Household Composition Research Articles

Multiscale rooftop greening and its socioeconomic implications in Hong Kong

Rooftop greening stands as a distinctive approach to delivering green space without occupying ground-level areas. The spatial configuration of rooftop greenery and its socioeconomic associations are critical for sustainable urban development and environmental justice. However, historical research trends have predominantly concentrated on open, ground-level environments, neglecting the vertical manifestation of urban greenery. Investigations into green roofs have typically been circumscribed to their environmental benefits, while little attention has been paid to the spatial distribution of rooftop greenery and the drivers behind it. This study aims to fill the gap by implementing a multiscale mapping approach with satellite imagery to quantify rooftop greenness in Hong Kong. An integrated analysis incorporating geographic and demographic data reveals a correlation between rooftop greenness and factors such as income levels, housing types, residential area sizes, and household compositions. This association exhibits pronounced environmental inequality, where lower-income individuals, solitary residents, and households with smaller living spaces in densely populated and aged neighborhoods are deprived of rooftop green spaces, in contrast to their counterparts in more affluent neighborhoods. Government-subsidized public housing initiatives have significantly contributed to enhancing the green living environment for low-income families. Buildings administered by government have demonstrated exceptional performance in rooftop greening efforts. This evidence provides nuanced insights into the advantages and deficiencies of green roof planning in Hong Kong and could serve as a critical reference for other densely urbanized cities working towards a sustainable and equitable urban green environment.

Health Literacy of Japanese Elderly who Participated in A Long-term Care Prevention Exercise Program by Household Composition

Objectives: With the development of services to improve the daily lives of older adults and the use of Internet of Things technology in healthcare in Japan, there is a growing need to address health literacy, especially among older adults living alone. The current study aims to fill this research gap by assessing the current state of health literacy in this population, and potentially providing guidance for future support strategies.Methods: In this study, 22 older female participants in long-term care preventive services were assessed for health literacy, cognitive function, and activities of daily living using the Household Composition and Basic Demographic Information, the Health Literacy Scale, the Japanese version of the Montreal Cognitive Assessment, and the Occupational Self-Assessment-Short Form.Results: The household composition was 13 older adults living alone and nine living with others. Older adults living alone had significantly lower functional health literacy than those living with others, which affected their ability to understand and apply health information. Difficulties reading health materials were also prevalent in this group, suggesting that visual impairment or a lack of assistive devices may affect their understanding of health information. Considering these specific needs through tailored strategies is essential for helping older adults to adapt to an increasingly digital society.Conclusions: Understanding the current state of functional health literacy among older adults living alone in the community is essential for developing strategies to improve their well-being, prevent isolation, and enable them to make informed decisions about their health.

It takes two to tango: Spousal risk preferences and CEO risk-taking behavior

Using hand-collected data on the cultural origins of S&P 500 CEOs and their spouses, we examine whether differences in risk attitudes within marriages influence corporate risk-taking behavior. We find that CEOs with more risk averse spouses adopt relatively safer corporate policies. The effect is stronger if the CEO comes from a more collectivist culture, has been married more recently, or shares more responsibilities with their spouse. Together, these findings suggest that the cultural composition of CEOs’ households and their spouses’ risk preference affect corporate risk-taking behavior.

Abstract PO1-09-10: County-level Social Vulnerability and Survival among Women with Inflammatory Breast Cancer

