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Müller C, Paulsen L, Bucksch J, Wallmann-Sperlich B. Built and natural environment correlates of physical activity of adults living in rural areas: a systematic review. Int J Behav Nutr Phys Act 2024; 21:52. [PMID: 38702772 PMCID: PMC11067138 DOI: 10.1186/s12966-024-01598-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Accepted: 04/17/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND According to social-ecological models, the built and natural environment has the potential to facilitate or hinder physical activity (PA). While this potential is well researched in urban areas, a current systematic review of how the built and natural environment is related to PA in rural areas is lacking. METHODS We searched five databases and included studies for adults (18-65 years) living in rural areas. We included quantitative studies investigating the association between any self-reported or objectively measured characteristic of the built or natural environment and any type of self-reported or objectively measured PA, and qualitative studies that reported on features of the built or natural environment perceived as barriers to or facilitators of PA by the participants. Screening for eligibility and quality assessment (using the Standard Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields) were done in duplicate. We used a narrative approach to synthesize the results. RESULTS Of 2432 non-duplicate records, 51 quantitative and 19 qualitative studies were included. Convincing positive relationships were found between the availability and accessibility of places for exercise and recreation and leisure-time PA as well as between the overall environment and leisure-time PA. Possible positive associations were found between the overall environment and total and transport-related PA, between greenness/natural environment and total PA, between cycling infrastructure and aesthetics and MVPA, and between pedestrian infrastructure and total walking. A possible negative relationship was found between safety and security and total walking. Qualitative studies complemented several environmental facilitators (facilities for exercise and recreation, sidewalks or streets with low traffic, attractive natural environment) and barriers (lack of facilities and destinations, lack of sidewalks, speeding traffic and high traffic volumes, lack of street lighting). CONCLUSIONS Research investigating the relationship between the built and natural environment and PA behaviors of adults living in rural areas is still limited and there is a need for more high-quality and longitudinal studies. However, our most positive findings indicate that investing in places for exercise and recreation, a safe infrastructure for active transport, and nature-based activities are possible strategies that should be considered to address low levels of PA in rural adults. TRIAL REGISTRATION PROSPERO: CRD42021283508.
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Affiliation(s)
- Christina Müller
- Institute of Sport Science, University of Würzburg, Judenbühlweg 11, 97082, Würzburg, Germany.
| | - Lisa Paulsen
- Department of Prevention and Health Promotion, Heidelberg University of Education, Keplerstraße 87, 69120, Heidelberg, Germany
| | - Jens Bucksch
- Department of Prevention and Health Promotion, Heidelberg University of Education, Keplerstraße 87, 69120, Heidelberg, Germany
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Liang S, Chen Y, Sun X, Dong X, He G, Pu Y, Fan J, Zhong X, Chen Z, Lin Z, Ma W, Liu T. Long-term exposure to ambient ozone and cardiovascular diseases: Evidence from two national cohort studies in China. J Adv Res 2023:S2090-1232(23)00226-6. [PMID: 37625570 DOI: 10.1016/j.jare.2023.08.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 08/15/2023] [Accepted: 08/16/2023] [Indexed: 08/27/2023] Open
Abstract
INTRODUCTION The health effects of ambient ozone have been investigated in many previous studies. However, the effects of long-term exposure to ambient ozone on the incidence of cardiovascular disease (CVD) remain inconclusive. OBJECTIVES To estimate the associations of long-term exposure to maximum daily 8-hours average ozone (MDA8 O3) with the incidence of total CVD, heart disease, hypertension, and stroke. METHODS This was a prospective cohort study, and the data was obtained from the China Health and Retirement Longitudinal Survey (CHARLS) implemented during 2011-2018 and the China Family Panel Studies (CFPS) implemented during 2010-2018. We applied a Cox proportional hazards regression model to evaluate the associations of MDA8 O3 with total CVD, heart disease, hypertension, and stroke risks, and the corresponding population-attributable fractions (PAF) attributable to MDA8 O3 were also calculated. All analyses were conducted by R software. RESULTS The mean MDA8 O3 concertation of all included participants in the CHARLS and CFPS were 51.03 part per billion (ppb) and 51.15 ppb, respectively. In the CHARLS including 18,177 participants, each 10 ppb increment in MDA8 O3 concentration was associated with a 31% increase [hazard ratio (HR) = 1.31, 95% confidence interval (CI): 1.22-1.42] in the risk of incident heart disease, and the corresponding population-attributable fractions (PAF) was 13.79% [10.12%-17.32%]. In the CFPS including 30,226 participants, each 10 ppb increment in MDA8 O3 concentration was associated with an increase in the risk of incident total CVD (1.07 [1.02-1.13]), and hypertension (1.10 [1.03-1.18]). The PAFs of total CVD, and hypertension attributable to MDA8 O3 were 3.53% [0.82%-6.16%], and 5.11% [1.73%-8.38%], respectively. Stratified analyses showed greater associations in males, urban areas, and Southern China. CONCLUSIONS Long-term exposure to MDA8 O3 may increase the incidence of CVD. Therefore, the policies that control O3 and related precursors are persistently needed.
