Health & place最新文献

Creating a healthy food environment in secondary schools has the potential to communicate social norms regarding healthy dietary choices. This study explored the relationship between the schools' food environment and perceived descriptive (what others do) and injunctive (what others approve) norms regarding healthy dietary choices among adolescents. An exploratory (quasi-experimental) study was conducted in 23 Dutch schools, differing between three arms based on implementation degree of a Healthy School Canteen Program: limited, moderate or sustainable. Students (n = 1004) completed a questionnaire about descriptive and injunctive norms regarding water, fruit/vegetables, snacks, sugar-containing beverages, brown/whole wheat bread. Multi-level analyses were conducted (two-level hierarchical data structure). Compared to limited implementation, students in schools with moderate implementation indicated less favorable norm perceptions with (a) lower descriptive norm scores regarding water (-.30, 95 % CI [-.47; -.12]), (b) lower injunctive norm scores regarding fruit/vegetables (-.29, 95 % CI [-.49; -.10]) and water (-.34, 95 % CI [-.49; -.20]), and (c) higher injunctive norm scores regarding sugar containing beverages (.17, 95 % CI [.02; .32]). No significant differences were observed between students in schools with sustainable implementation and limited implementation. Compared to sustainable implementation, students in schools with moderate implementation indicated less favorable injunctive norm perceptions regarding fruit/vegetables (-.28, 95 % CI [-.47; -.08] and water (-.26, 95 % CI [-.41; -.12]). This study illustrates the complex interplay between perceived social norms regarding healthy dietary choices and efforts to create a healthy food environment. Future research should examine how social norms evolve over time within schools, taking into account their unique context.

This study aims to examine the association between urban environment characteristics at birth and at adolescence and cardiometabolic health in adolescents from the PARIS birth cohort. Body mass index z-scores (BMIz) trajectories from birth to adolescence, weight status and two cardiometabolic profiles at adolescence were determined. Traffic-related air pollution (TRAP) exposure was estimated by a nitrogen oxides air dispersion model. The French Deprivation Index, walkability percentage, and the use of green spaces were considered. Built environment typologies were identified by a cluster analysis. Associations were assessed using multivariable (multinomial) logistic regression models and potential modifier effects were examined. Among 617 adolescents who participated in the health checkup, around one in ten were living with overweight/obesity. Five BMIz trajectories were identified. After adjustment, walkability and the use of green spaces at adolescence were negatively associated with overweight/obesity. Early TRAP exposure showed a positive association with overweight/obesity and with each BMIz trajectory compared to the low stable trajectory, with a higher level of association observed for the two ascending trajectories. TRAP exposure, parental overweight, use of green spaces, and sedentary behavior modified the associations between the urban environment and overweight. These findings show the beneficial effects of neighborhood walkability and using green spaces on overweight/obesity in adolescents. They also demonstrate that early TRAP exposure increases the risk of overweight. These results highlight the necessity of effective urban planning to contribute to a healthy environment.

The everyday activities of older adults are enabled through numerous micro-movements, which are small spatial and bodily movements and non-movements essential for maintaining health. This study introduces and applies the concept of collateral mobilities to capture both bodily and spatial micro-movements and their interactions in everyday activity spaces. Using GPS tracker and pedometer data, we analysed the collateral mobilities of older adults in Lancashire, United Kingdom, across 513 places and 452 trips. 'Places' refer to the locations visited and 'trips' refer to the journeys connecting these places within an activity space. Our results show that larger activity spaces are associated with lower levels of bodily movement, highlighting the need to take both spatial extent and bodily movement into account when evaluating mobility behaviour. We also found that considerable bodily movement occurs in places of spatial non-movement, particularly in places outside of the home. Furthermore, there is a positive correlation between bodily movement during trips and bodily movement within places before and after those trips. This study bridges geography and medical sciences by providing insights into the complex dynamics that shape everyday activity spaces in later life. It emphasises the importance of taking a holistic but detailed approach to understanding mobilities.