Abstract Purpose: Inflammatory breast cancer (IBC) is an aggressive form of breast cancer with a poor overall prognosis compared to other forms of breast cancer. Advances in treatment have contributed to improvement in IBC survival rates in recent years, yet disparities in outcomes persist. It is unclear whether social determinants of health impact IBC prognosis independent of access to quality cancer care. Thus, the aim of this study was to examine whether the US county-level social vulnerability index (SVI) was associated with IBC stage at diagnosis and overall survival (OS) among women with IBC treated at a single institution. Methods: Patients enrolled in the IBC registry at Dana-Farber Cancer Institute (DFCI) were included in this study. We linked participant’s residential zip codes to the 2020 CDC’s county-level SVI, which is calculated from 15 social determinants of health attributes from the American Community Survey including socioeconomic status, household composition, language and minority status, and housing and transportation factors. The SVI value reflects the percentile of counties in the nation that are less vulnerable than the county of interest. We assessed associations between SVI and stage at diagnosis using t-tests. Kaplan-Meier curves and log-rank tests were used to assess survival across SVI quartiles based on distribution (1st [least vulnerable] and 4th [most vulnerable]). Using hierarchical logistic regression models and Cox proportional hazards models with mixed effects incorporating cluster-specific random effects that modify the baseline hazard function, we assessed whether SVI is associated with the presence of de novo metastatic disease and OS in IBC. Results: A total of 586 women (86% White) enrolled in the IBC registry at DFCI between 1986 and 2021 were included in this study. Of these, 69.1% had stage III and 30.9% had de novo metastatic disease. 280 deaths occurred in the study population over a mean follow-up of 4.1 years. SVI for the counties where study participants resided ranged from 2.6% to 95.8% (median=34.2%). The mean SVI did not significantly differ according to stage at diagnosis (41.6% in non-metastatic and 40.8% in metastatic at presentation; p=0.70). OS did not significantly differ across SVI quartiles (p-value=0.63). In the age-adjusted models, the SVI was not associated with the presence of de novo metastatic disease (odds ratio (OR (95% CI)=0.99 (0.84, 1.16)) or OS (HR (95% CI)=0.79 (0.46, 1.33). Conclusions: Our findings that residing in socially vulnerable US counties is not associated with the presence of de novo metastatic disease or IBC survival among a subset of women accessing high-quality cancer care suggest that improving access to quality cancer care may overcome underlying socioeconomic factors that contribute to disparities in IBC outcomes. Future studies are needed to confirm these findings in other settings. Citation Format: Kelly Hirko, Elizabeth Troll, Sean Ryan, Faina Nakhlis, Jennifer Bellon, Olga Kantor, Christina Minami, Eren Yeh, Ilana Schlam, Laura Warren, Caroline Block, Susan Schumer, Filipa Lynce. County-level Social Vulnerability and Survival among Women with Inflammatory Breast Cancer [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO1-09-10.

Measuring quality of life in older migrants: assessing the construct and convergent validity of the CASP-12 among older Chinese migrants

Objectives: Many people are ageing outside of their countries of origin, and the older adult population is becoming increasingly diverse globally. Although research with older migrants is growing, key constructs, such as quality of life (QOL), are routinely measured with instruments developed with the native population within a single country. Understanding the cultural appropriateness and validity of these measures should be a key focus for research with older migrants to ensure findings reported are based on reliable estimates. In this study, we investigated the validity of the CASP-12, an older adult-specific QOL scale, with a sample of older Chinese migrants in Aotearoa New Zealand. Methods: Survey data were collected from 245 older Chinese migrants. The CASP-12 and criterion measures assessing QOL, self-reported health, income adequacy, length of residence, perceived language barriers, household composition and education were administered. Results: Confirmatory factor analyses confirmed the three-factor structure of the CASP-12. Control & Autonomy, Pleasure and Self-realisation emerged as independent factors. A significant method effect was, however, identified in connection with reverse-scored items of the Control & Autonomy subscale, indicating a potential response bias. The CASP-12 and its subscales related to criterion measures in expected ways. Conclusions: There is partial evidence for the validity and reliability of the CASP-12 as a QOL measure to be used with older Chinese migrants. The presence of a method effect, however, suggests that estimates related to the Control & Autonomy subscale are impacted by bias, and revision of the CASP-12 may be necessary in the future.

