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Bereziartua A, Cabrera-León A, Subiza-Pérez M, García-Baquero G, Delís Gomez S, Ballester F, Estarlich M, Merelles A, Esplugues A, Irles MA, Barona C, Mas R, Font-Ribera L, Bartoll X, Pérez K, Oliveras L, Binter AC, Daponte A, García Mochon L, García Cortés H, Sánchez-Cantalejo Garrido MDC, Lacasaña M, Cáceres R, Rueda M, Saez M, Lertxundi A. Urban environment and health: a cross-sectional multiregional project based on population health surveys in Spain (DAS-EP project) - study protocol. BMJ Open 2024; 14:e074252. [PMID: 38553060 PMCID: PMC10982794 DOI: 10.1136/bmjopen-2023-074252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 02/26/2024] [Indexed: 04/02/2024] Open
Abstract
INTRODUCTION The European Environment Agency estimates that 75% of the European population lives in cities. Despite the many advantages of city life, the risks and challenges to health arising from urbanisation need to be addressed in order to tackle the growing burden of disease and health inequalities in cities. This study, Urban environment and health: a cross-sectional multiregional project based on population health surveys in Spain (DAS-EP project), aims to investigate the complex association between the urban environmental exposures (UrbEEs) and health. METHODS AND ANALYSIS DAS-EP is a Spanish multiregional cross-sectional project that combines population health surveys (PHS) and geographical information systems (GIS) allowing to collect rich individual-level data from 17 000 adult citizens participating in the PHS conducted in the autonomous regions of the Basque Country, Andalusia, and the Valencian Community, and the city of Barcelona in the years 2021-2023. This study focuses on the population living in cities or metropolitan areas with more than 100 000 inhabitants. UrbEEs are described by objective estimates at participants' home addresses by GIS, and subjective indicators present in PHS. The health outcomes included in the PHS and selected for this study are self-perceived health (general and mental), prevalence of chronic mental disorders, health-related quality of life, consumption of medication for common mental disorders and sleep quality. We aim to further understand the direct and indirect effects between UrbEEs and health, as well as to estimate the impact at the population level, taking respondents' sociodemographic and socioeconomic characteristics, and lifestyle into consideration. ETHICS AND DISSEMINATION The study was approved by the regional Research Ethics Committee of the Basque Country (Ethics Committee for Research Involving Medicinal Products in the Basque Country; PI2022138), Andalusia (Biomedical Research Ethics Committee of the Province of Granada; 2078-N-22), Barcelona (CEIC-PSMar; 2022/10667) and the Valencian Community (Ethics Committee for Clinical Research of the Directorate General of Public Health and Center for Advanced Research in Public Health; 20221125/04). The results will be communicated to the general population, health professionals, and institutions through conferences, reports and scientific articles.
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Affiliation(s)
- Ainhoa Bereziartua
- Department of Preventive Medicine and Public Health, University of the Basque Country (UPV/EHU), Leioa, Bizkaia, Spain
- Group of Environmental Epidemiology and Child Development, IIS Biogipuzkoa, Donostia-San Sebastian, Guipuzcoa, Spain
| | - Andrés Cabrera-León
- Andalusian School of Public Health, Granada, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Comunidad de Madrid, Spain
| | - Mikel Subiza-Pérez
- Group of Environmental Epidemiology and Child Development, IIS Biogipuzkoa, Donostia-San Sebastian, Guipuzcoa, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Comunidad de Madrid, Spain
- Department of Clinical and Health Psychology and Research Methods, University of the Basque Country UPV/EHU, Bilbao, País Vasco, Spain
- Bradford Institute for Health Research, Bradford, UK
| | - Gonzalo García-Baquero
- Group of Environmental Epidemiology and Child Development, IIS Biogipuzkoa, Donostia-San Sebastian, Guipuzcoa, Spain
- Faculty of Pharmacy, University of Salamanca, Salamanca, Spain
| | | | - Ferran Ballester
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Comunidad de Madrid, Spain
- Faculty of Nursing and Chiropody, University of Valencia, Valencia, Comunitat Valenciana, Spain
- Epidemiology and Environmental Health Joint Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valèncian Region, FISABIO-Public Health, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain
| | - Marisa Estarlich
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Comunidad de Madrid, Spain
- Epidemiology and Environmental Health Joint Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valèncian Region, FISABIO-Public Health, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain
- Faculty of Nursing and Chiropody, Universitat de Valencia, Valencia, Comunitat Valenciana, Spain
| | - Antonio Merelles
- Epidemiology and Environmental Health Joint Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valèncian Region, FISABIO-Public Health, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain
- Faculty of Nursing and Chiropody, Universitat de Valencia, Valencia, Comunitat Valenciana, Spain
| | - Ana Esplugues
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Comunidad de Madrid, Spain
- Epidemiology and Environmental Health Joint Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valèncian Region, FISABIO-Public Health, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain
