Neighborhood Built Environment Research Articles

Neighbourhood walkability and greenspace and their associations with health-related fitness in urban dwelling Canadian adults

ObjectiveMuscular strength and body composition are important components of health-related fitness (HRF). Grip strength and body fat percent, in particular, are associated with chronic disease and affected by health behaviours. Evidence suggests relationships between the neighbourhood built environment (BE) and HRF exist, however, few studies have focused on grip strength and body fat percent. Therefore, our study aimed to estimate the sex-specific associations between the neighbourhood BE, grip strength, and body fat percent among urban-dwelling Canadian adults. MethodsWe analyzed cross-sectional survey and HRF data collected in 2011-2015 from 4052 males and 7841 females (Alberta's Tomorrow Project, Canada). Grip strength and body fat percent were measured via handgrip dynamometry and bioelectrical impedance analysis, respectively. Walkability (Canadian Active Living Index) and greenness (Normalized Difference Vegetation Index) estimates were linked to participant data. Sex-stratified covariate-adjusted linear regression models estimated the associations between the BE and HRF variables. ResultsWalkability was negatively associated with grip strength and body fat percent in males (β -0.21, 95%CI: -0.31 to -0.11 and β -0.08, 95%CI: -0.15 to -0.02, respectively) and females (β -0.06, 95%CI: -0.10 to -0.01 and β -0.08, 95%CI: -0.14 to -0.02, respectively). Greenness was positively associated with grip strength in males (β 6.99, 95%CI: 3.62 to 10.36) and females (β 2.72, 95%CI: 1.22 to 4.22) but not with body fat percent. Controlling for physical activity and sitting did not attenuate these associations. ConclusionCharacteristics of the neighbourhood BE appear to be associated muscular strength and body composition, independent of physical activity and sedentary behaviour.

Road Traffic Injuries and the Built Environment in Bogotá, Colombia, 2015-2019: A Cross-Sectional Analysis.

Nine in 10 road traffic deaths occur in low- and middle-income countries (LMICs). Despite this disproportionate burden, few studies have examined built environment correlates of road traffic injury in these settings, including in Latin America. We examined road traffic collisions in Bogotá, Colombia, occurring between 2015 and 2019, and assessed the association between neighborhood-level built environment features and pedestrian injury and death. We used descriptive statistics to characterize all police-reported road traffic collisions that occurred in Bogotá between 2015 and 2019. Cluster detection was used to identify spatial clustering of pedestrian collisions. Adjusted multivariate Poisson regression models were fit to examine associations between several neighborhood-built environment features and rate of pedestrian road traffic injury and death. A total of 173,443 police-reported traffic collisions occurred in Bogotá between 2015 and 2019. Pedestrians made up about 25% of road traffic injuries and 50% of road traffic deaths in Bogotá between 2015 and 2019. Pedestrian collisions were spatially clustered in the southwestern region of Bogotá. Neighborhoods with more street trees (RR, 0.90; 95% CI, 0.82-0.98), traffic signals (0.89, 0.81-0.99), and bus stops (0.89, 0.82-0.97) were associated with lower pedestrian road traffic deaths. Neighborhoods with greater density of large roads were associated with higher pedestrian injury. Our findings highlight the potential for pedestrian-friendly infrastructure to promote safer interactions between pedestrians and motorists in Bogotá and in similar urban contexts globally.

Understanding the Relationship between Neighbourhood Built Environment and Older Adults’ Health from the Perspective of Housing Differentiation

Studies have revealed an association between the built environment and the health of older adults. However, few studies distinguish between the objective and perceived built environments and explore their associations with older adults’ health, especially when considering housing differentiation. Drawing on a survey of 426 older adults in ten residential neighbourhoods in Dongfeng Township, Beijing, this study employed structural equation modelling and the Kruskal–Wallis test to analyse the relationship between the built environment of different housing types and older adults’ health. The findings revealed that the objective and perceived environments were significantly associated with older adults’ health, with physical activity and social interactions as mediating factors. The perceived built environment mediates the relationship between the objective built environment and older adults’ health. Moreover, it was observed that the relationship between the built environment and older adults’ health varied depending on housing type, which is a crucial reflection of spatial non-stationary in the relationship between health and environment. Therefore, the varying impacts of different housing types on older adults’ health should not be overlooked when developing planning and other policies for aging-friendly cities.