Visible women, invisible gender: Knowledge production on homelessness in Flanders

Homelessness as a distinct social problem is a relatively recent social construct. Many women are thought to experience so-called ‘hidden homelessness’, which is said to be the cause of their under-representation in the data. However, data now show a higher proportion of women among those experiencing homelessness. In addition, current definitions explicitly include women’s specific experiences such as living under the threat of violence. This article attempts to explore this contradiction between the alleged invisibility and the increased presence of women in the broader population experiencing homelessness, particularly in the Flemish context. First, the marginalisation and housing precariousness of women is analysed from a historical perspective, from the mid 1800s to the recent federalisation of Belgium. Second, it examines the current production of knowledge about homelessness. The article shows that women’s housing precariousness was conspicuous in the past, even if it was not framed as homelessness. The practices of categorising women and representing gender are explored in current reports, statistical data and expert discourses. The recent ‘numericisation’ of homelessness research, the methods and categorisations used to produce quantitative data, are constantly caught up in existing knowledge, policies and evaluations. As a result, other variables, such as household composition or housing situation, override gender. Fragmented policies and individual responses on the ground contribute to a multiplicity of discourses and a lack of advocacy for women’s homelessness as a distinct social problem. For organisations working and advocating for migrants, migration, not gender, is the defining dimension of vulnerability. For women’s organisations, gender meant inequality manifested in domestic and intimate partner violence. The discourses on these two groups make gender an ambiguous dimension of homelessness. As a result, existing data on homelessness is rarely analysed from a gender perspective. This in turn can hinder the introduction of more gender-sensitive policies.

Family network and household composition: a longitudinal dataset derived from the Karonga Health and Demographic Surveillance System, in rural Malawi.

Proximity to family, household composition, and structure are often studied as outcomes and as explanatory factors in a wide range of scientific disciplines. Here, we describe a large longitudinal dataset (currently including data from over 70,000 individuals from 2004 to 2017), including data on household structure, proximity to kin, population density, and other socio-demographic factors derived from data from the Karonga Health and Demographic Surveillance Site (HDSS) in Northern Malawi. We present how the dataset is generated, list some examples of how it can be used, and provide information on the limitations that affect the types of analyses that can be carried out.

Determinants of self-reported chronic disease diagnoses among older persons in South Africa.

Chronic diseases tend to affect the quality of life for older persons worldwide, especially in resource-constrained developing countries. Chronic diseases contribute to a large number of deaths among the population of South Africa. This study examines the determinants of self-reported chronic disease diagnoses among older persons in South Africa. The study setting was South Africa. Cross-sectional data from the 2019 South Africa General Household Survey were analysed (n[weighted] = 4 887 334). We fitted a binary logistic regression model to determine the relationship between socio-demographic factors and being diagnosed with self-reported chronic diseases. We found that at least 5 in 10 older persons were diagnosed with self-reported chronic disease. The bivariate findings showed that age, population group, sex, marital status, level of education, disability status, household composition and province were significantly associated with self-reported chronic disease diagnoses. At the multivariate level, we found that age, sex, population group, marital status, educational level, disability status, household wealth status, household composition and province were key predictors of self-reported chronic disease diagnoses. We found that various factors were key determinants of being diagnosed with self-reported chronic diseases. This study offers important insights into the main correlations between older adults and self-reported chronic illness diagnoses. More study is required on the health of the elderly as it will help direct policy discussions and improve the development of health policies about the elderly.Contribution:This study highlights the need for a better understanding of, and continued research into, the determinants health among older populations to guide future healthcare strategies.

Impact of Social Vulnerability on Cardiac Arrest Mortality in the United States, 2016 to 2020.

Cardiac arrest is 1 of the leading causes of morbidity and mortality, with an estimated 340 000 out-of-hospital and 292 000 in-hospital cardiac arrest events per year in the United States. Survival rates are lower in certain racial and socioeconomic groups. We performed a county-level cross-sectional longitudinal study using the Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research multiple causes of death data set between 2016 and 2020 among individuals of all ages whose death was attributed to cardiac arrest. The Social Vulnerability Index is a composite measure that includes socioeconomic vulnerability, household composition, disability, individuals from racial and ethnic minority groups status and language, and housing and transportation domains. We examined the impact of social determinants on cardiac arrest mortality stratified by age, race, ethnicity, and sex in the United States. All age-adjusted mortality rate (cardiac arrest AAMRs) are reported as per 100 000. Overall cardiac arrest AAMR during the study period was 95.6. The cardiac arrest AAMR was higher for men compared with women (119.6 versus 89.9) and for the Black population compared with the White population (150.4 versus 92.3). The cardiac arrest AAMR increased from 64.8 in counties in quintile 1 of Social Vulnerability Index to 141 in quintile 5, with an average increase of 13% (95% CI, 9.8%-16.9%) in AAMR per quintile increase. Mortality from cardiac arrest varies widely, with a >2-fold difference between the counties with the highest and lowest social vulnerability, highlighting the differential burden of cardiac arrest deaths throughout the United States based on social determinants of health.

