Understanding Community Green spaces’ Leisure Attractiveness for Older Adults Based on Spatial Heterogeneity

Although numerous studies have investigated the impact of urban green spaces on health, the association between street-level greenery and domain-specific physical activity (PA) among older adults remains underexplored. This study employed Baidu Street View imagery and deep learning techniques to objectively evaluate street greenery exposure and its relationship with various types of PA among older adults in China. We conducted a cross-sectional study involving 1326 older adults (aged 60 years and above) residing in Beijing, China. The Physical Activity Scale for the Elderly (PASE) was used to assess participants’ PA levels. Street greenery was measured within a 500 m buffer around each participant’s residence using Baidu Street View images and deep learning algorithms. Data were analyzed using ANOVA, Chi-square tests, and multilevel linear regression models. Correlation analyses revealed that street greenery within a 500 m buffer of participants’ residences was significantly and positively associated with transportation PA among older adults (p < 0.05), particularly with bicycling (p < 0.01). After adjusting for individual characteristics, annual household income, and other potential confounders, multilevel linear regression analysis indicated that street greenery remained a significant positive predictor of transportation PA (β = 0.08, p < 0.01). No significant associations were found between street greenery and either leisure PA or household PA (p > 0.05). Street greenery around residential areas is significantly associated with transportation PA among older adults in China. Urban green space planning should prioritize enhancing street greenery and creating safe, pleasant walking and cycling environments to support active aging in high-density cities.

This study systematically explores the association between community green space and preventing kidney failure among middle-aged and older adults in China, using street view data. The 33 Chinese Community Health Study was used to conduct the analysis. We used street view data to assess street view green space (SVG) exposure and clearly distinguished the difference between grass (SVG-grass) and trees (SVG-tree). The normalized difference vegetation index (NDVI) was also used. Kidney failure was defined as a serum creatinine concentration of above 177mol/L. We used multilevel logistic regression models (controlled for a series of covariates) to examine the associations between SVG and the odds of middle-aged and older adults having kidney failure. We also tested whether middle-aged and older adults from socioeconomically disadvantaged groups are likely to derive greater benefits from the effects of green space ("equigenesis"). The results showed that both SVG (OR = 0.353; 95% CI = 0.171-0.731) and SVG-trees (OR = 0.327; 95% CI = 0.146-0.736) were negatively associated with the likelihood of middle-aged and older adults experiencing kidney failure, but there was no significant evidence of any links between either SVG-grass (OR = 0.567; 95% CI = 0.300-1.076) or the NDVI (OR = 0.398; 95% CI = 0.237-1.058) and kidney failure. Furthermore, the moderation analysis indicated that income and educational attainment have a moderating effect on the association between green space and the improvement of kidney health, which suggests that green space has greater positive effects on the kidney health of disadvantaged groups. To reduce inequalities in relation to kidney disease through urban planning, policymakers are advised to provide more visual green space-especially trees-within the community and to focus in particular on socioeconomically disadvantaged population groups.

The relationship between green space accessibility by multiple travel modes and housing prices: A case study of Beijing

Prevalence of depressive symptoms among older adults in mainland China: A systematic review and meta-analysis

Urban-scale green spaces have been a central topic as of late, but community-scale green spaces are overlooked in urban studies. This paper takes community green spaces in the main urban area of Beijing as the case to quantitatively interpret the spatial-temporal patterns of their service efficiency and distribution characteristics. The measurement section of the paper includes two parts: the first part compares the applicability of two major green space service efficiency measurement methods on the community scale and determines that the Shortest Time Distance method performs better in describing the spatial-temporal patterns of service efficiency. The second part applies the Time Distance Entropy method to initially identify the locational relationship between community green spaces and neighboring residential buildings, then proposes the Green Space Distribution Coefficient method based on this relationship to analyze the ‘courtyard’, ‘mixed’, and ‘centralized’ distribution types alongside the transition relationships between them, and the spatial-temporal patterns of distribution characteristics are measured. The results of service efficiency reveal that the community paradigms transform from ‘humanistic-oriented’ to ‘benefit-oriented’ as the Shortest Time Distance measurement values show an ascending trend with the passage of years and the outward expansion of the ring roads. The results of distribution characteristics reveal that the community residential culture transforms from ‘closeness’ to ‘detachment’ as Green Space Distribution Coefficient measurement values show a descending trend under the same conditions. Based on the measurements, this paper further provides several optimizing strategies for community green spaces in the central urban area of Beijing.

