Could severe mobility and park use restrictions during the COVID-19 pandemic aggravate health inequalities? Insights and challenges from Latin America

Contesting views on mobility restrictions in urban green spaces amid COVID-19-Insights from Twitter in Latin America and Spain

Positive sentiments towards urban green spaces (UGS) unequivocally increased worldwide amid COVID-19. In contrast, this paper documents that views on mobility restrictions applicable to UGS are of a contested nature. That is, while residents unambiguously report positive sentiments towards UGS, they do not share views on how to administer access to UGS-which is a matter of public policy. These contesting views reflect opposite demands that managers of UGS had to balance during the pandemic as they faced the challenge of reducing risk of spread while providing services that support physical and mental health of residents. The empirical analysis in this paper relies on views inferred through a text classification algorithm implemented on Twitter messages posted from January to October 2020, by urban residents in three Latin American countries-Argentina, Colombia, and Mexico-and Spain. The focus on Latin America is motivated by the documented lack of compliance with mobility restrictions; Spain works as a comparison point to learn differences with respect to other regions. Understanding and following in real-time the evolution of contesting views amid a pandemic is useful for managers and city planners to inform adaptation measures-e.g. communication strategies can be tailored to residents with specific views.

School environments and obesity: a systematic review of interventions and policies among school-age students in Latin America and the Caribbean

BACKGROUND

The rapid rise in obesity rates among school children in Latin America and the Caribbean (LAC) could have a direct impact on the region's physical and mental health, disability, and mortality. This review presents the available interventions likely to reduce, mitigate and/or prevent obesity among school children in LAC by modifying the food and built environments within and around schools.

METHODS

Two independent reviewers searched five databases: MEDLINE, Web of Science, Cochrane Library, Scopus and Latin American and Caribbean Health Sciences Literature for peer-reviewed literature published from 1 January 2000 to September 2021; searching and screening prospective studies published in English, Spanish and Portuguese. This was followed by data extraction and quality assessment using the Cochrane risk-of-bias tool (RoB 2) and the Risk of Bias in Non-Randomized Studies of Interventions (ROBINS-I), adopting also the PRISMA 2020 guidelines. Due to the heterogeneity of the intervention's characteristics and obesity-related measurements across studies, a narrative synthesis was conducted.

RESULTS

A total of 1342 research papers were screened, and 9 studies were included; 4 in Mexico, and 1 each in Argentina, Brazil, Chile, Colombia, and Ecuador. Four studies reported strategies for modifying food provision; four other targeted the built environment, (modifying school premises and providing materials for physical activity); a final study included both food and built environment intervention components. Overall, two studies reported that the intervention was significantly associated with a lower increase over time in BMI/obesity in the intervention against the control group. The remaining studies were non-significant.

CONCLUSIONS

Data suggest that school environmental interventions, complementing nutritional and physical education can contribute to reduce incremental childhood obesity trends. However, evidence of the extent to which food and built environment components factor into obesogenic environments, within and around school grounds is inconclusive. Insufficient data hindered any urban/rural comparisons. Further school environmental intervention studies to inform policies for preventing/reducing childhood obesity in LAC are needed.

Preliminary quantitative assessment of the multidimensional impact of the COVID-19 pandemic on Sustainable Development Goals

The intersectoral impacts of the COVID-19 pandemic on humanity raises concerns about its implications for sustainable development. Here, we examine a global quantitative impact of COVID-19 pandemic on Sustainable Development Goals (SDGs) across all 17 goals using 65 proxy indicators across 72 countries collected from April 2020 to February 2021. Our data-driven analysis indicated that adverse impacts of the pandemic have been particularly concerned on gender equality (Goal 5), affordable and clean energy (Goal 7), decent work and economic growth (Goal 8), sustainable cities and communities (Goal 11), and responsible consumption and production (Goal 12) with global scores estimated to be -0.38, -0.21, -0.28, -0.22 and -0.16, respectively. Country income level was a variable that strongly differentiates the responses to the pandemic (e.g., lower incomes had 14 negative goals compared to 11 and 4 negative goals assigned to middle- and high-income countries, respectively). However, Goals 5 and 8 were highly impacted worldwide regardless of income status. Furthermore, countries that had already higher performance in SDGs were less impacted by the pandemic, highlighting the importance of progress on the SDGs in increasing societal resilience to pandemics. The findings provide insights into the reinforcement of recovery policies (e.g., protecting vulnerable groups and transitioning to a green economy) and a basis for a quantitative discussion on the sectors to be prioritized.

