Quality of Public Open Spaces and Recreational Walking

A systematic review on the associations between the built environment and adult's physical activity in global tropical and subtropical climate regions

BACKGROUND

Physical inactivity is a major public health concern, exacerbated in countries with a (sub)tropical climate. The built environment can facilitate physical activity; however, current evidence is mainly from North American and European countries with activity-friendly climate conditions. This study explored associations between built environment features and physical activity in global tropical or subtropical dry or desert climate regions.

METHODS

A systematic review of four major databases (Web of Science, Scopus, PubMed, and SportDISCUS) was performed. To be included, studies had to investigate associations between perceived or objective built environment characteristics and adult's physical activity and had to be conducted in a location with (sub)tropical climate. Each investigated association was reported as one case and results were synthesized based upon perceived and objectively assessed environment characteristics as well as Western and non-Western countries. Study quality was evaluated using a tool designed for assessing studies on built environment and physical activity.

RESULTS

Eighty-four articles from 50 studies in 13 countries with a total of 2546 built environment-physical activity associations were included. Design (connectivity, walking/cycling infrastructure), desirability (aesthetics, safety), and destination accessibility were the built environment characteristics most frequently associated with physical activity across the domains active transport, recreational physical activity, total walking and cycling, and moderate-to-vigorous physical activity, particularly if multiple attributes were present at the same time. Very few studies assessed built environment attributes specifically relevant to physical activity in (sub)tropical climates. Most studies were conducted in Western countries, with results being largely comparable with non-Western countries. Findings were largely generalizable across gender and age groups. Results from natural experiments indicated that relocating to an activity-friendly neighborhood impacted sub-groups differently.

CONCLUSIONS

Built environment attributes, including destination accessibility, connectivity, walking and cycling infrastructure, safety, and aesthetics, are positively associated with physical activity in locations with (sub)tropical climate. However, few studies focus on built environment attributes specifically relevant in a hot climate, such as shade or indoor recreation options. Further, there is limited evidence from non-Western countries, where most of the urban population lives in (sub)tropical climates. Policy makers should focus on implementing activity-friendly environment attributes to create sustainable and climate-resilient cities.

Public Open Spaces and Leisure-Time Walking: A Longitudinal Study With Brazilian People in the COVID-19 Pandemic

AIM

To examine whether changes in public open spaces (POS) were associated with leisure-time walking (LTW) between 2014 and 2021.

METHODS

The sample comprised a prospective cohort of individuals living in São Paulo City, Brazil. The baseline sample was collected in 2014/2015 (4042 people aged 12 y or older) and the second wave in 2020/2021 (1431 people aged 18 y or older, 35.4% of total). Changes in POS scores in 500-m network buffers were based on household address, including positive or negative maintenance and increases or decreases in parks, public squares, and bike paths between 2015 and 2020. The International Physical Activity Questionnaire was used to evaluate LTW in the baseline and second wave. To examine the association of LTW with changes in POS, we used multilevel models in 4 levels: health administration areas, census tracts, individuals, and observations of individuals. The exposure was the POS tertiles, and the outcome was LTW.

RESULTS

Changes in LTW prevalence were observed in both periods and according to POS tertiles distributions. When adjusted for time (baseline/second wave), gender, education, and age, the highest POS tertile was significantly associated with a high likelihood for LTW (odds ratio = 1.44; 95% confidence interval, 1.03-2.02).

CONCLUSION

The results showed that people in São Paulo who lived within 500-m buffers with the highest access to POS were more likely to practice LTW between 2014/2015 and 2020/2021. These results have important implications for policies that were implemented in 2014, including the New Master Plan to contribute to São Paulo's good ranking among healthy cities.

Associations between Neighborhood Disadvantage and Dog Walking among Participants in the Dog Aging Project

Although neighborhood socioeconomic disadvantage is negatively related to overall physical activity, prior studies reveal a complex relationship between disadvantage and particular walking behaviors. While disadvantage is associated with reduced recreational walking through a hypothesized "fear-of-crime" mechanism, the built environment in disadvantaged neighborhoods may encourage utilitarian walking. To date, no study has assessed how disadvantage relates to dog walking, a distinct walking behavior that is neither strictly recreational nor utilitarian but represents a key mechanism through which pet ownership may affect human health. We employ a large (n = 19,732) dataset from the Dog Aging Project to understand how neighborhood disadvantage is associated with dog walking when controlling for individual-, household-, and environmental-level factors. We find that dog owners in more disadvantaged neighborhoods report less on-leash walking activity compared to owners in advantaged neighborhoods and discuss the possibility of a fear-of-crime mechanism underlying this association. These findings improve our understanding of the relationship between neighborhood disadvantage and physical function and highlight the need for public health interventions that encourage dog ownership to consider neighborhood disadvantage.

A Systematic Review of Objective Factors Influencing Behavior in Public Open Spaces

As a significant part of outdoor built-environment, public open spaces are closely associated with people's daily lives. Studies of outdoor behavior in these spaces can shed light on users' environmental perceptions and contribute to the promotion of physiological and psychological health. Many recent studies are case studies focused where observations, surveys and interviews have been conducted to understand the factors influencing people's behavior on one or few sites or city environments. There have been few reviews related to this topic, and none have been based on the systematic understanding of influencing factors. This paper presents a systematic review of interactions between behavior and the built environment in public open spaces, and highlights the impacts of diverse and objective influencing factors. Followed the rules of PRISMA method (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), 109 papers published in 2000-2021 were selected and reviewed. The distribution of the studied interactions is analyzed, and the impacts of four distinct factors: personal background, location and context, environmental component, and climate stimuli, are extracted, categorized, and specified. Moreover, outdoor health benefits are discussed based on which, crucial factors that require emphasis after the outbreak of COVID-19 are identified. Throughout this paper, behavioral influencing processes, including objective influencing factors, subjective feedback, and the relationships involved, are considered to provide a comprehensive picture. With the robust classification of existing factors, architects, urban designers, policy makers and fellow researches could be easier to get a more comprehensive trend from the past. This paper also provides guidance for future research, especially given that COVID-19 has created huge changes to outdoor needs and customary behavior. Systematic Review Registration: http://www.prisma-statement.org/.

