Health & place最新文献

Background: Public toilets enable populations, including those who menstruate, to move through public spaces. Menstrual Friendly Public Toilets (MFPT) are accessible, safe, and clean public toilets that provide those who menstruate the space and resources to navigate cities with dignity and comfort. However, there is little evidence on the status of MFPTs in urban centers. This study assessed the menstrual friendly characteristics of public toilets in Barcelona, Kampala, Manila, New York City, Osaka, Rio de Janeiro and quantified the overall "menstrual friendliness" by city and neighborhood type.

Methods: We conducted public toilet audits in four types of neighborhoods (Business, Tourist, Transit hub, Residential) in each city. The audit tool captured a range of menstrual health and hygiene (MHH) characteristics. Aggregate scores ("MFPT Index") were calculated to summarize the menstrual friendliness of public toilets within the neighborhoods and across cities.

Results: A total of 181 public toilet audits were analyzed. Areas around Transit hubs had the highest density of toilets, Residential areas were comparatively under resourced, and toilets in Business areas were relatively more "menstrual friendly." The overall mean score for the MFPT Index was 0.67, ranging between 0.49 and 0.79 across cities. Sub-domain scores of the MFPT Index indicated key aspects for improvement in relation to Accessibility, Structure, Privacy/Safety, General Resources, Cleanliness, and MHH Resources.

Conclusion: There is a significant gap in the provision of MFPTs in urban centers. Further research is needed to understand the extent of challenges related to accessibility, structural amenities, and availability of MHH-related resources, and how they can best be addressed. Our study's findings underscore the need for the prioritization of MFPTs in public spaces to ensure all individuals have equitable access to manage their menstrual cycles.

The engagement of senior citizens with urban nature has been shown to provide multiple health benefits and mitigate health issues associated with demographic aging. This review utilized the PRISMA methodology to systematically analyze the relationship between monitoring tools, seniors' behaviors in urban nature, and influencing factors. The main findings are as follows: (1) 4 main types, including self-reports, on-site observations, sensors, and third-party data, and 24 sub-types of measurement tools: ranging from questionnaires to crowdsourced imagery services. Self-reports capture participants' awareness of behaviors, on-site observations record various types of behaviors, sensors collect indicators to detect the body's direct responses, and third-party data provide representative behavior data from large samples. (2) 4 categories and 45 types of behaviors: physical and sports behaviors, leisure and recreational behaviors, relaxation, and passive behaviors, social and care behaviors, based on their characteristics and purposes. Physical and sports behaviors are the most common types for the elderly in urban nature, with walking being the most frequently measured behavior. (3) 36 influencing factors: ranging from diabetes risk to balanced meal habits, classified into 4 categories from physical and vitality health to social and lifestyle health. Physical and vitality health are the most affected category, receiving more academic attention. Gardening is identified as having the most health benefits. This review provides a classification of tools and behaviors, and a detailed discussion of future trends in the field. It provides actionable insights for researchers, urban designers, city managers, and policymakers to select the appropriate measurement tool from 24 sub-tools to better understand behaviors of elderly people in urban nature. It can also help them select the right type of behavior from 45 sub-behaviors to investigate in line with their research goals to improve seniors' health and well-being.

Background: Cardiovascular disease (CVD) is one of the leading causes of death globally. Yet, further research is required into the relationship between CVD and extreme environmental temperatures. This study aims to explore the association between the incidence of CVD and extreme temperatures, and also to identify susceptible subgroups within the population.

Methods: We collected cardiovascular emergency ambulance dispatch (CEAD) records from Chongqing Emergency Dispatch Center in the main urban areas of Chongqing from 2019 to 2021. Then, we used distributed lag nonlinear modeling (DLNM) with a quasi-Poisson distribution to evaluate the association between extreme temperatures and CEADs. Susceptibility subgroups were identified by stratified analysis according to gender, age and initial diagnosis. Finally, the attribution analysis was used to calculate the scores and counts of CEADs caused by low and high temperatures.

