Longitudinal association between change in the neighbourhood built environment and the wellbeing of local residents in deprived areas: an observational study

Changes in UK price disparities between healthy and less healthy foods over 10 years: An updated analysis with insights in the context of inflationary increases in the cost-of-living from 2021

Food prices and affordability play an important role in influencing dietary choices, which in turn have implications for public health. With inflationary increases in the cost-of-living in the UK since 2021, understanding the dynamics of food prices becomes increasingly important. In this longitudinal study, we aimed to examine changes in food prices from 2013 to 2023 by food group and by food healthiness. We established a dataset spanning the years 2013-2023 by combining price data from the UK Consumer Price Index for food and beverage items with nutrient and food data from the UK nutrient databank and UK Department of Health & Social Care's National Diet and Nutrition Survey data. We calculated the price (£/100 kcal) for each food item by year as well as before and during the period of inflationary pressure, and classified items into food groups according to the UK Eatwell Guide and as either "more healthy" or "less healthy" using the UK nutrient profiling score model. In 2023, bread, rice, potatoes and pasta was cheapest (£0.12/100 kcal) and fruit and vegetables most expensive (£1.01/100 kcal). Less healthy food was cheaper than more healthy food (£0.33/100 kcal versus £0.81/100 kcal). Before the inflationary pressure period (from 2013 to late 2021), the price of foods decreased by 3%. After this period, the price of food increased by 22%: relative increases were highest in the food group milk and dairy food (31%) and less healthy category (26%). While healthier foods saw smaller relative price increases since 2021, they remain more expensive, potentially exacerbating dietary inequalities. Policy responses should ensure food affordability and mitigate price disparities via, for example, healthy food subsidies.

The pathways linking objectively-measured greenspace exposure and mental health: A systematic review of observational studies

BACKGROUND

With an increasing volume of research exploring the pathways linking greenspace exposure to mental health, there is a need to synthesise the strength of evidence on the mediation mechanisms. Synthesising the strength of evidence on the pathways can help us better understand how greenspace exposure affects mental health and guide future green space interventions to improve mental health.

PURPOSE

The purpose of this study was to synthesise current evidence on the pathways linking objectively-measured greenspace exposure and mental health using a systematic review approach.

METHODS

Literature searches were conducted in March 2020 from five common databases (i.e., MEDLINE, Embase, PsycINFO, SPORTDiscus, and Web of Science) using search terms of green spaces and mental health. English language and human population were imposed as search limits. The Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guideline was followed to synthesise and report results.

RESULTS

The initial systematic searches yielded 16,415 records, of which 26 studies met the inclusion criteria. Mixed or non-significant evidence was revealed for the mediating effects of air quality, physical activity, perceived stress, perceived restorativeness, residential noise, social cohesion, and social support on the pathways from greenspace exposure to mental illness. The effect of greenspace exposure on mental well-being was mediated by air quality, perceived stress, and physical activity. In addition, mixed evidence was revealed for the mediating role of social cohesion on the path from greenspace exposure to mental well-being.

CONCLUSIONS

This systematic review highlighted the key pathways linking green spaces to mental well-being via harmful mitigation, psychological restoration, and encouragement of health-related behaviours. Evidence for the pathway between greenspace exposure and mental illness is equivocal at present. Future research is recommended to adopt well-designed longitudinal and experimental studies to establish causal inferences on mental health benefits of greenspace exposure.

Impact of gentrification on adult mental health

OBJECTIVE

To estimate the net effect of living in a gentrified neighborhood on probability of having serious psychological distress.

DATA SOURCES

We pooled 5 years of secondary data from the California Health Interview Survey (2011-2015) and focused on southern California residents.

STUDY DESIGN

We compared adults (n = 43 815) living in low-income and gentrified, low-income and not gentrified, middle- to high-income and upscaled, and middle- to high-income and not upscaled neighborhoods. We performed a probit regression to test whether living in a gentrified neighborhood increased residents' probabilities of having serious psychological distress in the past year and stratified analyses by neighborhood tenure, homeownership status, and low-income status. Instrumental variables estimation and propensity scores were applied to reduce bias arising from residential selection and simultaneity. An endogenous treatment effects model was also applied in sensitivity analyses.

DATA COLLECTION/EXTRACTION METHODS

Adults who completed the survey on their own and lived in urban neighborhoods with 500 or more residents were selected for analyses. Survey respondents who scored 13 and above on the Kessler 6 were categorized as having serious psychological distress in the past year. We used eight neighborhood change measures to classify respondents' neighborhoods.

PRINCIPAL FINDINGS

Living in a gentrified and upscaled neighborhood was associated with increased likelihood of serious psychological distress relative to living in a low-income and not gentrified neighborhood. The average treatment effect was 0.0141 (standard error = 0.007), which indicates that the prevalence of serious psychological distress would have been 1.4 percentage points less if none of the respondents lived in gentrified neighborhoods. Gentrification appears to have a negative impact on the mental health of renters, low-income residents, and long-term residents. This effect was not observed among homeowners, higher-income residents, and recent residents.

CONCLUSIONS

Gentrification levies mental health costs on financially vulnerable community members and can worsen mental health inequities.

Neighbourhood identification buffers the effects of (de-)gentrification and personal socioeconomic position on mental health

Previous studies have suggested that the effects of gentrification on long-term residents' mental health depends upon individual socioeconomic position. However, the role of social psychological moderators of these effects remains unexplored. Drawing on the social identity approach to health, we examine whether social identification with the neighbourhood can be protective of mental health for residents in the context of (de-)gentrification. Using multi-level modelling in a longitudinal Australian sample (N = 8376), we show that neighbourhood identification protects the mental health of residents who live in neighbourhoods that undergo positive or negative neighbourhood socioeconomic status change.

Precision medicine and healthy living: The importance of the built environment

The built environment encompasses the major physical spaces, including buildings, streets, homes, schools, parks, playgrounds and other infrastructure in which we live, work and play. In an ideal world, the built environment should support and facilitate a healthy engagement in physical activity across the lifespan. However, in the context of an environment characterized by increased mechanization and urbanization, physical inactivity and higher levels of overweight and obesity, too many settings are not conducive to physical activity and/or are not safe and walkable. In the knowledge that there are multiple challenges to redress the low levels of physical activity seen in many parts of the world, this paper provides some examples of opportunities for healthy living (HL) in a built environment characteristic of an increasingly urbanized world. Particular foci include opportunities for HL fostered in child-friendly cities, in which walkability is high, and active transport is encouraged and supported.