Use of an Elevated Avenue for Leisure-Time Physical Activity by Adults from Downtown São Paulo, Brazil

Leisure-time physical activity (LTPA) is associated with access and use of public open spaces. The President João Goulart Elevated Avenue, currently denominated Minhocão, is a facility for leisure activities that is open for people during the night and weekends. The aim of this study was to examine if the prevalence of LTPA among individuals living in the surroundings of Minhocão is different according to proximity to, and use of, the facility. We conducted a cross-sectional study with cluster sampling with people aged ≥18 years who lived in households up to 500 m, and between 501 m and 1500 m of Minhocão. The survey was conducted between December 2017 and March 2019 using an electronic questionnaire. We conducted a bivariate analysis and Poisson regression to examine possible differences in LTPA according to the proximity of residences and use of Minhocão. The analysis used post-stratification weights. A total of 12,030 telephone numbers of people were drawn (≤500 m = 6942; and >500 m to ≤1500 m = 5088). The final sample included 235 residents who returned the questionnaires. There was a higher prevalence of individuals engaging in at least 150 min per week of LTPA among users than non-users (Prevalence Ratio = 2.19, IC95% 1.66 to 2.90), independently of sex, age, education, the distance of houses to nearest accesses and number of barriers. The main five barriers related to the usage of the Minhocão were safety issues in and around the Minhocão, rainy weather, lack of vegetation, and lack of facilities. People who used the park had higher prevalence of all types of LTPA than non-users. The results can serve to inform government decision-making on the future of Minhocão.

Barriers Affecting Women’s Access to Urban Green Spaces during the COVID-19 Pandemic

During the COVID-19 pandemic, urban green spaces (UGS) have gained relevance as a resilience tool that can sustain or increase well-being and public health in cities. However, several cities in Latin America have seen a decrease in their UGS use rates during the health emergency, particularly among vulnerable groups such as women. Using Mexico City as a case study, this research examines the main barriers affecting women’s access to UGS during the COVID-19 pandemic in Latin America. We applied a sequential mixed-methods approach in which the results of a survey distributed via social media in June 2020 to women aged 18 and older were used to develop semi-structured interviews with 12 women during October 2020. One year later, in November 2021, the continuity of the themes was evaluated through focus groups with the same group of women who participated in the interviews. Our results suggest that (1) prohibiting access to some UGS during the first months of the pandemic negatively impacted UGS access for women in marginalized neighborhoods; (2) for women, the concept of UGS quality and safety are intertwined, including the security level of the surrounding streets; and (3) women who live in socially cohesive neighborhoods indicated using UGS to a greater extent. Our findings highlight that while design interventions can affect women’s willingness to use UGS by improving their perceived safety and comfort, they remain insufficient to fully achieve equity in access to UGS.

Investigating the Association between Environmental Quality Characteristics and Mental Well-Being in Public Open Spaces

The issues related to the urban environment and mental well-being have become increasingly important in recent decades. Although this association has been mainly investigated in developed countries, there is limited knowledge on whether similar results can be acquired in the urban environments of developing countries like Iran. This study intends to present a new dynamic and active approach to determine the environmental quality characteristics that influence the mental well-being of urban residents and to engage people to healthy urban public environments. In this respect, the research is directed by both qualitative and quantitative surveys in the public open spaces of Kermanshah, Iran. Firstly, the data are collected by Grounded Theory (GT) to identify significant environmental quality characteristics related to mental well-being by applying 24 semi-structured interviews. Secondly, the questionnaire survey based on Structural Equation Modeling (SEM) is applied to examine the association between each characteristic of the developed conceptual framework. The results reveal that the environmental quality characteristics of public open spaces, directly and indirectly, relate to users’ mental well-being. It should be noted that the public open spaces with unique functional and intrinsic features seem to have different impacts on mental well-being.

Physical, mental, and physiological health benefits of green and blue outdoor spaces among elderly people

This study investigated the influence of designed natural outdoor spaces and space type on the physical, mental, and physiological health status of elderlies. A total of 978 questionnaires were distributed among a population-based randomized sample of elderlies residing in Bandar Abbas city, Iran. Blue space users reported better health status. Park access was associated with physical and physiological health. Those participants who had cardiovascular diseases were more likely to visit the parks more often, while the people with hypertension visited the parks less often. Length of park stay positively was associated with all aspects of health status. In addition, the level of physical activity positively was associated with physical and mental health. The park organizations should work on establishing parks in shorter distances and consider the opportunity for elderlies to participate in social programs to encourage them to frequently visit the parks and increase their length of park stay.

Evaluating the association between urban green spaces and subjective well-being in Mexico city during the COVID-19 pandemic

This paper examines the association between the frequency of use of urban green spaces (UGS) and the subjective well-being (SWB) of Mexico City's residents during the COVID-19 pandemic. We conducted an online survey (N = 1954) regarding individuals' perceptions and use of UGS and their SWB, evaluated through the short version of the Warwick-Edinburgh mental well-being scale. Multilevel mixed-effects regression analyses were performed to investigate the association between the frequency of UGS use and SWB, including individual and municipal level characteristics as covariates. Our results suggest that respondents who used UGS once or more per week during the pandemic reported higher SWB scores (8.7%) than those with zero visits. These findings have public policy implications that could enhance the role of UGS in urban environments during times of crisis.