Exploring farmer choices in Southern Togo: Utilizing a strategy game to understand decision-making in agricultural practices

CONTEXTAgriculture plays a vital role in African countries, driving economic growth, employment, and non-agricultural sector improvements. However, persistent food insecurity and poverty among smallholder families raise concerns. Land fragmentation compounds these issues, limiting agricultural productivity and pushing farmers towards off-farm activities, despite Africa's potential agricultural markets. OBJECTIVEThe study's focus is Donomadé, a remote village in southern Togo. This study pursues a dual objective. Firstly, it investigates how household characteristics, including family size and resource availability, influence farmers' resource management decisions. Secondly, the research employs serious games to comprehend farmers' livelihood strategy choices within constrained real-world-like conditions. METHODSThe iterative and participatory Companion Modelling (ComMod) approach was utilized for the co-design and co-development of a serious game. This involved close collaboration with a local research team from the University of Lomé, a local NGO, and Donomadé village farmers. Various farming systems were characterized, and collective insights into Donomadé's agricultural dynamics were gathered through surveys, interviews, and workshops. RESULTS AND CONCLUSIONSRegardless of their in-game roles, farmers prioritize fulfilling basic family needs, such as food security and education instead of investing in agriculture. The study underscores the significance of household composition and resource availability when designing technology interventions or support mechanisms for farmers. Aligning interventions with farmers' overarching goals and challenges can enhance technology adoption. Furthermore, addressing food security remains crucial for sustainable development, as it not only improves human welfare and alleviates hunger but also forms the foundation for comprehensive solutions in the face of climate change, resource constraints, and population growth. SIGNIFICANCEThis research highlights that heavy investment in agriculture is not the priority for many farmers in southern Togo, despite it being their main source of sustenance and income. Addressing immediate family needs, especially food security, education, and housing, takes precedence over long-term agricultural investments. Given the persistent challenge of food security amidst global uncertainties, addressing these priorities is paramount to stimulate more significant interest in agricultural investment.

Methodological issues of retrospective surveys for measuring mortality of highly clustered diseases: case study of the 2014–16 Ebola outbreak in Bo District, Sierra Leone

ABSTRACT Background There is a lack of empirical data on design effects (DEFF) for mortality rate for highly clustered data such as with Ebola virus disease (EVD), along with a lack of documentation of methodological limitations and operational utility of mortality estimated from cluster-sampled studies when the DEFF is high. Objectives The objectives of this paper are to report EVD mortality rate and DEFF estimates, and discuss the methodological limitations of cluster surveys when data are highly clustered such as during an EVD outbreak. Methods We analysed the outputs of two independent population-based surveys conducted at the end of the 2014–2016 EVD outbreak in Bo District, Sierra Leone, in urban and rural areas. In each area, 35 clusters of 14 households were selected with probability proportional to population size. We collected information on morbidity, mortality and changes in household composition during the recall period (May 2014 to April 2015). Rates were calculated for all-cause, all-age, under-5 and EVD-specific mortality, respectively, by areas and overall. Crude and adjusted mortality rates were estimated using Poisson regression, accounting for the surveys sample weights and the clustered design. Results Overall 980 households and 6,522 individuals participated in both surveys. A total of 64 deaths were reported, of which 20 were attributed to EVD. The crude and EVD-specific mortality rates were 0.35/10,000 person-days (95%CI: 0.23–0.52) and 0.12/10,000 person-days (95%CI: 0.05–0.32), respectively. The DEFF for EVD mortality was 5.53, and for non-EVD mortality, it was 1.53. DEFF for EVD-specific mortality was 6.18 in the rural area and 0.58 in the urban area. DEFF for non-EVD-specific mortality was 1.87 in the rural area and 0.44 in the urban area. Conclusion Our findings demonstrate a high degree of clustering; this contributed to imprecise mortality estimates, which have limited utility when assessing the impact of disease. We provide DEFF estimates that can inform future cluster surveys and discuss design improvements to mitigate the limitations of surveys for highly clustered data.

