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Chan JA, Koster A, Lakerveld J, Schram MT, van Greevenbroek M, Bosma H. Associations of neighborhood social cohesion and changes in BMI-The Maastricht Study. Eur J Public Health 2024; 34:949-954. [PMID: 38942603 PMCID: PMC11430969 DOI: 10.1093/eurpub/ckae109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2024] Open
Abstract
The role of the social environment can facilitate positive health outcomes through active community engagement, normalization of healthy behaviors, and stress buffering. We aim to examine the associations of neighborhood social cohesion with changes in BMI over time. A total of 7641 participants from The Maastricht Study between the ages of 40 and 75 years were analyzed. Weight and height were measured at baseline, and weight was self-reported annually up to 10 years of follow-up (median = 4.7 years). Perceived social cohesion was obtained by questionnaire. Home addresses for each participant were linked to geographic information system data from the Geoscience and Health Cohort Consortium to create neighborhood exposure variables including area level social cohesion, neighborhood walkability, and food environment within a 1000 m Euclidian buffer. Linear regression analyses were performed with BMI adjusted for socioeconomic variables. A mixed model analysis was carried out to examine changes in BMI. Living in the highest quartile area of individually perceived social cohesion was associated with lower BMI (Q4 B: -.53; 95% CI = -.79, -.28) compared to the lowest quartile. Similar findings were discovered using the area level measure (Q4 B: -.97; 95% CI = -1.29, -.65). There was no longitudinal association between social cohesion and BMI. Neighborhood social cohesion was associated with lower BMI classifying it as an obesogenic area characteristic that influences weight, independent of conventional built environment features.
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Affiliation(s)
- Jeffrey A Chan
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
- Department of Social Medicine, Maastricht University, Maastricht, The Netherlands
- Department of Physical Medicine and Rehabilitation, Northern California VA Healthcare System, Martinez, CA, United States
| | - Annemarie Koster
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
- Department of Social Medicine, Maastricht University, Maastricht, The Netherlands
| | - Jeroen Lakerveld
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Miranda T Schram
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
- Department of Internal Medicine, Maastricht University, Maastricht, The Netherlands
- Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Marleen van Greevenbroek
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
- Department of Internal Medicine, Maastricht University, Maastricht, The Netherlands
| | - Hans Bosma
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
- Department of Social Medicine, Maastricht University, Maastricht, The Netherlands
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Chandrabose M, Hadgraft N, Owen N, Mavoa S, Sugiyama T. Joint associations of neighbourhood walkability and greenery with walking among middle-aged and older adults: Findings from diverse urban settings in Australia. Health Place 2024; 89:103334. [PMID: 39106781 DOI: 10.1016/j.healthplace.2024.103334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 06/16/2024] [Accepted: 07/31/2024] [Indexed: 08/09/2024]
Abstract
There is evidence that neighbourhood walkability and greenery are associated with walking, but less is known about their joint associations. We investigated this using data from the AusDiab3 study (2011/12) with 3032 adults (mean age 60 years). Two-level logistic regression models were used with binary walking outcomes. There was an inverse relationship (r = -0.5) between walkability (a composite measure of residential, destinations and intersections densities) and greenery (the size of densely vegetated areas). However, both walkability and greenery were independently positively associated with odds of walking. Regarding joint associations, in low-walkability neighbourhoods, greenery was positively associated with walking. In high-walkability neighbourhoods, greenery was not associated with walking.
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Affiliation(s)
- Manoj Chandrabose
- Centre for Urban Transitions, Swinburne University of Technology, Melbourne, VIC, Australia; Baker Heart & Diabetes Institute, Melbourne, VIC, Australia.
| | - Nyssa Hadgraft
- Centre for Urban Transitions, Swinburne University of Technology, Melbourne, VIC, Australia; Baker Heart & Diabetes Institute, Melbourne, VIC, Australia; Environmental Public Health Branch, EPA Victoria, Melbourne, VIC, Australia.
| | - Neville Owen
- Centre for Urban Transitions, Swinburne University of Technology, Melbourne, VIC, Australia; Baker Heart & Diabetes Institute, Melbourne, VIC, Australia; Environmental Public Health Branch, EPA Victoria, Melbourne, VIC, Australia.
| | - Suzanne Mavoa
- Centre for Urban Transitions, Swinburne University of Technology, Melbourne, VIC, Australia; Murdoch Children's Research Institute, Melbourne, VIC, Australia; Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.
| | - Takemi Sugiyama
- Centre for Urban Transitions, Swinburne University of Technology, Melbourne, VIC, Australia; Baker Heart & Diabetes Institute, Melbourne, VIC, Australia.
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Meijer P, Lam TM, Vaartjes I, Moll van Charante E, Galenkamp H, Koster A, van den Hurk K, den Braver NR, Blom MT, de Jong T, Grobbee DE, Beulens JW, Lakerveld J. The association of obesogenic environments with weight status, blood pressure, and blood lipids: A cross-sectional pooled analysis across five cohorts. ENVIRONMENTAL RESEARCH 2024; 256:119227. [PMID: 38797463 DOI: 10.1016/j.envres.2024.119227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 05/10/2024] [Accepted: 05/24/2024] [Indexed: 05/29/2024]
Abstract
In this observational cross-sectional study, we investigated the relationship between combined obesogenic neighbourhood characteristics and various cardiovascular disease risk factors in adults, including BMI, systolic blood pressure, and blood lipids, as well as the prevalence of overweight/obesity, hypertension, and dyslipidaemia. We conducted a large-scale pooled analysis, comprising data from five Dutch cohort studies (n = 183,871). Neighbourhood obesogenicity was defined according to the Obesogenic Built-environmental CharacterisTics (OBCT) index. The index was calculated for 1000m circular buffers around participants' home addresses. For each cohort, the association between the OBCT index and prevalence of overweight/obesity, hypertension and dyslipidaemia was analysed using robust Poisson regression models. Associations with continuous measures of BMI, systolic blood pressure, LDL-cholesterol, HDL-cholesterol, and triglycerides were analysed using linear regression. All models were adjusted for age, sex, education level and area-level socio-economic status. Cohort-specific estimates were pooled using random-effects meta-analyses. The pooled results show that a 10 point higher OBCT index score was significantly associated with a 0.17 higher BMI (95%CI: 0.10 to 0.24), a 0.01 higher LDL-cholesterol (95% CI: 0.01 to 0.02), a 0.01 lower HDL cholesterol (95% CI: -0.02 to -0.01), and non-significantly associated with a 0.36 mmHg higher systolic blood pressure (95%CI: -0.14 to 0.65). A 10 point higher OBCT index score was also associated with a higher prevalence of overweight/obesity (PR = 1.03; 95% CI: 1.02 to 1.05), obesity (PR = 1.04; 95% CI: 1.01 to 1.08) and hypertension (PR = 1.02; 95% CI: 1.00 to 1.04), but not with dyslipidaemia. This large-scale pooled analysis of five Dutch cohort studies shows that higher neighbourhood obesogenicity, as measured by the OBCT index, was associated with higher BMI, higher prevalence of overweight/obesity, obesity, and hypertension. These findings highlight the importance of considering the obesogenic environment as a potential determinant of cardiovascular health.