Performance Assessment Indicators for Comparing Recreational Services of Urban Parks

Parks can offer varied services to human well-being, including recreational services (RS); however, there is insufficient understanding of park differences concerning the actual performance of their varied RS. To fill this gap, this study aimed to develop a set of performance indicators as a tool for comparing the functional efficacy of RS among different parks. The indicators covered three aspects of RS: recreational usage of various physical activities, their recreational satisfaction level and the collective performance rating. These indicators were applied in a case study of four parks in Guangzhou, China, based upon on-site observation and a questionnaire survey. The functional difference of these indicators was compared and the collective indicator was found to be able to effectively capture different efficacies of urban parks in supporting varied RS. Results show all the parks were far from reaching the maximum performance of designed RS, so it is worthy of consideration by urban managers to further improve their RS efficacy. In addition, the overall spatial design and configuration were inferred to be essential for improving the RS efficacy of urban parks, but not park size nor ornamental vegetation. The findings offered valuable evidence for the optimal spatial design and management of urban parks.

Change in walking steps and association with built environments during the COVID-19 state of emergency: A longitudinal comparison with the first half of 2019 in Yokohama, Japan

In Japan, a state of emergency (SoE) was declared in early April 2020 until late May in response to the first wave of the coronavirus disease (COVID-19). This longitudinal study analyzed the step counts of 18,817 citizens in Yokohama city in the first half of 2020 compared to the previous year, and investigated the association between the change in step counts and the individuals' neighborhood environment by sex and age using generalized linear mixed models. Step counts decreased especially in women and non-elderly people during the SoE. Older women were more susceptible to the neighborhood environment: high walkability (i.e., high population density, proximity to railway stations) adversely affected their step counts, whereas proximity to large parks came to have a positive effect during the SoE.

Are park availability and satisfaction with neighbourhood parks associated with physical activity and time spent outdoors?

BACKGROUND

There is substantial scope for enhancing population health through increased park visits and active use of parks; however, a better understanding of factors that influence park visitation is needed. This cross-sectional study examined how parent-reported satisfaction and perceived availability of parks were associated with adults' physical activity and children's physical activity and time spent outdoors, and whether these associations were mediated by park visitation.

METHODS

Self-reported surveys were completed by adults living within 5 km of two parks located in Melbourne, Australia. Participants reported their satisfaction with neighbourhood park quality, walking duration from home to the nearest park, and park visitation in the past 7 days. Participants with a child aged 2-15 years also answered similar questions in relation to their child. The primary outcome variable for adults was leisure-time physical activity (LTPA) and for children was proxy-reported time spent outside. The secondary outcome for adults was combined transportation and LTPA and for children (5-15 years) was the number of days physical activity recommendations were met in the past 7 days.

RESULTS

Significant positive associations between park availability and park visitation in the past 7 days, and between park visitation and the outcome variables were observed among both adults (n = 1085, M_age = 48.9, SD 13.4) and children (n = 753, M_age = 8.8, SD = 3.7). The association between park satisfaction and park visitation was only significant among adults. Park visitation mediated associations between park availability and park satisfaction and the outcome variables among both adults and children.

CONCLUSIONS

Improving park availability and users' satisfaction with parks may increase visitation and consequently increase physical activity and time spent outdoors.

Workplace neighbourhood built environment and workers' physically-active and sedentary behaviour: a systematic review of observational studies

Background

Many desk-based workers can spend more than half of their working hours sitting, with low levels of physical activity. Workplace neighbourhood built environment may influence workers’ physical activities and sedentary behaviours on workdays. We reviewed and synthesised evidence from observational studies on associations of workplace neighbourhood attributes with domain-specific physical activity and sedentary behaviour and suggested research priorities for improving the quality of future relevant studies.

Methods

Published studies were obtained from nine databases (PubMed, Web of Science, PsycINFO, Scopus, Transport Research International Documentation, MEDLINE, Cochrane, Embase, and CINAHL) and crosschecked by Google Scholar. Observational studies with quantitative analyses estimating associations between workplace neighbourhood built environment attributes and workers’ physical activity or sedentary behaviour were included. Studies were restricted to those published in English language peer-reviewed journals from 2000 to 2019.

Results

A total of 55 studies and 455 instances of estimated associations were included. Most instances of potential associations of workplace neighbourhood built environment attributes with total or domain-specific (occupational, transport, and recreational) physical activity were non-significant. However, destination-related attributes (i.e., longer distances from workplace to home and access to car parking) were positively associated with transport-related sedentary behaviour (i.e., car driving).

Conclusions

The findings reinforce the case for urban design policies on designing mixed-use neighbourhoods where there are opportunities to live closer to workplaces and have access to a higher density of shops, services, and recreational facilities. Studies strengthening correspondence between the neighbourhood built environment attributes and behaviours are needed to identify and clarify potential relationships.

Protocol registration

The protocol of this systematic review was registered on the International Prospective Register of Systematic Reviews (PROSPERO) on 2 December 2019 (registration number: CRD42019137341).

Supplementary Information

The online version contains supplementary material available at 10.1186/s12966-020-01055-x.