Assessing social vulnerabilities of salivary gland cancer care, prognosis, and treatment in the United States.

Salivary gland cancers (SGC)-social determinants of health (SDoH) investigations are limited by narrow scopes of SGC-types and SDoH. This Social Vulnerability Index (SVI)-study hypothesized that socioeconomic status (SES) most contributed to SDoH-associated SGC-disparities. Retrospective cohort of 24 775 SGCs assessed SES, minority-language status (ML), household composition (HH), housing-transportation (HT), and composite-SDoH measured by the SVI via regressions with surveillance and survival length, late-staging presentation, and treatment (surgery, radio-, chemotherapy) receipt. Increasing social vulnerability showed decreases in surveillance/survival; increased odds of advanced-presenting-stage (OR: 1.12, 95% CI: 1.07, 1.17), chemotherapy receipt (OR: 1.13, 95% CI: 1.03, 1.23); decreased odds of primary surgery (0.89, 0.84, 0.94), radiotherapy (0.91, 0.85, 0.97, p = 0.003) for SGCs. Trends were differentially correlated with SES, ML, HH, and HT-vulnerabilities. Through quantifying SDoH-derived SGC-disparities, the SVI can guide targeted initiatives against SDoH that elicit the most detrimental associations for specific sociodemographics.

Assessing social disparities in inpatient vs. outpatient arthroplasty: a in-state database analysis.

Given the growing emphasis on patient outcomes, including postoperative complications, in total joint arthroplasty (TJA), investigating the rise of outpatient arthroplasty is warranted. Concerns exist over the safety of discharging patients home on the same day due to increased readmission and complication rates. However, psychological benefits and lower costs provide an incentive for outpatient arthroplasty. The influence of social determinants of health disparities on outpatient arthroplasty remains unexplored. One metric that assesses social disparities, including the following individual components: socioeconomic status, household composition, minority status, and housing and transportation, is the Social Vulnerability Index (SVI). As such, we aimed to compare: (1) mean overall SVI and mean SVI for each component and (2) risk factors for total complications between patients undergoing inpatient and outpatient arthroplasty. Patients who underwent TJA between January 1, 2022 and December 31, 2022 were identified. Data were drawn from the Maryland State Inpatient Database (SID). A total of 7817 patients had TJA within this time period. Patients were divided into inpatient arthroplasty (n = 1429) and outpatient arthroplasty (n = 6338). The mean SVI was compared between inpatient and outpatient procedures for each themed score. The SVI identifies communities that may need support cause by external stresses on human health based on four themed scores: socioeconomic status; household composition and disability; minority status and language; and housing and transportation. The SVI uses the United States Census data to rank census tracts for each individual theme, as well as an overall social vulnerability score. The higher the SVI, the more social vulnerability, or resources needed to thrive in that area. Multivariate logistic regression analyses were performed to identify independent risk factors for total complications following TJA after controlling for risk factors and patient comorbidities. Total complications included: infection, aseptic loosening, dislocation, arthrofibrosis, mechanical complication, pain, and periprosthetic fracture. Patients who had inpatient arthroplasty had higher overall SVI scores (0.45 vs. 0.42, P < 0.001). The SVI scores were higher for patients who had inpatient arthroplasty for socioeconomic status (0.36 vs. 0.32, P < 0.001), minority status and language (0.76 vs. 0.74, P < 0.001), and housing and transportation (0.53 vs. 0.50, P < 0.001) compared to outpatient arthroplasty, respectively. There was no difference between inpatient and outpatient arthroplasty for household composition and disability (0.41 vs. 0.41, P = 0.99). When controlling for comorbidities, inpatient arthroplasty [Odds Ratio (OR) 1.91, 95% Confidence Interval (CI) 1.23-2.95, P = 0.004], hypertension (OR 2.11, 95% CI 1.23-3.62, P = 0.007), and housing and transportation (OR 2.00, 95% CI 1.17-3.42, P = 0.012) were independent risk factors for total complications. Inpatient arthroplasty was associated with increased social disparities across several components of deprivation as well as an independent risk factor total complications following TJA. To the best of our knowledge, this study is the first to examine the negative repercussions of inpatient arthroplasty through the lens of social disparities and can target specific areas for intervention.

