]
Abstract
Research addressing the impact of the COVID-19 pandemic on psychosocial well-being and health behavior is accumulating; however, implications for emerging adult populations are underexplored. This manuscript synthesizes findings from a mixed-methods study of well-being, eating and activity behaviors, and food insecurity among a diverse, longitudinal cohort of emerging adults. The review includes findings from 11 original studies that involved collecting online surveys from 720 emerging adults and in-depth, virtual interviews with 33 respondents who were food insecure. Findings indicated the pandemic had widespread impacts on well-being. Population groups at greatest risk for poor outcomes included women; those who identified as Black, Indigenous, or a Person of Color; persons in households of low socioeconomic status; parents of young children; and persons who previously experienced mental health challenges or weight stigma. Further research will be needed to evaluate efforts to improve the well-being of emerging adults in the aftermath of the pandemic.
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Affiliation(s)
- Nicole Larson
- Division of Epidemiology and Community
Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Rebecca Emery Tavernier
- Department of Family Medicine and
Biobehavioral Health, University of Minnesota Medical
School, Duluth, MN, USA
| | - Jerica M. Berge
- Department of Family Medicine and Community
Health, University of Minnesota Medical School,
University of Minnesota, Minneapolis, MN, USA
| | | | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community
Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
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Weber KA, Yang W, Carmichael SL, Collins RT, Luben TJ, Desrosiers TA, Insaf TZ, Le MT, Evans SP, Romitti PA, Yazdy MM, Nembhard WN, Shaw GM. Assessing associations between residential proximity to greenspace and birth defects in the National Birth Defects Prevention Study. ENVIRONMENTAL RESEARCH 2023; 216:114760. [PMID: 36356662 PMCID: PMC10353702 DOI: 10.1016/j.envres.2022.114760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 10/31/2022] [Accepted: 11/05/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Residential proximity to greenspace is associated with various health outcomes. OBJECTIVES We estimated associations between maternal residential proximity to greenspace (based on an index of vegetation) and selected structural birth defects, including effect modification by neighborhood-level factors. METHODS Data were from the National Birth Defects Prevention Study (1997-2011) and included 19,065 infants with at least one eligible birth defect (cases) and 8925 without birth defects (controls) from eight Centers throughout the United States. Maternal participants reported their addresses throughout pregnancy. Each address was systematically geocoded and residences around conception were linked to greenspace, US Census, and US Department of Agriculture data. Greenspace was estimated using the normalized difference vegetation index (NDVI); average maximum NDVI was estimated within 100 m and 500 m concentric buffers surrounding geocoded addresses to estimate residential NDVI. We used logistic regression to estimate odds ratios (ORs) and 95% confidence intervals comparing those in the highest and lowest quartiles of residential NDVI and stratifying by rural/urban residence and neighborhood median income. RESULTS After multivariable adjustment, for the 500 m buffer, inverse associations were observed for tetralogy of Fallot, secundum atrial septal defects, anencephaly, anotia/microtia, cleft lip ± cleft palate, transverse limb deficiency, and omphalocele, (aORs: 0.54-0.86). Results were similar for 100 m buffer analyses and similar patterns were observed for other defects, though results were not significant. Significant heterogeneity was observed after stratification by rural/urban for hypoplastic left heart, coarctation of the aorta, and cleft palate, with inverse associations only among participants residing in rural areas. Stratification by median income showed heterogeneity for atrioventricular and secundum atrial septal defects, anencephaly, and anorectal atresia, with inverse associations only among participants residing in a high-income neighborhood (aORs: 0.45-0.81). DISCUSSION Our results suggest that perinatal residential proximity to more greenspace may contribute to a reduced risk of certain birth defects, especially among those living in rural or high-income neighborhoods.
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Affiliation(s)
- Kari A Weber
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA; Arkansas Center for Birth Defects Research and Prevention, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
| | - Wei Yang
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
| | - Suzan L Carmichael
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA; Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA, USA.
| | - R Thomas Collins
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
| | - Thomas J Luben
- Center for Public Health and Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, RTP, NC, USA.
| | - Tania A Desrosiers
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
| | - Tabassum Z Insaf
- Bureau of Environmental and Occupational Epidemiology, New York State Department of Health and Department of Epidemiology and Biostatistics, University at Albany, Albany, NY, USA.
| | - Mimi T Le
- Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, TX, USA.
| | - Shannon Pruitt Evans
- Eagle Global Scientific LLC, San Antonio, TX, USA; Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Paul A Romitti
- Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, IA, USA.
| | - Mahsa M Yazdy
- Center for Birth Defects Research and Prevention, Massachusetts Department of Public Health, Boston, MA, USA.
| | - Wendy N Nembhard
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA; Arkansas Center for Birth Defects Research and Prevention, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
| | - Gary M Shaw
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
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Sallis JF, Carlson JA, Ortega A, Allison MA, Geremia CM, Sotres-Alvarez D, Jankowska MM, Mooney SJ, Chambers EC, Hanna DB, Perreira KM, Daviglus ML, Gallo LC. Micro-scale pedestrian streetscapes and physical activity in Hispanic/Latino adults: Results from HCHS/SOL. Health Place 2022; 77:102857. [PMID: 36027739 DOI: 10.1016/j.healthplace.2022.102857] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 06/23/2022] [Accepted: 06/30/2022] [Indexed: 11/29/2022]
Abstract
We examined associations of micro-scale environment attributes (e.g., sidewalks, street crossings) with three physical activity (PA) measures among Hispanic/Latino adults (n = 1776) living in San Diego County, CA. Systematic observation was used to quantify micro-scale environment attributes near each participant's home. Total PA was assessed with accelerometers, and PA for transportation and recreation were assessed by validated self-report. Although several statistically significant interactions between individual and neighborhood characteristics were identified, there was little evidence micro-scale attributes were related to PA. An important limitation was restricted environmental variability for this sample which lived in a small area of a single county.
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Affiliation(s)
- James F Sallis
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, MC 0631, La Jolla, CA, USA.
| | - Jordan A Carlson
- Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy, Kansas City, MO, USA
| | - Adrian Ortega
- Clinical Child Psychology Program, University of Kansas, Lawrence, KS, USA
| | - Matthew A Allison
- Department of Family Medicine, University of California, La Jolla, CA, USA
| | - Carrie M Geremia
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, MC 0631, La Jolla, CA, USA
| | - Daniela Sotres-Alvarez
- Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Marta M Jankowska
- Population Sciences, Beckman Research Institute, City of Hope, Duarte, CA, USA
| | - Stephen J Mooney
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Earle C Chambers
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA; Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
| | - David B Hanna
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Krista M Perreira
- Department of Social Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Martha L Daviglus
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL, USA
| | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, CA, USA
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11
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Besser LM, Bean C, Foor A, Hoermann S, Renne J. Evaluating Racial/Ethnic Equity in Planning-Related U.S. Health Impact Assessments Involving Parks and Greenspaces: A Review. JOURNAL OF THE AMERICAN PLANNING ASSOCIATION. AMERICAN PLANNING ASSOCIATION 2022; 89:472-486. [PMID: 38075559 PMCID: PMC10706852 DOI: 10.1080/01944363.2022.2096100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
Problem research strategy and findings Health impact assessment (HIA) reports are used by government agencies, other organizations, and stakeholders to evaluate potential health effects of plans/policies/projects. HIAs have the potential to promote anti-racist practices. We developed and used the Tool for the Racial/Ethnic Equity Evaluation of Health Impact Assessments (TREE-HIA) to score 50 U.S. HIA reports on planning-related projects/plans involving parks and greenspaces (2005-2020). More recent and more comprehensive HIA reports addressed racial/ethnic equity to a greater degree (e.g., median TREE-HIA scores: -1.3 in 2009-2012, 4.0 in 2017-2020, where higher scores indicate greater racial/equity considerations). Overall, HIA reports addressed racial/ethnic equity to a lesser degree than expected given the principal tenet of equity guiding HIAs and urban planning alike (42% had negative TREE-HIA scores indicating inadequate racial/ethnic equity consideration). However, the limited number and types of HIAs included in this study may affect generalization to all HIAs. Takeaway for practice HIAs incorporating racial/ethnic equity comprehensively throughout the HIA process will better enable urban planners, HIA practitioners, decision makers, and communities of color to work together to combat racist planning practices through the shared goals of addressing health disparities and equity. TREE-HIA provides professionals and researchers with a brief tool that can be used/adapted to guide and evaluate future HIAs for racial/ethnic equity considerations.