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Affiliation(s)
- Paul Meijer
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands; Upstream Team, Amsterdam UMC, VU University Amsterdam, the Netherlands.
| | - Thao Minh Lam
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands; Amsterdam University Medical Centers Location Vrije Universiteit, Epidemiology and Data Science, Amsterdam, the Netherlands; Amsterdam Public Health, Health Behaviours and Chronic Diseases, Amsterdam, the Netherlands; Upstream Team, Amsterdam UMC, VU University Amsterdam, the Netherlands
| | - Ilonca Vaartjes
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Eric Moll van Charante
- Amsterdam Public Health, Health Behaviours and Chronic Diseases, Amsterdam, the Netherlands; Amsterdam University Medical Centers, Location University of Amsterdam, Department of Public and Occupational Health, Amsterdam, the Netherlands
| | - Henrike Galenkamp
- Amsterdam Public Health, Health Behaviours and Chronic Diseases, Amsterdam, the Netherlands; Amsterdam University Medical Centers, Location University of Amsterdam, Department of Public and Occupational Health, Amsterdam, the Netherlands
| | - Annemarie Koster
- Department of Social Medicine, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | - Katja van den Hurk
- Donor Studies, Department of Donor Medicine Research, Sanquin Research, Amsterdam, the Netherlands
| | - Nicole R den Braver
- Amsterdam University Medical Centers Location Vrije Universiteit, Epidemiology and Data Science, Amsterdam, the Netherlands; Amsterdam Public Health, Health Behaviours and Chronic Diseases, Amsterdam, the Netherlands; Upstream Team, Amsterdam UMC, VU University Amsterdam, the Netherlands
| | - Marieke T Blom
- Amsterdam University Medical Centers Location Vrije Universiteit, Department of General Practice, Amsterdam, the Netherlands
| | - Trynke de Jong
- Lifelines Cohort and Biobank Study, Roden, the Netherlands
| | - Diederick E Grobbee
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Joline Wj Beulens
- Amsterdam University Medical Centers Location Vrije Universiteit, Epidemiology and Data Science, Amsterdam, the Netherlands; Amsterdam Public Health, Health Behaviours and Chronic Diseases, Amsterdam, the Netherlands
| | - Jeroen Lakerveld
- Amsterdam University Medical Centers Location Vrije Universiteit, Epidemiology and Data Science, Amsterdam, the Netherlands; Amsterdam Public Health, Health Behaviours and Chronic Diseases, Amsterdam, the Netherlands; Upstream Team, Amsterdam UMC, VU University Amsterdam, the Netherlands
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4
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Lam TM, den Braver NR, Ohanyan H, Wagtendonk AJ, Vaartjes I, Beulens JW, Lakerveld J. The neighourhood obesogenic built environment characteristics (OBCT) index: Practice versus theory. ENVIRONMENTAL RESEARCH 2024; 251:118625. [PMID: 38467360 DOI: 10.1016/j.envres.2024.118625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 02/22/2024] [Accepted: 03/03/2024] [Indexed: 03/13/2024]
Abstract
BACKGROUND Obesity is a key risk factor for major chronic diseases such as type 2 diabetes and cardiovascular diseases. To extensively characterise the obesogenic built environment, we recently developed a novel Obesogenic Built environment CharacterisTics (OBCT) index, consisting of 17 components that capture both food and physical activity (PA) environments. OBJECTIVES We aimed to assess the association between the OBCT index and body mass index (BMI) in a nationwide health monitor. Furthermore, we explored possible ways to improve the index using unsupervised and supervised methods. METHODS The OBCT index was constructed for 12,821 Dutch administrative neighbourhoods and linked to residential addresses of eligible adult participants in the 2016 Public Health Monitor. We split the data randomly into a training (two-thirds; n = 255,187) and a testing subset (one-third; n = 127,428). In the training set, we used non-parametric restricted cubic regression spline to assess index's association with BMI, adjusted for individual demographic characteristics. Effect modification by age, sex, socioeconomic status (SES) and urbanicity was examined. As improvement, we (1) adjusted the food environment for address density, (2) added housing price to the index and (3) adopted three weighting strategies, two methods were supervised by BMI (variable selection and random forest) in the training set. We compared these methods in the testing set by examining their model fit with BMI as outcome. RESULTS The OBCT index had a significant non-linear association with BMI in a fully-adjusted model (p<0.05), which was modified by age, sex, SES and urbanicity. However, variance in BMI explained by the index was low (<0.05%). Supervised methods increased this explained variance more than non-supervised methods, though overall improvements were limited as highest explained variance remained <0.5%. DISCUSSION The index, despite its potential to highlight disparity in obesogenic environments, had limited association with BMI. Complex improvements are not necessarily beneficial, and the components should be re-operationalised.