Alcohol and Substance Abuse in the General Population during the COVID-19 Pandemic: Results of the COMET-G International Study

The global impact of the COVID-19 pandemic on mental health and substance use behaviors has sparked extensive research efforts. The COMET-G international study, organized by the Department of Medicine and the Rectorate of the Aristotle University of Thessaloniki in collaboration with the World Psychiatric Association, delved into these issues. Running from March 2020 to April 2021, the study collected responses from 55,589 individuals across 40 countries. Through a comprehensive questionnaire, participants provided insights into their mental state, attitudes toward the pandemic, and the resultant changes in their personal and daily lives. Findings revealed, among other things, significant patterns of change in substance use, with notable correlations between reduced usage and the severity of lockdown measures among non-binary individuals. Mental health history emerged as a strong predictor of substance use changes, with influences from anxiety disorders, depression, and self-harm. Additionally, family and social dynamics, including economic expectations and household composition, significantly shaped substance use behaviors during lockdowns. Given these findings, the development of comprehensive approaches targeting the adverse effects of the pandemic on individual behaviors and general welfare is crucial.

Increasing food insecurity severity is associated with lower diet quality in Australian adults

Food insecurity, the inadequate or insecure access to food due to financial constraints, is a growing concern in high-income countries like Australia(1). Food insecure adults may have reduced diet quality due to constraints on food purchasing and consumption(2) but further research is needed to understand how the severity of food insecurity impacts diet quality in an Australian setting. This study aimed to examine the relationship between diet quality and increasing severity of household food insecurity using validated measurement tools. A cross-sectional, online survey of Australian adults (aged 18 years+) used the USDA Household Food Security Six-item Short Form to classify respondents as food secure or marginally, moderately, or severely food insecure. The Australian Recommended Food Score (ARFS; score between 0–73) determined diet quality (ARFS total) and sub-scale scores for eight food groups(3), with higher scores indicating higher diet quality. Diet quality score results are further categorised as “needs work” (&lt;33), “getting there” (33-38), “excellent” (39-46) or “outstanding” (47+). Survey-weighted linear regression (adjusted for age, sex, income, education, location, household composition) analyses indicate that 45% of participants were living in households that experienced food insecurity, comprising 7% marginally, 18% moderately and 20% severely food insecure households. The ARFS total survey-weighted mean score for the whole sample (n = 804) was 32.4 (SD = 9.8). As the severity of household food insecurity increased, ARFS scores decreased. Marginally food insecure respondents reported a mean ARFS score three points lower than food-secure adults (B=-2.7; 95%CI [−5.11, −0.34]; p = 0.03), and scores reduced by six points for moderately (B=-5.6; 95%CI [−7.26, −3.90]; p&lt;0.001) and twelve points for severely food insecure respondents (B=-11.5; 95%CI [−13.21, −9.78]; p&lt;0.001). Marginally food insecure respondents had significantly lower vegetable sub-scale scores, moderately food insecure respondents had significantly lower sub-scale scores for all food groups except dairy, severely food insecure respondents had significantly lower scores for all sub-scale scores. Poorer diet quality is evident in adults living with any food insecurity but gets progressively worse as the severity of food insecurity increases. Interventions to reduce food insecurity and increase diet quality are required to prevent adverse nutrition-related health outcomes in food-insecure populations in Australia and beyond.