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Affiliation(s)
- Lilah M Besser
- University of Miami's Comprehensive Center for Brain Health
| | | | | | | | - John Renne
- Center for Urban and Environmental Solutions (CUES)
- Florida Atlantic University (FAU)
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12
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Crist K, Full KM, Linke S, Tuz-Zahra F, Bolling K, Lewars B, Liu C, Shi Y, Rosenberg D, Jankowska M, Benmarhnia T, Natarajan L. Health effects and cost-effectiveness of a multilevel physical activity intervention in low-income older adults; results from the PEP4PA cluster randomized controlled trial. Int J Behav Nutr Phys Act 2022; 19:75. [PMID: 35761363 PMCID: PMC9235144 DOI: 10.1186/s12966-022-01309-w] [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: 12/22/2021] [Accepted: 05/31/2022] [Indexed: 11/18/2022] Open
Abstract
Background Older adults are the least active population in the U.S. Low-income communities have fewer physical activity (PA) resources, contributing to less PA and increased chronic disease risk. This study assessed the effect of the multilevel, peer-led, Peer Empowerment Program 4 Physical Activity (PEP4PA) on moderate-to-vigorous PA (MVPA) and health outcomes, over 2 years of follow up. Methods In a cluster-randomized controlled trial, 12 senior or community centers serving low-income older adults were assigned to a PA intervention (n = 6) or usual programming (n = 6) condition. PEP4PA included self-monitoring, health coaching, group walks, social support, and community advocacy to improve walking conditions. The primary outcome was daily minutes of MVPA (7-day accelerometer). Secondary outcomes included Perceived Quality of Life (PQoL), 6-Minute Walk Test (6-MWT), blood pressure (BP), and depressive symptoms at baseline, 6, 12, 18 and 24 months. Mixed effects regression models estimated the effects on outcomes between groups over time and included random effects for repeated measures and center clustering. Effect modification by sex and income status was assessed. We calculated the incremental cost per daily minute of MVPA gained in the intervention group relative to the control group to assess cost effectiveness. Results We enrolled 476 older adults (50 + years). Participants were on average 71 years old, 76% female, 60% low income, and 38% identified as racial or ethnic minorities. Compared to the control group, intervention participants sustained roughly a 10 min/day increase in MVPA from baseline at all time points and increased mean PQoL scores from unsatisfied at baseline to satisfied at 12, 18 and 24 months. Males and higher-income groups had greater improvements in MVPA. No significant effects were observed for 6-MWT or depressive symptoms, and BP results were mixed. The incremental cost per minute MVPA gained per person was $0.25, $0.09, $0.06, and $0.05 at 6, 12, 18 and 24 months, respectively. Conclusions PEP4PA achieved increases in MVPA and PQoL in low-income older adults, over 2 years of follow up. The peer-led, community-based intervention provides a sustainable and cost-effective model to improve health behaviors in underserved, aging populations. Trial registration ClinicalTrials.gov (NCT02405325) March 20, 2015. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-022-01309-w.
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Affiliation(s)
- Katie Crist
- Department of Urban Studies & Planning, UC San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA.
| | - Kelsie M Full
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S 2nd Street, Minneapolis, MN, 55415, USA
| | - Sarah Linke
- Herbert Wertheim School of Public Health and Human Longevity Science, UC San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
| | - Fatima Tuz-Zahra
- Herbert Wertheim School of Public Health and Human Longevity Science, UC San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
| | - Khalisa Bolling
- Herbert Wertheim School of Public Health and Human Longevity Science, UC San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
| | - Brittany Lewars
- Herbert Wertheim School of Public Health and Human Longevity Science, UC San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
| | - Chenyu Liu
- Herbert Wertheim School of Public Health and Human Longevity Science, UC San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
| | - Yuyan Shi
- Herbert Wertheim School of Public Health and Human Longevity Science, UC San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
| | - Dori Rosenberg
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Avenue, Seattle, WA, 98101, USA
| | - Marta Jankowska
- Population Sciences, Beckman Research Institute, City of Hope, 1500 E Duarte Rd, Duarte, CA, 91010, USA
| | - Tarik Benmarhnia
- Scripps Institution of Oceanography, UC San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
| | - Loki Natarajan
- Herbert Wertheim School of Public Health and Human Longevity Science, UC San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
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Huang Y, Lin T, Zhang G, Jones L, Xue X, Ye H, Liu Y. Spatiotemporal patterns and inequity of urban green space accessibility and its relationship with urban spatial expansion in China during rapid urbanization period. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 809:151123. [PMID: 34699811 DOI: 10.1016/j.scitotenv.2021.151123] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 10/08/2021] [Accepted: 10/17/2021] [Indexed: 06/13/2023]
Abstract
Equitable access to urban green spaces (UGS) is an important component of social justice and can be quantified using indices such as urban green space accessibility (UGSA). However, the spatiotemporal patterns and inequity of UGSA among cities with different developments during rapid urbanization are unclear, especially lack evidence at a macroscopic national scale during rapid urbanization. Therefore, we evaluated the UGSA in 366 cities of China during 1990-2015 by the Gaussian-based two-step floating catchment area method (Gaussian-based 2SFCA). Then, the inequity pattern of UGSA among cities with different economic developments was analyzed by the concentration curve and concentration index. Finally, the relationship between UGSA and urban spatial expansion was explored quantitatively by the spatial econometric model. The results showed that: (1) The overall UGSA in China declined significantly by nearly 57.23% during 1990-2015. From the regional perspective, the UGSA in the southeastern region was always lower than that in the northwestern region, the Eastern zone presented a downward trend. From the perspective of different sizes cities, the UGSA of the megacities kept decreasing during 1990-2015, while UGSA of the large, medium, and small cities had turned to increase since 2010. (2) During rapid urbanization, the equity of UGSA among the cities gradually improved, while the cities with low economic developments tended to have higher UGSA. (3) Urban spatial expansion led to the decrease of UGSA during 1990-2015, while the impact had spatiotemporal heterogeneity, and UGSA had a positive spatial spillover effect. Our research provides a comparative baseline for the improvement of UGSA from a macroscopic perspective for China's urbanization policy in the future and novel insights into the green justice issue. The results can be compared with the development of UGS in other countries at different urbanization stages to promote UGS design and policy.