- Faculty of Nursing and Chiropody, Universitat de Valencia, Valencia, Comunitat Valenciana, Spain
| | | | - Carmen Barona
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Comunidad de Madrid, Spain
- General Directorate of Public Health, Valencia, Valencian Community, Spain
- Research group "Local Action on Health and Equity (ALES)", Foundation for the Promotion of Health and Biomedical Research in the Valèncian Region, FISABIO-Public Health, Valencia, Spain
| | - Rosa Mas
- General Directorate of Public Health, Valencia, Valencian Community, Spain
- Research group "Local Action on Health and Equity (ALES)", Foundation for the Promotion of Health and Biomedical Research in the Valèncian Region, FISABIO-Public Health, Valencia, Spain
| | - Laia Font-Ribera
- Agencia de Salut Publica de Barcelona, Barcelona, Catalunya, Spain
- Institut d'Investigacio Biomedica Sant Pau (IIB SANT PAU), Barcelona, Spain
| | - X Bartoll
- Agencia de Salut Publica de Barcelona, Barcelona, Catalunya, Spain
- Institut d'Investigacio Biomedica Sant Pau (IIB SANT PAU), Barcelona, Spain
| | - Katherine Pérez
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Comunidad de Madrid, Spain
- Agencia de Salut Publica de Barcelona, Barcelona, Catalunya, Spain
- Institut d'Investigacio Biomedica Sant Pau (IIB SANT PAU), Barcelona, Spain
| | - Laura Oliveras
- Agencia de Salut Publica de Barcelona, Barcelona, Catalunya, Spain
- Institut d'Investigacio Biomedica Sant Pau (IIB SANT PAU), Barcelona, Spain
| | - Anne-Claire Binter
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Comunidad de Madrid, Spain
- Barcelona Institute for Global Health, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Antonio Daponte
- Andalusian School of Public Health, Granada, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Comunidad de Madrid, Spain
| | - Leticia García Mochon
- Andalusian School of Public Health, Granada, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Comunidad de Madrid, Spain
- Instituto de Investigación Biosanitaria de Granada, Granada, Spain
| | - Helena García Cortés
- Andalusian School of Public Health, Granada, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Comunidad de Madrid, Spain
| | - María Del Carmen Sánchez-Cantalejo Garrido
- Andalusian School of Public Health, Granada, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Comunidad de Madrid, Spain
| | - Marina Lacasaña
- Andalusian School of Public Health, Granada, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Comunidad de Madrid, Spain
- Instituto de Investigación Biosanitaria de Granada, Granada, Spain
| | - Rocío Cáceres
- Nursing Department, University of Seville, Sevilla, Spain
- Research group PAIDI CTS-1050: "Complex Care, Chronicity and Health Outcomes", University of Seville, Seville, Spain
| | - María Rueda
- Department of Statistics and Operational Research, University of Granada, Granada, Spain
- Institute of Mathematics, University of Granada, Granada, Spain
| | - Marc Saez
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Comunidad de Madrid, Spain
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Catalunya, Spain
| | - Aitana Lertxundi
- Department of Preventive Medicine and Public Health, University of the Basque Country (UPV/EHU), Leioa, Bizkaia, Spain
- Group of Environmental Epidemiology and Child Development, IIS Biogipuzkoa, Donostia-San Sebastian, Guipuzcoa, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Comunidad de Madrid, Spain
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Sah A, Rooney S, Kharitonova M, Sartori SB, Wolf SA, Singewald N. Enriched Environment Attenuates Enhanced Trait Anxiety in Association with Normalization of Aberrant Neuro-Inflammatory Events. Int J Mol Sci 2022; 23:13052. [PMID: 36361832 PMCID: PMC9657487 DOI: 10.3390/ijms232113052] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 10/14/2022] [Accepted: 10/20/2022] [Indexed: 11/22/2022] Open
Abstract
Neuroinflammation is discussed to play a role in specific subgroups of different psychiatric disorders, including anxiety disorders. We have previously shown that a mouse model of trait anxiety (HAB) displays enhanced microglial density and phagocytic activity in key regions of anxiety circuits compared to normal-anxiety controls (NAB). Using minocycline, we provided causal evidence that reducing microglial activation within the dentate gyrus (DG) attenuated enhanced anxiety in HABs. Besides pharmacological intervention, "positive environmental stimuli", which have the advantage of exerting no side-effects, have been shown to modulate inflammation-related markers in human beings. Therefore, we now investigated whether environmental enrichment (EE) would be sufficient to modulate upregulated neuroinflammation in high-anxiety HABs. We show for the first time that EE can indeed attenuate enhanced trait anxiety, even when presented as late as adulthood. We further found that EE-induced anxiolysis was associated with the attenuation of enhanced microglial density (using Iba-1 as the marker) in the DG and medial prefrontal cortex. Additionally, EE reduced Iba1 + CD68+ microglia density within the anterior DG. Hence, the successful attenuation of trait anxiety by EE was associated in part with the normalization of neuro-inflammatory imbalances. These results suggest that pharmacological and/or positive behavioral therapies triggering microglia-targeted anti-inflammatory effects could be promising as novel alternatives or complimentary anxiolytic therapeutic approaches in specific subgroups of individuals predisposed to trait anxiety.
