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Patwary MM, Bardhan M, Browning MHEM, Astell-Burt T, van den Bosch M, Dong J, Dzhambov AM, Dadvand P, Fasolino T, Markevych I, McAnirlin O, Nieuwenhuijsen MJ, White MP, Van Den Eeden SK. The economics of nature's healing touch: A systematic review and conceptual framework of green space, pharmaceutical prescriptions, and healthcare expenditure associations. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 914:169635. [PMID: 38159779 DOI: 10.1016/j.scitotenv.2023.169635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 12/20/2023] [Accepted: 12/21/2023] [Indexed: 01/03/2024]
Abstract
Green spaces play a crucial role in promoting sustainable and healthy lives. Recent evidence shows that green space also may reduce the need for healthcare, prescription medications, and associated costs. This systematic review provides the first comprehensive assessment of the available literature examining green space exposure and its associations with healthcare prescriptions and expenditures. We applied Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines to search MEDLINE, Scopus, and Web of Science for observational studies published in English through May 6, 2023. A quality assessment of the included studies was conducted using the Office of Health Assessment and Translation (OHAT) tool, and the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) assessment was used to evaluate the overall quality of evidence. Our search retrieved 26 studies that met the inclusion criteria and were included in our review. Among these, 20 studies (77 % of the total) showed beneficial associations of green space exposure with healthcare prescriptions or expenditures. However, most studies had risks of bias, and the overall strength of evidence for both outcomes was limited. Based on our findings and related bodies of literature, we present a conceptual framework to explain the possible associations and complex mechanisms underlying green space and healthcare outcomes. The framework differs from existing green space and health models by including upstream factors related to healthcare access (i.e., rurality and socioeconomic status), which may flip the direction of associations. Additional research with lower risks of bias is necessary to validate this framework and better understand the potential for green space to reduce healthcare prescriptions and expenditures.
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Affiliation(s)
- Muhammad Mainuddin Patwary
- Environment and Sustainability Research Initiative, Khulna, Bangladesh; Environmental Science Discipline, Life Science School, Khulna University, Khulna, Bangladesh.
| | - Mondira Bardhan
- Environment and Sustainability Research Initiative, Khulna, Bangladesh; Department of Park, Recreation and Tourism Management, Clemson University, Clemson, SC, USA
| | - Matthew H E M Browning
- Department of Park, Recreation and Tourism Management, Clemson University, Clemson, SC, USA.
| | - Thomas Astell-Burt
- School of Architecture, Design, and Planning, University of Sydney, Australia
| | - Matilda van den Bosch
- ISGlobal, Barcelona, Spain; European Forest Institute, Biocities Facility, Rome, Italy; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Jiaying Dong
- Department of Park, Recreation and Tourism Management, Clemson University, Clemson, SC, USA; School of Architecture, Clemson University, Clemson, SC, USA
| | - Angel M Dzhambov
- Research Group "Health and Quality of Life in a Green and Sustainable Environment", Strategic Research and Innovation Program for the Development of MU - Plovdiv, Medical University of Plovdiv, Plovdiv, Bulgaria; Environmental Health Division, Research Institute at Medical University of Plovdiv, Medical University of Plovdiv, Plovdiv, Bulgaria; Department of Hygiene, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria; Institute of Highway Engineering and Transport Planning, Graz University of Technology, Graz, Austria
| | - Payam Dadvand
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - Iana Markevych
- Research Group "Health and Quality of Life in a Green and Sustainable Environment", Strategic Research and Innovation Program for the Development of MU - Plovdiv, Medical University of Plovdiv, Plovdiv, Bulgaria; Environmental Health Division, Research Institute at Medical University of Plovdiv, Medical University of Plovdiv, Plovdiv, Bulgaria; Institute of Psychology, Jagiellonian University, Krakow, Poland
| | - Olivia McAnirlin
- Department of Park, Recreation and Tourism Management, Clemson University, Clemson, SC, USA
| | - Mark J Nieuwenhuijsen
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Mathew P White
- Cognitive Science Hub, University of Vienna, Vienna, Austria
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Liao Y, Cheng X, Li Z, Li Y. The mediating role of physical activity and health status between a health-supportive environment and well-being: a cross-sectional study. Front Public Health 2023; 11:1233970. [PMID: 37927875 PMCID: PMC10622802 DOI: 10.3389/fpubh.2023.1233970] [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: 06/03/2023] [Accepted: 09/28/2023] [Indexed: 11/07/2023] Open
Abstract
Objective Based on the social-ecological systems theory and social support theory, this study aims to explore the relationship between a health-supportive environment and well-being among residents. It further examined the mediating role of physical activity and health status in the pathway between a health-supportive environment and well-being. Methods The study utilized data from 2,717 samples of the China General Social Survey (2021) and conducted multiple regression analysis and mediation analysis using statistical software Stata 16.0 and SPSS PROCESS 3.3. Results (1) A health-supportive environment had a significant impact on residents' well-being (t = 8.476, p < 0.001). (2) Among the three dimensions of natural environment, built environment, and neighborhood social environment, the influence of neighborhood social relationship environment had the strongest influence on residents' well-being (t = 8.443, p < 0.001). (3) Physical activity and health status played a mediating role in the relationship between a health-supportive environment and residents' well-being. The mediating effect was as follows: health-supportive environment → physical activity → well-being with a mediation effect of 0.020; health-supportive environment → health status → well-being with a mediation effect of 0.029; health-supportive environment → physical activity → health status → well-being with a mediation effect of 0.008. Conclusion A health-supportive environment not only directly influences residents' well-being but also indirectly affects it through physical activity and health status. It is essential to focus on improving both the natural and built environment as well as the neighborhood social relationship environment in enhancing residents' well-being. Physical activity serves as an important means to improve residents' health level and promote their well-being.