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Affiliation(s)
- Yiyi Huang
- Key Laboratory of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021, China; Coastal and Ocean Management Institute, Xiamen University, Xiamen 361102, China
| | - Tao Lin
- Key Laboratory of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021, China; University of Chinese Academy of Sciences, Beijing 100049, China.
| | - Guoqin Zhang
- Key Laboratory of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Laurence Jones
- UK Centre for Ecology & Hydrology, Environment Centre Wales, Bangor LL57 2UW, UK
| | - Xiongzhi Xue
- Coastal and Ocean Management Institute, Xiamen University, Xiamen 361102, China
| | - Hong Ye
- Key Laboratory of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Yuqin Liu
- Key Laboratory of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021, China; University of Chinese Academy of Sciences, Beijing 100049, China
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Literature Review Reveals a Global Access Inequity to Urban Green Spaces. SUSTAINABILITY 2022. [DOI: 10.3390/su14031062] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Differences in the accessibility to urban resources between different racial and socioeconomic groups have exerted pressure on effective planning and management for sustainable city development. However, few studies have examined the multiple factors that may influence the mitigation of urban green spaces (UGS) inequity. This study reports the results of a systematic mapping of access inequity research through correspondence analysis (CA) to reveal critical trends, knowledge gaps, and clusters based on a sample of 49 empirical studies screened from 563 selected papers. Our findings suggest that although the scale of cities with UGS access inequity varies between countries, large cities (more than 1,000,000 population), especially in low- and middle-income countries (LMICs), are particularly affected. Moreover, the number of cities in which high socioeconomic status (high-SES) groups (e.g., young, rich, or employed) are at an advantage concerning access to UGS is substantially higher than the number of cities showing better accessibility for low-SES groups. Across the reviewed papers, analyses on mitigating interventions are sparse, and among the few studies that touch upon this, we found different central issues in local mitigating strategies between high-income countries (HICs) and LMICs. An explanatory framework is offered, explaining the interaction between UGS access inequity and local mitigating measures.
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Bernhart JA, Wende ME, Kaczynski AT, Wilcox S, Dunn CG, Hutto B. Assessing the Walkability Environments of Churches in a Rural Southeastern County of the United States. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2022; 28:E170-E177. [PMID: 31688738 PMCID: PMC7190400 DOI: 10.1097/phh.0000000000001076] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
CONTEXT Churches can serve as important health promotion partners, especially in rural areas. However, little is known about the built environment surrounding churches in rural areas, including how these environments may impact opportunities for physical activity (PA) and may differ by neighborhood income levels. OBJECTIVE This study described walkability around churches in a rural county and examined differences in church walkability between high-, medium-, and low-income neighborhoods. DESIGN As part of the Faith, Activity, and Nutrition study, trained data collectors conducted a windshield survey of adjacent street segments within a half-mile of churches. SETTING Churches (N = 54) in a rural southeastern county in the United States. MAIN OUTCOME MEASURE A summary walkability score (eg, presence of sidewalks, safety features, low traffic volume) was created with a possible range from 0 to 7. Analysis of variance was used to assess differences in walkability of churches by neighborhood income levels. RESULTS Walkability scores ranged from 0 to 6 (M = 2.31, SD = 1.23). Few churches had sidewalks, shoulders or buffers, or amenities nearby. In contrast, most churches had low traffic volume and no environmental incivilities. While not statistically significant, churches in low-income neighborhoods scored higher for walkability than churches in medium- and high-income neighborhoods. CONCLUSIONS This study used low-cost environmental audits to analyze walkability in a sample of churches in a rural area and examined differences by neighborhood income. While churches may improve reach of people living in underserved and rural communities, a lack of environmental supports may limit effective PA promotion activities. Partnerships focused on improving existing areas or providing alternative PA opportunities for church and community members may be needed, especially in African American communities.
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Affiliation(s)
- John A Bernhart
- Prevention Research Center (Messrs Bernhart and Hutto, Ms Wende, and Drs Kaczynski, Wilcox, and Dunn), Department of Exercise Science (Mr Bernhart and Dr Wilcox), and Department of Health Promotion, Education, and Behavior (Ms Wende and Drs Kaczynski and Dunn), Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
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Levy JJ, Lebeaux RM, Hoen AG, Christensen BC, Vaickus LJ, MacKenzie TA. Using Satellite Images and Deep Learning to Identify Associations Between County-Level Mortality and Residential Neighborhood Features Proximal to Schools: A Cross-Sectional Study. Front Public Health 2021; 9:766707. [PMID: 34805078 PMCID: PMC8602058 DOI: 10.3389/fpubh.2021.766707] [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] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 10/06/2021] [Indexed: 12/15/2022] Open
Abstract
What is the relationship between mortality and satellite images as elucidated through the use of Convolutional Neural Networks? Background: Following a century of increase, life expectancy in the United States has stagnated and begun to decline in recent decades. Using satellite images and street view images, prior work has demonstrated associations of the built environment with income, education, access to care, and health factors such as obesity. However, assessment of learned image feature relationships with variation in crude mortality rate across the United States has been lacking. Objective: We sought to investigate if county-level mortality rates in the U.S. could be predicted from satellite images. Methods: Satellite images of neighborhoods surrounding schools were extracted with the Google Static Maps application programming interface for 430 counties representing ~68.9% of the US population. A convolutional neural network was trained using crude mortality rates for each county in 2015 to predict mortality. Learned image features were interpreted using Shapley Additive Feature Explanations, clustered, and compared to mortality and its associated covariate predictors. Results: Predicted mortality from satellite images in a held-out test set of counties was strongly correlated to the true crude mortality rate (Pearson r = 0.72). Direct prediction of mortality using a deep learning model across a cross-section of 430 U.S. counties identified key features in the environment (e.g., sidewalks, driveways, and hiking trails) associated with lower mortality. Learned image features were clustered, and we identified 10 clusters that were associated with education, income, geographical region, race, and age. Conclusions: The application of deep learning techniques to remotely-sensed features of the built environment can serve as a useful predictor of mortality in the United States. Although we identified features that were largely associated with demographic information, future modeling approaches that directly identify image features associated with health-related outcomes have the potential to inform targeted public health interventions.
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Affiliation(s)
- Joshua J. Levy
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
- Program in Quantitative Biomedical Sciences, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
- Emerging Diagnostic and Investigative Technologies, Department of Pathology and Laboratory Medicine, Dartmouth Hitchcock Medical Center, Lebanon, NH, United States
| | - Rebecca M. Lebeaux
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
- Program in Quantitative Biomedical Sciences, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
| | - Anne G. Hoen
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
- Program in Quantitative Biomedical Sciences, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
- Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
| | - Brock C. Christensen
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
| | - Louis J. Vaickus
- Emerging Diagnostic and Investigative Technologies, Department of Pathology and Laboratory Medicine, Dartmouth Hitchcock Medical Center, Lebanon, NH, United States
| | - Todd A. MacKenzie
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
- Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
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Li Q, Peng K, Cheng P. Community-Level Urban Green Space Equity Evaluation Based on Spatial Design Network Analysis (sDNA): A Case Study of Central Wuhan, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910174. [PMID: 34639480 PMCID: PMC8507989 DOI: 10.3390/ijerph181910174] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 09/19/2021] [Accepted: 09/20/2021] [Indexed: 11/16/2022]
Abstract
Urban green spaces (UGSs) provide numerous irreplaceable environmental and social benefits to humankind, but the lack of baseline information makes it difficult to propose a reasonable greening strategy so as to achieve an equitable allocation of community green spaces. This paper divides UGSs into three classes using the spatial design network analysis (sDNA) and quantifies the UGS accessibility of communities in central Wuhan. Based on these results and the Gini coefficient, we analyze the UGS equity of the spatial distribution at the community level, then propose future greening strategies both at the city and community levels. The results show that the railway station and old Wuhan city are the core areas of traffic network strength (TNS). UGSs are evenly distributed in the core areas of TNS, but the number of UGSs in non-core areas is small, and their distribution is relatively uneven, and the number of communities with medium UGS accessibility is the largest, carrying the densest residential population. Most communities perform well in terms of UGS equity, but the UGS equity of 163 communities, covering a population of more than one million, remains to be improved. The method and conclusions of this study will contribute to the future greening policy making of 965 communities in central Wuhan, thus promoting the orderly planning and high-quality construction of community living circles.