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Affiliation(s)
- Anupam Sah
- Department of Pharmacology and Toxicology, Institute of Pharmacy and Center for Molecular Biosciences Innsbruck (CMBI), University of Innsbruck, Innrain 80-82/III, A-6020 Innsbruck, Austria
| | - Sinead Rooney
- Department of Pharmacology and Toxicology, Institute of Pharmacy and Center for Molecular Biosciences Innsbruck (CMBI), University of Innsbruck, Innrain 80-82/III, A-6020 Innsbruck, Austria
| | - Maria Kharitonova
- Department of Pharmacology and Toxicology, Institute of Pharmacy and Center for Molecular Biosciences Innsbruck (CMBI), University of Innsbruck, Innrain 80-82/III, A-6020 Innsbruck, Austria
| | - Simone B. Sartori
- Department of Pharmacology and Toxicology, Institute of Pharmacy and Center for Molecular Biosciences Innsbruck (CMBI), University of Innsbruck, Innrain 80-82/III, A-6020 Innsbruck, Austria
| | - Susanne A. Wolf
- Cellular Neurocience, Max-Delbrueck-Center for Molecular Medicine in the Helmholtz Association, 13125 Berlin, Germany
- Department of Experimental Ophthalmology, Charité-Universitätsmedizin Berlin, 13353 Berlin, Germany
| | - Nicolas Singewald
- Department of Pharmacology and Toxicology, Institute of Pharmacy and Center for Molecular Biosciences Innsbruck (CMBI), University of Innsbruck, Innrain 80-82/III, A-6020 Innsbruck, Austria
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Yang H, Cui X, Dijst M, Tian S, Chen J, Huang J. Association Between Natural/Built Campus Environment and Depression Among Chinese Undergraduates: Multiscale Evidence for the Moderating Role of Socioeconomic Factors After Controlling for Residential Self-Selection. Front Public Health 2022; 10:844541. [PMID: 35480591 PMCID: PMC9037627 DOI: 10.3389/fpubh.2022.844541] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 02/02/2022] [Indexed: 11/13/2022] Open
Abstract
Aim Evidence on the association between natural-built environments and depression is largely derived from the general population and prone to residential self-selection bias because of the nature of cross-sectional research design. Despite emerging adulthood, which includes the university years, is a critical stage for forming life-long health habits, studies on this topic focusing on undergraduate students are limited. The current study aims to illustrate the underlying mechanisms for how the campus-based environments affect depression in undergraduate students. Methods Based on a nationwide representative analytical sample of 22,009 Chinese undergraduates in 2018, we examined participants' reports of depression and campus-centered natural/built environments within multiple buffer sizes including 0.5, 1.0, and 2.5 km. After disentangling residential self-selection, we explored the moderating role of the socioeconomic attributes of undergraduates. The depression outcome was measured by the nine-item Patient Health Questionnaire (PHQ9). Indicators of exposure to green and blue space, transportation infrastructure, and food environments were objectively assessed using different circular buffers around each campus address. Results Modeling results indicated that campus neighborhoods with more scattered trees (0.5 km), water (0.5, 1.0, and 2.5 km), and street intersections (1.0 and 2.5 km) were protective against depression. In contrast, those living near denser distributions of outlets serving take-away sweets and fast food (0.5, 1.0, and 2.5 km) were susceptible to depression. These associations were modified by undergraduates' socioeconomic attributes (e.g., grade, Hukou status, and ethnicity) and varied according to geographical scales and exposure metrics. Conclusion To deliver effective environmental interventions to curb the prevalence of depression among undergraduate students, further planning policies should focus on the careful conception of the campus-based environment, especially regarding different spatial scales.
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Affiliation(s)
- Haoran Yang
- The Centre for Modern Chinese City Studies, Research Center for China Administrative Division, Future City Lab, East China Normal University, Shanghai, China
| | - Xiangfen Cui
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming, China
| | - Martin Dijst
- Department of Urban Development and Mobility, Luxembourg Institute of Socio-Economic Research (LISER), Esch-sur-Alzette, Luxembourg
| | - Senlin Tian
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming, China
| | - Jie Chen
- Faculty of Land Resource Engineering, Kunming University of Science and Technology, Kunming, China
| | - Jianhong Huang
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming, China
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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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