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Affiliation(s)
- Thao Minh Lam
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, De Boelelaan 1117, 1081HV, Amsterdam, the Netherlands; Amsterdam Public Health, Health Behaviours and Chronic Diseases, Amsterdam, the Netherlands; Upstream Team, Amsterdam UMC, VU University Amsterdam, De Boelelaan 1089a, 1081HV, Amsterdam, the Netherlands.
| | - Nicolette R den Braver
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, De Boelelaan 1117, 1081HV, Amsterdam, the Netherlands; Amsterdam Public Health, Health Behaviours and Chronic Diseases, Amsterdam, the Netherlands; Upstream Team, Amsterdam UMC, VU University Amsterdam, De Boelelaan 1089a, 1081HV, Amsterdam, the Netherlands
| | - Haykanush Ohanyan
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, De Boelelaan 1117, 1081HV, Amsterdam, the Netherlands; Upstream Team, Amsterdam UMC, VU University Amsterdam, De Boelelaan 1089a, 1081HV, Amsterdam, the Netherlands; Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Alfred J Wagtendonk
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, De Boelelaan 1117, 1081HV, Amsterdam, the Netherlands; Amsterdam Public Health, Health Behaviours and Chronic Diseases, Amsterdam, the Netherlands; Upstream Team, Amsterdam UMC, VU University Amsterdam, De Boelelaan 1089a, 1081HV, Amsterdam, the Netherlands
| | - Ilonca Vaartjes
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Internal Mail No. Str6.131, P.O. Box 85500, 3508, GA, Utrecht, the Netherlands
| | - Joline Wj Beulens
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, De Boelelaan 1117, 1081HV, Amsterdam, the Netherlands; Amsterdam Public Health, Health Behaviours and Chronic Diseases, Amsterdam, the Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Internal Mail No. Str6.131, P.O. Box 85500, 3508, GA, Utrecht, the Netherlands
| | - Jeroen Lakerveld
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, De Boelelaan 1117, 1081HV, Amsterdam, the Netherlands; Amsterdam Public Health, Health Behaviours and Chronic Diseases, Amsterdam, the Netherlands; Upstream Team, Amsterdam UMC, VU University Amsterdam, De Boelelaan 1089a, 1081HV, Amsterdam, the Netherlands
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5
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Ohanyan H, van de Wiel M, Portengen L, Wagtendonk A, den Braver NR, de Jong TR, Verschuren M, van den Hurk K, Stronks K, Moll van Charante E, van Schoor NM, Stehouwer CD, Wesselius A, Koster A, ten Have M, Penninx BW, van Wier MF, Motoc I, Oldehinkel AJ, Willemsen G, Boomsma DI, Beenackers MA, Huss A, van Boxtel M, Hoek G, Beulens JW, Vermeulen R, Lakerveld J. Exposome-Wide Association Study of Body Mass Index Using a Novel Meta-Analytical Approach for Random Forest Models. ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:67007. [PMID: 38889167 PMCID: PMC11218701 DOI: 10.1289/ehp13393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 04/04/2024] [Accepted: 05/20/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND Overweight and obesity impose a considerable individual and social burden, and the urban environments might encompass factors that contribute to obesity. Nevertheless, there is a scarcity of research that takes into account the simultaneous interaction of multiple environmental factors. OBJECTIVES Our objective was to perform an exposome-wide association study of body mass index (BMI) in a multicohort setting of 15 studies. METHODS Studies were affiliated with the Dutch Geoscience and Health Cohort Consortium (GECCO), had different population sizes (688-141,825), and covered the entire Netherlands. Ten studies contained general population samples, others focused on specific populations including people with diabetes or impaired hearing. BMI was calculated from self-reported or measured height and weight. Associations with 69 residential neighborhood environmental factors (air pollution, noise, temperature, neighborhood socioeconomic and demographic factors, food environment, drivability, and walkability) were explored. Random forest (RF) regression addressed potential nonlinear and nonadditive associations. In the absence of formal methods for multimodel inference for RF, a rank aggregation-based meta-analytic strategy was used to summarize the results across the studies. RESULTS Six exposures were associated with BMI: five indicating neighborhood economic or social environments (average home values, percentage of high-income residents, average income, livability score, share of single residents) and one indicating the physical activity environment (walkability in 5 -km buffer area). Living in high-income neighborhoods and neighborhoods with higher livability scores was associated with lower BMI. Nonlinear associations were observed with neighborhood home values in all studies. Lower neighborhood home values were associated with higher BMI scores but only for values up to € 300,000 . The directions of associations were less consistent for walkability and share of single residents. DISCUSSION Rank aggregation made it possible to flexibly combine the results from various studies, although between-study heterogeneity could not be estimated quantitatively based on RF models. Neighborhood social, economic, and physical environments had the strongest associations with BMI. https://doi.org/10.1289/EHP13393.
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Affiliation(s)
- Haykanush Ohanyan
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Health Behaviours and Chronic Diseases, Amsterdam Public Health, Amsterdam, the Netherlands
- Upstream Team, Amsterdam UMC, VU University Amsterdam, Amsterdam, the Netherlands
| | - Mark van de Wiel
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Health Behaviours and Chronic Diseases, Amsterdam Public Health, Amsterdam, the Netherlands
| | - Lützen Portengen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Alfred Wagtendonk
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Health Behaviours and Chronic Diseases, Amsterdam Public Health, Amsterdam, the Netherlands
| | - Nicolette R. den Braver
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Health Behaviours and Chronic Diseases, Amsterdam Public Health, Amsterdam, the Netherlands
- Upstream Team, Amsterdam UMC, VU University Amsterdam, Amsterdam, the Netherlands
| | | | - Monique Verschuren
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Katja van den Hurk
- Donor Medicine Research – Donor Studies, Sanquin Research, Amsterdam, the Netherlands
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Karien Stronks
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Eric Moll van Charante
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Natasja M. van Schoor
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Aging & Later Life, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Coen D.A. Stehouwer
- School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Anke Wesselius
- School for Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, the Netherlands
- Department of Epidemiology, Maastricht University, Maastricht, the Netherlands
| | - Annemarie Koster
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
- Department of Social Medicine, Maastricht University, Maastricht, the Netherlands
| | - Margreet ten Have
- Trimbos-Instituut, Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - Brenda W.J.H. Penninx
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Mood, Anxiety, Psychosis, Sleep & Stress Program, Mental Health Program and Amsterdam Neuroscience, Amsterdam Public Health, Amsterdam, the Netherlands
| | - Marieke F. van Wier
- Department of Otolaryngology—Head and Neck Surgery, section Ear and Hearing, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Quality of Care, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Irina Motoc
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Amsterdam Reproduction & Development Research Institute, Amsterdam, the Netherlands
| | - Albertine J. Oldehinkel
- Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Gonneke Willemsen
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Dorret I. Boomsma
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Mariëlle A. Beenackers
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Anke Huss
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Martin van Boxtel
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands
| | - Gerard Hoek
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Joline W.J. Beulens
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Health Behaviours and Chronic Diseases, Amsterdam Public Health, Amsterdam, the Netherlands
- Upstream Team, Amsterdam UMC, VU University Amsterdam, Amsterdam, the Netherlands
- Lifelines Cohort & Biobank, Roden, the Netherlands
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
- Lifelines Cohort & Biobank, Roden, the Netherlands
| | - Jeroen Lakerveld
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Health Behaviours and Chronic Diseases, Amsterdam Public Health, Amsterdam, the Netherlands
- Upstream Team, Amsterdam UMC, VU University Amsterdam, Amsterdam, the Netherlands
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Chan JA, Bosma H, Lakerveld J, Schram MT, van Greevenbroek M, Koster A. Social cohesion and associations with sedentary time, physical activity and dietary quality in The Maastricht Study. Prev Med 2024; 183:107970. [PMID: 38653391 DOI: 10.1016/j.ypmed.2024.107970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 04/04/2024] [Accepted: 04/20/2024] [Indexed: 04/25/2024]
Abstract
INTRO We aim to investigate the relationship between social cohesion and sedentary behavior (SB), total physical activity (PA), moderate-to-vigorous PA (MVPA), and dietary quality. Additionally, we assess whether these associations are independent of neighborhood walkability and the food environment. METHODS A total of 7641 participants from The Maastricht Study in the Netherlands between the ages of 40 and 75 years were analyzed. Neighborhood social cohesion was obtained by participant questionnaire completed at baseline and measured by the Dutch Livability meter. Home addresses were linked to geographic information system (GIS) data from the Geoscience and Health Cohort Consortium (GECCO) to create neighborhood exposures of walkability and food environment. A thigh worn accelerometer collected data to measure sedentary time, total daily PA, and MVPA. Dietary quality was measured with a food frequency questionnaire. Multivariate linear regression analyses were adjusted for age, sex, socioeconomic position, neighborhood walkability, and food environment. RESULTS Those living in the highest quartile area of perceived social cohesion had statistically significant lower levels of SB (Q4 B: -13.04; 95% CI = -20.23, -5.85), higher total PA (Q4 B: 4.39; 95% CI = 1.69, 7.10), and higher MVPA (Q4 B: 2.57; 95% CI = 0.83, 4.31) and better diet quality (Q4 B: 1.12; 95% CI = 0.24, 2.01) compared to the lowest quartile independent of walkability and food environment. Similar results were found using the Livability meter. CONCLUSION We discovered neighborhood social cohesion as an important obesogenic determinant that should be considered in policymaking to encourage higher levels of PA and higher diet quality.
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Affiliation(s)
- Jeffrey Alexander Chan
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands; Department of Social Medicine, Maastricht University, Maastricht, the Netherlands; Department of Physical Medicine and Rehabilitation, Northern California VA Healthcare System, Martinez, CA, USA.
| | - Hans Bosma
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands; Department of Social Medicine, Maastricht University, Maastricht, the Netherlands
| | - Jeroen Lakerveld
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Miranda T Schram
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands; Department of Internal Medicine, Maastricht University, Maastricht, the Netherlands; Heart and Vascular Centre, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - Marleen van Greevenbroek
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands; Department of Internal Medicine, Maastricht University, Maastricht, the Netherlands
| | - Annemarie Koster
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands; Department of Social Medicine, Maastricht University, Maastricht, the Netherlands
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7
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Ocaña-Ortiz A, Gea-Caballero V, Juárez-Vela R, Peiró R, Pérez-Sanz E, Santolalla-Arnedo I, Sufrate-Sorzano T, Garrote-Cámara ME, Paredes-Carbonell JJ. Health equity in urban and rural settings: implementation of the place standard tool in Spain. Front Public Health 2024; 12:1292032. [PMID: 38803816 PMCID: PMC11129683 DOI: 10.3389/fpubh.2024.1292032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 04/17/2024] [Indexed: 05/29/2024] Open
Abstract
The physical, social, and economic characteristics of neighborhoods and municipalities determine the health of their residents, shaping their behaviors and choices regarding health and well-being. Addressing local environmental inequalities requires an intersectoral, participatory, and equity-focused approach. Community participation plays a vital role by providing deeper insights into local contexts, integrating community knowledge and values into processes, and promoting healthier, fairer, and more equitable actions. In recent years, various tools have been developed to assess places and transform them into health-promoting settings. One such tool, the Place Standard Tool (PST), facilitates discussions on Social Determinants of Health grouped into 14 themes, serving as a starting point for local health interventions. In this study, that took place between August 2019 and February 2020, we described the resident's perceptions of two municipalities in the Valencian Community, Spain, using the validated Spanish version of the PST. A mixed-method convergent-parallel design was used to gain a holistic insight into residents' experiences concerning their physical, economic, and social environment. A total of 356 individuals from both municipalities participated in the study through discussion groups, structured interviews, and online survey. Descriptive analysis of the individual questionnaire answers was conducted, and differences between municipalities were explored. Qualitative thematic analysis was conducted on structured interviews and discussion groups. Quantitative and qualitative data were integrated to facilitate their comparison and identify areas of convergence or divergence in the findings. Overall, rural areas received more favorable evaluations compared to urban ones. Public Transport as well as Work and Local Economy were consistently rated the lowest across all groups and contexts, while Identity and Belonging received the highest ratings. In the urban area, additional negative ratings were observed for Traffic and Parking, Housing and Community, and Care and Maintenance. Conversely, Identity and Belonging, Natural Spaces, Streets and Spaces, Social Interaction, and Services emerged as the highest-rated themes overall. In the rural context, positive evaluations were given to Walking or Cycling, Traffic and Parking, Housing and Community, and Influence and Sense of Control. Significant differences (p < 0.01) between urban and rural settings were observed in dimensions related to mobility, spaces, housing, social interaction, and identity and belonging. Our study illustrated the capacity of the PST to identifying aspects within local settings that influence health, revealing both positive and challenging factors. Successful implementation requires appropriate territorial delineation, support from local authorities, and effective management of expectations. Furthermore, the tool facilitated community participation in decision-making about local environments, promoting equity by connecting institutional processes with citizen needs.
