Health & Place最新文献

Accelerated molecular aging in socioeconomically disadvantaged neighborhoods: A racial/ethnic comparison

IF 3.8 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Health & Place

Pub Date : 2025-03-16 DOI: 10.1016/j.healthplace.2025.103446

Jennifer W. Robinette , Jennifer A. Smith

In the US, racial/ethnic health disparities are undeniable. These disparities partially stem from residing in low socioeconomic neighborhoods, a circumstance to which racial/ethnic minorities are disproportionately exposed. Associations between socioeconomic status (SES) and health may have some underlying molecular mechanisms reflected in the epigenome. Yet, a growing body of research suggests that neighborhood characteristics are not experienced the same way for individuals from differing racial/ethnic backgrounds. The present study evaluated associations between area-based SES and epigenetic age as assessed by the Horvath, Hannum, PhenoAge, and GrimAge epigenetic clocks in a national sample of older non-Hispanic White, non-Hispanic Black, and Hispanic participants. The present study used epigenetic age data from 3790 participants in the 2016 wave of the Health and Retirement Study and census tract SES data from the 2012–2016 American Community Survey. Four epigenetic clocks were regressed on area-based SES, adjusting for age, sex, and educational attainment. Although area-based SES was not significantly associated with Horvath or Hannum clocks, living in lower SES census tracts was associated with older PhenoAge and GrimAge. After considering smoking status, however, only the association with GrimAge remained. Investigating interactions with race/ethnicity suggested that area-based SES was more strongly associated with accelerated Hannum, PhenoAge, and GrimAge among non-Hispanic White participants than for other racial/ethnic groups. These racial/ethnic differences were completely reduced, however, in models that included smoking status. The present results illuminated racially/ethnically distinct patterns of biological (epigenetic aging) and behavioral (smoking) risk for poor health, and suggested that ameliorating low area-based SES may be beneficial for racially/ethnically diverse populations.

在美国，种族/族裔之间的健康差距是不争的事实。这些差异部分源于居住在社会经济地位较低的社区，而少数种族/人种在这种环境中的比例过高。社会经济地位（SES）与健康之间的联系可能有一些潜在的分子机制，反映在表观基因组中。然而，越来越多的研究表明，来自不同种族/民族背景的个体对邻里特征的体验并不相同。本研究以全国非西班牙裔白人、非西班牙裔黑人和西班牙裔老年参与者为样本，通过 Horvath、Hannum、PhenoAge 和 GrimAge 表观遗传时钟评估了地区 SES 与表观遗传年龄之间的关联。本研究使用了 2016 年健康与退休研究（Health and Retirement Study）中 3790 名参与者的表观遗传年龄数据，以及 2012-2016 年美国社区调查（American Community Survey）中的人口普查区 SES 数据。在对年龄、性别和教育程度进行调整后，对四个表观遗传时钟与地区 SES 进行了回归。虽然地区 SES 与 Horvath 或 Hannum 时钟无明显关联，但生活在较低 SES 人口普查区与较老的 PhenoAge 和 GrimAge 有关。然而，在考虑了吸烟状况后，只有与 GrimAge 的关系仍然存在。调查与种族/族裔的交互作用表明，与其他种族/族裔群体相比，非西班牙裔白人参与者中基于地区的社会经济地位与汉纳姆、PhenoAge 和 GrimAge 的加速相关性更强。然而，在包含吸烟状况的模型中，这些种族/人种差异被完全缩小。本研究结果揭示了不同种族/民族的生物（表观遗传老化）和行为（吸烟）健康不良风险模式，并表明改善基于地区的低社会经济地位可能对不同种族/民族的人群有益。

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引用次数: 0

Exploring socio-ecological factors that influence the use of urban greenspace: A case study of a deprived ethnically diverse community in the UK. 探索影响城市绿地使用的社会生态因素：英国一个贫困的种族多元化社区案例研究。

IF 3.8 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Health & Place

Pub Date : 2025-03-14 DOI: 10.1016/j.healthplace.2025.103437

Erica Jane Cook , Alfredo Gaitan , Izobella Kabasinguzi , Abby Moffat , Gurch Randhawa , Faye Powell , Nasreen Ali

Urban greenspaces are considered an important health asset associated with improved population health and well-being. However, inequalities in access to and use of the outdoors continue to exist, particularly among low-income and minority ethnic populations. Following a socio-ecological approach, this study aimed to investigate the individual, interpersonal, and environmental factors that influence the use of greenspaces among an ethnically diverse community in the UK and explore strategies to increase use. A mixed-methods cross-sectional community survey was conducted between March and June 2022 with residents of two ethnically diverse towns situated in Southeast England, UK. Data were collected on factors that influence greenspace use alongside demographic information on age, ethnicity, and social deprivation. An open-ended question explored respondents’ views on strategies to increase engagement with greenspaces. The survey was completed by 906 participants aged between 16 and 94 (60.7% female; 94.5% non-white British). The findings revealed that age, gender, perceived importance of using greenspaces, awareness of greenspaces, and the natural environment were all significant predictors of greenspace use. Qualitative evidence supported these findings and provided useful strategies for increasing access. The findings have provided an increased understanding of the factors that influence greenspace use and suggest that to improve access. There is a clear need to improve the quality of the available green spaces, making them safe and visually appealing to the local communities they serve. Increasing awareness and providing more opportunities for social and intergenerational interaction were also considered important strategies for increasing use.