Abstract TP85: Neighborhood Built Environment May Not Influence Reintegration to Normal Living Post-Stroke

Introduction: Reintegration to normal living post-stroke is important to foster peer support and recovery. Reintegration may be facilitated through neighborhood resources and out-of-home facilities. Methods: The Discharge Educational Strategies for Reduction of Vascular Events (DESERVE) intervention randomized stroke survivors to skills-based intervention or usual care with the goal of improving post-stroke blood pressure. Three domains of reintegration to normal living (RINL) through daily functioning (community mobility, recreational, and social activity participation) at 12-months post-stroke were evaluated. Participants’ addresses were linked to census tract area density of community resources from the National Neighborhood Data Archive. Recreational, arts, entertainment, religious, social and civil, and personal care resources were assessed in separate linear regression models for related RINL domains first unadjusted and then adjusting for age, race-ethnicity, gender, education, insurance status, number of identified alters, intervention status, and stroke severity. Loss-to-follow-up was accounted for using inverse probability weights. Results: Of the 546 DESERVE participants, 342 responded to 12-month RINL elements. Respondents were 64.9 years on average (SD=12.1) with a median NIHSS of 2.0 (IQR=4.0). The median level of RINL for each domain was the maximum (10). Comparing high to low, resource densities were not associated with any of the RINL domains in unadjusted or adjusted models ( Figure ). Conclusion: In our novel exploration of neighborhood resources and RINL, the density of these built environment resources did not seem to influence individuals’ reintegration to normal living 12-months post-stroke. However, the metric of reintegration had a ceiling effect; future evaluations may need to consider different tools to better identify more sensitive metrics of reintegration post-stroke.

TRANSITION AND STABILITY OF PLACE AND AGING IN LATER LIFE: HOUSING AND NEIGHBORHOOD CONTEXTS

Abstract Transition and stability in housing and neighborhood contexts reflect both, a central field of research and policies on place and aging for health and well-being in later life. Studies have demonstrated effects of improving the physical environment, particularly with respect to specific needs, such as for people living with dementia. Moreover, relationships between perceived housing and health and well-being on the one hand and life transitions and health and well-being on the other hand have been addressed. However, research on complex interactions of place and transitions in later life is scarce. This symposium aims to address the dynamic relationship between transition and stability of place and aging in later life in relation to indicators of good ageing. The first contribution by Eriksson and colleagues presents quantitative results on the relationships between perceived housing and changes in health and well-being over time among community-dwelling Swedish older adults. Second, Kylén and colleagues present quantitative data describing which housing preferences are most important when considering relocation in older age. The third contribution by Slaug and colleagues uses a quantitative approach to qualitative interview data from Sweden and Germany, analyzing sequences of and relationships between life transitions over 10 years. Fourth, Chaudhury and colleagues show data that aims to identify spatial and temporal patterns in activities undertaken outside home by people living with dementia, and ways in which the neighborhood-built environment affects their outdoor mobility and social participation. Finally, Malcom P. Cutchin will serve as the session’s discussant.

Correlation Between Neighborhood Built Environment and Leisure Walking Time Around a Riverside Park.

This study aimed to investigate whether the distance to a riverside park and the neighborhood built environment are related to individuals' leisure walking time by examining the case of the Geumho riverside park in Daegu, South Korea. Walking, being an inexpensive means of transportation with numerous health benefits, is influenced by the conditions of neighborhood built environments. A survey was conducted from October 12 to November 8, 2022, including 184 adults aged 18 years or older. The dependent variable was the total weekly minutes of leisure walking, and the independent variables included the neighborhood built environment measured objectively using geographic information systems as well as demographic/individual characteristics and health attitude data. Analysis of variance was conducted to determine whether leisure walking time differed depending on the distance to the riverside park, and regression analysis was conducted to examine the association between leisure walking time and the neighborhood built environment. Individuals living within a quarter-mile of the park walked an average of 155 min per week for leisure, which was significantly more than those living further than 1 mile (mean = 85.14 min/week). Moreover, greater access to the park, higher crosswalk density, and a lower road density were associated with more leisure walking time for residents. The findings of this study indicate that good access to riverside parks and pedestrian-centered neighborhood environments may be related to leisure walking among residents. These findings hold significance for urban planning and the formulation of public health policies.