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Affiliation(s)
- Ana Ocaña-Ortiz
- Local Action and Health Equity Group (ALES Group), Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia, Spain
- Gandia Health Department, Gandia, Spain
| | - Vicente Gea-Caballero
- Faculty of Health Sciences, VIU Valencia International University, Valencia, Spain
- Research Group SALCOM Community Health and Care, Valencia International University, Valencia, Spain
| | - Raúl Juárez-Vela
- Department of Nursing, University of La Rioja, Logroño, La Rioja, Spain
- GRUPAC, University of La Rioja, Logroño, La Rioja, Spain
| | - Rosana Peiró
- Local Action and Health Equity Group (ALES Group), Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia, Spain
- Publica Health General Directorate, Health Department, Generalitat Valenciana, Valencia, Spain
- CIBERESP ISCIII, Madrid, Spain
| | - Elena Pérez-Sanz
- Local Action and Health Equity Group (ALES Group), Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia, Spain
- Publica Health General Directorate, Health Department, Generalitat Valenciana, Valencia, Spain
| | - Iván Santolalla-Arnedo
- Department of Nursing, University of La Rioja, Logroño, La Rioja, Spain
- GRUPAC, University of La Rioja, Logroño, La Rioja, Spain
| | - Teresa Sufrate-Sorzano
- Department of Nursing, University of La Rioja, Logroño, La Rioja, Spain
- GRUPAC, University of La Rioja, Logroño, La Rioja, Spain
| | - María Elena Garrote-Cámara
- Department of Nursing, University of La Rioja, Logroño, La Rioja, Spain
- GRUPAC, University of La Rioja, Logroño, La Rioja, Spain
| | - Joan Josep Paredes-Carbonell
- Local Action and Health Equity Group (ALES Group), Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia, Spain
- Public Health Center of Alzira, Valencia, Spain
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Osmënaj T, Lam TM, Wagtendonk AJ, den Braver NR. Walking to work: The role of walkability around the workplace in a Dutch adult commuting population. SSM Popul Health 2024; 25:101578. [PMID: 38173691 PMCID: PMC10761905 DOI: 10.1016/j.ssmph.2023.101578] [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: 09/22/2023] [Revised: 11/09/2023] [Accepted: 12/03/2023] [Indexed: 01/05/2024] Open
Abstract
Current evidence on neighborhood walkability and active commuting focuses on residential rather than workplace environment. This cross-sectional study investigated whether higher workplace walkability (WW) was associated with commute walking, both independently and together with residential walkability, using data from 6769 respondents of the 2017 Dutch national travel survey. In a fully adjusted logistic regression model, 10% increase in WW was associated with 32% higher odds of commute walking (Odds ratio (OR): 1.31, 95% Confidence Interval (CI: 1.27-1.36). The estimates were stronger in rural dwellers than urban residents, (ORrural 1.49, 95%CI: 1.34-1.64 vs ORhighly.urban 1.19, 95%CI: 1.13-1.26). In participants with both high residential walkability and WW, we observed 215% higher odds (OR 3.15, 95% CI: 2.48-3.99) of commute walking compared to those with low walkability in both. Our study indicated the importance and complementary nature of walkable residence and workplace in contribution to physical activity of working individuals through active commuting.
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Affiliation(s)
- Tea Osmënaj
- Amsterdam UMC location Vrije Universiteit Amsterdam, Epidemiology and Data Science, De Boelelaan 1117, Amsterdam, the Netherlands
- The National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Thao Minh Lam
- Amsterdam UMC location Vrije Universiteit Amsterdam, Epidemiology and Data Science, De Boelelaan 1117, Amsterdam, the Netherlands
- Amsterdam Public Health Institute, Health Behaviours and Chronic Diseases, Amsterdam, the Netherlands
- Upstream Team, Vrije Universiteit, Amsterdam, the Netherlands
| | - Alfred J. Wagtendonk
- Amsterdam UMC location Vrije Universiteit Amsterdam, Epidemiology and Data Science, De Boelelaan 1117, Amsterdam, the Netherlands
- Amsterdam Public Health Institute, Health Behaviours and Chronic Diseases, Amsterdam, the Netherlands
- Upstream Team, Vrije Universiteit, Amsterdam, the Netherlands
| | - Nicolette R. den Braver
- Amsterdam UMC location Vrije Universiteit Amsterdam, Epidemiology and Data Science, De Boelelaan 1117, Amsterdam, the Netherlands
- Amsterdam Public Health Institute, Health Behaviours and Chronic Diseases, Amsterdam, the Netherlands
- Upstream Team, Vrije Universiteit, Amsterdam, the Netherlands
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9
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Chan JA, Bosma H, Drosinou C, Timmermans EJ, Savelberg H, Schaper N, Schram MT, Stehouwer CDA, Lakerveld J, Koster A. Association of perceived and objective neighborhood walkability with accelerometer-measured physical activity and sedentary time in the Maastricht Study. Scand J Med Sci Sports 2023; 33:2313-2322. [PMID: 37489093 DOI: 10.1111/sms.14455] [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: 04/08/2023] [Revised: 07/11/2023] [Accepted: 07/12/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND We investigated the association of neighborhood walkability with accelerometer-measured physical activity (PA) and sedentary behavior (SB) and examined whether objective and subjective measures of walkability resulted in similar findings. METHODS PA and SB from the first 7689 Maastricht Study participants ages 40-75 from 2010 to 2017 were measured using accelerometers for 7 days. Mean daily step count, light-intensity PA, moderate- to vigorous- intensity PA (MVPA), and SB were calculated. Objective walkability was measured by the 7-component Dutch Walkability Index within 500 m Euclidean buffers around residential addresses of participants. Subjective walkability was obtained from the Abbreviated Neighborhood Environment Walkability Scale. Linear regression models analyzed the associations of walkability with PA and SB, controlling for potential confounders. RESULTS Objective walkability was negatively associated with light intensity PA in the most walkable quartile (b = -14.58, 95% CI = -20.94, -8.23). Compared to participants living in the least walkable neighborhoods, those in the most walkable quartile had statistically significantly higher SB levels (b = 11.64, 95% CI = 4.95, 18.32). For subjective walkability, mean daily step count was significantly higher in the most walkable quartile (b = 509.60, 95% CI = 243.38, 775.81). Higher subjective walkability was positively associated with MVPA (b = 4.40, 95% CI = 2.56, 6.23). CONCLUSION Living in a neighborhood with higher objective walkability was associated with lower levels of PA and higher SB levels while higher subjective walkability was associated with higher levels of PA. These results show discordant findings and thus, the effect of walkability on participant PA and SB within our sample is to be determined.
