Health & Place最新文献_第7页

Socio-ecological barriers to women's empowerment in sanitation in Eastern Indonesia 印度尼西亚东部环境卫生领域妇女赋权的社会生态障碍。

IF 4.1 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Health & Place

Pub Date : 2025-10-13 DOI: 10.1016/j.healthplace.2025.103554

Ni Made Utami Dwipayanti , I Desak Ketut Dewi Satiawati Kurnianingsih , Angelina Mustafa , Anindrya Nastiti , D. Daniel , Mellysa Kowara , I Gusti Ayu Devi Savitri

Low-income and marginalised groups in any setting are affected by inadequate water, sanitation and hygiene (WASH) sanitation access, particularly women and girls who are disproportionately affected mainly because of gender inequality. This paper discusses barriers to women's access to and participation in sanitation programs based on the case study in Central Lombok and West Manggarai, Eastern Indonesia. In-depth interviews and focus group discussions were conducted on 28 informants and 6 groups, respectively, and analysed using thematic analysis. The study found that women and girls in Eastern Indonesia experience inadequate access to sanitation due to being less involved in WASH decision-making processes at household and community levels while having the double burden of maintaining the facilities and taking care of their families simultaneously. Barriers to women's empowerment in sanitation programs exist at different socio-ecological scales from individual to structural scales indicating the relationship of health with the context and characteristics of the place. At the individual scale, those barriers are women's lack of awareness, low education and economic status; gender-expected roles in society due to patriarchal cultures, and restrictions on women's mobility due to social norms are barriers at community scale. Meanwhile, at the institutional scale, the barriers come from the government's lack of commitment and clear guidelines to support women involvement and the government's lack of capacity and skills in implementing gender-transformative WASH programs in their jurisdiction areas. All different scales of barriers are interconnected, requiring comprehensive and systematic strategies to simultaneously address barriers to mainstreaming gender issues in national sanitation programs.

在任何情况下，低收入和边缘化群体都受到水、环境卫生和个人卫生设施不足的影响，特别是妇女和女孩，她们主要由于性别不平等而受到不成比例的影响。本文以印度尼西亚东部龙目岛中部和西Manggarai的案例研究为基础，讨论了妇女获得和参与卫生项目的障碍。分别对28名举报人和6个小组进行了深度访谈和焦点小组讨论，并采用专题分析进行了分析。该研究发现，印度尼西亚东部的妇女和女孩获得卫生设施的机会不足，因为她们较少参与家庭和社区一级的讲卫生运动决策过程，同时还要承担维护设施和照顾家庭的双重负担。妇女在卫生项目中获得权力的障碍存在于不同的社会生态尺度上，从个人到结构尺度，这表明了健康与当地环境和特征的关系。在个人层面上，这些障碍是妇女缺乏意识、受教育程度低和经济地位低；父权文化对社会性别角色的期望，以及社会规范对女性流动的限制，都是社区层面的障碍。与此同时，在制度层面，障碍来自政府缺乏支持妇女参与的承诺和明确的指导方针，以及政府在其管辖范围内实施改变性别的WASH项目的能力和技能。所有不同程度的障碍都是相互关联的，需要采取全面和系统的战略，同时解决阻碍性别问题在国家卫生规划中主流化的障碍。

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引用次数: 0

Learning the trade of navigating and tinkering within a disparate welfare system: Older adults as bricoleurs of home arrangements and support 学习在不同的福利体系中导航和修补的技巧：老年人作为家庭安排和支持的工匠

IF 4.1 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Health & Place

Pub Date : 2025-10-11 DOI: 10.1016/j.healthplace.2025.103562

Glenn Möllergren , Håkan Jönson , Marianne Granbom

Challenging conventional provider-oriented perspectives on older adults’ spatial realities, this study explores how community-dwelling care users in Sweden manage their home environments. It investigates how older adults use the welfare system and coordinate widely available but disparate material and social resources to achieve a spatially sustainable ageing-in-place. Research on domiciliary care for older adults has largely focused on the provider, overlooking the skills and strategies older care users themselves employ to make arrangements work; this study adopts a fresh lens by examining the active engagement of older adults in shaping their own home arrangements.