Inclusive green environment for all? An investigation of spatial access equity of urban green space and associated socioeconomic drivers in China

BackgroundThis study examined the moderating effects of built environment attributes on the relationship between family support and depressive symptoms among community-dwelling older adults in urban China.MethodsQuota sampling was used to recruit participants from Tianjin (one of the four municipalities in China) and Shijiazhuang (the capital city of Hebei Province). Face-to-face interviews were conducted with 799 respondents aged 60 years and older, in either their homes or local community centers. Multi-level modeling was used to test the proposed model.ResultsThis study found that family support was negatively associated with depressive symptoms. Green spaces were negatively associated with depressive symptoms among older participants, although most indicators of the objective built environment attributes were not. The moderation analysis revealed a significant interaction effect between family support and green spaces on depressive symptoms. Specifically, living in areas with a higher percentage of green spaces may mitigate the negative effects of lower levels of family support on depression.ConclusionsThis study contributes a new direction for investigating the relationship between family support and depressive symptoms among community-dwelling older adults in China by considering the moderating effect of objective built environment attributes. The findings may guide practices and urban design in mental health promotion for older adults. Specifically, this study provides evidence useful for both policy designers and urban planners by highlighting modifiable environmental and objective factors that can promote community mental health for older adults who find it difficult to obtain family support in modern society.

In developing countries aging is in many ways more difficult than in developed countries. In order simply to maintain the same standard of living as they age people must rely on pensions their savings and/or their children or other relatives. However few developing nations offer formal pension plans for rural residents. Nor can they live off of their savings; in developing countries they are generally poor and are not able to accumulate sufficient assets or saving during their lifetimes. Therefore villagers in developing countries typically rely on their extended family to support them in their old age. Life in rural China traditionally has been like rural life in many other developing countries as families have played an important role in maintaining the elderlys livelihood. As in time past this still primarily means reliance on the support of sons. In a typical situation the elderly in rural China live with or next door to one of their sons in an extended family arrangement. (excerpt)

<sec><title>Objective</title> Rapid urbanization has exacerbated traffic congestion, aggravated air and noise pollution, and limited public spaces, increasing the risk of suffering cardiovascular diseases (CVDs) such as hypertension and heart disease. Urban green spaces play a vital role in mitigating these risks by promoting mental restoration, reducing stress, encouraging outdoor exercise, improving air quality, and regulating temperature. The current research is identified with the following shortcomings despite the revealment of multiple positive health effects of urban green space. First, the research often focuses on single green exposure type, such as park accessibility or vegetation cover, overlooking the diverse pathways through which different green exposures influence cardiovascular health. Second, using streets or neighborhoods as research units can more comprehensively capture the group effect on health from people’s use of green space, and more specifically reveal the integrated effect of social interaction among residents, group behaviors and community public resources on health. Lastly, street-level analyses allow more precise environmental data integration, such as data on air pollution and temperature, which is often challenging in smaller individual-level units. Therefore, there is a need to conduct research on the influence of urban green exposure on CVDs mortality at the street level. </sec><sec><title>Methods</title> This research uses the partial least squares structural equation modeling (PLS-SEM) to analyze how different types of green exposure (vegetation cover, park accessibility, street green visibility, and park area per capita) influence cardiovascular disease mortality in 212 communities in Shanghai, China. The model incorporates three key mediating factors: Air pollution (measured by PM_2.5 concentration), extreme high temperature, and physical activity level. Through this approach, the research examines both the direct and indirect effects of vegetation coverage, park accessibility, street greenery, and per capita park area on CVDs mortality. The research draws on diverse data sources to ensure robust analysis: CVDs mortality data provided by the Shanghai Municipal Center for Disease Control and Prevention, PM_2.5 concentration data retrieved from MODIS satellite imaging, temperature data sourced from Google Earth Engine, and LBS (location based services) data serving as the basis for estimating physical activity levels. This comprehensive dataset allows for an in-depth exploration of the pathways through which green exposure influences cardiovascular health in an urban context. </sec><sec><title>Results</title> The research finds that green exposure primarily influences CVDs mortality through physical activity levels, based on which a pathway of “green exposure − physical activity level − CVDs mortality” is established (pathway coefficient = －0.184, <italic>p</italic> &amp;lt; 0.05). Notably, direct associations between PM_2.5 levels, extreme heat days, heat waves, and CVDs mortality are not statistically significant. Specifically, visibility of street greenery and vegetation coverage were shown to reduce CVDs mortality by promoting higher levels of physical activity among residents. Residential green spaces, “pocket parks” and street trees — due to their extensive reach, longer boundaries, and greater accessibility — encourage walking, cycling, and other active travel modes. This frequent, natural exposure to green spaces significantly enhances cardiovascular health by increasing both the duration and frequency of interaction with greenery, even surpassing the health benefits of larger centralized parks. The results indicate that smaller green spaces within residential areas and street greenery in densely populated and resource-limited areas are particularly effective in supporting cardiovascular health. In contrast, streets with a higher per capita green space show lower levels of physical activity, a trend attributed to their location on the urban fringe area, where park accessibility, green space quality, and safety are generally lower. Additionally, building density, road density, and land-use mix emerge as direct predictors of CVDs mortality. Building density, in particular, can indirectly influence the influence of green exposure on CVDs mortality by modulating physical activity levels as a mediating factor. </sec><sec><title>Conclusion</title> This research offers an in-depth analysis of the complex mechanisms by which various types of green exposure influence CVDs mortality, with a particular focus on the key mediating role of physical activity. Findings suggest that increasing street greenery, vegetation coverage, and per capita park area can significantly enhance residents’ physical activity levels, which in turn helps lower CVDs mortality. However, the research does not find significant mediating effects of air pollution or heat waves, and the potential of green spaces to improve air quality remains relevant. These findings contribute valuable insights to the theoretical understanding of how green exposure influences chronic non-communicable diseases and provide critical scientific support for urban planning and public health policies. In practice, urban planners should holistically consider the integration of diverse types of green spaces to maximize their benefits for cardiovascular health, thereby supporting the broader well-being of urban populations. </sec>