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Grants
- Cardiovascular Center (CVC, Maastricht, the Netherlands)
- Cardiovascular Research Institute Maastricht (CARIM, Maastricht, the Netherlands)
- Dutch Ministry of Economic Affairs (grant 31O.041)
- European Regional Development Fund
- Health Foundation Limburg (Maastricht, the Netherlands)
- Janssen-Cilag B.V. (Tilburg, the Netherlands)
- Novo Nordisk Farma B.V. (Alphen aan den Rijn, the Netherlands)
- Pearl String Initiative Diabetes (Amsterdam, the Netherlands)
- Province of Limburg
- Sanofi-Aventis Netherlands, B.V. (Gouda, the Netherlands)
- School for Nutrition, Toxicology and Metabolism (NUTRIM, Maastricht, the Netherlands)
- School for Public Health and Primary Care (CAPHRI, Maastricht, the Netherlands)
- Stichting Annadal (Maastricht, the Netherlands)
- Stichting De Weijerhorst (Maastricht, the Netherlands)
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Affiliation(s)
- Jeffrey Alexander Chan
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
- Department of Social Medicine, Maastricht University, Maastricht, The Netherlands
- Department of Physical Medicine and Rehabilitation, Northern California VA Healthcare System, Martinez, California, USA
| | - Hans Bosma
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
- Department of Social Medicine, Maastricht University, Maastricht, The Netherlands
| | - Connie Drosinou
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
- Department of Social Medicine, Maastricht University, Maastricht, The Netherlands
| | - Erik J Timmermans
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Hans Savelberg
- School for Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands
| | - Nicolaas Schaper
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
- Department of Internal Medicine, Maastricht University, Maastricht, The Netherlands
| | - Miranda T Schram
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
- Department of Internal Medicine, Maastricht University, Maastricht, The Netherlands
- Heart and Vascular Centre, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Coen D A Stehouwer
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
- Department of Internal Medicine, Maastricht University, Maastricht, The Netherlands
| | - Jeroen Lakerveld
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Annemarie Koster
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
- Department of Social Medicine, Maastricht University, Maastricht, The Netherlands
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10
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Jeong I, Choi M, Kwak J, Ku D, Lee S. A comprehensive walkability evaluation system for promoting environmental benefits. Sci Rep 2023; 13:16183. [PMID: 37758828 PMCID: PMC10533864 DOI: 10.1038/s41598-023-43261-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 09/21/2023] [Indexed: 09/29/2023] Open
Abstract
Pedestrian-oriented urban strategies such as the Paris 15-minute City are needed to respond to the global boiling. Quantitative evaluation of pedestrian-oriented urban objectives is important for various cities, and in this paper, a walkability evaluation system for the advanced model is developed considering the characteristics of a large city. The system calculates the walkability of Seoul. The evaluation system uses the Betweenness index as a weight in the urban network analysis. Considering stations with a high betweenness in urban traffic is essential for evaluating a pedestrian-oriented metropolis. Our findings in this study are that the UNA index in WES is critical for transit-oriented, walkable cities. The large city needs to find the location for mobility hubs or stations to observe the last mile. Installing a mobility hub or station at a high-value location in the city center is functionally important. In a pedestrian-oriented city, citizens can walk and bike the last mile in a busy city center. Walkable cities can encourage active transport and ultimately create more sustainable and environmentally friendly transportation systems. This study offers valuable insights into pedestrian infrastructure, urban systems, and policies that promote green transportation.
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Affiliation(s)
- Ilho Jeong
- Department of Transportation Engineering/Department of Smart Cities, University of Seoul, Seoul, South Korea
| | - Minje Choi
- Department of Transportation Engineering/Department of Smart Cities, University of Seoul, Seoul, South Korea
| | - Juhyeon Kwak
- Department of Transportation Engineering/Department of Smart Cities, University of Seoul, Seoul, South Korea
| | - Donggyun Ku
- University of Cambridge, Cambridge, United Kingdom
| | - Seungjae Lee
- Department of Transportation Engineering, University of Seoul, Seoul, South Korea.
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11
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Spoelder M, Schoofs MCA, Raaphorst K, Lakerveld J, Wagtendonk A, Hartman YAW, van der Krabben E, Hopman MTE, Thijssen DHJ. A positive neighborhood walkability is associated with a higher magnitude of leisure walking in adults upon COVID-19 restrictions: a longitudinal cohort study. Int J Behav Nutr Phys Act 2023; 20:116. [PMID: 37752497 PMCID: PMC10521432 DOI: 10.1186/s12966-023-01512-3] [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: 04/24/2023] [Accepted: 09/07/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Previous cross-sectional and longitudinal observational studies revealed positive relationships between contextual built environment components and walking behavior. Due to severe restrictions during COVID-19 pandemic lockdowns, physical activity was primarily performed within the immediate living area. Using this unique opportunity, we evaluated whether built environment components were associated with the magnitude of change in walking activity in adults during COVID-19 restrictions. METHODS Data on self-reported demographic characteristics and walking behaviour were extracted from the prospective longitudinal Lifelines Cohort Study in the Netherlands of participants ≥ 18 years. For our analyses, we made use of the data acquired between 2014-2017 (n = 100,285). A fifth of the participants completed the questionnaires during COVID-19 restrictive policies in July 2021 (n = 20,806). Seven spatial components were calculated for a 500m and 1650m Euclidean buffer per postal code area in GIS: population density, retail and service destination density, land use mix, street connectivity, green space density, sidewalk density, and public transport stops. Additionally, the walkability index (WI) of these seven components was calculated. Using multivariable linear regression analyses, we analyzed the association between the WI (and separate components) and the change in leisure walking minutes/week. Included demographic variables were age, gender, BMI, education, net income, occupation status, household composition and the season in which the questionnaire was filled in. RESULTS The average leisure walking time strongly increased by 127 min/week upon COVID-19 restrictions. All seven spatial components of the WI were significantly associated with an increase in leisure walking time; a 10% higher score in the individual spatial component was associated with 5 to 8 more minutes of leisure walking/week. Green space density at the 500m Euclidean buffer and side-walk density at the 1650m Euclidean buffer were associated with the highest increase in leisure walking time/week. Subgroup analysis revealed that the built environment showed its strongest impact on leisure walking time in participants not engaging in leisure walking before the COVID-19 pandemic, compared to participants who already engaged in leisure walking before the COVID-19 pandemic. CONCLUSIONS These results provide strong evidence that the built environment, corrected for individual-level characteristics, directly links to changes observed in leisure walking time during COVID-19 restrictions. Since this relation was strongest in those who did not engage in leisure walking before the COVID-19 pandemic, our results encourage new perspectives in health promotion and urban planning.