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Affiliation(s)
- Qing Li
- College of Public Administration, Huazhong Agricultural University, Wuhan 430070, China; (Q.L.); (P.C.)
- College of Humanities & Social Sciences, Huazhong Agricultural University, Wuhan 430070, China
| | - Kaili Peng
- College of Public Administration, Huazhong Agricultural University, Wuhan 430070, China; (Q.L.); (P.C.)
- Correspondence:
| | - Peng Cheng
- College of Public Administration, Huazhong Agricultural University, Wuhan 430070, China; (Q.L.); (P.C.)
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Fontán-Vela M, Rivera-Navarro J, Gullón P, Díez J, Anguelovski I, Franco M. Active use and perceptions of parks as urban assets for physical activity: A mixed-methods study. Health Place 2021; 71:102660. [PMID: 34454253 DOI: 10.1016/j.healthplace.2021.102660] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 07/23/2021] [Accepted: 08/19/2021] [Indexed: 10/20/2022]
Abstract
Parks are potential key urban assets for improved population health; however, their use is not equal among all social groups. Individual and contextual factors could influence residents' perceptions of parks and how they interact with and, eventually, benefit from them. The use of complementary methodologies provides a deeper understanding of the relationship between park use, physical activity (PA), and residents' perceptions. Thus, we designed a mixed-methods study to analyze differences in park use and PA, and the perceptions of parks as urban assets for PA. We selected six parks from three neighborhoods in Madrid (Spain) with different neighborhood socioeconomic status (NSES) for systematic social observation. We registered park users by age, PA level (low, medium, and high), gender, and NSES using the System for Observing Play and Recreation in Communities (SOPARC) audit tool adapted for iOS software (iSOPARC). We also conducted 37 semi-structured interviews and 29 focus groups to analyze residents' perceptions of parks as urban assets for PA in the same neighborhoods. We adopted a convergent-parallel design to analyze both quantitative and qualitative data, and to describe the convergence and divergence areas between them. Parks within the high-NSES were more visited, showing a higher proportion of people performing high PA (11.9%) as compared to residents of the middle (9.3%) and low-NSES (3.2%). Female visitors showed lower PA levels compared to men, especially for parks within high-NSES. The following issues were reported as influence urban park use and perceptions: park maintenance and area perception, works constraints, insecurity and crime, differential perceptions by age, and the availability of organized activities in the parks. Residents from high-NSES reported fewer barriers to park use compared to residents from the other areas, who reported limitations such as less leisure time due to job constrains or perceived insecurity in parks. Senior participants reported that having parks with organized activities and a design oriented towards different age-groups are valuable. Our study shows consistency between the fewer and less intense use of parks registered in the middle and low-NSES neighborhoods, and the more barriers for PA reported in this areas during the qualitative analysis. Mixed-methods provided an insight of the potential causes leading to the differences in park use and PA within cities, which is essential in terms of environmental justice and health equity. Thus, a mixed-methods comprehensive approach to public health problems can help designing public policies addressing relevant factors related to urban health inequities.
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Affiliation(s)
- Mario Fontán-Vela
- Universidad de Alcalá, Facultad de Medicina y Ciencias de La Salud, Departamento de Cirugía, Ciencias Médicas y Sociales, Grupo de Investigación en Epidemiología y Salud Pública, Alcalá de Henares, Madrid, Spain; Preventive Medicine Department, Infanta Leonor University Hospital, 28031, Madrid, Spain
| | - Jesús Rivera-Navarro
- Universidad de Alcalá, Facultad de Medicina y Ciencias de La Salud, Departamento de Cirugía, Ciencias Médicas y Sociales, Grupo de Investigación en Epidemiología y Salud Pública, Alcalá de Henares, Madrid, Spain; Department of Sociology and Communication, University of Salamanca, 37007, Salamanca, Spain
| | - Pedro Gullón
- Universidad de Alcalá, Facultad de Medicina y Ciencias de La Salud, Departamento de Cirugía, Ciencias Médicas y Sociales, Grupo de Investigación en Epidemiología y Salud Pública, Alcalá de Henares, Madrid, Spain; School of Global, Urban and Social Studies, RMIT University, Melbourne, Australia.
| | - Julia Díez
- Universidad de Alcalá, Facultad de Medicina y Ciencias de La Salud, Departamento de Cirugía, Ciencias Médicas y Sociales, Grupo de Investigación en Epidemiología y Salud Pública, Alcalá de Henares, Madrid, Spain
| | - Isabelle Anguelovski
- Catalan Institution for Research and Advanced Studies (ICREA), Universitat Autònoma de Barcelona (UAB), Institute for Environmental Sciences and Technology (ICTA), Barcelona Laboratory for Urban Environmental Justice and Sustainability, Medical Research Institute Hospital Del Mar (IMIM), 08003, Barcelona, Spain
| | - Manuel Franco
- Universidad de Alcalá, Facultad de Medicina y Ciencias de La Salud, Departamento de Cirugía, Ciencias Médicas y Sociales, Grupo de Investigación en Epidemiología y Salud Pública, Alcalá de Henares, Madrid, Spain; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
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Zhang R, Zhang CQ, Lai PC, Cheng W, Schüz B, Kwan MP. Park environment and moderate-to-vigorous physical activity in parks among adolescents in a high-density city: the moderating role of neighbourhood income. Int J Health Geogr 2021; 20:35. [PMID: 34399765 PMCID: PMC8365917 DOI: 10.1186/s12942-021-00289-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Accepted: 08/06/2021] [Indexed: 12/02/2022] Open
Abstract
Background Urban parks are critical environmental resources in which adolescents engage in physical activity (PA). Evidence on the associations between park environmental characteristics and park-based PA in adolescents is mixed, particularly for high-density cities. Evidence is also lacking concerning the moderating role of neighbourhood socioeconomic status on the park-PA relationships. The current study aimed to examine the associations between park environmental characteristics and moderate-to-vigorous physical activity (MVPA) in parks among adolescents in Hong Kong and the moderating effect of neighbourhood income on these associations. Methods A cross-sectional study involving direct observations of adolescents was conducted in 32 randomly selected urban parks in Hong Kong. Park environmental characteristics were measured using the Community Park Audit Tool. Park-based MVPA among adolescents was measured using the System for Observation Play and Recreation in Communities. Neighbourhood income was extracted from the 2011 Hong Kong Population Census data on median household income. Results There was a significant positive association between the quality of amenities and park-based MVPA (metabolic equivalents per observation) in adolescents. However, the associations between the diversity of active facilities, greenness and adolescents’ park-based MVPA were not significant. Neighbourhood income moderated the association between adolescents’ park-based MVPA and park safety, where the relationship between park safety and park-based MVPA was significantly positive in low-income neighbourhoods but not significant in high-income neighbourhoods. An income-by-environment interaction was also observed concerning park aesthetics, with a negative relationship between park aesthetics and park-based MVPA in high-income neighbourhoods but not in low-income neighbourhoods. Conclusion Our findings provide evidence regarding how park environment and neighbourhood income impact adolescents’ park-based MVPA in Hong Kong. These findings can inform urban planning and policymakers who seek to improve urban park development in high-density cities. Supplementary Information The online version contains supplementary material available at 10.1186/s12942-021-00289-7.
