Health & Place最新文献

Background

Emerging evidence points to the beneficial role of greenspace exposure in promoting cardiovascular health. Most studies have evaluated such associations with conventional cardiovascular endpoints such as mortality, morbidity, or macrovascular markers. In comparison, the microvasculature, a crucial compartment of the vascular system where early subclinical signs of cardiovascular problems appear, has not been studied in association with greenspace exposure. The current study assessed the association between surrounding greenness and microvascular status, as assessed by retinal vessel diameters.

Methods

This study included a sample of healthy adults (n = 114 and 18–65 years old) residing in three European cities [Antwerp (Belgium), Barcelona (Spain), and London (UK)]. The exposures to greenspace at the home and work/school locations were characterized as average surrounding greenness [normalized difference vegetation index (NDVI)] within buffers of 100 m, 300 m, and 500 m. The central retinal arteriolar equivalent (CRAE) and central retinal venular equivalent (CRVE) were calculated from fundus pictures taken at three different time points. We developed linear mixed-effect models to estimate the association of greenspace exposure with indicators of retinal microvasculature, adjusted for relevant individual and area-level covariates.

Results

We observed the most robust associations with CRVE. Higher levels of greenspace at work/school were associated with smaller retinal venules [(seasonal NDVI) 300m: 3.85, 95%CI -6.67,-1.03; 500m: 5.11, 95%CI -8.04, −2.18]. Findings for surrounding greenness and CRAE were not conclusive.

Conclusion

Our study suggests an association of greenspace exposure with better microvascular status, specifically for retinal venules. Future research is needed to confirm our findings across different contextual settings.

This systematic review explored how nature-based care settings influence engagement in mental health therapy. We relied on Joanna Briggs Institute's guidelines for systematic reviews to synthesise data from nine articles selected from an initial pool of 649 records retrieved from PubMed, CINAHL, ScienceDirect, SocINDEX, and JBI EPB. Synthesis revealed six analytical themes: nature as a therapeutic tool, therapeutic relationships, nature's impact on power balance, nature as a safe space, risk of nature and patient-centered care. The findings shed light on the benefits while highlighting some challenges that influence participation in mental health interventions. The findings suggest that integrating nature into mental health care could be an alternative or complementary approach to enhancing patient engagement. However, the specific types of mental health care of this impact vary. Robust clinical trials that examine the effectiveness of the reported benefits are recommended. Such studies must target specific patient groups, such as the young and the elderly. Longitudinal studies that examine the long-term effects and moderating factors are needed to strengthen the evidence base and enhance patient-centered care.

The goal of this study was to understand how neighborhood greenspace access may support or hinder the effectiveness of community programs and policies (CPPs) aimed at reducing racial and ethnic inequities in screen time among 4598 US children. We found higher CPP intensity was significantly associated with fewer screen time behaviors in high greenspace neighborhoods, but not neighborhoods with low or moderate greenspace. Moreover, there were significant differences in greenspace access by neighborhood-level race and ethnicity. Implementing CPPs without regard for racial and ethnic greenspace inequities may be an underlying cause in the perpetuation of inequities in childhood screen time.

Industrial chemical pollution is released into surface water at a large scale annually in the United States. However, geographic variation and racial disparities in potential exposure are poorly understood at a national scale. Using county-level Risk-Screening Environmental Indicators data for 2011–2021 and American Community Survey data, this study analyzes the spatial and temporal distribution of health risk from modeled water releases using a Gamma hurdle model. Several racial disparities in presence of risk and amount of risk were identified, particular for Black or African American and Asian populations. At least 200 million U.S. residents live in a county where health risk from this pollution is present. Exposure reduction in high-risk areas may improve health for the broader population while also reducing inequities.

People's feelings about their neighbourhoods are important for health, but they may be undervalued in urban development decision-making. This study explores how decision-makers understand and respond to residents' emotions. Reflexive thematic analysis was conducted on a secondary dataset consisting of 123 interviews with influential professionals in urban development decision-making. We developed three themes and one subtheme: ‘(mis)understanding residents’ emotions', ‘neglecting the health impact of positive emotions’, ‘avoidance of emotion in community engagement’ and ‘sanitized emotions’. We recommend decision-makers engage directly with residents' emotions during urban development processes to ensure healthier place-making.

Urban greenways are multipurpose and multi-user trails that provide a range of socio-ecological and health benefits, including active transportation, social interactions, and increased well-being. However, despite their numerous benefits, barriers exist that limit urban greenway access and use, particularly among older and disadvantaged adults. This study addresses a significant research gap by examining the nuanced factors that influence the choices and experiences of these specific user groups in Québec City, Canada. We use a mixed-methods’ approach to explore the facilitators of and barriers to access and use of two urban greenway trails among older and disadvantaged adults. Our methods included a greenway user count, 96 observation time slots, and 15 semi-structured user interviews. The results revealed significant use of greenway trails by older adults for afternoon walks in both seasons studied (autumn and winter). We also observed variations in use patterns, such as higher levels of solitary walking, reduced levels of winter cycling, and the impracticality of the secondary greenway trail owing to snow conditions. In addition, the findings revealed a wide range of factors that influence greenway access and use, categorized as individual or personal, physical or built environment, social environment, and meteorological or climatic dimensions. Future research can build on these insights to design and assess interventions that capitalize on the facilitators and address any barriers, enhancing the value of urban greenways for older and disadvantaged adults.

This systematic review and meta-analysis summarizes the effectiveness of school-based physical activity (PA) interventions on children's and adolescents' PA. As no robust empirical evidence exists regarding what seems to characterize the school-based PA interventions that are most effective, we further aimed to map key factors of particular importance when trying to increase PA in early stages of life through school-based strategies.

Intervention effects were calculated as standardized between-group (i.e., intervention vs. control) mean differences (SMD) in PA from baseline to follow-up. In total, 189 publications were included. Few studies (7%) were of high quality. Our results demonstrate that school-based interventions only have a small positive effect on children's and adolescents' PA levels. Compared to the effect observed during total day (SMD = 0.27, p < 0.001), a slightly larger effect was observed during school hours (SMD = 0.37, p < 0.001), while no intervention effect was observed during leisure time (SMD = 0.07, p = 0.20). There was a tendency for interventions to be more effective if theoretical frameworks for behavior changes were used in the design phase. The largest effect size was observed when experts from outside school delivered the program (SMD = 0.56, p = 0.01), but training of personnel involved in delivery was the determining factor for program effectiveness as no effect was observed if interventions were delivered primarily by schools' untrained staff (SMD = 0.06, p = 0.61). Intervention effects where larger if parents were involved in the intervention program (parents involved: SMD = 0.35, p < 0.001; parents not involved: SMD = 0.16, p = 0.02). Small positive intervention effects were sustained at long-term follow-up after end of intervention. Overall, the certainty of the evidence of the findings is rated as low.

There is increasing evidence indicating air pollution is an important factor influencing the aging brain. However, much of this work measures air pollution using particulate matter (PM). Yet we know that the chemical components of PM are not consistent across space or time. Rather, the possible chemical mixtures of PM vary and are therefore not reliably measuring the same thing across studies. In this study we attempt to disentangle the effects of the components of measured PM by using estimates of concurrent exposures of 415 industrial air toxics, as well as 44 neuro- and developmental toxics. Using bivariate latent curve models, we leverage individual level panel data from the bi-annual Health and Retirement Study to test how these exposures relate to cognitive score trajectories of respondents across the years 2002–2012. We find that more exposure to neurotoxics was associated with faster rate of cognitive decline by 1.09 points (p < 0.05).