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Affiliation(s)
- Marcia Spoelder
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Philips Van Leydenlaan 15, Nijmegen, 6525 EX, The Netherlands.
- Present affiliation: Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Geert Grooteplein Noord 21, Nijmegen, 6525 EZ, The Netherlands.
| | - Merle C A Schoofs
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Philips Van Leydenlaan 15, Nijmegen, 6525 EX, The Netherlands
| | - Kevin Raaphorst
- Department of Geography, Planning and Environment, Institute for Management Research, Radboud University, Nijmegen, The Netherlands
| | - Jeroen Lakerveld
- Amsterdam UMC, Department of Epidemiology and Data Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Boelelaan 1089a, Amsterdam, 1081HV, The Netherlands
- Amsterdam Public Health, Health Behaviours and Chronic Diseases, Amsterdam, The Netherlands
- Upstream Team, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Alfred Wagtendonk
- Amsterdam UMC, Department of Epidemiology and Data Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Boelelaan 1089a, Amsterdam, 1081HV, The Netherlands
- Amsterdam Public Health, Health Behaviours and Chronic Diseases, Amsterdam, The Netherlands
- Upstream Team, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Yvonne A W Hartman
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Philips Van Leydenlaan 15, Nijmegen, 6525 EX, The Netherlands
| | - Erwin van der Krabben
- Department of Geography, Planning and Environment, Institute for Management Research, Radboud University, Nijmegen, The Netherlands
| | - Maria T E Hopman
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Philips Van Leydenlaan 15, Nijmegen, 6525 EX, The Netherlands
| | - Dick H J Thijssen
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Philips Van Leydenlaan 15, Nijmegen, 6525 EX, The Netherlands
- Research Institute for Sports and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
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12
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Rocke KD, Howitt C, Panter J, Tully M, Hambleton I. Neighbourhood Walkability and Its Influence on Physical Activity and Cardiometabolic Disease: A Cross-Sectional Study in a Caribbean Small Island Developing State. Cureus 2023; 15:e44060. [PMID: 37746352 PMCID: PMC10517735 DOI: 10.7759/cureus.44060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction Cities and neighborhoods may provide opportunities for population-level environmental interventions to reduce physical inactivity and cardiometabolic risk. In this study, we describe the association between neighborhood walkability, physical activity (PA), and cardiometabolic outcomes, by linking data from a nationally representative survey of adults (25 years and older) collected in 2012-2013 with spatial data on built environment features in Barbados. Methods We estimated a walkability index for 45 neighborhoods using objectively measured built environment features (residential density, street connectivity, and land use mix). We used the Recent Physical Activity Questionnaire to capture time spent in outdoor walking, active commuting, moderate-to-vigorous PA (MVPA), and total PA. Our primary cardiometabolic outcome was a predicted 10-year cardiovascular risk (CVD) score, estimated using the American College of Cardiology/American Heart Association pooled cohort equation. Our secondary cardiometabolic outcomes were hypertension and diabetes. We explored the effect of neighborhood walkability on PA and cardiometabolic outcomes using several multivariable regression models (tobit and linear and logistic multi-level mixed effects), with the model choice depending on the structure of the outcome. Results The average time spent walking weekly for any purpose among participants was 75 minutes/week, time spent on active commuting was 15 minutes/week, and MVPA was 221 minutes/week. We estimated that the average 10-year CVD risk in the study population was 11.7% (95%CI 10.9-12.5). Our confounder-adjusted analyses showed positive linear relationships between neighborhood walkability and each PA outcome (p<0.05 in all cases), and a negative relationship between walkability and predicted 10-year CVD risk (p<0.001). Conclusion In our setting, adults residing in higher walkability neighborhoods spent more time engaged in PA, had a lower predicted 10-year CVD risk, and were less likely to have diabetes. Urban planners may consider shorter-term interventions, such as those on a microscale, which may provide additional ways to increase activity in a mostly fixed macroscale environment.
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Affiliation(s)
- Kern D Rocke
- George Alleyne Chronic Disease Research Centre, Caribbean Institute for Health Research, The University of the West Indies, Bridgetown, BRB
| | - Christina Howitt
- George Alleyne Chronic Disease Research Centre, Caribbean Institute for Health Research, The University of the West Indies, Bridgetown, BRB
| | - Jenna Panter
- Medical Research Council (MRC) Epidemiology Unit, Centre for Diet & Activity Research (CEDAR), University of Cambridge, Cambridge, GBR
| | - Mark Tully
- Institute of Mental Health Sciences, School of Health Sciences, Ulster University, Newtownabbey, GBR
| | - Ian Hambleton
- George Alleyne Chronic Disease Research Centre, Caribbean Institute for Health Research, The University of the West Indies, Bridgetown, BRB
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Mudd AL, Oude Groeniger J, Bal M, Verra SE, van Lenthe FJ, Kamphuis CB. Testing conditionality with Bourdieu's capital theory: How economic, social, and embodied cultural capital are associated with diet and physical activity in the Netherlands. SSM Popul Health 2023; 22:101401. [PMID: 37123560 PMCID: PMC10139966 DOI: 10.1016/j.ssmph.2023.101401] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 04/05/2023] [Accepted: 04/09/2023] [Indexed: 05/02/2023] Open
Abstract
Although Bourdieu's capital theory emphasized that economic, social, and embodied cultural capital interact to shape health behavior, existing empirical research mainly considered separate associations of the three forms of capital. Our aim was to investigate if and how economic, social, and embodied cultural capital are conditional on each other in their associations with adults' diet and physical activity. Cross-sectional, self-reported data from the 2014 GLOBE survey of 2812 adults aged between 25 and 75 years residing in Eindhoven, the Netherlands were used. Step-wise multiple logistic regression models included economic, social, and embodied cultural capital and adjustment for potential confounders. The models estimated odds ratios of main effects and two-way interactions of the forms of capital with fruit consumption, vegetable consumption, sports participation, and leisure time walking or cycling. In the main effects models, embodied cultural capital was consistently positively associated with all outcomes. Social capital was positively associated with sports participation, fruit consumption, and vegetable consumption, and economic capital was positively associated with sports participation and vegetable consumption. In the two-way interaction models, having specific higher levels of both economic and social capital strengthened their positive association with sports participation. No other combinations of capital were conditional on each other. Economic and social capital were conditional on each other in their association with sports participation, so interventions that provide both economic and social support may be especially effective for increasing this type of physical activity. As its association was strong with all outcomes but not conditional on other forms of capital, embodied cultural capital may operate distinctly from economic and social resources. Policy that takes differences in embodied cultural capital into account or changes to the environment that dampen the importance of embodied cultural resources for health behavior may help improve both diet and physical activity.