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Affiliation(s)
- Ru Zhang
- School of Physical Education and Sports Science, South China Normal University, Guangzhou, China
| | - Chun-Qing Zhang
- Department of Psychology, Sun Yat-Sen University, No. 132 Waihuan East Road, Guangzhou Higher Education Mega Center, Guangzhou, China.
| | - Poh Chin Lai
- Department of Geography, Faculty of Social Sciences, The University of Hong Kong, Hong Kong, China
| | - Wei Cheng
- Department of Geography, Faculty of Social Sciences, The University of Hong Kong, Hong Kong, China
| | - Benjamin Schüz
- Institute for Public Health and Nursing Research, University of Bremen, Bremen, Germany
| | - Mei-Po Kwan
- Department of Geography and Resource Management, The Chinese University of Hong Kong, Hong Kong, China.,Institute of Space and Earth Information Science, The Chinese University of Hong Kong, Hong Kong, China.,Department of Human Geography and Spatial Planning, Utrecht University, Utrecht, The Netherlands
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Creating the Future of Physical Activity Surveillance in the United States: Better Data for Better Health. J Phys Act Health 2021; 18:S1-S5. [PMID: 34465655 DOI: 10.1123/jpah.2021-0182] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 03/17/2021] [Indexed: 12/16/2022]
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Jacobs J, Crooks N, Allender S, Strugnell C, Backholer K, Nichols M. Is the physical activity environment surrounding primary schools associated with students' weight status, physical activity or active transport, in regional areas of Victoria, Australia? A cross-sectional study. BMJ Open 2021; 11:e045785. [PMID: 34215603 PMCID: PMC8256746 DOI: 10.1136/bmjopen-2020-045785] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To explore whether the physical activity (PA) environment (walkability, greenspace and recreational facilities) surrounding regional primary schools is associated with children's PA levels, active transport and weight status. Limited research on this topic has been conducted outside of major cities. DESIGN Cross-sectional ecological study using baseline data from two large-scale obesity prevention interventions. SETTING Eighty (n=80) primary schools across two regional areas in Victoria, Australia. PARTICIPANTS Students aged 8-13 years (n=2144) attending participating primary schools. OUTCOME MEASURES Measured weight status (body mass index z-score, proportion overweight/obese) and self-reported PA behaviours (meeting PA recommendations and active travel behaviour). RESULTS When adjusted for student and school demographics, students had significantly increased odds of using active transport to or from school when the school neighbourhood was more walkable (OR 1.21 (95% CI 1.09 to 1.35), had a greater number of greenspaces (OR 1.35 (95% CI 1.20 to 1.53)) and a greater number of recreational facilities (OR 1.18 (95% CI 1.07 to 1.31)). A higher cumulative PA environment score was also associated with a higher proportion of children using active transport (OR 1.33 (95% CI 1.28 to 1.51)). There were no significant associations between the PA environment measures and either weight status or meeting the PA recommendations in adjusted models. CONCLUSIONS This study is the first of its kind exploring school neighbourhood environments and child weight status and PA in regional areas of Australia. It highlights the potential of the environment surrounding primary schools in contributing to students' active travel to and from school. Further research with the use of objective PA measurement is warranted in regional areas that have been under-researched. TRIAL REGISTRATION NUMBER Australian New Zealand Clinical Trials Registry (ANZCTR.org.au) identifier 12616000980437; Results.
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Affiliation(s)
- Jane Jacobs
- Global Obesity Centre, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Nic Crooks
- Global Obesity Centre, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Steven Allender
- Global Obesity Centre, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Claudia Strugnell
- Global Obesity Centre, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Kathryn Backholer
- Global Obesity Centre, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Melanie Nichols
- Global Obesity Centre, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
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22
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Baker C, Chinaka O, Stewart EC. The time is now: why we must identify and address health disparities in sport and recreation injury. Inj Epidemiol 2021; 8:25. [PMID: 34120655 PMCID: PMC8200301 DOI: 10.1186/s40621-021-00320-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 03/15/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Social and structural determinants of health (SDOH) are the conditions in which individuals are born, live, learn, work, play, worship, and age. These drivers of health are integral in contextualizing the understanding and prevention of sport and recreation injury (SRI), and recognizing their impact is necessary to provide a complete and accurate picture of health and health outcomes related to injury. MAIN: Reducing disparities and achieving equity in sports and recreation is possible in part by improving data collection methodologies and utilization. Often, many SDOH have considerable effect on SRI. Although SRI epidemiology frequently examines differences by sex, there is limited inclusion of factors such as socioeconomic status, housing, gender, and food security, in sport specific data sources or in analysis of sport recreation and injury using other sources (e.g. administrative data). The ongoing dual epidemics in the United States - racism and COVID-19 - have emphasized the importance of having and utilizing SDOH data to reduce the burden of injury and disproportionate effects on our diverse population. CONCLUSION Moving forward, to address disparities in SRI, SDOH must be included as a part of research priorities, health related goals, and policies. This difference can be made in developing consistency in data collection and utilization. This will provide an accurate picture of the intersections and interdisciplinary changes required to design the best approach to problems to develop solutions. Future data collection and utilization should prioritize SDOH.
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Affiliation(s)
- Charlotte Baker
- Department of Population Health Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, VA, USA.
| | - Oziomachukwu Chinaka
- Department of Population Health Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, VA, USA
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23
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Randomized Informational Intervention and Adult Park Use and Park-Based Physical Activity in Low-Income, Racially Diverse Urban Neighborhoods. J Phys Act Health 2021; 18:920-928. [PMID: 34077911 DOI: 10.1123/jpah.2020-0751] [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: 11/10/2020] [Revised: 02/15/2021] [Accepted: 04/11/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Neighborhood parks are important locations to encourage and stimulate physical activity (PA) among the urban population. This study aims to evaluate the impact of an informational intervention on adult park use and PA behaviors in 3 low-income, racially diverse urban neighborhoods in Minneapolis, MN. METHOD The study employed a household-level randomized controlled trial and collected baseline and follow-up data from 171 participants. Within each neighborhood, participants were randomized to an informational intervention or to a no-intervention comparison. Intervention households received monthly, neighborhood-specific newsletters about park-based PA opportunities, park program brochures, trail maps, and activity guides. RESULTS The average treatment effect of the newsletter intervention was positive yet moderated by respondent age. For a 20-year-old resident, treatment was associated with 0.97 (P < .05) additional park visits and 31.24 (P < .05) additional minutes of park-based PA over a 3-day recall period. For 40-year-old respondents, these positive effects are smaller at 0.36 (P < .05) additional visits and 4.66 (P < .05) additional minutes, respectively. CONCLUSIONS An intervention to increase awareness about park-based PA opportunities and benefits increased self-reported park visits and in-park PA among adults who lived in low-income, racially diverse neighborhoods.