The Social Utility and Health Benefits for Older Adults of Amenity Buildings in China's Urban Parks: A Nanjing Case Study

As China's population rapidly ages, research and discussion on how to better optimize public spaces for the elderly's health and benefit continue to deepen. This study uses observational surveys and questionnaires to investigate the elderly visitors of Nanjing's urban parks and explore the impact the parks' amenity buildings (structures built to provide visitors with conveniences, e.g., shelters and pavilions) has on their health and associated socialization tendencies. Data were collected from ten amenity buildings in ten separate parks to compose a total dataset of 728 activity statistics and 270 valid questionnaires. The study's results indicate that amenity buildings significantly increase opportunities for older adults to socialize and thereby can increase this demographic's associated health benefits. The social activities formed around amenity buildings are found to improve social interactions and connectedness among older adults more compared to other age groups. Elderly participation in social activities is also found to positively correlate with environmental characteristics. High-quality landscapes ensure healthy development of social activities within amenity buildings and promote the occurrence and continuation of social interactions. In order of highest to lowest impact on elderly activities, the following factors were identified and scored: amenity building scale, lighting, comprehensive surrounding environment, surrounding amenities, water features, and vegetation. This research also reveals that among existing amenity buildings, there is insufficient support for certain activities and therefore, parks need to be improved to address this deficiency. Overall, this study indicates that under China's current aging trends, amenity buildings have become an especially important infrastructure within urban public space, and their design trend is to incorporate the dual characteristics of "recreation + society".

Walkability and its association with walking/cycling and body mass index among adults in different regions of Germany: a cross-sectional analysis of pooled data from five German cohorts

OBJECTIVES

To examine three walkability measures (points of interest (POI), transit stations and impedance (restrictions to walking) within 640 m of participant's addresses) in different regions in Germany and assess the relationships between walkability, walking/cycling and body mass index (BMI) using generalised additive models.

SETTING

Five different regions and cities of Germany using data from five cohort studies.

PARTICIPANTS

For analysing walking/cycling behaviour, there were 6269 participants of a pooled sample from three cohorts with a mean age of 59.2 years (SD: 14.3) and of them 48.9% were male. For analysing BMI, there were 9441 participants of a pooled sample of five cohorts with a mean age of 62.3 years (SD: 12.8) and of them 48.5% were male.

OUTCOMES

(1) Self-reported walking/cycling (dichotomised into more than 30 min and 30 min and less per day; (2) BMI calculated with anthropological measures from weight and height.

RESULTS

Higher impedance was associated with lower prevalence of walking/cycling more than 30 min/day (prevalence ratio (PR): 0.95; 95% CI 0.93 to 0.97), while higher number of POI and transit stations were associated with higher prevalence (PR 1.03; 95% CI 1.02 to 1.05 for both measures). Higher impedance was associated with higher BMI (ß: 0.15; 95% CI 0.04 to 0.25) and a higher number of POI with lower BMI (ß: -0.14; 95% CI -0.24 to 0.04). No association was found between transit stations and BMI (ß: 0.005, 95% CI -0.11 to 0.12). Stratified by cohort we observed heterogeneous associations between BMI and transit stations and impedance.

CONCLUSION

We found evidence for associations of walking/cycling with walkability measures. Associations for BMI differed across cohorts.

Is a liveable city a healthy city? Health impacts of urban and transport planning in Vienna, Austria

Each year, The Economist Intelligence Unit (EIU) computes the Global Liveability Index and determines the most liveable cities around the world. Vienna, Austria, was ranked by the EIU as the most liveable city worldwide in 2018 and 2019. However, the relationship between a liveable as well as healthy and environmentally-just city has not been previously explored. To explore whether the most liveable city is also a healthy and environmentally-just one, we estimated the premature mortality burden related to non-compliance with international exposure level recommendations for physical activity (PA), air pollution (PM_2.5 and NO₂), road traffic noise, green space and heat for Vienna, as well as its distribution by socioeconomic status (SES). We applied the Urban and TranspOrt Planning Health Impact Assessment (UTOPHIA) methodology and estimated the annual mortality, life expectancy (LE) and economic impact of non-compliance with exposure guidelines for the Viennese adult population ≥ 20 years. We compared current with recommended exposure levels, quantified the association between exposures and mortality and calculated attributable health impact fractions. Eight percent of premature mortality (i.e. 1239 deaths, 95% CI: 679-1784) was estimated to be attributable to non-compliance with the recommended exposure levels. Seventy-six percent of the attributable premature mortality was due to PM_2.5 exposure and insufficient PA. Non-compliance also resulted in an average of 199 days of LE lost for the adult population (95% CI: 111-280) and an economic impact of 4.6 (95% CI: 2.5-6.7) billion 2015€ annually. Overall, residents of lower SES neighbourhoods faced higher risk of premature mortality due to higher exposure to NO₂, road traffic noise, heat and less green space. Despite high liveability standards according to EIU definition, a considerable premature mortality burden was attributable to non-compliance with exposure recommendations, and socioeconomic inequalities were estimated. Although the exposure attributable mortality burden was lower than in other European cities and local Viennese policies favour the reduction of motorized traffic, alongside the promotion of active and public transport and urban greening, there is room for further alignment of liveability, environmental health and justice objectives.

Living liveable? RESIDE's evaluation of the "Liveable Neighborhoods" planning policy on the health supportive behaviors and wellbeing of residents in Perth, Western Australia

BACKGROUND

The RESIDential Environments (RESIDE) project is a unique longitudinal natural experiment designed to evaluate the health impacts of the "Liveable Neighbourhoods" planning policy, which was introduced by the Western Australian government to create more walkable suburbs.

OBJECTIVES

To summarize the RESIDE evidence of the impact of the planning policy on a range of health-supportive behaviours and wellbeing outcomes and to assess the consistency and direction of the estimates of associations.