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Affiliation(s)
- Andrea L. Mudd
- Department of Interdisciplinary Social Science- Social Policy and Public Health, Utrecht University, PO Box 80140, 3508, TC, Utrecht, the Netherlands
- Corresponding author.
| | - Joost Oude Groeniger
- Department of Public Health, Erasmus University Medical Centre, PO Box 2040, 3000, CA, Rotterdam, the Netherlands
| | - Michèlle Bal
- Department of Interdisciplinary Social Science- Social Policy and Public Health, Utrecht University, PO Box 80140, 3508, TC, Utrecht, the Netherlands
| | - Sanne E. Verra
- Department of Interdisciplinary Social Science- Social Policy and Public Health, Utrecht University, PO Box 80140, 3508, TC, Utrecht, the Netherlands
| | - Frank J. van Lenthe
- Department of Public Health, Erasmus University Medical Centre, PO Box 2040, 3000, CA, Rotterdam, the Netherlands
- Department of Human Geography and Spatial Planning, Utrecht University, PO Box 80140, 3508, TC, Utrecht, the Netherlands
| | - Carlijn B.M. Kamphuis
- Department of Interdisciplinary Social Science- Social Policy and Public Health, Utrecht University, PO Box 80140, 3508, TC, Utrecht, the Netherlands
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14
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Timmermans EJ, Leeuwis AE, Bots ML, van Alphen JL, Biessels GJ, Brunner-La Rocca HP, Kappelle LJ, van Rossum AC, van Osch MJP, Vaartjes I. Neighbourhood walkability in relation to cognitive functioning in patients with disorders along the heart-brain axis. Health Place 2023; 79:102956. [PMID: 36525834 DOI: 10.1016/j.healthplace.2022.102956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 12/01/2022] [Accepted: 12/05/2022] [Indexed: 12/15/2022]
Abstract
This study examined associations of neighbourhood walkability with cognitive functioning (i.e., global cognition, memory, language, attention-psychomotor speed, and executive functioning) in participants without or with either heart failure, carotid occlusive disease, or vascular cognitive impairment. Neighbourhood walkability at baseline was positively associated with global cognition and attention-psychomotor speed. These associations were stronger in patients with vascular cognitive impairment. Individuals who live in residential areas with higher walkability levels were less likely to have impairments in language and executive functioning at two-year follow-up. These findings highlight the importance of the built environment for cognitive functioning in healthy and vulnerable groups.
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Affiliation(s)
- Erik J Timmermans
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
| | - Anna E Leeuwis
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, VU University Medical Center, Amsterdam, the Netherlands
| | - Michiel L Bots
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Juliette L van Alphen
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, VU University Medical Center, Amsterdam, the Netherlands
| | - Geert Jan Biessels
- Department of Neurology, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands
| | | | - L Jaap Kappelle
- Department of Neurology, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Albert C van Rossum
- Department of Cardiology, Amsterdam UMC, VU University Medical Center, Amsterdam, the Netherlands
| | - Matthias J P van Osch
- C.J. Gorter MRI Center, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Ilonca Vaartjes
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
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Zhang Y, Koene M, Reijneveld SA, Tuinstra J, Broekhuis M, van der Spek S, Wagenaar C. The impact of interventions in the built environment on physical activity levels: a systematic umbrella review. Int J Behav Nutr Phys Act 2022; 19:156. [PMID: 36550583 PMCID: PMC9773501 DOI: 10.1186/s12966-022-01399-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022] Open
Abstract
Physical activity is good for people's health. The relationship between the built environment and physical activity has been well documented. However, evidence is both scarce and scattered on specific urban interventions, i.e., intentional redesigns of the built environment that promote physical activity accompanied by pre- and post-effect measurement. This umbrella review aims to synthesize the findings of systematic reviews focused on these urban interventions. We followed the PRISMA 2020 and JBI umbrella review protocol guidelines and searched seven databases covering the period between Jan 2010 and April 2022 using keywords relating to the built environment, health, physical activity, and interventions. This yielded seven systematic reviews, in which we identified several urban interventions that can promote physical activity. We found positive effects of urban interventions on physical activity regarding park renovations, adding exercise equipment, introducing a (new) pocket park, improving cycling environments, improving walking & cycling environments, as well as multi-component initiatives for active travel and enhancing the availability & accessibility of destinations. The findings suggest that the urban environment can effectively promote physical activity, especially by adding various facilities and destinations and by making the environment better suitable for active use.
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Affiliation(s)
- Yufang Zhang
- Expertise Center Architecture, Urbanism and Health, Faculty of Arts, University of Groningen, Groningen, the Netherlands.
| | - Marijke Koene
- Expertise Center Architecture, Urbanism and Health, Faculty of Arts, University of Groningen, Groningen, the Netherlands
| | - Sijmen A Reijneveld
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Jolanda Tuinstra
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Manda Broekhuis
- Department of Operations, Faculty of Economics & Business, University of Groningen, Groningen, the Netherlands
| | - Stefan van der Spek
- Department of Urbanism, Delft University of Technology, Delft, the Netherlands
| | - Cor Wagenaar
- Expertise Center Architecture, Urbanism and Health, Faculty of Arts, University of Groningen, Groningen, the Netherlands
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