The Heterogeneous Effects of Social Assistance and Unemployment Insurance: Evidence from a Life Cycle Model of Family Labor Supply and Savings

We empirically analyze the heterogeneous welfare effects of unemployment insurance and social assistance. We estimate a structural life cycle model of singles’ and married couples’ labor supply and savings decisions. The model includes heterogeneity by age, education, wealth, sex, and household composition. In aggregate, social assistance dominates unemployment insurance; however, the opposite holds true for married men, whose leisure time declines more than that of their spouses when unemployment insurance is reduced. A revenue-neutral rebalancing of social support away from unemployment insurance and toward social assistance increases aggregate welfare. Income pooling in married households decreases the welfare value of social assistance. (JEL D13, D15, G51, I38, J22, J64, J65)

Development of electricity simulation model of urban houses and evaluating surplus electricity of photovoltaics (PV) considering housing stock transformation

The Japanese government is advocating for the introduction of decentralized renewable energy devices such as photovoltaics (PV) and high thermal performance houses in urban areas. Due to variations in housing stock among different urban areas, the implementation of these houses and devices would have diverse effects on the supply and demand sides, potentially leading to diverse overproduction of PV electricity, referred to as surplus electricity. Existing research focuses on increasing the utilization of surplus electricity and quantifying the surplus electricity from individual buildings at a regional scale. Considering the lack of research that quantifies surplus electricity through shared PVs under the urban-scale contextual changes (widespread introduction of high-performance houses). Therefore, this study aims to address this gap by utilizing an archetype house simulation model to simulate and compare two scenarios (with or without houses retrofitting) regarding electricity demand for each street-level area, maximum power and duration time of surplus electricity in areas where surplus electricity would occur in the target city Fukuoka in 2025. The results indicate that, under the current residential PV stock and existing introduction rates, the peak surplus power occurs around noon in May, approximately 396 out of 1051 areas in Fukuoka would generate surplus electricity during 2025. Houses retrofitting would increase the surplus electricity (include maximum power and duration time) in these areas. Additionally, this study identifies the residential characteristics of areas that generate surplus electricity, including construction year, household composition, and the proportion of detached houses, whether with retrofitting or not. The results suggest attention to surplus electricity increasing in areas with a high proportion of detached houses when considering houses retrofitting.

Abstract P104: Geospatially Varying Relationships of Green and Blue Spaces With Biomarkers of Stress and Cardiometabolic Risk in Racially and Ethnically Diverse Children

Introduction: Neighborhood green (e.g., parks) and blue (e.g., lakes) spaces have been associated with reduced stress and cardiometabolic risk (CMR), but research is limited in socially vulnerable urban communities affected by structural racism and redlining. This study explored the spatial correlation between green and blue spaces and cortisol levels, BMI percentile, waist circumference (WC), pulse, and systolic (SBP) and diastolic blood (DBP) pressure in a sample of racially/ethnically diverse children. Methods: We used cross-sectional data from the Family Matters cohort study, consisting of 1307 racially/ethnically diverse families with children (age 7±1.5 yrs). Participant addresses were matched to the US 2010 Census tract attributes. We used 246 sample locations across 149 census tracts in the 7-county Twin Cities, MN, metro area. Green and blue spaces were retrieved from the Twin Cities Metropolitan Council. Hair cortisol (chronic stress biomarker), BMI, WC, pulse, SBP and DBP were objectively measured in a subsample of 246 children. We used Decision Tree and Geographically Weighted Regression (GWR) to examine the spatially varying associations of CDC’s Social Vulnerability Index (SVI) and green and blue spaces (independent variables) with biomarkers of stress and CMR (dependent variables). SVI reflects four themes: socioeconomic status, household composition and disability, racial and ethnic minority status and language, and housing type and transportation. Results: Northwest Minneapolis was identified as a hotspot for elevated cortisol, BMI, and WC, while east St. Paul was a hotspot for elevated BMI and WC. Decision trees indicated that green and blue spaces explain variation in accumulated cortisol after tract socioeconomic status and racial and ethnic minority status. GWR revealed nonuniform relationships with the highest explanatory power in high social vulnerability hotspots. GWR’s R 2 for cortisol (0.07), BMI (0.14), and WC (0.14) were driven by hotspots where local R 2 was 2-5 times stronger than areas not identified as hotspots indicating robust geographical variations in the northern areas (areas of high social vulnerability) and distance from green and blue spaces. Patterns were inconsistent for pulse, SBP, and DBP. Conclusions: The spatially varying relationships of green and blue spaces with biomarkers of stress and CMR in children were heterogeneous, possibly indicating different mechanisms across biomarkers and geographical areas. Higher cortisol levels, BMI percentile, and WC in northern Twin Cities areas may reflect the legacy of structural racism and redlining, which have resulted in inequitable use of green and blue spaces for minoritized communities. Future interventions co-developed with local communities to improve green and blue spaces’ access and use, as well as to reduce disparities in stress and CMR, are needed to advance health equity.