METHODS

An audit of 26 RESIDE research papers (from 2003 to 2012) identified the number of positive associations (statistically significant and consistent with policy expectations), negative associations (statistically significant and inconsistent with policy expectations), and null findings from multiple-exposure models between objective and perceived measures of 20 policy design requirements and 13 health-supportive behaviors and wellbeing outcomes.

RESULTS

In total 332 eligible estimates of associations (n = 257 objective measures and n = 75 perceived measures) were identified. Positively significant findings were detected for: 57% of walking estimates with objectively measured policy design features (negative = 3%; null = 40%) (n = 115) and 54% perceived measures (negative = 0%; null = 33%) (n = 27); 42% of sense of community estimates with objectively measured of policy design features (negative = 8%; null = 50%) (n = 12) and 61% perceived measures (negative = 8%; null = 31%) (n = 13); 39% of safety or crime-related estimates with objectively measured of policy design features (negative = 22%; null = 39%) (n = 28) and 100% perceived measures (n = 7). All (n = 4) estimates for mental health outcomes with objectively measured policy-related design features were positively significant.

CONCLUSIONS

The synthesis of findings suggests that new suburban communities built in accordance with the "Liveable Neighbourhoods" policy have the potential to encourage health supportive behaviors and wellbeing outcomes including transport and recreation walking, and to create neighborhoods with a stronger sense of community where residents may feel safer.

Positive HABITATS for physical activity: Examining use of parks and its contribution to physical activity levels in mid-to older-aged adults

Studies of parks and physical activity rarely identify the actual spaces participants use. Using data from the HABITAT project, a longitudinal cohort of mid-to older-aged (40-70 years) respondents (n = 11,036) living in Brisbane Australia, this study examined (1) the demographic characteristics of users and non-users of parks; (2) the park used and the characteristics and features of the most popular reported spaces; and (3) the level of physical activity undertaken in the reported parks and whether users had higher total physical activity levels than non-users. Park use was significantly higher (p < 0.01) among dog walkers, couples (over 40) living with children, and those living in least disadvantaged areas. Regular park use was significantly higher among users of larger-sized neighbourhood and district-catchment parks. Park users were 35% more likely to meet the physical activity guidelines (OR = 1.35, 95%CI 1.21-1.50, p < 0.001) compared with those who indicated they did nto regularly use a park. The size of the park used was positively associated with participation in physical activity. Users of larger-sized parks spent more time doing vigorous activity and engaged in more activity sessions than non-users. Future data obtained from large populations, including spatial examination of the actual parks used and their characteristics, are essential to facilitate planning for park provision, optimising the use of these spaces for recreation and physical activity by mid-to older-aged adults, and creating healthy communities.

Contributions of Multiple Built Environment Features to 10-Year Change in Body Mass Index and Waist Circumference in a South Australian Middle-Aged Cohort

Residential areas may shape health, yet few studies are longitudinal or concurrently test relationships between multiple residential features and health. This longitudinal study concurrently assessed the contributions of multiple environmental features to 10-year change in clinically measured body mass index (BMI) and waist circumference (WC). Longitudinal data for adults (18+ years of age, n = 2253) from the north-west of Adelaide, Australia were linked to built environment measures representing the physical activity and food environment (expressed for residence-based 1600 m road-network buffers) and area education. Associations were concurrently estimated using latent growth models. In models including all environmental exposure measures, area education was associated with change in BMI and WC (protective effects). Dwelling density was associated with worsening BMI and WC but also highly correlated with area education and moderately correlated with count of fast food outlets. Public open space (POS) area was associated with worsening WC. Intersection density, land use mix, greenness, and a retail food environment index were not associated with change in BMI or WC. This study found greater dwelling density and POS area exacerbated increases in BMI and WC. Greater area education was protective against worsening body size. Interventions should consider dwelling density and POS, and target areas with low SES.

Observational physical activity in public open spaces: environmental determinants of physical activity intensity levels in Iran

Public open spaces play an important role in promoting physical activity (PA). This study aimed to describe user characteristics of public open spaces (POSs) given the type of location and levels of PA. The study also evaluated the relationship between the environmental determinants of POSs and PA intensity. The study used observational data to measure environmental determinants and obtain information on users and their activity levels in the POSs of Darab in Iran. Out of 13,342 individuals observed, the proportion of men was slightly higher than that of women. More than half of the users observed in the community parks performed vigorous activities. Children and teenagers were found more often than other age groups doing vigorous activities. Most of the observed users performed vigorous activities in the evening and sedentary activities during weekends. Seniors were more sedentary than the other groups. Greater size, and better facilities and aesthetics of POSs increased the odds of being more active. However, a higher number of incivilities was associated with a greater chance of walking and lower odds of performing vigorous activities. As the quality of POSs contributes to PA levels, stakeholders should consider the quality of such spaces to improve retrofitting and designing POSs to maximize activity levels.