Association between Sleep Quality and Physical Activity in Physical Education Students in Chile in the Pandemic Context: A Cross-Sectional Study

Background: Due to the health restrictions put in place to face the pandemic, a decrease in the levels of physical activity and an alteration in the quality of sleep have been observed. One group susceptible to these changes is represented by students of physical education pedagogy, who, under normal conditions, present high levels of physical activity. However, the correlation between these variables has not been studied in the context of a pandemic lockdown. Objective: The aim of this study was to determine the prevalence of the quality of sleep and physical activity level as a function of gender and evaluate the association between quality of sleep and physical activity level in physical education pedagogy students during the COVID-19 pandemic considering sociodemographic and health characteristics. Methods: This was a cross-sectional study. An online questionnaire was applied to 280 Chilean university students of physical education pedagogy. The survey considered sociodemographic information, healthy habits, and self-reported health and included the International Physical Activity Questionnaire (IPAQ) for physical activity levels and the Pittsburgh Sleep Quality Index (PSQI) for sleep quality. Results: The prevalence of good sleep quality was 20.4%. Furthermore, 52.9% of students had a high level of physical activity. Regression analysis between PSQI global score and age-adjusted physical activity levels indicated that being male and presenting a high level of physical activity favored a better PSQI global score. Conclusions: The prevalence of good sleep quality was low in general and significantly lower in women. Being male and having a high level of physical activity during quarantine benefits good sleep quality, regardless of age.

Sociodemographic Differences in COVID-19 Self-Reported Symptoms by Ethnicity and Older Adults in Bolivia

The effects of COVID-19 revealed the fragility of health systems in the LAC region, with greater risk of death in older people than in younger people, as well as greater vulnerability to infection due to living with people aged 30–59 years, who have a higher prevalence of COVID-19. On the other hand, there is not much information on inequalities in the incidence of COVID-19 in indigenous people, a population with lower immunological resistance. The objectives are: 1) To determine the association between sociodemographic variables with self-reported COVID-19 symptoms. 2) To investigate whether this relationship shows inequalities by ethnicity and age. For that purpose I conducted a cross-sectional analysis using the 2020 Household Survey and investigated the association between sociodemographic variables and self -reported COVID-19 symptoms and explore the contribution of factors such as employment type, household living arrangements, years of education, age, ethnicity, gender, current status of working and residence area. I performed bivariate analysis to establish trends. Subsequently using logistic regressions to establish the risks to self-reported COVID-19 symptoms. A fully interacted model is analysed by ethnicity. I found those who were living alone were less likely than those living in a Couple with/without relatives’ household arrangement to self-reported COVID-19 symptoms (OR = 0.79, 95% CI: 0.66–0.94, p < .01). Odds of the older persons aged 45–59 (OR = 1.44, 95% CI: 1.27–1.62, p < .05) were relatively more likely than younger people (OR = 1.19, 95% CI: 1.05–1.35, p < .01). Indigenous living in a couple with/without children household arrangement were less likely than non-Indigenous (OR = 0.75, 95% CI: 0.62–0.90, p < .01). Odds of Indigenous people of age 30–44 (OR = 1.26, 95% CI: 1.04–1.53, p < .01) were more likely than non-Indigenous. Odds of Indigenous persons of age 45–59 (OR = 1.59, 95% CI: 1.32–1.91, p < .05) were more likely than non-Indigenous (OR = 1.32, 95% CI: 1.12–1.55, p < .01). As conclusions, 45–59 age group shows higher risk factors and those aged 60 + show lower risks. These are increased in people working in managerial, administrative and professional, and technical positions, those living in a household with/without relatives, men, those living in urban areas, and/or non-indigenous people.