Abstract 19: Time-Varying Exposure to Food Retailers and Cardiovascular Disease Incidence and Mortality in the Netherlands: A Nationwide Prospective Cohort Study

Background: The food environment is suggested as a risk factor of cardiovascular disease (CVD), but current evidence is inconsistent and does not account for changes in the food environment. We aimed to explore if time-varying exposure to the food environment was associated with hospitalisation and mortality due to total and specific types of CVD in The Netherlands. We hypothesized that favourable time-varying trends in food environment exposure would be associated with decreased risk of CVD, stroke, heart failure (HF), and coronary heart disease (CHD) morbidity and mortality among the Dutch general population. Methods: A prospective cohort study was performed among all Dutch residents aged 35+ years who did not change residence in 2002-2018 without CVD in 2004, identified through registry data from Statistics Netherlands (n=4,641,435; 51.3% female, 91.2% Dutch). Time-varying Food Environment Healthiness Index (FEHI) scores (range: -5 to 5) and time-varying Kernel density of six specific food retailers (food delivery outlets, fast food outlets, restaurants, local food shops, supermarkets and convenience stores) around the home location were based on bi-annual updates between 2004-2018. Hospitalisation and mortality due to overall CVD, stroke, HF, and CHD occurring between 2004 and 2020 were used as outcomes, based on hospital and death registries. Models were adjusted for age, sex, ethnic origin, household composition, income, marital status and neighbourhood urbanisation level and effect modification by age, sex, urbanization and income was studied. Results: Each unit increase in the FEHI, representing a 10% improvement, was associated with a lower hospitalisation and mortality of CVD (hospitalization Hazard Ratio (HR h )=0.90, 0.89-0.91, mortality Hazard Ratio (HR m )=0.85, 0.82-0.89), CHD (HR h =0.88, 0.85-0.91, HR m =0.80, 0.75-0.86), stroke (HR h =0.89, 0.84-0.93, HR m =0.89, 0.82-0.98), and HF (HR h =0.90, 0.84-0.96, HR m =0.84, 0.76-0.92). Increased density of local food shops, fast food outlets, supermarkets and convenience stores, and decreased density of food delivery outlets and restaurants were associated with a higher risk of CVD, CHD, stroke and HF incidence and mortality, albeit with small effect sizes. Stratified analyses suggest slightly stronger associations in highly urbanized areas, younger adults and those with higher incomes. Conclusions: Favourable trends in time-varying food retailer exposure were associated with a risk reduction in CVD hospitalisation and mortality, in particular in urbanized areas and for younger adults and those with higher incomes.

Determinants for energy-efficient housing adoption – a scoping review for owner-occupants in Germany

The sustainability goals of the European Union require countries to reduce carbon-emissioning energy demand significantly. As “housing” is responsible for substantial CO2 emissions, societies must increase the energy-efficient housing adoption rate. We use a scoping review as a methodology to identify the determinants for energy-efficient housing adoption of owner-occupants in Germany. Based on two separate search quests with the search engine EBSCO, we find 55 manuscripts primarily for economic/financial (i.e., subsidies and taxes) and regulatory (i.e., certifications and labels) determinants, followed by technological (i.e., innovation), demographic (i.e., household composition), as well as historical and cultural determinants. Policymakers hold owner-occupants accountable for the ambitious energy and climate goals. As we expect rising costs during the transition to net zero energy, we emphasize that policymakers should consider homeowners' social and economic situation and not overburden them in the fight against climate change, especially not with a “one-size-fits-it-all-approach”. The regulator must encourage individuals to independently exceed the minimum standards for energy-efficient investments.