BackgroundCondom use has long been recommended as an effective method for preventing HIV/AIDS. However, a large proportion of older adults in China reported not using condoms, leading to an alarming increase in HIV prevalence among this population. Negative attitudes, especially condom-related stigma, have been identified as the main barrier. However, no condom-related stigma scale has been developed or validated for older adults in the Chinese cultural context. This study aimed to adapt and validate a condom-related stigma scale for older adults (CRSS-OA) in China, based on a scale previously developed for men who have sex with men (CRSS).MethodsBased on qualitative interviews, we adapted and revised the CRSS to better address the ageism and unique stigma faced by older adults in the Chinese cultural context. The reliability and validity of the adapted CRSS-OA were examined using a random sample of 498 older adults in Hunan Province, south-central China. Reliability was assessed by calculating Cronbach’s alpha. Construct validity was assessed through exploratory and confirmatory factor analyses. Concurrent validity was assessed by examining the correlation between each factor of the CRSS-OA and two criterion scales (the HIV/AIDS Stigma Scale and the Aging Sexual Attitudes Scale). Predictive validity was evaluated by analyzing the association between condom-related stigma and engagement in condomless sexual behavior.ResultsThe adapted scale included 16 items, loading on three factors, and collectively explaining 70.646% of the variance. These factors were named “labeling condom use,” “shaming condom purchase,” and “violating traditional sex beliefs,” demonstrating strong internal consistency with Cronbach’s alpha coefficients of 0.942, 0.850, and 0.852, respectively. Concurrent validity was established by evaluating the correlation between each factor of the CRSS-OA and two criterion scales, with Pearson correlation coefficients ranging from 0.227 to 0.508 (p < 0.05). Predictive validity was assessed by measuring the scale’s ability to correctly predict condomless sexual behavior, with an average predictability of 0.77.ConclusionsThe adapted CRSS-OA has proven to be a valid and cultural-adaptive tool for assessing condom-related stigma among older adults in China. Further studies are needed to explore the external validity of this scale in the future.

IntroductionChildhood family risks (CFRs) are believed to have long-arm effects on people's mental health. However, it is unclear whether age can alleviate these long-arm effects.AimThis study aimed to explore the relationship between CFRs and the mental health of older adults (mean [M] = 62.10, standard deviation [SD] = 8.02) in China and investigate whether age could moderate this relationship.MethodsThis cross-sectional, survey-based study used data from the Chinese General Social Survey conducted in 2015, and the data of 4,237 respondents were included in the final analysis. Mental health was measured by two items, namely negative and positive emotions. The step-by-step regression procedure and moderation analysis technique were used.ResultsFor older adults in China, CFRs were significantly negatively associated with their mental health (β = −0.046, t = −2.690, p < 0.01), age was positively correlated with their mental health (β = 0.115, t = 7.157, p < 0.01), and age significantly moderated the relationship between CFRs and mental health (β = 0.277, t = 2.172, p < 0.05). As age increases, the correlation between CFRs and mental health decreases, and when age is one SD above the M, CFRs are no longer significantly associated with the mental health level (bsimple = −0.01, t = −0.077, p > 0.05).ConclusionThis study showed that CFRs were negatively associated with the mental health level of older Chinese adults, and age could significantly moderate the association. Therefore, it is essential to take preventive measures in advance to protect people's mental health and teach older adults to use emotion-regulation techniques to weaken the association between CFRs and mental health.