The data comprised twelve qualitative interviews with older care users, along with walk-alongs in their homes, focusing on how different areas of the home were used in everyday life. The concepts of bricoleur, bricolage, and tinkering, were employed to analyse the activities and arrangements respondents implemented to utilise services in managing their daily lives. The findings revealed that participants had been prompted to develop sophisticated procedures and competencies, leveraging supportive networks and combining housing adaptations, assistive devices, and innovative uses of household items to make the services useful. The study highlights the importance of recognising the active coordination efforts of older care users and underscores the need to focus on their expertise and adaptive learning within supportive systems. An eldercare provision such as the one in Sweden, offering a variety of different services, can be perceived as fragmented and challenging to navigate, necessitating a user-centred approach to improve accessibility and effectiveness.

挑战传统的以提供者为导向的老年人空间现实观点，本研究探讨了瑞典社区居住护理用户如何管理他们的家庭环境。它调查老年人如何利用福利制度，并协调广泛可用但不同的物质和社会资源，以实现空间上可持续的就地老龄化。对老年人居家护理的研究主要集中在提供者身上，忽视了老年人护理使用者自己为安排工作所使用的技能和策略；这项研究采用了一种新的视角，考察了老年人在塑造自己的家庭安排方面的积极参与。这些数据包括对老年护理使用者的12次定性访谈，以及在他们家中的散步，重点关注家庭在日常生活中如何使用不同的区域。bricoleur、bricolage和tinting的概念被用来分析受访者在管理日常生活中利用服务所实施的活动和安排。调查结果显示，参与者被鼓励发展复杂的程序和能力，利用支持性网络，结合住房适应、辅助设备和家庭用品的创新使用，使这些服务有用。该研究强调了认识到老年人护理使用者积极协调努力的重要性，并强调了在支持系统内关注他们的专业知识和适应性学习的必要性。像瑞典这样提供各种不同服务的老年人护理服务，可能被认为是分散的，难以驾驭，需要以用户为中心的方法来提高可及性和有效性。

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引用次数: 0

The digitalization of young women's food environments in Norway 挪威年轻女性食物环境的数字化。

IF 4.1 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Health & Place

Pub Date : 2025-10-08 DOI: 10.1016/j.healthplace.2025.103552

Sabrina Ionata Granheim , Laura Terragni , Liv Elin Torheim , Miranda Thurston

Food environments, which significantly influence dietary patterns and health outcomes, are undergoing an accelerated process of digitalization. Young people are vulnerable to the adverse effects of food environment digitalization, with young women particularly affected due to their heavy exposure to social media. This study explores the process of digitalization of young women's food environments in Norway. Using a grounded theory approach, we conducted 14 semi-structured interviews with young women aged 18–25 years in Norway, complemented by an analysis of secondary materials such as websites, smartphone apps, and social media platforms identified during the interviews. We propose a theoretical model outlining four degrees of digitalization in young women's food environment interactions: analogue, digitally mediated, digitally enhanced, and digital-only. These interactions were influenced by processes at an individual level, through which young women strove to preserve their agency while seeking novelty, entertainment, social connection and self-optimization in relation to their food practices and bodies. Simultaneously, societal processes such as the normalization of technology use, increased personalization of digital services and intensification of exposure to digital food content and marketing shaped young women's action. These can conflict with their individual motivations or complement and reinforce them, thus creating tensions in how agency is exercised in increasingly digitalized food environments. We argue that the digitalization of food environments is likely to augment the complexity and intensity of their effects on health and nutrition, warranting further investigation.

对饮食模式和健康结果有重大影响的粮食环境正在加速数字化进程。年轻人容易受到食品环境数字化的不利影响，年轻女性受到的影响尤其严重，因为她们大量接触社交媒体。本研究探讨了挪威年轻女性食物环境的数字化过程。采用基于理论的方法，我们对挪威18-25岁的年轻女性进行了14次半结构化访谈，并对访谈中发现的网站、智能手机应用程序和社交媒体平台等二手材料进行了分析。我们提出了一个理论模型，概述了年轻女性食物环境互动中的四个数字化程度：模拟、数字介导、数字增强和纯数字。这些相互作用受到个人层面过程的影响，年轻女性通过这些过程努力保持她们的能动性，同时寻求与她们的饮食习惯和身体有关的新奇、娱乐、社会联系和自我优化。与此同时，技术使用的正常化、数字服务的日益个性化以及数字食品内容和营销的增加等社会进程影响了年轻女性的行动。这些可能与他们的个人动机相冲突，也可能是对个人动机的补充和加强，从而在日益数字化的食品环境中如何行使代理权造成紧张。我们认为，食品环境的数字化可能会增加其对健康和营养影响的复杂性和强度，值得进一步研究。