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Affiliation(s)
- Yi Liao
- School of Mathematics and Statistics, Jiangxi Normal University, Nanchang, China
| | - Xiaoyu Cheng
- School of Physical Education, Wuhan Sports University, Wuhan, China
| | - Zhuangzhuang Li
- School of Physical Education, Wuhan Sports University, Wuhan, China
| | - Yanyan Li
- School of Sports Economics and Management, Hubei University of Economics, Wuhan, China
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Testa A, Mungia R, van den Berg A, C Hernandez D. Food deserts and dental care utilization in the United States. J Public Health Dent 2023; 83:389-396. [PMID: 38073040 DOI: 10.1111/jphd.12593] [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: 03/09/2023] [Revised: 09/15/2023] [Accepted: 11/03/2023] [Indexed: 12/18/2023]
Abstract
OBJECTIVES Although food deserts are known to impact health and healthcare utilization, no research has investigated the relationship between food deserts and dental care utilization. This study aimed to fill this gap by assessing the relationship between living in a food desert and self-reported dental care utilization in the past year. METHODS Data are from the National Longitudinal Study of Adolescent to Adult Health (N = 10,495). The association between food deserts and dental care utilization was assessed using covariate-adjusted multiple logistic regression. RESULTS Living in a food desert was associated with higher odds of not utilizing dental care in the past year. This association was concentrated among high-poverty areas (≥20% poverty rate). CONCLUSIONS The current study is the first to assess the relationship between living in a food desert and dental care utilization. The findings demonstrate that individuals living in low-income urban food deserts may be at increased risk for not utilizing dental care.
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Affiliation(s)
- Alexander Testa
- School of Public Health, Department of Management, Policy and Community Health, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Rahma Mungia
- School of Dentistry, Department of Periodontics, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Alexandra van den Berg
- School of Public Health, Department of Health Promotion & Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Daphne C Hernandez
- Cizik School of Nursing, Department of Research, University of Texas Health Science Center at Houston, Houston, Texas, USA
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Gozum IEA, Garcia AE, Nucum JLAM. Laudato si and the Role of the Church in Promoting Environmental Awareness Toward a Better Health-Related Quality of Life. JOURNAL OF RELIGION AND HEALTH 2023; 62:2532-2546. [PMID: 35953602 DOI: 10.1007/s10943-022-01631-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/01/2022] [Indexed: 06/15/2023]
Abstract
This paper looks at the efforts of the Catholic Church in promoting a healthy environment and how educating citizens with responsible stewardship helps to achieve a better health-related quality of life (HRQoL). In this study, the researchers use See-Discern-Act as their method. First, we discuss the need for environmental awareness and protection. Second, we expound on the main points of Pope Francis' encyclical Laudato si, the Church document which focuses on the environment. Third, the paper looks into the Church's role in promoting environmental awareness and protection so that the Church can help in the goal to achieve a better HRQoL. Lastly, the researchers claim that the Church's effort to preserve the environment aligns with promoting a better HRQoL through the concept of a preferential option for the poor.