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Reed JA, Ballard RM, Hill M, Berrigan D. Identification of Effective Programs to Improve Access to and Use of Trails among Youth from Under-Resourced Communities: A Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7707. [PMID: 33105592 PMCID: PMC7659949 DOI: 10.3390/ijerph17217707] [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: 09/07/2020] [Revised: 10/13/2020] [Accepted: 10/15/2020] [Indexed: 11/16/2022]
Abstract
The primary purpose of this paper is to identify and review studies evaluating the effectiveness of programs to increase access to trails and trails use (physical activity) among youth from under-resourced communities. Three additional goals include identifying: (1) Correlates of physical activity/trail use and features of transportation systems and/or built environment and land use destinations, that may inform and support the planning and implementation of programs to promote trail use among youth, (2) benefits associated with trail use, and (3) barriers to trail use. Under-resourced communities are defined as those lacking sufficient resources (i.e., under-funded). METHODS A review of the literature was conducted to identify, abstract, and evaluate studies related to programs to promote trail use among youth and youth from under-resourced communities. In anticipation of very few studies being published about this topic, studies were also reviewed to identify correlates of transportation systems and built environment and land use destinations related to increases in physical activity, and benefits of, and barriers to trail use. PUBMED, MEDLINE, PsycINFO, Sportdiscus, Annual Reviews, American Trails, and Google Scholar databases were searched using terms including trails, built environment, physical activity, exercise, walking, children, adolescents, and youth to identify studies that potentially related to the purposes for conducting this review. Review methods identified, 5278 studies based on our search terms. A review of study titles, abstracts, and select full article screens determined that 5049 studies did not meet the study inclusion criteria, leaving 221 studies included in this review. RESULTS No studies were located that evaluated programs designed to promote and increase trail use among youth, including youth from under-resourced communities. Eight studies used longitudinal or quasi-experimental designs to evaluate physical activity and neighborhood characteristics prospectively among adolescent girls (n = 1), the effects of the path or trail development on physical activity behaviors of children, youth, and adults (n = 4), marketing or media campaigns (n = 2), and wayfinding and incremental distance signage (n = 1) to promote increased trail use. Correlates of transportation systems (e.g., trail access, road traffic congestion related to safe active travel, lack of sidewalks, closer proximity to trails, access to transportation), destinations (e.g., park availability and access, park improvements, greenspaces), or both routes and destinations (e.g., perceptions of safety, lighting), were identified. These correlates may support the planning and implementation of programs to increase trail use among youth, or may facilitate the connection of trails or routes to destinations in communities. Barriers to trail use included costs, crime, lack of transportation, lack of role models using trails, and institutional discrimination. CONCLUSIONS Scientific evidence in support of addressing the underrepresentation of trail use by youth from under-resourced communities is lacking. However, there is a related body of evidence that may inform how to develop programs that support trail use by youth from under-resourced areas. Dedicated, deliberate, and systematic efforts will be required to address research and knowledge gaps, and to evaluate programs and practice related to trail use among youth from low income, often racially or ethnically diverse under-resourced neighborhoods or communities.
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Affiliation(s)
- Julian A. Reed
- Health Sciences, Furman University, Greenville, SC 29613, USA
| | - Rachel M. Ballard
- Prevention Research Coordination, Office of Disease Prevention, NIH, Bethesda, MD 20892, USA;
| | - Michael Hill
- Landscape Architect, Enterprise Program, U.S. Forest Service, Washington, DC 20250, USA;
| | - David Berrigan
- Behavioral Research Program, Division of Cancer Control and Population Sciences National Cancer Institute, 9609 Medical Center Drive MSC 7344, Bethesda, MD 20892-7344, USA;
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Dobbinson SJ, Simmons J, Chamberlain JA, MacInnis RJ, Salmon J, Staiger PK, Wakefield M, Veitch J. Examining Health-Related Effects of Refurbishment to Parks in a Lower Socioeconomic Area: The ShadePlus Natural Experiment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176102. [PMID: 32825776 PMCID: PMC7503361 DOI: 10.3390/ijerph17176102] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 08/08/2020] [Accepted: 08/09/2020] [Indexed: 11/16/2022]
Abstract
Degraded parks in disadvantaged areas are underutilized for recreation, which may impact long-term health. Using a natural experiment, we examined the effects of local government refurbishments to parks (n = 3 intervention; n = 3 comparison) in low socioeconomic areas (LSEA) of Melbourne on park use, health behavior, social engagement and psychological well-being. Amenities promoting physical activity and sun protection included walking paths, playground equipment and built shade. Outcomes were measured via systematic observations, and self-report surveys of park visitors over three years. The refurbishments significantly increased park use, while shade use increased only in parks with shade sails. A trend for increased social engagement was also detected. Findings infer improvement of quality, number and type of amenities in degraded parks can substantially increase park use in LSEA. Findings support provision of shade over well-designed playgrounds in future park refurbishments to enhance engagement and sun protection behavior. Further research should identify park amenities to increase physical activity.
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Affiliation(s)
- Suzanne J. Dobbinson
- Cancer Council Victoria, Melbourne, VIC 3004, Australia; (J.S.); (J.A.C.); (R.J.M.); (M.W.)
- Correspondence:
| | - Jody Simmons
- Cancer Council Victoria, Melbourne, VIC 3004, Australia; (J.S.); (J.A.C.); (R.J.M.); (M.W.)
| | - James A. Chamberlain
- Cancer Council Victoria, Melbourne, VIC 3004, Australia; (J.S.); (J.A.C.); (R.J.M.); (M.W.)
| | - Robert J. MacInnis
- Cancer Council Victoria, Melbourne, VIC 3004, Australia; (J.S.); (J.A.C.); (R.J.M.); (M.W.)
- Centre for Epidemiology and Biostatistics, The University of Melbourne, Parkville, VIC 3010, Australia
| | - Jo Salmon
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3220, Australia; (J.S.); (J.V.)
| | - Petra K. Staiger
- School of Psychology, Deakin University, Geelong, VIC 3220, Australia;
| | - Melanie Wakefield
- Cancer Council Victoria, Melbourne, VIC 3004, Australia; (J.S.); (J.A.C.); (R.J.M.); (M.W.)
| | - Jenny Veitch
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3220, Australia; (J.S.); (J.V.)
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26
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Bernhart JA, La Valley EA, Kaczynski AT, Wilcox S, Jake-Schoffman DE, Peters N, Dunn CG, Hutto B. Investigating Socioeconomic Disparities in the Potential Healthy Eating and Physical Activity Environments of Churches. JOURNAL OF RELIGION AND HEALTH 2020; 59:1065-1079. [PMID: 30132179 PMCID: PMC6384145 DOI: 10.1007/s10943-018-0687-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Faith-based settings have the potential to improve health in underresourced communities, but little research has quantified and compared health-promoting elements in church environments. This study examines the number of potential indoor and outdoor physical activity opportunities, healthy eating opportunities, healthy living media, and total environmental resources present in churches (n = 54) in a rural, southeastern US county and the relationship between these resources and neighborhood income. In our sample, most churches offered potential indoor and outdoor opportunities for physical activity and healthy eating opportunities, with more variability in the number of healthy living media items on display compared to other environmental components. Common potential opportunities present in churches for physical activity included a fellowship hall and green/open space, while potential opportunities for healthy eating frequently included a refrigerator and sink. Compared to those in medium- and high-income neighborhoods, churches in low-income neighborhoods scored higher on measures of potential outdoor physical activity opportunities and lower on measures of total potential environment resources, healthy eating opportunities, healthy living media, and indoor physical activity opportunities, though only indoor physical activity opportunities reached statistical significance. Potential opportunities for using existing resources in and around churches for health promotion should be investigated further, particularly in rural areas.