Depression constitutes a substantial psychological issue among older adults in China. Traditional Chinese culture emphasizes family care for older adults; however, modernization has increased institutional care. This study aimed to examine the association between living arrangements and depression among older adults in China while considering the moderating effect of household registration status (hukou) due to rural–urban disparities in social resources. We utilized Chinese Longitudinal Healthy Longevity Survey 2018 data involving 10,089 older adults. Depression was assessed utilizing the 10-item Center for Epidemiologic Studies Depression Scale. Living arrangements included living alone or with a spouse, with children, and in institutions. The household registration status was urban or rural. A hierarchical multiple regression analysis was performed to investigate the direct and moderating effects. Older adults living with children were less depressed than those living alone or with a spouse. Older adults staying in institutions had fewer depressive symptoms. Rural older adults experienced higher levels of depression than their urban counterparts. The household registration status played a role in the relationship between living in institutions versus living alone or with a spouse and depression, where urban areas showed a significant positive effect. The results are consistent with the convoy model of social relations, social integration theory, and the stress-buffering hypothesis, which explain how social resources and living arrangements can lessen depression among the older adults. Living in urban areas provides more opportunities for social networks and resources, contributing to better mental health. The present work serves to inform urban and rural policies with regard to increasing social support and decreasing ‍‌depression.

To explore impact of the propensity to coronavirus disease 2019 (COVID-19) vaccine/vaccination on influenza vaccination from willingness to behavior after COVID-19 pandemic among older adults in rural China. A combined study involving a cross-sectional survey for the willingness of influenza vaccination, a health education momentary intervention and a community intervention program were conducted from September 11th to 16th, 2023 among rural older adults in China. Totally 3138 individuals were investigated in this study with 1923 (61.3%) willing to receive influenza vaccination. After the momentary intervention, 47.8% (582/1215) individuals changed to be willing to receive influenza vaccination. There were 1440 (78.8%) vaccinated. The influenza vaccination willingness rate was significantly higher in the participants willing to receive COVID-19 vaccine booster dose vaccination than the participants unwilling to (69.4% vs. 37.7%, adjusted OR [aOR] = 2.671, 95% CI 2.211–3.227, p < .001), as well as for the influenza vaccination willingness change rate (52.2% vs. 41.7%, aOR = 1.303, 95% CI 1.022–1.662, p < .05) and the influenza vaccination behavior rate (79.7% vs. 74.9%, aOR = 1.337, 95% CI 1.002–1.784, p < .05). The influenza vaccination behavior rate was significantly higher in those positive toward COVID-19 vaccine effectiveness or safety overall (80.0% vs. 74.9%, aOR = 1.394, 95% CI 1.065–1.823; 80.6% vs. 70.9%, aOR = 1.850, 95% CI 1.395–2.454; both p < .05). There was a positive impact of COVID-19 vaccine/vaccination on influenza vaccination from willingness to behavior among the older adults in rural China after COVID-19 pandemic, suggesting that integrating health education of related pathogens and vaccines might promote influenza vaccination.

When healthy aging meets Vitamin G: Assessing the associations between green space and heart health in older adults using street view and electrocardiography

The purpose of this research is to reveal the internal relationship among community green space, space perception, and activity behavior response to supplement the lack of research results on the binary relationship between green space and behavior. Nine residential community green spaces and 398 residents were selected as the research objects. Thematic clustering and factor identification were used to determine the spatial dimensions of community green space that residents were concerned about. The analysis of the green exposure index, spatial perception evaluation, and activity behavior survey were combined to determine the influence of the green exposure index on spatial perception and activity behavior and its internal correlation path. According to research data, the community green view index (GVI) and normalized difference vegetation index (NDVI) negatively affected the perception factor, while the perception factor positively affected the activity frequency. The SEM model shows that the green exposure index stimulated activity behavior through the intermediate effect of the internal perception path of perceived landscape quality, perceived workability, and perceived accessibility. Spatial perception as the basis of the instantaneous emotional reaction process may affect people's choices for activities but be unable to extend the duration of the activities. The internal association among community green space, spatial perception, and physical activity behavior develops on the basis of spatial patterns at certain scales. This study provides a theoretical basis for understanding the spatial experience and residents' behavioral needs, evaluating the quality of urban green space scientifically, and promoting the optimization of community green space structure.