城市绿地被认为是与改善人口健康和福祉相关的重要健康资产。然而，在获取和使用户外活动方面仍然存在不平等现象，尤其是在低收入人群和少数民族人群中。本研究采用社会生态学方法，旨在调查影响英国一个种族多元化社区使用绿地的个人、人际和环境因素，并探索提高使用率的策略。2022 年 3 月至 6 月期间，对英国英格兰东南部两个种族多元化城镇的居民进行了一次混合方法横断面社区调查。除年龄、种族和社会贫困程度等人口统计学信息外，还收集了有关影响绿地使用的因素的数据。一个开放式问题探讨了受访者对提高绿地参与度的策略的看法。906 名年龄在 16 岁至 94 岁之间的参与者（60.7% 为女性；94.5% 为非英国白人）完成了调查。调查结果显示，年龄、性别、认为使用绿地的重要性、对绿地的认识以及自然环境都是预测绿地使用情况的重要因素。定性证据支持了这些研究结果，并为提高使用率提供了有用的策略。研究结果加深了人们对影响绿地使用的因素的理解，并提出了提高绿地使用率的建议。显然需要提高现有绿地的质量，使其安全并在视觉上吸引当地社区。提高人们对绿地的认识，提供更多社交和代际互动的机会，也被认为是提高绿地使用率的重要策略。

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引用次数: 0

When the basic seems like a luxury: Menstrual friendly public toilets in six cities

IF 3.8 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Health & Place

Pub Date : 2025-03-14 DOI: 10.1016/j.healthplace.2025.103436

Sarah C. Blake , Kim J. Hopper , Angela-Maithy Nguyen , Andrew R. Maroko , Natalie Wyss , Elli Sugita , Natalia Fazzioni , Helen V.S. Cole , Marian Fe Theresa C. Lomboy , Ernesto R. Gregorio , Justine Bukenya , Eva Polio , Marni Sommer

Background

Public toilets are an important resource for securing gender equitable access to public space, but they are neglected across global contexts. This qualitative study explored the status, opportunities and challenges to creating menstrual friendly public toilets (MFPTs) in six cities: Barcelona, Kampala, Manila, New York City, Osaka, and Rio de Janeiro.

Methods

We conducted key informant interviews (KIIs) representing public, private, and non-governmental organizations familiar with public toilets or menstrual health and equity advocacy in their respective cities. Interviews covered various topics related to the quality and priority of public toilets, status of menstruation-related provisions, and opportunities and challenges for creating menstrual friendly public toilets. We conducted thematic analysis of interview transcripts to identify overarching emerging themes and their city-specific implications.

Results

Three themes emerged: 1) “Menstrual friendly public toilet” is a compelling concept 2) Bureaucratic complexity and low priority for public toilets present barriers to MFPTs; and 3) Connecting menstrual stigma and public toilet inadequacy are advocacy opportunities.

Discussion

Despite variations in resourcing, infrastructure, and priorities for public sanitation across cities, the idea of an MFPT prompted a common reflection on the inequities inherent in deficiencies in public toilet infrastructure; challenges posed by the combination of complicated public toilet decision-making and under-resourcing; and menstrual stigma. Mobilizing action around the shared need to improve public toilets and defining concrete context-specific features of an MFPT are common strategic priorities.

Conclusion

Findings highlight the value of the concept of an MFPT and its potential to contribute to improving gender equitable access to urban public spaces through investments in sanitation.

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引用次数: 0

Variation in U.S. county-level cardiovascular disease death rates by measure of rural-urban status

IF 3.8 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Health & Place

Pub Date : 2025-03-01 DOI: 10.1016/j.healthplace.2025.103431

Kara B. Beck , Michele L. Casper , Adam S. Vaughan

This study examined variation in county-level cardiovascular disease (CVD) death rates among adults aged 35–64 years using four measures of rural-urban status: Urban Influence Codes, Rural-Urban Continuum Codes (RUCC), National Center for Health Statistics Urban-Rural Classification Scheme, and Core-Based Statistical Areas. We estimated 2021 CVD death rates and used Poisson regression models to calculate rate ratios (RR) for full and dichotomized rural-urban measures. All measures identified the largest RR in the middle of the rural-urban spectrum. RUCC demonstrated patterns by population size and adjacency. RR magnitude varied across dichotomization methods. These findings demonstrate complexity underlying rural-urban differences and can guide public health practice.