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Affiliation(s)
- Shuru Liang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China; China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou 510632, China
| | - Yumeng Chen
- Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan 528000, China
| | - Xiaoli Sun
- Gynecology Department, Guangdong Women and Children Hospital, Guangzhou 511442, China
| | - Xiaomei Dong
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China; China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou 510632, China
| | - Guanhao He
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China; China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou 510632, China
| | - Yudong Pu
- Songshan Lake Central Hospital of Dongguan City, Dongguan 523808, China
| | - Jingjie Fan
- Department of Prevention and Health Care, Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen 518028, China
| | - Xinqi Zhong
- Department of Neonatology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, China
| | - Zhiqing Chen
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China; China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou 510632, China
| | - Ziqiang Lin
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China; China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou 510632, China
| | - Wenjun Ma
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China; China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou 510632, China
| | - Tao Liu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China; China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou 510632, China.
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Hu C, Pan W, Wen L, Pan W. Classification of Regional Healthy Environment and Public Health in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3809. [PMID: 36900818 PMCID: PMC10001294 DOI: 10.3390/ijerph20053809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/15/2023] [Accepted: 02/17/2023] [Indexed: 06/18/2023]
Abstract
Environmental pollution has become a hot topic of concern for the government, academia and the public. The evaluation of environmental health should not only relate to environmental quality and exposure channels but also the level of economic development, social environmental protection responsibility and public awareness. We put forward the concept of the "healthy environment" and introduced 27 environmental indicators to evaluate and classify the healthy environment of 31 provinces and cities in China. Seven common factors were extracted and divided into economic, medical, ecological and humanistic environment factors. Based on the four environmental factors, we classify the healthy environment into five categories-economic leading healthy environment, robust healthy environment, developmental healthy environment, economic and medical disadvantageous healthy environment and completely disadvantageous healthy environment. The population health differences among the five healthy environment categories show that economic environment plays a major role in population health. Public health in regions with sound economic environment is significantly better than that in other areas. Our classification result of healthy environment can provide scientific support for optimizing environmental countermeasures and realizing environmental protection.
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Affiliation(s)
- Cheng Hu
- School of Economic and Management, Wuhan University, Wuhan 430072, China
| | - Wulin Pan
- School of Economic and Management, Wuhan University, Wuhan 430072, China
| | - Li Wen
- School of Applied Economics, Renmin University of China, 54 Zhongguancun Street, Haiding District, Beijing 100872, China
| | - Wei Pan
- School of Applied Economics, Renmin University of China, 54 Zhongguancun Street, Haiding District, Beijing 100872, China
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Arifin EN, Hoon CY, Slesman L, Tan A. Self-rated health and perceived environmental quality in Brunei Darussalam: a cross-sectional study. BMJ Open 2022; 12:e060799. [PMID: 35981772 PMCID: PMC9394210 DOI: 10.1136/bmjopen-2022-060799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES This paper examines the relationship between individuals' perceptions of environmental quality and self-rated health (SRH) after controlling for dimensions of socioeconomic, demographic and healthy lifestyle variables. DESIGN A cross-sectional survey. SETTING The survey was conducted in Belait, an oil-rich and gas-rich district in Brunei Darussalam, from 17 October to 11 November 2019 and focused on the most populated subdistricts (Kuala Belait, Seria and Liang), where 97% of the people reside. PARTICIPANTS A final sample of 1000 respondents aged 18 years and older were randomly selected from the population of the chosen subdistricts, with 95% CI and ±3 margin of error. Due to variable selection, only 673 respondents were available for analysis. OUTCOME MEASURES SRH was dichotomised into 1 for good health and 0 otherwise. Perceptions of environmental quality included perceptions of the natural environment (air quality, marine quality, water supply, noise and olfactory pollution) and the social environment (crime). χ2 and logistic regression models were used to assess the relationship between individuals' perceived environmental quality and SRH. RESULTS Most respondents perceived themselves with good SRH (72%). The adjusted logistic regression shows that perceptions of air quality (OR=2.20, 95% CI 1.15 to 4.22, p=0.018) and marine resources (OR=1.84, 95% CI 1.24 to 2.74, p=0.002) in their surrounding areas were significantly associated with good SRH. However, other environmental variables were insignificantly associated with SRH. Among the control variables, healthy lifestyle and employment had positive associations with good SRH (OR=3.89, 95% CI 1.96 to 7.71, p=0.000, for exercising 3-5 times a week; OR=1.72, 95% CI 1.09 to 2.71, p=0.021, for being employed). In addition, frequent physical exercise compensated for the negative health impact of environmental pollution. CONCLUSIONS This study suggests that environmental quality has an important role in SRH. However, a healthy lifestyle measured with frequency of physical exercise seems to compensate for the adverse environmental effects on SRH.