Results: Compared with the optimal temperature (23 °C), the cumulative lagged risk of total CEADs was increased under extreme low-temperature conditions (CRR: 1.732, 95% CI: [1.157, 2.593]), with the lagged effect lasting for 8 days. Under extreme high-temperature conditions, it decreased (CRR: 0.752, 95% CI: [0.611, 0.926]) and a protective effect was observed. Compared to the group under 60, those over 60 were more sensitive to temperature changes, showing a higher risk of disease with cold exposure (RR: 1.087, 95% CI: [1.021, 1.157]). In addition, a reduction in risk of disease was observed just one day after heat exposure. There were also gender differences in the elderly group: males showed longer lagged effects after cold exposure, while females had higher dispatch risk in cold weather and less heat adaptation in hot weather than males.

Conclusion: Ambient temperature is significantly associated with the risk of CVD, with elderly patients, especially females, being a high-risk subgroup. Governments need to formulate localized health policies that address regional climate patterns and population vulnerabilities. As one of the famous "Furnace Cities", Chongqing's measures for coping with hot environments can serve as a reference. Nonetheless, improving our understanding and preparation for cold weather is also crucial. Public warning systems should be improved, and local heating strategies for vulnerable groups should be developed to minimize the negative risk of extreme cold temperatures to the public.

Spatial modelling was employed to identify high-risk zones for the transmission of cutaneous leishmaniasis in hyperendemic urban environments, focusing on Mashhad, Iran. Data analysis from 3033 CL patients (2016-2020) integrated socio-demographic, environmental, and geological factors using negative binomial regression and the technique for order of preference by similarity to ideal solution (TOPSIS) model. Findings indicate that 42.8% of the study area, affecting 20% of Mashhad's population, is at heightened risk due to factors such as high illiteracy rates, dense populations, poor built environment quality, and specific geological conditions. The model achieved an area under the curve (AUC) of 0.83, signifying strong discrimination, with Kappa statistics (KNO = 0.60, K standard = 0.56) showing substantial agreement. These insights can be used to inform targeted surveillance and effective disease control strategies.

While the dominant patterns of migration for livelihood among the poor in India are rural-to-rural and circular, literature on the health implications of child migration has largely focused on rural-to-urban, permanent movement. We compared child growth across three migration typologies rural Bihar: circular migrant families that repeatedly migrate to rural destination sites with accompanying young children, rural households with male migrants, and rural households that do not engage in migration. We integrated network theory based on caste and tribe geography to inform our analytical approach. Our results demonstrate complex associations between nutrition status and repeated movement of children between home and destination spaces. In addition to the policy imperative of multilocational strategies for migrant families, households that do not engage in migration yet are located in high outmigration regions also require targeted livelihood and health interventions.

Air pollution is a critical global public health and environmental concern, leading to over 6.7 million premature deaths annually, disproportionately affecting low- and middle-income countries (LMICs), where the use of polluting fuels for cooking remains widespread. Incorporating perceptions of air pollution is argued as vital for developing effective intervention strategies. However, this has seldom been given focus in the development of clean cooking interventions. The use of firewood in Kenyan schools is commonplace and the transition to clean cooking methods in school settings is gaining international attention. We investigated how air pollution is perceived and understood by staff in three schools from an informal settlement in Nairobi, Kenya which predominately use firewood or charcoal for school catering. We conducted focus group discussions and in-depth interviews and used thematic analysis to explore perceptions of air pollution in the schools and how these differed between different staff groups. Perceptions of air pollution were dominated by external environmental factors from the surrounding informal settlement. While the impacts of air pollution from firewood on catering staff and teaching activities were recognised, understandings of the long-term health impacts were often blurred and dislocated from the school setting. Responsibilities for addressing air pollution were said to be with external stakeholders, but the school staff cited a lack of government interventions to address underlying poverty and multiple pollution sources. Effective strategies to tackle air pollution must involve careful engagement with stakeholders and community members to incorporate local perceptions of air pollution and address broader systemic issues that increase exposure. Clean cooking interventions focused solely on reducing air pollution may face challenges due to competing financial demands and a tendency to shift responsibilities for tackling such an issue. Broader benefits, such as economic and environmental improvements, might be more compelling drivers for successful implementation.