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引用次数: 0

Adolescent girls and physical activity in public spaces: insights from the city of Antwerp 少女和公共场所的体育活动：来自安特卫普市的见解

IF 4.1 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Health & Place

Pub Date : 2025-10-08 DOI: 10.1016/j.healthplace.2025.103559

Hannah Robinson , Josefien van Olmen , Ruth Lowry , Hilde Bastiaens

Physical activity in adolescence is a key determinant of long-term health, yet teenage girls remain consistently less active than boys. Urban public spaces play a central role in facilitating everyday opportunities for physical activity, from informal play to organised sport. However, these spaces are not equally accessible or welcoming to all. They are sites where gendered hierarchies and norms surface, but also where other intersecting structures of inequality — such as socioeconomic background, migration status, dis/ability, and religion — shape who feels entitled to participate and who does not. This study explores how different factors intersect to influence teenage girls' participation in physical activity in the urban areas of Antwerpen-Noord and Borgerhout. Based on 32 interviews with policymakers, youth workers, and local organisations, we apply an adapted socio-ecological framework to analyse the interplay of individual, sociocultural, built environment, and policy dimensions. The findings show how political choices such as disinvestment in youth services limit access to activities, while the absence of inclusive design in the built environment reinforce these inequalities. At the sociocultural level, gender stereotypes shape expectations about who belongs in public space, which in turn feeds into individual-level concerns about body image amongst adolescent girls. These intersecting barriers show how physical activity opportunities are mediated not only by individual factors but by systemic forms of exclusion embedded in the urban fabric. To counter this, inclusive policies and participatory approaches to urban planning are needed to create public spaces that actively support girls’ engagement in physical activity and their health and wellbeing.

青少年时期的体育活动是长期健康的一个关键决定因素，然而，十几岁的女孩始终不如男孩活跃。城市公共空间在促进从非正式游戏到有组织的体育活动的日常机会方面发挥着核心作用。然而，这些空间并不是对所有人开放的。在这些地方，性别等级和规范浮出水面，但也有其他交叉的不平等结构——如社会经济背景、移民身份、残疾/能力和宗教——决定了谁有资格参与，谁没有资格参与。本研究探讨了不同因素如何交叉影响安特卫普-北和博尔格豪特城市地区少女参加体育活动的情况。基于对政策制定者、青年工作者和当地组织的32次访谈，我们应用适应性社会生态框架来分析个人、社会文化、建筑环境和政策维度的相互作用。研究结果表明，诸如减少对青年服务的投资等政治选择如何限制了参与活动的机会，而建筑环境中缺乏包容性设计则加剧了这些不平等。在社会文化层面，性别刻板印象塑造了人们对谁属于公共空间的期望，这反过来又助长了青春期女孩对个人身体形象的关注。这些相互交织的障碍表明，体育活动机会不仅受到个人因素的影响，还受到城市结构中系统性排斥形式的影响。为解决这一问题，需要采取包容性政策和参与性城市规划方法，创造积极支持女孩参与体育活动及其健康和福祉的公共空间。

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引用次数: 0

Medical training pathways and underdoctored areas: a qualitative study of doctors working in areas that struggle to recruit and retain 医学培训途径和医生不足的地区：对在难以招聘和留住的地区工作的医生进行定性研究。

IF 4.1 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Health & Place

Pub Date : 2025-10-07 DOI: 10.1016/j.healthplace.2025.103560

Liz Brewster, Choon Key Chekar, Michael Lambert, Clare Mumford, Tasneem Patel, Nicola Rennie, Cliff Shelton