Neighborhood Built Environments and Health in Later Life: A Literature Review.

Objectives: This literature review aims to assess the current state of the field linking neighborhood environments to later-life health and wellbeing. Methods: We used electronic databases (e.g., PubMed, Google Scholar, and ProQuest) to search for studies published between 2010 and 2022 examining associations between neighborhood built environmental variables and later-life physical, cognitive, mental, and social health outcomes. Results: Among 168 studies reviewed, the majority were quantitative (n = 144) and cross-sectional (n = 122). Neighborhood environmental variables significantly associated with later-life health outcomes included population density/rurality, walkability/street connectivity, access to services and amenities, neighborhood quality and disorder, and parks/green/blue/open space. Neighborhoods operated through behavioral and biological pathways including hazardous exposures, affective states (e.g., stress and restoration), and lifestyle (e.g., exercise, socialization, and diet). Discussion: Neighborhoods and healthy aging research is a burgeoning interdisciplinary and international area of scholarship. Findings can inform upstream community interventions and strengthen clinical care.

Characteristics of Home and Neighborhood Built Environments During COVID-19 for Older Adults in the United States and Italy

The home and neighborhood environments impact the social and mental health of older adults, yet little research has addressed the various contexts that can affect these relationships, such as community culture, built and natural elements, and demographics. This survey-based study examined community-dwelling older adults’ access and use of transitional outdoor/indoor space (i.e., porches, gardens, windows, etc.), and how that use was related to health variables and changed with the pandemic in two available samples of older adults in the United States and Italy. Use of both outdoor and indoor space was found to be more individualistic in Boston, in the United States, than in Chieti, Italy, where use of these areas with others was more common. Results suggest that window viewing from within the home may be an activity that individuals in Italy engage in when feeling lonely. Changes in the use of home and community space after COVID-19 were minimal; only in the United States did individuals report greater time indoors since the onset of the pandemic. Use of the built environment in and around the home by older adults was found to have multidimensional characteristics between the United States and Italy, with the potential to foster connections and improve well-being.

Exploring the Quality of Life of People with Incomplete Spinal Cord Injury Who Can Ambulate

(1) Purpose: To examine associations between subjective quality of life and other socio-demographic variables and to explore differences in experiences of people with different levels of quality of life (low, moderate, high). (2) Materials and methods: Semi-structured interviews and standardized measures of mobility, function, health-related quality-of-life, and quality-of-life were used to collect the data for this mixed-method study. (3) Results: Twenty-four participants were interviewed with an average age of 55 years and 54% were male. High quality of life, according to quantitative analysis, was strongly associated with being male, attending rehabilitation, and being married. The qualitative findings supported the quantitative findings and also revealed that people with a low quality of life felt the neighborhood-built environment was not supportive of people with incomplete spinal cord injury who can walk. Participants who reported a low/moderate quality of life reported feeling devalued by able-bodied people and that their mobility was getting worse over time. (4) Conclusion: Findings suggest that those with incomplete spinal cord injuries who can walk could benefit from improved quality of life by modifying their social support and neighborhood’s built environment. For instance, sensitivity training for the general population could help to reduce negative attitudes and misperceptions about invisible impairments and promote inclusion.

Neighborhood Social Environment and Body Mass Index: The Mediating Role of Mental Wellbeing.