In response to the growing demand for healthier food, online fresh food platforms have emerged as a convenient solution, aiming to meet this need. This study employs a difference-in-differences design and an imputation method to evaluate the impact of online fresh food platforms on population health. These methodological approaches enable the identification of causal effects, offering insights into how these platforms influence health outcomes across different demographic groups. Our findings reveal that the availability of online fresh food options positively influences health outcomes by increasing physical activity, such as walking time, and reducing BMI, hypertension, and depression rates. Easier access to healthier food fosters healthier lifestyles, contributing to both improved physical and mental health. These findings may offer insights for policymakers, suggesting that the availability of accessible healthy diet options could contribute to improving community health.

Health implications of mobility during pregnancy entail a need to understand pregnant women's activity spaces. We present ActMAP, a framework for quantifying multiple aspects of activity spaces from distinct trips and stays derived from GPS data. We applied ActMAP to data from 238 pregnant women in Barcelona, Spain (2018-2020) and explored weekday, weekend and intraday associations between pregnancy trimester and activity spaces. Activities were more centred around the home later in pregnancy. However, the number of visited places and daily trips remained largely constant throughout pregnancy. By constructing activity spaces from individual trips and stays, ActMAP could provide a framework for GPS-based holistic assessments of mobility.

Despite a large body of work on neighborhood effects on health, past studies are limited in their treatment of neighborhoods as largely static spaces with (dis)advantages based primarily on the average characteristics of their residents. In this study, we draw on the triple neighborhood disadvantage perspective to explore how socioeconomic disadvantage in a neighborhood's mobility network uniquely relates to children's overall health levels, independent of residential disadvantage. We investigate this by combining 2019 SafeGraph data on mobility patterns from roughly 40 million U.S. mobile devices with information on children, families, and neighborhoods from the 2015-19 American Community Survey and 2019 Panel Study of Income Dynamics Child Development supplement. We find that mobility-based neighborhood disadvantage (MND) generally predicts child health better than residential neighborhood disadvantage (RND), but associations vary by race and by family income and are contingent on the broader metropolitan context. Our study advances existing research on the effects of mobility networks by shifting from analyzing aggregate-level outcomes to exploring how mobility-based disadvantage affects individual outcomes. Overall, our results indicate that the relationship between neighborhood disadvantage and child health is nuanced and complex. Findings from our study suggest that researchers aiming to understand the influence of neighborhood contexts should examine individuals' residential environments as well as the environments of neighborhoods connected through individuals' everyday mobility.

Objective: To characterize the spatio-temporal association between features of the built environment and subclinical liver disease.

Design: We used data from a large community-based population, the Multi-Ethnic Study of Atherosclerosis (2000-2002, N = 5542) with linked historical residential data that characterized past exposure to alcohol outlets (bars and liquor stores), healthy foods stores, and physical activity facilities (1990-2001). We examined whether and how past residential relate to hepatic steatosis (proxied by liver attenuation measured using computed tomography, with lower attenuation indicating higher hepatic steatosis). Hepatic steatosis is the most common.

Results: We found significant associations between past residential exposure to neighborhood alcohol outlets, healthy food and physical activity resources, and hepatic steatosis. The spatial scale where the association between these features of the built environment and hepatic steatosis operate lies within 3 km (∼2 miles). The average association on liver attenuation per additional bar, liquor, healthy food store, and physical activity facility within a 2-mile buffer, were: -0.06 (95% CI -0.09, -0.03), -0.02 (95% CI -0.04, -0.009), 0.05 (95% CI 0.02, 0.07), 0.02 (95% CI 0.01, 0.04), respectively, in the preceding year of the measurement of hepatic steatosis. Furthermore, the association and spatial scale remains consistent ten years prior to the measurement of hepatic steatosis.

Conclusion: Our results suggest that modifying neighborhood environments (decreasing alcohol outlets and improving access to healthy food and physical activity) may represent an effective population-wide approach to reduce liver-related morbidity.