It is unknown whether living in neighborhoods historically rated as "high-risk" mortgage by lenders (i.e., "redlining") defined by maps of the Home Owners' Loan Corporation (HOLC) neighborhood ratings may associate with obesity through neighborhood factors and health behaviors, or how such associations might differ by race and gender. We used data from the 1985-86 Coronary Artery Risk Development in Young Adults (CARDIA) study to test whether retrospective cohort associations between redlining and body mass index (BMI) were mediated by paths from census-derived social and economic neighborhood factors, food availability, physical activity (PA) resources to diet and physical activity behaviors. We found that the HOLC ratings (which reflected institutionalized racial sentiment of the time) were associated with higher levels of neighborhood socioeconomic deprivation within all racial and gender groups. For White adults and men, historically redlined neighborhoods were indirectly associated with higher BMI through neighborhood socioeconomic deprivation and lower diet quality. An indirect pathway connecting redlining to BMI was also identified for Black adults, but higher quality diet correlated with higher BMI. While women's dietary quality was not associated with BMI, redlining was directly associated with neighborhood socioeconomic deprivation which was directly associated with higher BMI and lower dietary quality, separately. Food and PA resource availability were inconsistently associated with HOLC ratings. Overall, historically redlined neighborhoods remained socioeconomically deprived 50 years later, which may have contributed to lower diet quality for all race and gender groups. The historic intertwining of race and value, as illustrated by the redlining maps, may have influenced disparities in BMI across race and gender groups. This suggests complex interactions among redlining, race, gender, and BMI.

Introduction: Local food systems are shaped by complex and interdependent social, economic, environmental, and cultural factors that influence population health and resilience. The Latrobe Valley (LV) in Victoria, Australia, presents a compelling case study: a region in economic transition, facing health inequities, yet rich in agricultural heritage and community engagement. This study applied systems science and co-creation to explore the LV food system and develop an action plan to enhance its health, sustainability, and accessibility.

Methods: Group Model Building (GMB) was employed through three facilitated workshops recruiting 38 participants, representing health professionals, local government, consumers, agronomy experts, and researchers. The process was built on a previous long-term relationship between academics and community partners, both of which were involved in decisions about GMB design. Participants collaboratively developed a Causal Loop Diagram (CLD) that describes the relationships between causal factors affecting access to healthy and sustainable food in the LV.

Results: Participants identified several key system interactions shaping food access in the Latrobe Valley, such as the reinforcing relationship between socioeconomic disadvantage and food relief demand, the reinforcing loop between food literacy, healthy eating norms, and community engagement, and the opportunity-constraint tension around local food production and fresh food availability. These insights informed the generation and prioritisation of community-led actions to improve affordability, availability, and healthy food literacy.

Conclusion: This study demonstrates the value of systems thinking and co-creation in designing adaptive, inclusive, and context-sensitive interventions. It supports the community in creating actionable pathways toward a more resilient local food system.

This paper reports on the challenges of handling menstrual waste in informal settlements in Kisumu, Kenya, and the emerging conflicts between reducing the use of these 'complicated plastics' and ensuring human health and dignity. To investigate these interconnections, we draw on a survey conducted among sanitation workers conducting manual pit emptying. We then conducted a knowledge co-production workshop including generating maps showing flows of menstrual waste around Kisumu. The maps were used as the basis for a discussion of desirable futures in the context of waste and sanitation adapted from the Three Horizons methodology. Findings indicated that sanitation workers deal with large quantities of menstrual waste when conducting their day-to-day work, which produces a range of health, environmental, and social risks that are difficult to mitigate. Men were more likely than women workers to be unregistered, producing additional health and social risks due to this form of work often being conducted at night. Maps of waste flows in Kisumu showed very different realities among sanitation workers compared with other stakeholder groups such as government officials. When considering desirable waste futures, government and civil society stakeholders were in favour of an aspirational 'zero waste' future where plastic products are phased out in favour of reusable or biodegradable products. This was in tension with the future vision of sanitation workers who do not want to reduce waste, which is their main livelihood, and preferred better managed waste streams that reduced their risks and improved their standing in the community. These findings highlight conflicting priorities among stakeholders when addressing taboo waste streams such as menstrual waste, and the challenges of focusing on aspirational sustainability transitions that may harm socially marginalized groups.

Objectives: Physical food outlets are increasingly offering delivery through Online Food Delivery Service (OFDS) platforms, but the scale of this expansion remains unclear due to the labour-intensive process of manually matching outlets to online platforms. Understanding the share of outlets offering delivery is important, as it impacts food availability and thus potentially influences dietary behaviours. This paper demonstrates how a machine learning model can efficiently match physical to online outlets. We also analysed how the proportion of physical outlets listed online and online-only outlets varies by area-level deprivation.