The association between neighborhood-built environment and body mass index (BMI) is well-characterized, whereas fewer studies have explored the mechanisms underlying the relationship between neighborhood social environment and obesogenic behaviors. Using data from a random sample of 16,820 residents ≥18 years from all 169 Connecticut towns and seven ZIP Codes in New York, this study examines the influence of neighborhood social environment on residents' mental wellbeing, physical activity, and BMI. Structural equation modeling was conducted to estimate direct and indirect effects of neighborhood social environment on BMI, using mental wellbeing and physical activity as intermediate variables. There were significant total [β(SE) = 0.741 (0.170), p < 0.0001], direct [β(SE) = 0.456 (0.1890), p = 0.016], and indirect [β(SE) = 0.285 (0.061), p < 0.0001] effects of neighborhood social environment on BMI. Low physical activity was a partial mediator of the effect of non-favorable neighborhood social environment on BMI [β(SE) = -0.071 (0.011), p < 0.0001]. The association between neighborhood social environment and BMI was also mediated by mental wellbeing [β(SE) = 0.214 (0.060), p < 0.0001], and by mental wellbeing through physical activity [β(SE) = 0.071 (0.011), p < 0.0001]. Study findings provide further support for building strong social environments to improve population health and suggest that strategies prioritizing mental wellbeing may benefit behavioral interventions aimed at reducing obesity risk and should be a focus of prevention efforts in and of itself.

Understanding Possible Mechanisms Behind the Relation Between Neighborhood Built Environments and Mental Health - A Review of the Individual-level Behavioral and Psycho-social Mediating Processes -

Understanding Possible Mechanisms Behind the Relation Between Neighborhood Built Environments and Mental Health - A Review of the Individual-level Behavioral and Psycho-social Mediating Processes -

Associations of Subjective Memory with Life Space and Neighborhood Built Environment in Older Adults in the ACTIVE Study.

Objectives: To investigate the longitudinal association of life space and neighborhood and built environment (NBE) with subjective memory among individuals 65 and older, and the mediating role of depressive symptoms, a major correlate of life space mobility, NBE, and subjective memory. Methods: We examined community-dwelling participants in the Advanced Cognitive Training for Independent and Vital Elderly study (N = 2,622, Mean age = 73.7 years, 24.9% Black) across annual assessments of up to 3years. Results: Baseline life space and NBE were positively associated with subjective memory, and these associations were partly mediated by depressive symptoms. Over time, higher baseline life space predicted a better subjective memory as one aged. Life space was concurrently associated with subjective memory across time, mediated by concurrent depressive symptoms. Discussion: Potentially modifiable environmental factors such as life space and NBE appear to influence level and change in subjective memory as we age. Interventions supporting movement in our environments may help offset subjective memory problems, a potential early sign of dementia.

Association Between Perceived and Objective Measures of School Neighbourhood Built Environment and Active Transport to School in New Zealand Adolescents

School neighbourhood built environment (BE) characteristics are related to active transport to school (ATS) among adolescents. This study examined objectively measured and perceived school neighbourhood BE correlates of ATS in adolescents and compared school neighbourhood BE features in rural versus small-to-medium urban areas.&amp;nbsp;We analysed data from adolescents (n=95; 68.4% under 16 years of age; 58.9% female) from 11 schools located in small-to-medium urban areas and rural settings in Otago, New Zealand, who were familiar with their school neighbourhood environment and living within 4.8 km from school. Adolescents reported perceptions of their school neighbourhood using a modified version of Neighbourhood Environment Walkability Scale for Youth (NEWS-Y) questionnaire. Objectively measured BE features were generated using Geographic Information Systems (GIS). In a multivariate analysis, perceived residential density (odds ratio (95% CI): 0.17 (0.04, 0.82)) and traffic safety concerns (0.13(0.02, 0.95)) were negatively associated with adolescents' ATS rates, but those associations were no longer significant once distance to school was taken into account. Compared to small-to-medium urban area schools, perceived land use mix diversity and recreational facilities and objectively measured intersection density in school neighbourhoods were higher, whereas perceived residential density and land use mix accessibility and objectively measured neighbourhood walkability were lower in rural schools (all p &amp;lt; 0.05).&amp;nbsp;Future initiatives should address both perceived and objectively measured school neighbourhood BE to promote ATS among adolescents.

Examining the Contribution of the Neighborhood Built Environment to the Relationship Between Neighborhood Disadvantage and Early Childhood Development in 205,000 Australian Children.