[Accessibility to public spaces for leisure and physical activity in adults in Curitiba, Paraná State, Brazil]

The study aimed to analyze the association between accessibility to public spaces for leisure activities, availability of equipment for physical exercise in these spaces, and leisure-time physical activity (PA) in adults. A household survey was conducted with 699 adults from 32 census tracts selected according to income and "walkability". Accessibility to public spaces for leisure activities was determined by geoprocessing according to proximity to public spaces for leisure activities and the amount of such spaces within radiuses of 500 and 1,000 meters around the participants' homes. Presence of equipment for physical exercise in these public spaces was assessed by the observation method and classified as: (a) without equipment for physical exercise; (b) with equipment for physical exercise; (c) equipment for physical exercise for adults; and (d) with three or more pieces of equipment for physical exercise. PA was self-reported, and walking was analyzed separately from moderate-vigorous PA, classified in two levels (≥ 10 minutes/week and ≥ 150 minutes/week). The amount of public spaces for leisure activities in a 500-meter radius with one or more pieces of equipment for physical exercise was negatively associated with walking (OR = 0.84, based on ≥ 150 minutes/week). The amount of public spaces for leisure activities in a 1,000-meter radius was positively associated with moderate-vigorous PA (OR = 1.03). The distance to a public space for leisure activities with three or more pieces of equipment for physical exercise (OR = 0.95) was inversely associated with moderate-vigorous PA. Proximity and amount of public spaces for leisure activities are associated with higher levels of moderate-vigorous PA in adults. The combination of methods can help reveal the contribution that access to (and quality of) public spaces for leisure activities can make to PA.

Role of Urban Public Space and the Surrounding Environment in Promoting Sustainable Development from the Lens of Social Media

The development of mobile social network has shown the power to change the ways people gather and communicate in urban public spaces (UPSs). In this study, we utilized a check-in database collected from Instagram in 2016 and 2017 in two central districts of Ho Chi Minh City (HCMC) to analyze the city dynamics and activities over the course of the day. By quantifying the popularity of contemporary UPSs, a comprehensive study was conducted on many attraction features spreading over the two central districts. Pearson’s correlation was used to explore the proximity and attractiveness associated with the surrounding environment of three types of UPSs. The results show that the lifetime of UPSs is very stable during weekdays and weekends. Within that, commercial UPSs are proved to play a dominant role in urban dynamics. This paper’s finding is at odds with the urban planning stereotype that public facilities often help people to get around. In the case of HCMC, it has proved the opposite: people are attracted to urban public spaces even though there are not many cultural and social specialties there. The results will contribute to enhancing the predictability of each UPS on socio-economic performance and to understanding of the role of urban facilities in urban sustainability.

Public toilets in parklands or open spaces in international cities using geographic information systems

INTRODUCTION AND HYPOTHESIS

Availability of public toilets in parklands and open spaces is a community resource for all persons and may support self-management of incontinence. The purpose of this study was to describe and map the availability of public toilets in parklands and open spaces in major international cities by city population and area.

METHODS

Observational/descriptive design. Twelve cities in nine countries with available data about toilets in parklands (Minneapolis-St. Paul (MSP), New York City, Philadelphia, Toronto, and Osaka) or open spaces (Greater London, Greater Sydney, Paris, Berlin, Brussels, and Seoul) were included in the analysis. Data were from online open/free data sets. Availability of publicly owned and/or operated permanent toilet facilities was measured/analyzed as number, density (calculated by population and area (km²)), and distribution (visualized using Geographic Information Systems).

RESULTS

Density of public toilets/area (km²) in parklands was highest in Osaka. MSP had the most toilets per 100,000 residents. In open spaces, the density of public toilets/area (km²) was highest in Paris. Sydney had the most toilets in open spaces per 100,000 residents. The distribution of public toilets across parklands was fairly even in MSP, Philadelphia, and Toronto. The distribution of public toilets in open spaces was highly concentrated in one area in Brussels. Sydney has a low population density but a high toilet density in open spaces.

CONCLUSIONS

Availability of public toilets in parklands or open spaces varies among international cities. Toilet availability should be considered in urban planning and community healthcare programs to promote continence, health, and quality of life.

Availability of Public Toilets in Parks and Recreational Sites in Selected US Cities

PURPOSE

The principal aim of this study was to map and describe the availability of parkland public toilets in major US cities per population and area.

DESIGN

Observational and descriptive.

SUBJECTS AND SETTING

Data were collected from the following cities: Austin, Texas; Minneapolis-St Paul (MSP), Minnesota; Nashville, Tennessee; New York City (NYC), New York; Philadelphia, Pennsylvania; San Francisco, California (SFC); Seattle, Washington; and Tampa, Florida. These cities are located throughout the United States.

METHODS

Data from the US Census and cities' parks/recreation departments about publicly owned and operated permanent toilet facilities were analyzed and then mapped using geographic information systems. Toilet density by population and residential area (mi) was calculated, and toilet distribution was visualized.

RESULTS

When calculated per 100,000 residents, MSP had the most parkland public toilets with 24; Tampa, Seattle, and Philadelphia had 17 to 22; and Nashville, NYC, and SFC had the fewest, around 7 toilets. Parkland public toilet density per residential area was highest in NYC and Philadelphia (>2/mi), followed by MSP, Seattle, and SFC (1/mi), then Tampa, Austin, and Nashville (<1/mi). The proportion of Census tracts containing parkland public toilets was more than 0.4 in MSP, Seattle, Tampa, and Philadelphia, more than 0.20 in Nashville and Austin, and less than 0.20 in the other cities. Toilet mapping showed fairly even distribution across Census tracts in MSP, Seattle, Tampa, and Philadelphia.

CONCLUSIONS

Availability of parkland public toilets was highest in MSP and lowest in SFC. Findings inform WOC nurses for counseling incontinent patients about self-management strategies. Urban planning that provides an adequate number and distribution of parkland public toilets may improve quality of life.

Land use proportion and walking: Application of isometric substitution analysis

Entropy measures of land use mix are a commonly used component of walkability. However, they present methodological challenges, and studies on their associations with walking have produced mixed findings. This study examined associations of the proportion of discrete land uses with walking, using isometric substitution models that take the complementary nature of land use proportions into account. Analysis of data collected from middle-aged adults living in Brisbane, Australia (n = 10,794) found that replacing residential or other land with commercial land was associated with higher levels of walking. The isometric substitution approach may explain the potential impact of land use changes on residents' walking.