引用次数: 0

The association of neighborhood walkability and food environment with incident cardiovascular disease in The Maastricht Study

IF 3.8 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Health & Place

Pub Date : 2025-03-01 DOI: 10.1016/j.healthplace.2025.103432

Jeffrey Alexander Chan , Rachelle Meisters , Jeroen Lakerveld , Miranda T. Schram , Hans Bosma , Annemarie Koster

Built environmental determinants can drive lifestyle behaviors and potentially reduce chronic disease prevalence. Few studies exist that have examined the association of obesogenic environment exposures with cardiovascular disease (CVD) outcomes. We aim to specifically examine the association between neighborhood walkability, food environment and CVD. Data from 6117 Dutch participants of The Maastricht Study, between the ages of 40 and 75 years in the Netherlands were examined. Home addresses were linked to geographic information systems data from the Geoscience and Health Cohort Consortium to create neighborhood exposures of walkability and food environment. Perceived walkability was obtained from the Abbreviated Neighborhood Environment Walkability Scale. An 11-year incidence of CVD was defined by self-reported non-fatal or fatal event (as registered by Statistics Netherlands). Cox regression models examined the association of environment exposures with incident CVD adjusted for demographic and socioeconomic variables. There was lower incidence of CVD using the perceived walkability questionnaire in those living in the most walkable neighborhood (Quartile 4 HR: .77; 95% CI = .62, .97) but not using the objective walkability index (Quartile 4 HR: 1.10; 95% CI = .89, 1.38). There was no association between the food environment and incident CVD (Quartile 4 HR: .82; 95% CI = .65, 1.04). The discordant findings between walkability measures suggest integrating residential feedback and accounting for lived experiences should be prioritized by policymakers when designing equitable neighborhoods to prevent CVD.

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引用次数: 0

Exploring relationships between household crowding and health in two First Nations communities

IF 3.8 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Health & Place

Pub Date : 2025-03-01 DOI: 10.1016/j.healthplace.2025.103441

Shannon Hyslop , Shelley Kirychuk , Chandima P. Karunanayake , Wanda Martin , Donna Rennie , Lori Bradford , Vivian R. Ramsden , Brooke Thompson , Clarice Roberts , Jeremy Seeseequasis , Kathleen McMullin , Mark Fenton , Sylvia Abonyi , Punam Pahwa , James A. Dosman

Lasting results of federal government influence for housing on-reserve include challenges with housing quantity and quality. Some First Nations communities face distressing housing shortages and household crowding. This study used a cross-sectional survey and the Canadian National Occupancy Standard definition of crowding to explore how household crowding affects health of people living on-reserve. and. First Nations Peoples from two reserve communities in Saskatchewan participated, a total of 831 individuals 18 years and older from 379 households. Household crowding and reports of respiratory diseases were high. The household crowding measure was significantly associated with chronic bronchitis. A culturally appropriate lens and more context are needed to understand household crowding on-reserve.

引用次数: 0

Exploring neighborhood transformations and community gardens to meet the cultural food needs of immigrants and refugees: A scoping review

IF 3.8 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Health & Place

Pub Date : 2025-03-01 DOI: 10.1016/j.healthplace.2025.103433

Elizabeth Onyango, Destiny Otoadese, Keji Mori, Nkechinyere Chinedu-Asogwa, Joyce Kiplagat, Binita Jirel

International migration is contributing to changes in the sociocultural and the economic landscapes of many cities in the world. As part of the changes in cities, we are witnessing an increased use of community gardens as spaces for wellbeing restoration, for social connection, and for addressing the challenge of food insecurity, particularly cultural food insecurity. Cultural food security is one major under-recognized issue, yet is pivotal to address given its role in positively supporting immigrants’ settlement and health. However, there is lack of comprehensive evidence of how neighborhoods are changing to accommodate these initiatives and meet the cultural food needs of diverse communities. Our scoping review explored evidence from existing literature on how neighborhoods are changing to accommodate community gardens (CG) as a novel means to address cultural food insecurity among immigrant communities and support place-making and resettlement. Our literature search identified several areas of transformations including the different kinds of community gardens that have emerged, the associated physical, social, cultural, environmental, economic, and policy changes that have been reported in other countries in the Global North. The review also identified multifold benefits of CG in this regard, including benefits to health and wellbeing – the physical (i.e. nutrition and physical activity), mental (e.g., a place for healing for immigrants fleeing war-torn countries, domestic violence, trauma; fostering a connection to the land in new environments via place-making), and social (e.g., fostering community connections and cultural knowledge exchange). Despite the known benefits of community gardens to immigrants' health and wellbeing, there remains a lack of comprehensive evidence in Canada on how neighborhoods are changing to accommodate these initiatives and meet the cultural food needs of diverse communities. Such studies will serve as sources of evidence for novel ideas to address the cultural food needs and food insecurity of immigrant communities, which is becoming a growing public health concern.