Adaptive governance of urban green spaces across Latin America - Insights amid COVID-19

Urban green spaces' well documented role as a hub for physical and mental health was enhanced by restrictions to mobility issued worldwide as a response to COVID-19. In this context, managers of urban green spaces (UGS) were prompted to provide controlled access under impromptu safety protocols. This unprecedented challenge required planning and operational strengths reflecting flexibility, innovation and learning. These management features are essential for an adaptive governance - an underdeveloped research topic within the study of UGS. Using eighteen semi-structured interviews from six countries, we analyze adaptive governance as reflected by UGS managers' responses across Latin America - a region where access to UGS is a matter of public health and of environmental justice. We document responses that can be categorized based on the governance arrangement in place. On one hand, both polycentric and dedicated-management governances have been able to learn through piloting ideas, adapting personnel roles and the function of UGS infrastructure, and adjusting their decision-making process. On the other hand, managers within municipal public services areas - the most prevalent governance arrangement across Latin America - report difficulty to adapt - likely due to their dependence on political will, limited autonomy, insufficient budgets, absence of formal paths to self-funding, shortage of technical know-how, and insufficient citizens' involvement. We discuss implications of UGS adaptive governance in terms of capacity to deal with future public health, climate-related or other types of shocks.

Perceived accessibility and mental health consequences of COVID-19 containment policies

BACKGROUND

Individuals have experienced various degrees of accessibility loss during the COVID-19 pandemic, which may consequently have influenced their mental health. Although efforts have been made to understand the mental health consequences of the pandemic and corresponding containment measures, the impacts of accessibility loss remain underexplored.

METHODS

Based on 186 family interviews, a 569-respondent panel survey was designed and distributed monthly from February to October 2020 in Kunming, China. A 3-wave cross-lagged panel model was developed to understand the causal relationship between mental health and perceived accessibility of daily necessities, key services, and social activities.

RESULTS

Goodness-of-fit indicators imply that the hypothesised model fits the observed data well: χ2/df = 2.221, AGFI = 0.910, NFI = 0.907, CFI = 0.933, RMSEA = 0.052. The results indicate that perceived accessibility of daily necessities and social activities had lagged effects on mental health status. The within-wave effects show that perceived accessibility of daily necessities (0.619, p < 0.01) and social activities (0.545, p < 0.01) significantly influenced respondents' mental health during the peak of the pandemic whilst perceived accessibility of social activities dominantly influenced their mental health after restrictions were lifted (0.779, p < 0.01). Perceived accessibility of public services such as healthcare did not significantly influence respondents' mental health in any wave. COVID-19 containment policies had different mental outcomes across population groups. Disadvantaged people experienced mental health issues due to accessibility loss for daily necessities and social activities until the lifting of compulsory QR-code-for-buses, whilst better-off populations had better mental health during the early phase of the outbreak and rapidly recovered their mental health after mobility restrictions eased.

CONCLUSION

Reduced perceived accessibility of daily necessities and social activities may be an underlying cause of mental health problems. Relative accessibility deprivation exacerbated mental health inequities during the COVID-19 pandemic.

Redrawing Cities with Children and Adolescents: Development of a Framework and Opportunity Index for Wellbeing-The REDibuja Study Protocol

Global changes require urgent integration of health and wellbeing into all urban policies. Complex social and environmental factors define wellbeing outcomes and inequities present in cities. Additionally, political decisions are seldom thought and developed considering the needs and participation of children and adolescents. The REDibuja study aims to develop a multidimensional framework of wellbeing for children and adolescents and to validate an index of opportunities for better wellbeing for children and adolescents in the urban context of Temuco, Chile. This child-centered and cross-sectional study will involve mixed methodologies throughout the implementation of five work packages for two years (2022–2023): (1) development of a conceptual framework for child and adolescent wellbeing, (2) integration of available and public data, (3) studies in the local context, (4) data integration using geographic information systems, and (5) validation of the wellbeing opportunity index for children and adolescents. REDibuja will implement methodologies that until now are little used to facilitate political decisions in our regional context. This process and results could be transferred for assessment and decision-making in Latin America and low- and middle-income countries in other regions.