Some areas struggle more than others to recruit and retain doctors to provide healthcare services. Often, these areas are rural, coastal, remote, deprived or a combination of all these factors, compounding difficulties in access to healthcare; we refer to these areas as ‘underdoctored’. This paper aims to describe experiences of working in underdoctored areas, with a focus on exploring why doctors work in these places to highlight what might enable future recruitment. It considers: the routes by which they arrived in an area and the drivers that facilitated those routes; the key stages in participants' lives at which transitions into the area were made; the agency – or lack thereof – that was involved in the choice to work in the area. While previous research has focused on factors driving workforce attrition, we work here to identify what encourages retention, particularly in areas that are known to have difficulties maintaining sufficient medical workforce. Drawing on interviews with doctors who work in these areas across case study sites, we conceptualise how there is a need to understand experiences of working in these areas to surface three intertwined elements – people, career, and place – within a doctors' place-life trajectory. We then explore how one or more of these elements might need to be compromised, how the acceptability of these compromises might change over time, and how the affordances associated with an underdoctored area can be negotiated and re-negotiated in order for those who move to an underdoctored area to want to stay. These findings have implications for improving recruitment and retention, health service provision, and ultimately, health inequalities in these underdoctored areas.

一些地区比其他地区更难以招募和留住医生来提供医疗服务。这些地区往往是农村、沿海、偏远、贫困或所有这些因素的综合，加剧了获得医疗保健的困难；我们把这些领域称为“治疗不足”。本文旨在描述在医生不足的地区工作的经验，重点探讨为什么医生在这些地方工作，以突出未来可能的招聘。它考虑：他们到达一个地区的路线和便利这些路线的司机；参与者生命中过渡到该区域的关键阶段；选择在该地区工作的机构——或者缺乏机构——参与其中。虽然以前的研究主要集中在推动劳动力流失的因素上，但我们在这里的工作是确定鼓励留住的因素，特别是在已知难以维持足够医疗劳动力的领域。通过对在这些领域工作的医生在案例研究站点的采访，我们概念化了如何需要理解在这些领域工作的经验，从而在医生的场所生活轨迹中揭示三个相互交织的因素——人、职业和场所。然后，我们将探讨如何妥协这些元素中的一个或多个，这些妥协的可接受性如何随着时间的推移而变化，以及如何协商和重新协商与医疗不足地区相关的能力，以便让那些搬到医疗不足地区的人想要留下来。这些发现对改善这些医疗不足地区的招聘和保留、卫生服务提供以及最终解决卫生不平等问题具有重要意义。

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引用次数: 0

Places of end-of-life care and death in health policies of four countries (EOLinPLACE Project) 4个国家卫生政策中临终关怀和死亡的位置（EOLinPLACE项目）。

IF 4.1 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Health & Place

Pub Date : 2025-10-07 DOI: 10.1016/j.healthplace.2025.103534

Sifra H. van de Beek , Barbara Gomes , Krista Eckels , Sara Pinto , Beatriz Sanguedo , Dorothy A. Olet , Elizabeth Namukwaya , Joanna V. Brooks , Emmanuelle Belanger , Jenny T. van der Steen

Background

Place of death and its concordance with patient preference is a key indicator for end-of-life care, studied cross-nationally and flagged as a priority by the OECD. However, it is unclear if and how ‘place’ is considered in health policy in relation to end-of-life care. This study aims to examine if and how health policies in different nations consider places of end-of-life care and death.

Methods

We conducted a comparative qualitative study across the US, the Netherlands, Portugal, and Uganda, of health policy documents following the READ (i.e., Ready materials, Extract data, Analyze data, Distill findings) systematic approach for document analysis in health policy research. Documents were analyzed using directed content analysis following Hsieh and Shannon (2005). Timelines for document publication were country-specific, based on local health policy developments relevant to end-of-life care in the last two decades. Backdates ranged from 2001 in Uganda to 2015 in the Netherlands; the most recent publication year was 2024 for all countries.

Findings

We identified 89 policy documents relevant to end-of-life care mentioning preferred or actual places of end-of-life care or death. The first topic was ‘Narratives around places’, where home was prioritized while inpatient facilities were most problematized. A second topic ‘Policy measures acting on places’ included: i) Availability of services across places, where the rural-urban divide, workforce shortages, waitlists and financial considerations challenged availability of end-of-life care across places; and ii) Professional expertise vs. community empowerment, which highlighted a key tension in the extent to which countries invest in professional expertise versus community empowerment.