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引用次数: 0

Policymaker and stakeholder perspectives on determinants of fertility decisions through changing environmental and economic conditions in Greenland

IF 3.8 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Health & Place

Pub Date : 2025-03-01 DOI: 10.1016/j.healthplace.2025.103443

Malory Peterson , Augustine Rosing , Gitte Adler Reimer , Christina VL. Larsen , Julia Haggerty , Mark Schure , Elizabeth Rink

This study explored linkages between natural resources and determinants of fertility decisions in Greenland. Interviews were conducted with 26 policymakers and key stakeholders in two communities about climate adaptation, hunting and fishing, economic development, and fertility and reproductive health. Participants link fertility outcomes to disparate community socioeconomic circumstances that affect individual access to education and financial mobility. Workforce and education challenges in Greenland limit ability to expand culturally grounded reproductive healthcare. Coordinating healthcare, education, and housing policy may improve material resources to support fertility decisions in Greenland. We contextualize drivers of fertility decisions within Greenland's climate adaptation policy options.

引用次数: 0

Novel indices of state- and county-level social disadvantage in older Americans and disparities in mortality 美国老年人的州和县一级社会不利条件新指数及死亡率差异

IF 3.8 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Health & Place

Pub Date : 2025-03-01 DOI: 10.1016/j.healthplace.2025.103438

Yi Wang , Emma X. Zang , Kendra Davis-Plourde , Thomas M. Gill , Robert D. Becher

Studying and defining social contextual disadvantage in community-living older persons is vitally important, yet no composite indices of social disadvantage have been developed and validated specifically for the geriatric population. The current study aims to create two novel composite indices representing state- and county-level social contextual disadvantage in older (≥65 years) persons in the United States (US), and to evaluate whether disparities in mortality exist between index-defined disadvantaged and non-disadvantaged groups. Publicly-available state- and county-level (2006–2014) contextual factors from all 50 US states and 3132 counties were used to create indices of social contextual disadvantage. Associations of disadvantage-status with mortality (2010–2019) were assessed by negative binomial models. We found mortality rates were significantly higher in index-defined disadvantaged states/counties compared with non-disadvantaged ones for 2010–2015 and 2014–2019. For both periods, compared with non-disadvantaged states, the disadvantaged states had at least 11% increased mortality risk. At the county-level, the disadvantaged counties had an approximately 10% increased mortality risk. The findings suggest that the two indices of state- and county-level contextual disadvantage in older persons may serve as useful tools for identifying place-based disadvantaged populations of older Americans and as multidimensional factors driving mortality disparities. State- and county-level social contextual disadvantage should be considered when formulating public health policies and interventions aimed at reducing health disparities.

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引用次数: 0

Would intervening on financial strain reduce inequalities in mental health between renters and homeowners?

IF 3.8 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Health & Place

Pub Date : 2025-03-01 DOI: 10.1016/j.healthplace.2025.103434

Daina Kosīte , Maria Gueltzow , Frank J. van Lenthe , Mariëlle A. Beenackers , Joost Oude Groeniger

Background

Renters generally experience higher psychological distress than homeowners, which may be partially due to financial strain and difficulties to cover the costs of living. Whether interventions targeting financial strain will reduce the mental health disparities between renters and homeowners needs further investigation.

Aims

We investigated the potential impact of hypothetical interventions targeting the reduction of financial strain on the observed inequality in mental health between renters and homeowners.

Method

We analysed longitudinal data from the Dutch GLOBE study (2011–2014, N = 2400). Causal mediation analysis (marginal structural model with inverse probability weighting) was employed as a methodological framework to assess how much the observed inequality in mental health between homeowners and renters would be reduced if no one would experience financial strain (estimated using the counterfactual disparity measure (CDM)) and if renters would experience the same levels of financial strain as homeowners (estimated using the interventional analogue of the natural direct effect (NDE_analogue)).

Results

Our findings revealed a substantial inequality in mental health scores between renters and homeowners, with renters exhibiting an average mental health score of 5.36 (95% CI = 4.05, 7.09) points lower on a 100-point scale. The CDM suggested that complete elimination of financial strain could lead to a 16% reduction in the observed mental health inequality between renters and homeowners (CDM = 4.51 (95% CI = 3.04, 6.56)). The NDE_analogue indicated a 14% reduction in mental health inequality under a hypothetical intervention where the distribution of financial strain among renters was set to that of the homeowners (NDE = 4.60 (95% CI = 2.75, 6.49)).

Conclusion

Addressing financial strain may reduce the disparities in mental health outcomes associated with housing tenure.

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引用次数: 0