Using Social Media Data to Evaluate Urban Parks Use during the COVID-19 Pandemic

In the context of increasing urbanization and associated economic, social and environmental challenges, cities have increasingly acknowledged the importance of urban parks in delivering social, economic and environmental benefits to the population. The importance has been demonstrated also during the COVID-19 pandemic that generated lockdowns and reduced the capacity of urban inhabitants in accessing such benefits. The present study aims to determine how the presence in urban parks was reflected on social media during the pandemic period of 2020. We examined Instagram posts associated with a sample of eight urban parks in Bucharest, Romania and also the entire history of Google reviews between January and August 2020. The selection of parks was made according to their size, location in Bucharest, previous reported number of visitors and profile of attractiveness. Results revealed that the peak period of the COVID-19 pandemic and the first initiation of the lockdowns strongly affected the recreation and leisure activities that people performed almost daily in the parks of Bucharest. Reviews and comments of the population were not that focused on the pandemic even after the restrictions were lifted, but they evidenced the positive and negative aspects of each park. Our results can represent a useful instrument for local administrations in determining both the flow of visitors but also their perceptions towards the endowments, landscape and most important management of urban parks.

Associations Between Movement Behaviors and Emotional Changes in Toddlers and Preschoolers During Early Stages of the COVID-19 Pandemic in Chile

Background: There is limited evidence about emotional and behavioral responses in toddlers and preschoolers during the novel coronavirus (COVID-19) pandemic, particularly in Latin America. Objective: To assess associations between changes in movement behaviors (physical activity, screen time and sleeping) and emotional changes in toddlers and preschoolers during early stages of the pandemic in Chile. Methods: A cross-sectional study conducted from March 30th to April 27th, 2020. Main caregivers of 1- to 5-year-old children living in Chile answered an online survey that included questions about sociodemographic characteristics, changes in the child's emotions and behaviors, movement behaviors and caregivers' stress during the pandemic. Multiple linear regressions were used to assess the association between different factors and emotional changes in toddlers and preschoolers. Results: In total, 1727 caregivers provided complete data on emotional changes for children aged 2.9 ± 1.36 years old, 47.9% girls. A large proportion of toddlers and preschoolers in Chile experienced emotional and behavioral changes. Most caregivers reported that children "were more affectionate" (78.9%), "more restless" (65.1%), and 'more frustrated' (54.1%) compared with pre-pandemic times. Apart from changes in movement behaviors, factors such as child age, caregivers' age and stress, and residential area (urban/rural) were consistently associated with changes in emotions and behaviors. Conclusion: The pandemic substantially affected the emotions and behaviors of toddlers and preschoolers in Chile. The findings suggest that supportive actions for caregivers may have a positive impact not only on adults but also on children. Mental health promotion programs should consider multilevel approaches in which the promotion of movement behaviors and support for caregivers should be essential pieces for future responses.

Sociodemographic Predictors of Changes in Physical Activity, Screen Time, and Sleep among Toddlers and Preschoolers in Chile during the COVID-19 Pandemic

The aim was to examine the sociodemographic predictors associated with changes in movement behaviors (physical activity, screen time, and sleep) among toddlers and preschoolers during the early stages of the coronavirus disease 2019 pandemic in Chile. Caregivers of 1- to 5-year-old children completed an online survey between 30 March and 27 April 2020. Information about the child's movement behaviors before (retrospectively) and during the pandemic, as well as family characteristics were reported. In total, 3157 participants provided complete data (mean children age: 3.1 ± 1.38 years). During early stages of the pandemic, time spent in physical activity decreased, recreational screen time and sleep duration increased, and sleep quality declined. Toddlers and preschoolers with space to play at home and living in rural areas experienced an attenuated impact of the pandemic restrictions on their physical activity levels, screen time, and sleep quality. Older children, those whose caregivers were aged ≥35-<45 years and had a higher educational level, and those living in apartments had greater changes, mainly a decrease in total physical activity and increase in screen time. This study has shown the significant impact of the pandemic restrictions on movement behaviors in toddlers and preschoolers in Chile.