Conclusions

While improving care at home is prioritized with evidence-based reasons to support it, our study shows that policymakers overlook the potential benefits of other care settings and flexible care solutions that promote continuity of care. This comparative analysis unveiled implications to improve end-of-life care across care settings.

背景：死亡地点及其与患者偏好的一致性是临终关怀的关键指标，经跨国研究并被经合组织列为优先事项。然而，尚不清楚在与临终关怀有关的卫生政策中是否以及如何考虑“地点”。本研究旨在检验不同国家的卫生政策是否以及如何考虑临终关怀和死亡的场所。方法：采用READ （Ready materials, Extract data, Analyze data, Distill findings）系统方法，对美国、荷兰、葡萄牙和乌干达的卫生政策文件进行了比较定性研究。采用Hsieh和Shannon（2005）的直接内容分析法对文献进行分析。根据过去二十年中与临终关怀有关的地方卫生政策发展，文件出版的时间表是针对具体国家制定的。从乌干达的2001年到荷兰的2015年；所有国家最近的出版年份是2024年。研究结果：我们确定了89份与临终关怀相关的政策文件，其中提到了首选或实际的临终关怀或死亡地点。第一个主题是“围绕地方的叙事”，其中家庭是优先考虑的，而住院设施则是最成问题的。第二个主题“对地方采取的政策措施”包括：i)各地服务的可用性，城乡差距，劳动力短缺，等候名单和财务考虑挑战了各地临终关怀的可用性；专业知识与社区赋权，这突出了国家在专业知识与社区赋权方面的投资程度之间的关键紧张关系。结论：虽然改善家庭护理被优先考虑，并有证据支持，但我们的研究表明，政策制定者忽视了其他护理环境和灵活的护理解决方案的潜在好处，这些解决方案可以促进护理的连续性。这一比较分析揭示了在护理环境中改善临终关怀的意义。

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引用次数: 0

Social drivers of type 2 diabetes in Mexico: A spatial multilevel approach to urbanization and unhealthy food expenditure 墨西哥2型糖尿病的社会驱动因素：城市化和不健康食品支出的空间多层次方法。

IF 4.1 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Health & Place

Pub Date : 2025-10-05 DOI: 10.1016/j.healthplace.2025.103555

Aldo Daniel Jiménez-Ortega , J. Mauricio Galeana-Pizaña , Gustavo M. Cruz-Bello , Juan Manuel Núñez

Type 2 diabetes mellitus (T2DM) is growing worldwide, particularly in Latin American countries. The determinants of this pandemic are diverse and exhibit distinctive spatial variations. Moreover, there is often a mismatch between the scale of disease reporting units and the spatial resolution of disease determinants. This study examines the social drivers of T2DM mortality in Mexican municipalities for 2016 and 2022, focusing on variables related to urbanization and expenditure on unhealthy food. We applied general linear mixed-effects models with a spatial random component to account for state heterogeneity. We found that some urbanization-related variables were significantly associated with T2DM mortality in both years, such as urban land use area per 1000 inhabitants, access to basic housing services, and population employed in informal activities. The effect of unhealthy food access became significant only in 2022, coinciding with an increase in spatial dependence, suggesting a broader geographic diffusion of urban and dietary risk factors. The marginal and conditional R-squared values indicate high explanatory power in both models (marginal: 0.811 in 2016 and 0.808 in 2022; and conditional: 0.834 and 0.832, respectively), with most variance explained by the fixed effects. Notably, the mean mortality rate for T2DM increased by 26 % during the study period. This approach enhances our understanding of how structural and spatial factors interact to shape health outcomes, highlighting the need for targeted public health strategies in rapidly urbanizing regions and emphasizing the multifactorial impact of urban conditions and food environments on health, particularly in guiding dietary interventions to mitigate T2DM.