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Affiliation(s)
- Ivan Efreaim A Gozum
- Center for Christian Formation and Praxis, Angeles University Foundation, 2009, Angeles City, Pampanga, Philippines.
| | - Abelardo E Garcia
- Center for Christian Formation and Praxis, Angeles University Foundation, 2009, Angeles City, Pampanga, Philippines
| | - John Lu Allan M Nucum
- College of Social Science and Philosophy, Don Honorio Ventura State University, 2001, Bacolor, Pampanga, Philippines
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Kodali HP, Ferris EB, Wyka K, Evenson KR, Dorn JM, Thorpe LE, Huang TTK. The association of park use and park perception with quality of life using structural equation modeling. Front Public Health 2023; 11:1038288. [PMID: 36761118 PMCID: PMC9907326 DOI: 10.3389/fpubh.2023.1038288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 01/05/2023] [Indexed: 01/26/2023] Open
Abstract
Introduction The literature is limited on the impact of neighborhood parks on quality of life (QoL) and the mechanism linking them. Methods In this paper, we applied the structural equation model to data from a cross-sectional sample of 650 participants in low-income communities of New York City, we examined the associations of neighborhood park use vs. park perception and QoL, and whether these associations were mediated through self-reported perceived stress. We also examined whether park use mediated the relationship between park perception and QoL. Results We found that park use had a significant but weak association with QoL (standardized β = 0.08, 95% confidence interval (CI): 0.02, 0.15, p = 0.02), but this relationship was not mediated by self-reported stress. Park perception was more strongly associated with QoL than park use (standardized β = 0.23, 95% CI: 0.16, 0.30, p < 0.01), and this was partly mediated by self-reported stress (indirect effect- standardized β = 0.08, 95% CI: 0.03, 0.13, p < 0.01) and, to a lesser extent, by park use (indirect effect- standardized β = 0.01, 95% CI: 0.00, 0.02, p = 0.01). Discussion Having well-perceived parks appears to be an important factor for QoL independent of park use, suggesting that quality parks may benefit everyone in a community beyond park users. This strengthens the argument in favor of increasing park investment as a strategy to improve population wellbeing.
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Affiliation(s)
- Hanish P. Kodali
- Center for Systems and Community Design, Graduate School of Public Health & Health Policy, City University of New York, New York, NY, United States
| | - Emily B. Ferris
- Center for Systems and Community Design, Graduate School of Public Health & Health Policy, City University of New York, New York, NY, United States
| | - Katarzyna Wyka
- Center for Systems and Community Design, Graduate School of Public Health & Health Policy, City University of New York, New York, NY, United States
| | - Kelly R. Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, NC, United States
| | - Joan M. Dorn
- Department of Community Health and Social Medicine, City University of New York School of Medicine, New York, NY, United States
| | - Lorna E. Thorpe
- Department of Population Health, School of Medicine, New York University, New York, NY, United States
| | - Terry T.-K. Huang
- Center for Systems and Community Design, Graduate School of Public Health & Health Policy, City University of New York, New York, NY, United States
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Boudier A, Markevych I, Jacquemin B, Abramson MJ, Accordini S, Forsberg B, Fuertes E, Garcia-Aymerich J, Heinrich J, Johannessen A, Leynaert B, Pin I, Siroux V. Long-term air pollution exposure, greenspace and health-related quality of life in the ECRHS study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 849:157693. [PMID: 35907524 DOI: 10.1016/j.scitotenv.2022.157693] [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: 04/19/2022] [Revised: 07/11/2022] [Accepted: 07/25/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Associations of long-term exposure to air pollution and greenspace with health-related quality of life (HRQOL) are poorly studied and few studies have accounted for asthma-rhinitis status. OBJECTIVE To assess the associations of air pollution and greenspace with HRQOL and whether asthma and/or rhinitis modify these associations. METHODS The study was based on the participants in the second (2000-2002, n = 6542) and third (2011-2013, n = 3686) waves of the European Community Respiratory Health Survey (ECRHS) including 19 centres. The mean follow-up time was 11.3 years. HRQOL was assessed by the SF-36 Physical and Mental Component Summary scores (PCS and MCS). NO2, PM2.5 and PM10 annual concentrations were estimated at the residential address from existing land-use regression models. Greenspace around the residential address was estimated by the (i) mean of the Normalized Difference Vegetation Index (NDVI) and by the (ii) presence of green spaces within a 300 m buffer. Associations of each exposure variable with PCS and MCS were assessed by mixed linear regression models, accounting for the multicentre design and repeated data, and adjusting for potential confounders. Analyses were stratified by asthma-rhinitis status. RESULTS The mean (SD) age of the ECRHS-II and III participants was 43 (7.1) and 54 (7.2) years, respectively, and 48 % were men. Higher NO2, PM2.5 and PM10 concentrations were associated with lower MCS (regression coefficients [95%CI] for one unit increase in the inter-quartile range of exposures were -0.69 [-1.23; -0.15], -1.79 [-2.88; -0.70], -1.80 [-2.98; -0.62] respectively). Higher NDVI and presence of forests were associated with higher MCS. No consistent associations were observed for PCS. Similar association patterns were observed regardless of asthma-rhinitis status. CONCLUSION European adults who resided at places with higher air pollution and lower greenspace were more likely to have lower mental component of HRQOL. Asthma or rhinitis status did not modify these associations.