We examined associations between neighborhood built environment features and early childhood development (ECD), and tested the contribution of the built environment to associations between neighborhood disadvantage and ECD. Spatial neighborhood built environment measures were linked to participant addresses in the 2015 Australian Early Development Census (AEDC) for children ∼5 years old living in Australia's 21 most populous cities. The 2015 AEDC contains teacher-reported national data on five key child development domains for children in their first year of formal full-time schooling (approximately 5 years old). AEDC scores were classified as 'developmentally vulnerable' (≤10th centile). Using multilevel modeling, 44 built environment measures were tested with developmental vulnerability on at least one domain of the AEDC, adjusting for socioeconomic factors and neighborhood disadvantage. The dataset consisted of 205,030 children; 89.2% living in major cities. In major cities, children with more early childhood education and care services (OR 0.997) and preschool services (OR 0.991) exceeding Australian standards, and access to healthier food outlets within 3200 m of their home (OR 0.999) had decreased odds of developmental vulnerability, controlling for socioeconomic factors and neighborhood disadvantage. Neighborhood disadvantage remained significantly associated with developmental vulnerability after adjustment for child/family variables and neighborhood built environment characteristics. The neighborhood built environment had small effects on the neighborhood disadvantage-ECD relationship at the national level. Few built environment measures were associated with ECD. Small effects at the population level may have wide-ranging impacts; modifying the built environment at scale are promising levers for supporting good child outcomes.

Neighborhood-Built Environment and Ageism in Later Life.

Ageism is a global challenge and a public health concern that the recent COVID-19 pandemic has further exacerbated. Existing research has mainly focused on individual factors, overlooking the association between the neighborhood-built environment and ageism. This study examined this association and whether its effect varied among areas possessing different socioeconomic characteristics. We conducted a cross-sectional survey of 1278 older people in Hong Kong and merged this with the built environment factors derived from geographical information system data. We used multivariable linear regression to examine the association. Findings revealed that more parks were significantly associated with a lower level of ageism, an impact that remained significant in low-income or low-education areas. Conversely, more libraries in high-income areas were associated with a lower level of ageism. Our findings provide urban planners and policymakers insight into planning for the built environment that reduces ageism enabling older people to achieve a better life.

Influence of neighborhood-level social determinants of health on a heart-healthy lifestyle among Black church members: A mixed-methods study

BackgroundFew church-based health interventions have evaluated the influence of neighborhood-level social determinants of health (SDOH) on adopting heart-healthy lifestyles; none has occurred in Louisiana. We aimed to characterize neighborhood-level SDOH that may influence the ability to adopt a heart-healthy lifestyle among Black community church members in New Orleans, LA. MethodsThis mixed methods study used quantitative data (surveys) and qualitative data (focus groups) to explore SDOH at the neighborhood- and church-area- level, including factors related to the physical (e.g., walkability, accessibility to recreational facilities) and social (e.g., social cohesion, perceived safety) environments. Descriptive analyses were conducted for quantitative data. Qualitative data were coded and analyzed using grounded theory and thematic analysis. ResultsAmong survey respondents (n = 302, 77 % female, 99 % Black), most reported having walkable neighborhood sidewalks and high neighborhood social cohesion. Two-thirds did not feel violence was a problem in their neighborhood and felt safe walking, day, or night. Focus group participants (n = 27, 74 % female, 100 % Black) reported facilitators to heart-healthy living, including social support promoting physical activity, intentionality in growing, buying, and preparing produce, and the neighborhood-built environment. Reported barriers included: crime, the COVID-19 pandemic, individual-level factors limiting physical activity, and city-wide disparities influencing health. Participants discussed strategies to promote healthy living, centered around the theme of establishing and rebuilding community relationships. ConclusionsFuture health interventions aimed at improving cardiovascular outcomes among church communities should continue to inquire about neighborhood-level SDOH and tailor interventions, as appropriate, to address barriers and leverage facilitators within these communities.

Neighborhood Built Environment and Sleep Health: A Longitudinal Study in Low-Income and Predominantly African-American Neighborhoods.