2型糖尿病（T2DM）在世界范围内呈增长趋势，特别是在拉丁美洲国家。这次大流行的决定因素多种多样，并表现出明显的空间差异。此外，疾病报告单位的规模与疾病决定因素的空间分辨率之间往往存在不匹配。本研究考察了2016年和2022年墨西哥各城市2型糖尿病死亡率的社会驱动因素，重点关注与城市化和不健康食品支出相关的变量。我们应用一般线性混合效应模型与空间随机成分来解释状态异质性。我们发现，在这两年中，一些与城市化相关的变量与2型糖尿病死亡率显著相关，如每1000名居民的城市土地利用面积、基本住房服务的获得情况和从事非正式活动的人口。直到2022年，不健康食品获取的影响才变得显著，与空间依赖性的增加相一致，表明城市和饮食风险因素的地理扩散范围更广。两种模型的边际和条件r平方值均具有较高的解释力（2016年边际为0.811,2022年为0.808；条件r平方值分别为0.834和0.832），大部分方差被固定效应解释。值得注意的是，在研究期间，2型糖尿病的平均死亡率增加了26%。这种方法增强了我们对结构和空间因素如何相互作用以形成健康结果的理解，突出了快速城市化地区有针对性的公共卫生战略的必要性，并强调了城市条件和食物环境对健康的多因素影响，特别是在指导饮食干预以减轻2型糖尿病方面。

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引用次数: 0

From sanitation to safety: Investigating the link between water, sanitation and hygiene and intimate partner violence in Nepal 从环境卫生到安全：调查尼泊尔的水、环境卫生和个人卫生与亲密伴侣暴力之间的联系。

IF 4.1 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Health & Place

Pub Date : 2025-10-04 DOI: 10.1016/j.healthplace.2025.103556

Karan Babbar , Supriya Garikipati

Intimate Partner Violence (IPV) disproportionately affects women globally. While the link between Water, Sanitation, and Hygiene (WASH) and IPV is recognized, the underlying mechanisms require further exploration. This study investigates the mediating role of Menstrual Health and Hygiene (MHH) practices and the moderating role of Partner Controlling Behaviors in the WASH-IPV relationship in Nepal. Drawing on Sen's Capability Approach and Social Control Theory, we hypothesize that access to WASH facilities, by improving MHH practices, is negatively associated with IPV. We propose that this relationship is moderated by Partner Controlling Behaviors. Using Nepal Demographic Health Survey data of 5178 women and girls, we employed Structural Equation Modelling. Our findings reveal that access to WASH facilities was positively associated with better MHH outcomes, which were significantly negatively associated with IPV. The indirect effect of WASH on IPV via MHH was statistically significant, supporting MHH's mediating role. The interaction between Partner Controlling Behavior and MHH outcomes significantly predicts IPV, highlighting the moderating influence of gender norms. The protective effect of improved MHH practices is weakened where Partner Controlling Behavior are more prevalent. These findings underscore the importance of addressing both resource availability (enhancing capabilities) and harmful gender norms (enacted through controlling behaviors) to mitigate IPV. We advocate for a comprehensive approach that includes enhanced WASH access, improved MHH practices, and interventions targeting harmful gender norms and controlling behaviors within relationships.

亲密伴侣暴力对全球妇女的影响尤为严重。虽然人们认识到水、环境卫生和个人卫生（WASH）与IPV之间的联系，但其潜在机制需要进一步探索。本研究探讨了月经健康与卫生（MHH）实践在尼泊尔WASH-IPV关系中的中介作用和伴侣控制行为的调节作用。根据Sen的能力方法和社会控制理论，我们假设通过改善卫生保健实践，获得WASH设施与IPV呈负相关。我们认为这种关系受到伴侣控制行为的调节。利用尼泊尔5178名妇女和女孩的人口健康调查数据，我们采用结构方程模型。我们的研究结果表明，获得WASH设施与更好的MHH结果呈正相关，而MHH结果与IPV显着负相关。WASH通过MHH对IPV的间接影响具有统计学意义，支持MHH的中介作用。伴侣控制行为与MHH结果之间的相互作用显著预测IPV，突出了性别规范的调节作用。在伴侣控制行为更为普遍的地方，改进的MHH实践的保护作用减弱。这些发现强调了解决资源可用性（增强能力）和有害的性别规范（通过控制行为制定）以减轻IPV的重要性。我们提倡采取一种综合方法，包括加强WASH的获取，改进卫生保健做法，以及针对有害性别规范和控制关系中的行为的干预措施。

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引用次数: 0

To go or not to go: The challenges of UK public toilet provision 去还是不去：英国公共厕所供应面临的挑战

IF 4.1 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Health & Place

Pub Date : 2025-09-27 DOI: 10.1016/j.healthplace.2025.103545

Jo-Anne Bichard, Gail Ramster

The United Kingdom's public toilet provision currently faces many challenges. This paper sets out some of the key barriers to providing inclusive toilet provision. We suggest that one of the key challenges provision faces is the taboo of the public toilet and that this contributes to a lack of recognition in the essentials of provision. However, we argue that the taboo around public toilets also affects future funding, not only of the provision itself but extends to research of the provision and it's social and economic necessity. Such research would generate evidence on the importance of public toilets for everyone's successful urban living, but especially from a public health perspective that affects everyone.