Built environment and cardio-metabolic health: systematic review and meta-analysis of longitudinal studies

Built environment attributes may be related to cardio-metabolic diseases (e.g. type 2 diabetes, heart disease and stroke) and their risk factors, potentially by influencing residents' physical activity. However, existing literature reviews on the built environment and health for the most part focus on obesity as the outcome and rely on cross-sectional studies. This systematic review synthesized current evidence on longitudinal relationships between built environment attributes and cardio-metabolic health outcomes among adults and on the potential mediating role of physical inactivity. By searching eight databases for peer-reviewed journal articles published in the English language between January 2000 and July 2016, the review identified 36 articles. A meta-analysis method, weighted Z-test, was used to quantify the strength of evidence by incorporating the methodological quality of the studies. We found strong evidence for longitudinal relationships of walkability with obesity, type 2 diabetes and hypertension outcomes in the expected direction. There was strong evidence for the impact of urban sprawl on obesity outcomes. The evidence on potential mediation by physical activity was inconclusive. Further longitudinal studies are warranted to examine which specific built environment attributes influence residents' cardio-metabolic health outcomes and how physical inactivity may be involved in these relationships.

Public Green Infrastructure Contributes to City Livability: A Systematic Quantitative Review

Consistent with the Land Urbanism and Green Infrastructure theme of this special issue of Land, the primary goal of this review is to provide a plain language overview of recent literature that reports on the psychological, physiological, general well-being, and wider societal benefits that humans receive as a result of experiencing public green infrastructure (PGI) and nature in urbanized landscapes. This enhanced well-being and the wider societal benefits that accrue to urban dwellers as a result of interacting with quality PGI contributes to the concept known as city or urban livability. The quantitative analysis and theoretical synthesis reported in this review can inform decision makers, stakeholders, and other PGI and urban nature (UN) researchers of the benefits that urban populations receive from experiencing quality PGI spaces and UN and the contribution those spaces make to the livability of urban areas. With diminishing opportunities for the acquisition of new public open space to increase PGI and re-establish UN near urban centers, the efficient management and continuous improvement of existing PGI and UN is essential to promote and foster opportunities for human-to-nature contact and the known benefits therein derived. In addition to identifying an increased research interest and publication of articles that report on the contribution of PGI spaces to urban livability over the past decade, the review identifies and reports on the seven focus areas of PGI-livability research and the six attributes of PGI spaces that the current literatures report as contributing to the livability of urbanized landscapes. After providing a quantitative analysis for the reporting of those research areas and PGI attributes and summarizing key findings reported in the literature regarding the contribution that PGI spaces make to urban livability, this review also identifies knowledge gaps in the published literature and puts forward recommendations for further research in this rapidly expanding multidisciplinary field of research and policy development.

Data for an Importance-Performance Analysis (IPA) of a Public Green Infrastructure and Urban Nature Space in Perth, Western Australia

This Data Descriptor shares the dataset generated by a visitor satisfaction survey of users of a mixed-use public green infrastructure (PGI) space in Perth, Western Australia, that incorporates remnant and reintroduced urban nature (UN). Conducted in the Austral summer of 2016–2017, the survey (n = 393) utilized the technique of Importance-Performance Analysis (IPA) to elucidate perceptions of PGI users regarding performance of the amenity and facilities at the study site. There is a growing body of research that reports the innate, inbuilt affinity of humans to natural systems and living things. As humankind has grown exponentially over the past 50 years, humanity, as a species, is living an increasingly urbanized lifestyle, resulting in spreading urban footprints and increased population densities that are causing humans to become increasingly disconnected from nature. These conflicting phenomena are driving research to understand the contribution that PGI and UN can make to enhancing the quality of life of urban residents. With diminishing opportunities to acquire or create new PGI spaces within ever-more-densely populated urban centers, understanding, efficiently managing, and continuously improving existing PGI spaces is crucial to access the benefits and services that PGI and UN provide. The IPA technique can provide the data necessary to inform an evidenced-based approach to managing and resourcing PGI and UN spaces.

A prescription for "nature" - the potential of using virtual nature in therapeutics

Many studies suggest that increased exposure to urban greenness is associated with better population health. Accessing nature can in some circumstances, however, be difficult, especially for individuals with mobility constraints. Therefore, a growing body of work is investigating the ways to replace the in vivo experience with forms of "virtual" contact, in order to provide these individuals with at least some benefits of the natural environment. The aim of this paper is to provide a review of previous use of virtual reality (VR) nature in health and care settings and contemplate the potential use of this technology in future. Our central question is whether engaging with virtual nature can contribute to enhanced physical and emotional well-being in housebound or mobility-constrained individuals. We conclude that while contact with real-world nature is preferred, VR use can be an alternative in cases when in vivo contact with nature is not possible. There are many possibilities for the use of VR technology in psychiatric and medical care; however, the risks, benefits, and cost efficiency of these attempts should be carefully assessed and the outcomes should be measured in a scientifically valid manner. The current review has nonetheless demonstrated that VR nature could play a role in each of the proposed mediating mechanisms linking natural environments and health.

Beyond the Normalized Difference Vegetation Index (NDVI): Developing a Natural Space Index for population-level health research

BACKGROUND

Natural spaces can provide psychological benefits to individuals, but population-level epidemiologic studies have produced conflicting results. Refining current exposure-assessment methods is necessary to advance our understanding of population health and to guide the design of health-promoting urban forms.

OBJECTIVES

The aim of this study was to develop a comprehensive Natural Space Index that robustly models potential exposure based on the presence, form, accessibility, and quality of multiple forms of greenspace (e.g., parks and street trees) and bluespace (e.g., oceans and lakes).