In the present study, we examined the associations between physical characteristics of neighborhoods and sleep health outcomes and assessed the mediating role of physical activity in these associations. A longitudinal study (the Pittsburgh Hill/Homewood Research on Eating, Shopping, and Health (PHRESH) Zzz Study; n=1,051) was conducted in 2 low-income, predominately African-American neighborhoods in Pittsburgh, Pennsylvania, with repeated measures of neighborhood characteristics and sleep health outcomes from 2013 to 2018. Built environment measures of walkability, urban design, and neighborhood disorder were captured from systematic field observations. Sleep health outcomes included insufficient sleep, sleep duration, wakefulness after sleep onset, and sleep efficiency measured from 7-day actigraphy data. G-computations based on structural nested mean models were used to examine the total effects of each built environment feature, and causal mediation analyses were used to evaluate direct and indirect effects operating through physical activity. Urban design features were associated with decreased wakefulness after sleep onset (risk difference (RD) = -1.26, 95% confidence interval (CI): -4.31, -0.33). Neighborhood disorder (RD = -0.46, 95% CI: -0.86, -0.07) and crime rate (RD = -0.54, 95% CI: -0.93, -0.08) were negatively associated with sleep efficiency. Neighborhood walkability was not associated with sleep outcomes. We did not find a strong and consistent mediating role of physical activity. Interventions to improve sleep should target modifiable factors, including urban design and neighborhood disorder.

Barriers to health in women of reproductive age living with or at risk of non-communicable diseases in Nigeria: a Photovoice study

BackgroundNigeria has one of the highest maternal mortality ratios (MMR) globally with an MMR of 512 (per 100,000 live births) and the proportion of maternal deaths due to non-communicable diseases (NCDs) is increasing. While evidence shows that many of these deaths are preventable, limited attention is being paid to the unique vulnerabilities and experiences of women of reproductive age (WRA) with NCDs and their risk factors, as well as the barriers to the screening, diagnosis, and management of these diseases in Nigeria.MethodsThis study explored the lives of WRA in Lagos and Federal Capital Territory in Nigeria from May to June 2019 using a community-based participatory research (CBPR) methodology called Photovoice which is aligned with CBPR as it includes procedures such as the identification of important community issues, discussion of photo assignments and data analysis. Twenty-four women of reproductive age were provided with digital cameras and trained on how to capture photos that conveyed their current health, healthcare utilization and engagement, and experience journeys. Individual interviews with the women were held for an in-depth exploration of the photographs. The data was then analysed thematically.ResultsSix distinct themes were identified across the barriers highlighted by the women: food and nutrition, home and family, neighborhood-built environment, economic instability, religion and spirituality and low prioritization of self-care. These themes captured the challenge of reduced agency, limited contribution and participation, and a complex relationship between visible and invisible illness.ConclusionThe perspectives of WRA in Nigeria obtained through this qualitative research provided a strong substratum for understanding the environmental barriers that predispose WRA to NCDs in Nigeria. The results of the study are useful for the improvement of woman-centred services of prevention, diagnosis, and management of NCD risk factors across the maternal and reproductive health care continuum in Nigeria.

ASSOCIATION OF RESIDENTS’ STEP COUNT WITH NEIGHBORHOOD BUILT ENVIRONMENT AND TRAVEL BEHAVIOR

To deeply understand walkable environments, this study analyzed associations between residents' daily step counts and their living environments. The primary characteristic of this study is the analysis incorporating travel behavior in addition to neighborhood built environment. Specifically, we developed and compared three multi-level regression models: 1) neighborhood environment model; 2) travel behavior model; 3) model that integrated both elements. As a result, the integrated model estimated residents' step counts more precisely, implying the other models might overestimate direct associations of the two elements. We also found the amount of model improvement varied depending on the group of age and gender.

Cross-sectional associations between neighbourhood walkability and objective physical activity levels in identical twins

ObjectivesPhysical activity is a cornerstone of chronic disease prevention and treatment, yet most US adults do not perform levels recommended for health. The neighborhood–built environment (BE) may support or hinder...