英国的公共厕所供应目前面临许多挑战。本文列出了提供包容性厕所的一些主要障碍。我们认为，供应面临的主要挑战之一是公共厕所的禁忌，这导致了对供应的基本要素缺乏认识。然而，我们认为，围绕公厕的禁忌也影响了未来的资金，不仅是提供本身，而且延伸到提供的研究及其社会和经济必要性。这样的研究将为公厕对每个人成功的城市生活的重要性提供证据，尤其是从影响每个人的公共卫生角度来看。

引用次数: 0

Inequalities in road traffic noise exposure levels in greenspaces in Greater London 大伦敦绿地中道路交通噪音暴露水平的不平等。

IF 4.1 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Health & Place

Pub Date : 2025-09-24 DOI: 10.1016/j.healthplace.2025.103536

Kathryn Adams , Calvin Jephcote , Benjamin Fenech , Anna Hansell , Tess Osborne , John Gulliver

Exposure to road traffic noise in residential settings has been associated with detrimental effects on health including annoyance, sleep disturbance, cardiometabolic outcomes, and mental health. Conversely, exposure to natural sounds improves cognitive performance and aids in stress recovery in humans. Environmental exposure studies have shown that the distribution of noise exposures is often not equitable across cities, but evidence related to noise in UK greenspaces remains limited. This study provides an analysis of noise variability and inequalities in noise levels for greenspaces in Greater London related to residential addresses. Noise levels from major and minor roads were modelled across 2,532 greenspaces for the daytime and evening period in accordance with the European Commission Common Framework for Noise Assessment (CNOSSOS-EU) methods from Environment Noise Directive 2002/49/EC and the inverse square law of sound attenuation. Using modelled road traffic noise estimates, we found that 28 % of greenspaces exceeded equivalent World Health Organization noise guideline levels during daytime and evening periods. Greenspaces in Central London were more likely to have noise levels that exceeded the WHO noise guidelines. Distance-based proximity analyses showed that for populations in Central London, greenspace areas nearest to residential addresses were more likely to feature high noise levels. As distance travelled from residential locations increased, the distribution of high greenspace noise levels became more dispersed. However, no inequality gradient was observed between different deprivation groups, except for the least deprived communities’, who experienced noise levels that were 2 dB lower within greenspace areas within a 5 km radius.

在住宅环境中接触道路交通噪音会对健康产生有害影响，包括烦恼、睡眠障碍、心脏代谢结果和心理健康。相反，接触自然的声音可以提高人类的认知能力，并有助于恢复压力。环境暴露研究表明，噪音暴露在城市之间的分布往往不公平，但与英国绿地噪音有关的证据仍然有限。本研究分析了大伦敦与住宅地址相关的绿地噪音水平的可变性和不平等。根据欧盟委员会噪声评估通用框架（CNOSSOS-EU） 2002/49/EC环境噪声指令中的方法和声衰减的平方反比定律，在2,532个绿地上模拟了白天和晚上主要道路和次要道路的噪声水平。通过模拟道路交通噪声估算，我们发现28%的绿地在白天和晚上超过了世界卫生组织的等效噪声指导标准。伦敦市中心的绿色空间的噪音水平更有可能超过世界卫生组织的噪音标准。基于距离的接近度分析表明，对于伦敦市中心的人口来说，离居民区最近的绿地更有可能具有高噪音水平。随着距离居住地点的距离增加，高绿地噪音水平的分布变得更加分散。然而，在不同的被剥夺群体之间没有观察到不平等梯度，除了最不贫困的社区，在5公里半径内的绿地区域内，他们的噪音水平要低2分贝。

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