MATERIAL AND METHODS

The index was developed for greater Vancouver, Canada. Greenness presence was derived from remote sensing (NDVI/EVI); forms were extracted from municipal and private databases; and accessibility was based on restrictions such as private ownership. Quality appraisals were conducted for 200 randomly sampled parks using the Public Open Space Desktop Appraisal Tool (POSDAT). Integrating these measures in GIS, exposure was assessed for 60,242 postal codes using 100- to 1,600-m buffers based on hypothesized pathways to mental health. A single index was then derived using principal component analysis (PCA).

RESULTS

Comparing NDVI with alternate approaches for assessing natural space resulted in widely divergent results, with quintile rankings shifting for 22-88% of postal codes, depending on the measure. Overall park quality was fairly low (mean of 15 on a scale of 0-45), with no significant difference seen by neighborhood-level household income. The final PCA identified three main sets of variables, with the first two components explaining 68% of the total variance. The first component was dominated by the percentages of public and private greenspace and bluespace and public greenspace within 250m, while the second component was driven by lack of access to bluespace within 1 km.

CONCLUSIONS

Many current approaches to modeling natural space may misclassify exposures and have limited specificity. The Natural Space Index represents a novel approach at a regional scale with application to urban planning and policy-making.

A Longitudinal Analysis of the Influence of the Neighborhood Environment on Recreational Walking within the Neighborhood: Results from RESIDE

BACKGROUND

There is limited longitudinal evidence confirming the role of neighborhood environment attributes in encouraging people to walk more or if active people simply choose to live in activity-friendly neighborhoods. Natural experiments of policy changes to create more walkable communities provide stronger evidence for a causal effect of neighborhood environments on residents' walking.

OBJECTIVES

We aimed to investigate longitudinal associations between objective and perceived neighborhood environment measures and neighborhood recreational walking.

METHODS

We analyzed longitudinal data collected over 8 yr (four surveys) from the RESIDential Environments (RESIDE) Study (Perth, Australia, 2003-2012). At each time point, participants reported the frequency and total minutes of recreational walking/week within their neighborhood and neighborhood environment perceptions. Objective measures of the neighborhood environment were generated using a Geographic Information System (GIS).

RESULTS

Local recreational walking was influenced by objectively measured access to a medium-/large-size park, beach access, and higher street connectivity, which was reduced when adjusted for neighborhood perceptions. In adjusted models, positive perceptions of access to a park and beach, higher street connectivity, neighborhood esthetics, and safety from crime were independent determinants of increased neighborhood recreational walking. Local recreational walking increased by 9 min/wk (12% increase in frequency) for each additional perceived neighborhood attribute present.

CONCLUSIONS

Our findings provide urban planners and policy makers with stronger causal evidence of the positive impact of well-connected neighborhoods and access to local parks of varying sizes on local residents' recreational walking and health. https://doi.org/10.1289/EHP823.

Is the Association between Park Proximity and Recreational Physical Activity among Mid-Older Aged Adults Moderated by Park Quality and Neighborhood Conditions?

Previous studies have reported mixed findings on the relationship between park proximity and recreational physical activity (PA), which could be explained by park quality and the surrounding neighborhood environment. We examined whether park quality and perceptions of the neighborhood physical and social environment moderated associations between park proximity and recreational PA among mid-older aged adults. Cross-sectional self-reported data on park proximity, park quality, neighborhood physical and social environmental factors, recreational walking and other moderate- to vigorous-intensity recreational physical activity (MVPA) were collected among 2700 Australian adults (57–69 years) in 2012. Main effects between park proximity and measures of recreational PA were non-significant. Park proximity was positively related to engagement in recreational walking among participants who reported average and high social trust and cohesion, but not among those reporting low social trust and cohesion. No other moderating effects were observed. Current findings suggest synergistic relationships between park proximity and social trust and cohesion with mid-older aged adults’ recreational walking. More research is needed to unravel the complex relationship between parks, recreational PA and the social context of neighborhoods.

The Prevalence and Use of Walking Loops in Neighborhood Parks: A National Study

BACKGROUND

Previous studies indicate that the design of streets and sidewalks can influence physical activity among residents. Park features also influence park use and park-based physical activity. Although individuals can walk on streets and sidewalks, walking loops in parks offer a setting to walk in nature and to avoid interruptions from traffic.

OBJECTIVES

Here we describe the use of walking loops in parks and compare the number of park users and their physical activity in urban neighborhood parks with and without walking loops.

METHODS

We analyzed data from the National Study of Neighborhood Parks in which a representative sample of neighborhood parks (n = 174) from 25 U.S. cities with > 100,000 population were observed systematically to document facilities and park users by age group and sex. We compared the number of people and their physical activity in parks with and without walking loops, controlling for multiple factors, including park size, facilities, and population density.

RESULTS

Overall, compared with parks without walking loops, on average during an hourly observation, parks with walking loops had 80% more users (95% CI: 42, 139%), and levels of moderate-to-vigorous physical activity were 90% higher (95% CI: 49, 145%). The additional park use and park-based physical activity occurred not only on the walking loops but throughout the park.

CONCLUSIONS

Walking loops may be a promising means of increasing population level physical activity. Further studies are needed to confirm a causal relationship. Citation: Cohen DA, Han B, Evenson KR, Nagel C, McKenzie TL, Marsh T, Williamson S, Harnik P. 2017. The prevalence and use of walking loops in neighborhood parks: a national study. Environ Health Perspect 125:170-174; http://dx.doi.org/10.1289/EHP293.