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Affiliation(s)
- John A Bernhart
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA.
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA.
| | - Elizabeth A La Valley
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Andrew T Kaczynski
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Sara Wilcox
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Danielle E Jake-Schoffman
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Nathan Peters
- School of Human Movement, Sport and Leisure Studies, Bowling Green University, Bowling Green, OH, USA
| | - Caroline G Dunn
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Brent Hutto
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
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Neighborhood Greenery as a Predictor of Outdoor Crimes between Low and High-Income Neighborhoods. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051470. [PMID: 32106474 PMCID: PMC7084215 DOI: 10.3390/ijerph17051470] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 02/23/2020] [Accepted: 02/24/2020] [Indexed: 11/30/2022]
Abstract
Neighborhood greenery contributes to improving mental, emotional, and physical health and may help to promote neighborhood safety. Several studies have reported positive effects of neighborhood greenery on the improvement of outdoor safety, but little is known about whether the relationship between green vegetation and outdoor safety varies with the income status of neighborhoods. The purpose of this study is to examine neighborhood greenery as a predictor of outdoor crime rates between low and high-income neighborhoods while controlling for the sociodemographic conditions of the neighborhoods. This study used 2010 census block group data and objectively measured natural environment data derived from GIS in Austin, Texas. Comparison t-tests and ordinal least square regressions were conducted as statistical analyses. The t-tests showed that low-income neighborhoods were more socioeconomically disadvantaged and had less greenery than high-income neighborhoods. The final regression models showed that neighborhood greenery had a negative relationship with outdoor crimes for low-income neighborhoods but a positive relationship with crimes for high-income neighborhoods. The results suggest that different strategies may be needed in dealing with neighborhood safety according to neighborhood-level income.
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28
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Marquet O, Hipp JA, Alberico C, Huang JH, Fry D, Mazak E, Lovasi GS, Floyd MF. Use of SOPARC to assess physical activity in parks: do race/ethnicity, contextual conditions, and settings of the target area, affect reliability? BMC Public Health 2019; 19:1730. [PMID: 31870351 PMCID: PMC6929368 DOI: 10.1186/s12889-019-8107-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 12/18/2019] [Indexed: 11/20/2022] Open
Abstract
Background Since its introduction in 2006, SOPARC (Systematic Observation of Play and Recreation in Communities) has become a fundamental tool to quantify park visitor behaviors and characteristics. We tested SOPARC reliability when assessing race/ethnicity, physical activity, contextual conditions at the time of observation, and settings of target areas to understand its utility when trying to account for individual characteristics of users. Methods We used 4725 SOPARC observations completed simultaneously by two independent observers to evaluate intraclass correlation and agreement rate between the two observers when trying to assess sex, age group, race/ethnicity, and level of physical activity of urban park users in different park settings. Observations were in 20 New York City parks during Spring and Summer 2017 within the PARC3 project. Results Observers counted 25,765 park users with high interobserver reliability (ICC = .94; %Agreement.75). Reliability scores were negatively affected by the population being observed, the intensity of physical activity, and the contextual conditions and settings of the target area at the time of observation. Specific challenges emerged when assessing the combination of physical activity and race/ethnicity. Conclusions SOPARC training should aim to improve reliability when assessing concurrent measures such as physical activity, race/ethnicity, age, and sex. Similarly, observing crowded park areas with many active users areas may require more observation practice hours.
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Affiliation(s)
- Oriol Marquet
- ISGlobal Barcelona Institute for Global Health, Barcelona, Spain.
| | - J Aaron Hipp
- Department of Parks, Recreation, and Tourism Management, NC State University, Raleigh, NC, USA.,Center for Geospatial Analytics, NC State University, Raleigh, NC, USA
| | - Claudia Alberico
- Department of Parks, Recreation, and Tourism Management, NC State University, Raleigh, NC, USA.,Center for Geospatial Analytics, NC State University, Raleigh, NC, USA
| | - Jing-Huei Huang
- Department of Parks, Recreation, and Tourism Management, NC State University, Raleigh, NC, USA.,Center for Geospatial Analytics, NC State University, Raleigh, NC, USA
| | - Dustin Fry
- Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Elizabeth Mazak
- Department of Parks, Recreation, and Tourism Management, NC State University, Raleigh, NC, USA.,Center for Geospatial Analytics, NC State University, Raleigh, NC, USA
| | - Gina S Lovasi
- Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Myron F Floyd
- Department of Parks, Recreation, and Tourism Management, NC State University, Raleigh, NC, USA
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Evenson KR, Williamson S, Han B, McKenzie TL, Cohen DA. United States' neighborhood park use and physical activity over two years: The National Study of Neighborhood Parks. Prev Med 2019; 123:117-122. [PMID: 30898586 PMCID: PMC6534437 DOI: 10.1016/j.ypmed.2019.03.027] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 02/08/2019] [Accepted: 03/16/2019] [Indexed: 11/27/2022]
Abstract
The United States lacks surveillance to monitor park use and conditions. The purpose of this study was to use the System for Observing Play and Recreation in Communities (SOPARC) as a surveillance tool to describe the conditions, user characteristics, and physical activity of a national sample of neighborhood parks at two time points. Using a stratified multistage sampling strategy, a representative sample of 174 neighborhood parks in 25 major United States' cities were selected. During 2014 and 2016, park-related use, conditions, and physical activity were assessed using SOPARC in 169 parks. Overall, 74,106 park users were observed at baseline and 69,150 park users were observed two years later (p = 0.37). There were persistent disparities in park use by gender and age, with disproportionately more male than female users in each age group (child, teenager, adult, older adult). Older adults used the park less than other age groups. Almost two-thirds of park users were observed being sedentary (61.9% in 2014, 60.7% in 2016), followed by moderate (30.8%, 32.0%) and vigorous (7.3%, 7.3%) activity. Empty target areas increased over two years (75.3%, 77.6%; p = 0.01) and those that were equipped (2.6%, 1.2%; p = 0.0003), accessible (95.4%, 94.3%; p = 0.01), and organized (2.6%, 1.7%; p = 0.01) decreased. Areas that were usable (97.5%, 97.4%) or provided supervised activities (2.0%, 2.4%) did not change significantly. The findings demonstrate the value of SOPARC as a surveillance tool, identify user groups under represented at parks, and suggest an opportunity to encourage more park-based physical activity among park visitors.
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Affiliation(s)
- Kelly R Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina - Chapel Hill, 123 W Franklin Street, Building C, Suite 410, Chapel Hill, NC 27514, United States.
| | | | - Bing Han
- RAND Corporation, 1776 Main Street, Santa Monica, CA 90407, United States.
| | - Thomas L McKenzie
- School of Exercise and Nutritional Sciences, San Diego State University, 5127 Walsh Way, San Diego, CA 92115, United States.
| | - Deborah A Cohen
- RAND Corporation, 1776 Main Street, Santa Monica, CA 90407, United States.