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Affiliation(s)
- Anne Boudier
- Team of Environmental Epidemiology Applied to the Development and Respiratory Health, Institute for Advanced Biosciences, Inserm U 1209, CNRS UMR 5309, Université Grenoble Alpes, 38000 Grenoble, France; Pediatrics, CHU Grenoble-Alpes, Grenoble, France
| | - Iana Markevych
- Institute of Psychology, Jagiellonian University, Krakow, Poland
| | - Bénédicte Jacquemin
- Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail), UMR_S 1085, F-35000 Rennes, France
| | - Michael J Abramson
- School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Simone Accordini
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Bertil Forsberg
- Department of Public Health and Clinical Medicine, Umea University, Umea, Sweden
| | - Elaine Fuertes
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Judith Garcia-Aymerich
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Joachim Heinrich
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Comprehensive Pneumology Center Munich (CPC-M), German Center for Lung Research (DZL), Germany
| | - Ane Johannessen
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | | | - Isabelle Pin
- Pediatrics, CHU Grenoble-Alpes, Grenoble, France
| | - Valérie Siroux
- Team of Environmental Epidemiology Applied to the Development and Respiratory Health, Institute for Advanced Biosciences, Inserm U 1209, CNRS UMR 5309, Université Grenoble Alpes, 38000 Grenoble, France.
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Chen S, Wang T, Bao Z, Lou V. A Path Analysis of the Effect of Neighborhood Built Environment on Public Health of Older Adults: A Hong Kong Study. Front Public Health 2022; 10:861836. [PMID: 35359794 PMCID: PMC8964032 DOI: 10.3389/fpubh.2022.861836] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 02/16/2022] [Indexed: 11/15/2022] Open
Abstract
Introduction Health deterioration among frail older adults is a public health concern. Among the multi-dimensional factors, the neighborhood built environment is crucial for one's health. Although the relationship between the built environment and health in the general population has been thoroughly investigated, it has been ignored in the case of frail older adults, who may have difficulties in their daily basic living skills. A path analysis is constructed to model the proposed theoretical framework involving the neighborhood built environment and health among frail older adults. This study thus aims to investigate the environmental influences on health, and to validate the theoretical framework proposed for health and social services. Methods This study used secondary data collected in Hong Kong. A sample of 969 older community dwellers aged 60 or above were frail with at least one activity of daily living. Demographic information, neighborhood built environment data, service utilization, and health conditions were collected from these participants and their caregivers. A path analysis was performed to examine the proposed theoretical framework. Results The health condition was of general concern, including frailty and incapacities in daily activities in frail older adults. Besides psychosocial factors, service use, and caregivers' care quality, the built environment had a significant impact on the health of older adults as well. Specifically, more facilities offering services and groceries, a shorter distance to the nearest metro station, and more greenery exposure are associated with a better-expected health condition among frail older adults. Discussion The proposed theoretical framework successfully supplements past negligence on the relationship between the built environment and the health of frail older adults. The findings further imply that policymakers should promote the usability of transit and greenery in neighborhoods and communities. In addition, service utilization should be improved to meet the basic needs of frail older adults in the communities.
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Affiliation(s)
- Shuangzhou Chen
- Department of Social Work and Social Administration, Faculty of Social Sciences, The University of Hong Kong, Hong Kong, China.,Sau Po Center on Ageing, The University of Hong Kong, Hong Kong, China
| | - Ting Wang
- Division of Landscape Architecture, Department of Architecture, The University of Hong Kong, Hong Kong, China
| | - Zhikang Bao
- Department of Real Estate and Construction, Faculty of Architecture, The University of Hong Kong, Hong Kong, China
| | - Vivian Lou
- Department of Social Work and Social Administration, Faculty of Social Sciences, The University of Hong Kong, Hong Kong, China.,Sau Po Center on Ageing, The University of Hong Kong, Hong Kong, China
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