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Affiliation(s)
- Evi Nurvidya Arifin
- Centre for Advanced Research (CARe), Universiti Brunei Darussalam, Gadong, Brunei Darussalam
| | - Chang-Yau Hoon
- Centre for Advanced Research (CARe), Universiti Brunei Darussalam, Gadong, Brunei Darussalam
| | - Ly Slesman
- Centre for Advanced Research (CARe), Universiti Brunei Darussalam, Gadong, Brunei Darussalam
| | - Abby Tan
- Chancellery, Universiti Brunei Darussalam, Gadong, Brunei Darussalam
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Midorikawa H, Tachikawa H, Aiba M, Watanabe T, Tamiya N, Arai T. Factors associated with short and long sleep duration in older adults: Analysis of a national survey in Japan. Geriatr Gerontol Int 2022; 22:660-666. [PMID: 35844191 DOI: 10.1111/ggi.14438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 06/20/2022] [Accepted: 06/21/2022] [Indexed: 11/29/2022]
Abstract
AIM This study aimed to clarify the association between sleep duration and various physical and psychosocial factors among older Japanese adults. METHODS Data from 295 367 households were obtained from the 2013 Comprehensive Survey of Living Conditions in Japan, a self-administered questionnaire survey. We restricted our analyses to 115 205 participants who responded to all the items required for this study. Multinomial logistic regression models examined the association between sleep duration and various factors. RESULTS Overall, 26.0% of the participants slept for <6 h, 56.0% slept for 6-8 h, and 18.0% slept for ≥8 h. Poor subjective health and mental health increased the risk of both short (poor subjective health: odds ratio [OR] 1.22, 95% confidence interval [CI] 1.17-1.27; severe mental distress: OR 2.21, 95% CI 2.04-2.40) and long (poor subjective health: OR 1.19, 95% CI 1.13-1.24; severe mental distress: OR 1.25, 95% CI 1.13-1.38) sleep duration. Many subjective symptoms, including chest, respiratory, musculoskeletal and urogenital symptoms, were associated with short sleep duration. However, only memory loss was associated with long sleep duration (OR 1.23, 95% CI 1.16-1.31). CONCLUSIONS We need to be aware that older people with short sleep duration may have various physical symptoms. Moreover, as physical and mental problems, cognitive decline and unhealthy lifestyles are associated with long sleep duration, we also need to pay attention to the living conditions of those who complain of long sleep duration. The limitations of this study were that the variables were self-reported and sleep duration was not evaluated objectively. Geriatr Gerontol Int ••; ••: ••-•• Geriatr Gerontol Int 2022; ••: ••-••.
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Affiliation(s)
| | - Hirokazu Tachikawa
- Department of Disaster and Community Psychiatry, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.,Research and Development Center for Health Services, University of Tsukuba, Ibaraki, Japan
| | - Miyuki Aiba
- Faculty of Human Sciences, Toyo Gakuen University, Tokyo, Japan
| | - Taeko Watanabe
- Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Nanako Tamiya
- Research and Development Center for Health Services, University of Tsukuba, Ibaraki, Japan.,Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Tetsuaki Arai
- Department of Psychiatry, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
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An Empirical Study on the Inequality in Health and Healthcare in China’s Medical Reform. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2022; 2022:5789118. [PMID: 35664426 PMCID: PMC9162853 DOI: 10.1155/2022/5789118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 04/26/2022] [Accepted: 05/06/2022] [Indexed: 11/17/2022]
Abstract
To make clear what role the Urban and Rural Residents Basic Medical Insurance (URRBMI) plays in the inequality in health and healthcare, this article combines the time-varying DID method with the concentration index to conduct an empirical study. We find that the URRBMI improves health but expands health inequality among different income groups, with its contribution growing over time. Besides, the URRBMI significantly promotes healthcare utilization, reduces the medical burden, and narrows the gap among different income groups, though this effect is generally downward. These findings help clarify what deserves more attention to enlarge benefits and reduce inequality in this medical reform and provide policy implications for policymakers. Increasing investment in medical resources and constructing the hierarchical medical system and medical treatment combination may make a difference.
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