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Association Between Neighborhood Income, Patterns of Use, and Physical Activity Levels in Fitness Zones of Curitiba, Brazil. J Phys Act Health 2019; 16:447-454. [PMID: 31023140 DOI: 10.1123/jpah.2018-0234] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background: Socioeconomic characteristics of locations where physical activity equipment is installed may affect the activity level of users. The purpose of this study was to verify patterns of use and physical activity levels in fitness zones installed in low- and high-income neighborhoods in the city of Curitiba, Brazil. Methods: Over 1200 observations were conducted in 20 fitness zones in the city of Curitiba, Brazil. Data were collected during the months of November and December 2012, in 4 periods of the day (8 AM, 11 AM, 2 PM, and 5 PM), on 2 weekdays and 2 weekend days. Results: A total of 2232 people were observed in the fitness zones. Age group, level of physical activity in the area, use of fitness zones during weekend days, and occupation of spaces were significantly associated with neighborhood income. Moreover, users of fitness zones located in high-income neighborhoods showed higher odds ratio (OR = 1.74; 95% confidence interval, 1.46-2.07) of moderate to vigorous physical activity than light or sedentary activities, regardless of gender or day of the week. Conclusions: The sole presence of equipment does not seem to favor the use of fitness zones in low-income neighborhoods. Future studies should investigate intrinsic factors for the use of fitness zones for physical activity.
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Jacobs J, Alston L, Needham C, Backholer K, Strugnell C, Allender S, Nichols M. Variation in the physical activity environment according to area-level socio-economic position-A systematic review. Obes Rev 2019; 20:686-700. [PMID: 30624854 DOI: 10.1111/obr.12818] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 11/07/2018] [Accepted: 11/11/2018] [Indexed: 01/29/2023]
Abstract
Physical inactivity is a major contributing factor to obesity, and both follow a socio-economic gradient. This systematic review aims to identify whether the physical activity environment varies by socio-economic position (SEP), which may contribute to socio-economic patterning of physical activity behaviours, and in turn, obesity levels. Six databases were searched. Studies were included if they compared an objectively measured aspect of the physical activity environment between areas of differing SEP in a high-income country. Two independent reviewers screened all papers. Results were classified according to the physical activity environment analysed: walkability/bikeability, green space, and recreational facilities. Fifty-nine studies met the inclusion criteria. A greater number of positive compared with negative associations were found between SEP and green space, whereas there were marginally more negative than positive associations between SEP and walkability/bikeability and recreational facilities. A high number of mixed and null results were found across all categories. With a high number of mixed and null results, clear socio-economic patterning in the presence of physical activity environments in high-income countries was not evident in this systematic review. Heterogeneity across studies in the measures used for both SEP and physical activity environments may have contributed to this result.
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Affiliation(s)
- Jane Jacobs
- Global Obesity Centre, Centre for Population Health Research, Deakin University, Geelong, Victoria, Australia
| | - Laura Alston
- Global Obesity Centre, Centre for Population Health Research, Deakin University, Geelong, Victoria, Australia
| | - Cindy Needham
- Global Obesity Centre, Centre for Population Health Research, Deakin University, Geelong, Victoria, Australia
| | - Kathryn Backholer
- Global Obesity Centre, Centre for Population Health Research, Deakin University, Geelong, Victoria, Australia
| | - Claudia Strugnell
- Global Obesity Centre, Centre for Population Health Research, Deakin University, Geelong, Victoria, Australia
| | - Steven Allender
- Global Obesity Centre, Centre for Population Health Research, Deakin University, Geelong, Victoria, Australia
| | - Melanie Nichols
- Global Obesity Centre, Centre for Population Health Research, Deakin University, Geelong, Victoria, Australia
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Stewart OT, Moudon AV, Littman A, Seto E, Saelens BE. The association between park facilities and the occurrence of physical activity during park visits. JOURNAL OF LEISURE RESEARCH 2019; 49:217-235. [PMID: 31602048 PMCID: PMC6786780 DOI: 10.1080/00222216.2018.1534073] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Prior research has found a positive relationship between the variety of park facilities and park-based physical activity (PA), but has not provided an estimate of the effect that additional different PA facilities have on whether an individual is active during a park visit. Using objective measures of park visits and PA from an urban sample of 225 adults in King County, Washington, we compared the variety of PA facilities in parks visited where an individual was active to PA facilities in parks where the same individual was sedentary. Each additional different PA facility at a park was associated with a 6% increased probability of being active during a visit. Adding additional different PA facilities to a park appears to have a moderate effect on whether an individual is active during a park visit, which could translate into large community health impacts when scaled up to multiple park visitors.
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Affiliation(s)
| | | | - Alyson Littman
- Department of Epidemiology, School of Public Health, University of Washington
| | - Edmund Seto
- Department of Environmental & Occupational Health Sciences, School of Public Health, University of Washington
| | - Brian E. Saelens
- Seattle Children’s Research Institute
- Department of Pediatrics, School of Medicine, University of Washington
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Geremia CM, Cain KL, Conway TL, Sallis JF, Saelens BE. Validating and Shortening the Environmental Assessment of Public Recreation Spaces Observational Measure. J Phys Act Health 2018; 16:1-8. [PMID: 30541362 DOI: 10.1123/jpah.2018-0142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Assessment of park characteristics that may support physical activity (PA) can guide the design of more activity-supportive parks. Direct-observation measures are seldom used due to time and resource restraints. METHODS The authors developed shortened versions of the original Environmental Assessment of Public Recreation Spaces (EAPRS) tool and tested their construct validity by comparing scores from 40 parks in San Diego, CA to observe park use and PA. RESULTS PA elements were positively associated with park use and park PA across all versions, with the highest correlations for trails (.45 for use and .51 for PA using EAPRS-Original; .57 use and .62 PA using Abbreviated; and .38 use and .43 PA using Mini). Presence of amenities, using Abbreviated and Mini versions, was correlated with park use (.71, .64) and PA (.67, .59). The overall park quality score using Abbreviated and Mini had similar correlations (adjusted for park size) with park use (.74, .72) and PA (.72, .70) as EAPRS-Original (.71 use and .73 PA). CONCLUSION In all 3 versions, EAPRS overall park scores were strongly related to observed park use and PA. Shorter versions of EAPRS make it more feasible to use park observations in research and practice.
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Socioeconomic Inequalities in Green Space Quality and Accessibility-Evidence from a Southern European City. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14080916. [PMID: 28809798 PMCID: PMC5580619 DOI: 10.3390/ijerph14080916] [Citation(s) in RCA: 95] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2017] [Revised: 08/09/2017] [Accepted: 08/11/2017] [Indexed: 11/17/2022]
Abstract
Background: The provision of green spaces is an important health promotion strategy to encourage physical activity and to improve population health. Green space provision has to be based on the principle of equity. This study investigated the presence of socioeconomic inequalities in geographic accessibility and quality of green spaces across Porto neighbourhoods (Portugal). Methods: Accessibility was evaluated using a Geographic Information System and all the green spaces were audited using the Public Open Space Tool. Kendall’s tau-b correlation coefficients and ordinal regression were used to test whether socioeconomic differences in green space quality and accessibility were statistically significant. Results: Although the majority of the neighbourhoods had an accessible green space, mean distance to green space increased with neighbourhood deprivation. Additionally, green spaces in the more deprived neighbourhoods presented significantly more safety concerns, signs of damage, lack of equipment to engage in active leisure activities, and had significantly less amenities such as seating, toilets, cafés, etc. Conclusions: Residents from low socioeconomic positions seem to suffer from a double jeopardy; they lack both individual and community resources. Our results have important planning implications and might contribute to understanding why deprived communities have lower physical activity levels and poorer health.
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