Methods: The physical locations of outlets selling food in Great Britain was obtained from a centrally held register for food hygiene data, while online outlet data was collected through web scraping an OFDS platform. We calculated string distances based on outlet names and postcodes, which were then used to train a Random Forest model to match outlets from the two lists. Area-level deprivation was assessed using the Index of Multiple Deprivation.

Results: The Random Forest classifier model achieved an F1 score of 90 %, a recall of 98 %, and a precision of 83 %. Overall, the median percentage of physical outlets also listed online was 14 % (IQR 0-23), and the median percentage of online-only outlets was also 14 % (IQR 0-27). The proportion of physical outlets listed online and online-only outlets was highest in more deprived areas. For example, compared to the least deprived areas, the most deprived areas were associated with a 6 % greater proportion of physical food outlets listed online (95 %CI 5 %-6 %) and a 3 % greater proportion of online-only outlets (95 %CI 1 %-4 %).

Conclusion: This study demonstrates the potential of machine learning techniques to efficiently match physical and online food outlets. This automated approach can provide insights into the relationship between physical and online food availability. Researchers and policymakers can use this method to better understand inequalities in food outlet availability and monitor the expansion of online delivery services.

The 20-min neighborhood (20 MN) concept, aimed at fostering livable communities, has garnered increasing attention among urban planners and policy makers. 20 MNs provide most daily needs (e.g., grocery, parks) within a 20-min walk of home. Among 352 older adults in the Healthy Brain Initiative (HBI), we examined whether 20 MN measures were associated with resilience against future cognitive impairment/dementia measured via the Resilience Index (RI), as well as with structural magnetic resonance imaging measures (i.e., hippocampal volume, white matter hyperintensity (WMH) volume). We calculated density of destinations within a 20-min walk of home across seven domains (i.e., social destinations, dining places, shopping/retail, grocery/supermarkets, healthcare facilities, parks, and transit availability) and created a dichotomous 20 MN variable (≥1 destination within a 20-min walk in all seven domains, yes versus no). In multivariable linear regression analyses, greater density of parks, greater density of grocery/supermarkets, and living in a 20 MN were associated lower WMH volumes. Our study suggests brain health benefits for older adults with greater densities of grocery and park destinations within a 20-min walk of home, as well as those living in 20 MNs. Future studies corroborating our findings for beneficial associations between 20 MNs and brain health would provide significant policy implications for dementia prevention.

Achieving good population level measures of access to healthy food retailers have been suggested to support healthy diets and weight. However, there is little evidence to suggest that population measures of access to healthy food at the local government level is effective in supporting healthier weight of the community. The objective of this study was to establish whether in Greater Melbourne (Australia) population measures of food retail accessibility to Supermarkets and a mix of Healthy outlets (e.g., supermarkets, greengrocers, sushi outlets) within 1 km from home (based on the guidelines for metropolitan areas) at the local government area (LGA) level is associated with significantly different measures of healthy weight; and, whether this association is consistent over time after adjusting for sociodemographic factors and access to Less Healthy and Unhealthy food retail outlets within this area. The findings of this secondary repeat cross-sectional analysis indicate that in LGAs where over 50 % of the population has access to a variety of healthy food outlets within a 1 km buffer, mean BMI is significantly lower than in LGAs with less than 50 % of the population. Healthy food outlets in this study include greengrocers, butchers, supermarkets, and specialty stores (such as wholefoods and cultural food shops), along with healthier takeaway options like sushi, salad, and sandwich bars. In contrast, the availability of a supermarket within 1 km alone showed no significant association with lower BMI at the LGA level. Findings support future efforts to routinely measure access to food retail at the LGA level and enforce accessibility recommendations to support population health.

Our special issue on "Longitudinal Analysis in Geospatial Health Applications" highlights major advances in understanding how dynamic environments shape health across the life course. Featuring innovative methods, including medical informatics, artificial intelligence, and precise residential history protocols, authors demonstrate how exposures, neighborhood opportunities, and social inequalities accumulate and interact over time and space. Studies span global contexts, documenting the health impacts of mobility, residential (dis)advantage, environmental hazards, built and food environments, and access to greenspace. Key findings reveal that persistent disadvantage, climate-driven or voluntary mobility, and environmental injustice all profoundly influence health trajectories. The COVID-19 pandemic further spotlighted and amplified spatial inequities in resource access and health behaviors. Collectively, the contributions call for integrated, longitudinal, and place-based public health strategies, emphasizing that effective interventions must consider both spatial and temporal dynamics. These works pave the way for building healthier, more equitable communities through sustained, data-driven, and context-aware action.