Neighborhood Environmental Factors Research Articles

The cross-sectional and prospective associations of parental practices and environmental factors with 24-hour movement behaviours among school-aged Asian children

BackgroundParental practices and neighbourhood environmental factors may influence children’s movement behaviours. We aimed to investigate the cross-sectional and prospective associations of parental practices and neighbourhood environmental factors with accelerometer-measured 24-hour movement behaviours (24 h-MBs) among school-aged children in Singapore.MethodsThe Growing Up in Singapore Towards healthy Outcomes (GUSTO) study collected information on dimensions of parental practices and neighbourhood environment at age 5.5 years. Confirmatory factor analyses were performed to generate latent variables and used to compute overall parental practices [involvement in PA + support for PA + control of screen viewing context] and environmental scores [facilities for active play + active mobility facilitators + barriers*-1]. Children wore an accelerometer on their non-dominant wrist for seven consecutive days at ages 5.5 and 8 years. The R-package GGIR 2.6 was used to derive moderate-to-vigorous-intensity physical activity (MVPA), light-intensity physical activity (LPA), inactivity, and total-sleep (napping+night sleep) minutes per day. Associations were determined using compositional data analysis with multivariate linear regression models, taking into account potential confounders.ResultsAmong 425 children (48% girls, 59% Chinese), higher parental involvement in PA, parental support for PA and overall parental practices were associated with 24 h-MBs at ages 5.5 and 8 years, specifically with greater time spent in MVPA and less time being inactive relative to the remaining movement behaviours. The corresponding mean changes in the overall 24 h-MB for increasing parental practices from lowest to highest scores (− 2 to + 2 z-scores) indicated potential increases of up to 15-minutes in MVPA, 20-minutes in LPA, 5-minutes in sleep duration, and a reduction of 40-minutes in inactivity at age 5.5 years. At age 8 years, this could translate to approximately 15-minutes more of MVPA, 20-minutes more of LPA, a 20-minute reduction in sleep duration, and a 20-minute reduction in inactivity. Parental control of screen viewing contexts and neighbourhood environmental factors were not associated with 24 h-MBs.ConclusionsParental practices but not environmental factors were associated with higher MVPA and lower inactivity among Singaporean children, even at a later age. Further research may provide insights that support development of targeted public health strategies to promote healthier movement behaviours among children.Study registrationThis study was registered on 4th August 2010 and is available online at ClinicalTrials.gov: NCT01174875.

Increasing habitual walking in mobility-limited older adults through a personalized GIS-based intervention

Background
 Ample evidence supports the health benefits of low-intensity physical activity such as walking, which is universally accessible and impacted by neighbourhood environmental factors like green spaces and availability of local amenities.
 Aim
 The MOBITEC-Routes project will investigate the effects of an individualized GIS-based walking intervention on physical and psychosocial functioning in mobility-limited older adults.
 Methods
 A randomized controlled trial to promote habitual walking will take place. The sample will include 130 inactive, chronically ill, mobility-limited older adults. The intervention will combine professional consultations with map-based planning and behaviour change techniques derived from the Health Action Process Approach.
 Results
 Expected outcomes include increase in participants’ daily step count, physical activity levels, physical function, life space mobility, self-efficacy, social participation, and quality of life.
 Conclusion
 MOBITEC-Routes is poised to offer new insights into personalized GIS-based interventions’ effectiveness in improving mobility and overall well-being in older adults with mobility impairments.

LEVERAGING NEIGHBORHOOD EXPOSURES AS MODIFIERS OF INDIVIDUAL RISK FACTORS FOR COGNITIVE DECLINE AND DEMENTIAS

Abstract There are numerous ways in which neighborhood environmental factors have been shown to contribute to adverse health. More remains to be done to link long-term neighborhood exposures, such as social and physical activities, to modifiable individual risk factors for cognitive decline and dementia. Individual interventions are usually small in scale and conducted in those with higher socioeconomic status (SES). Additionally, increases in healthy behaviors, such as walking, have been difficult to promote and sustain. Each of these risk factors is known to be influenced by environmental features. This symposium will explore the roles of neighborhood-level social (nSES, affluence, cohesion, discrimination) and physical (air pollution) factors as drivers of cognitive aging and dementia across multiple longitudinal studies of community-based aging. Studies span urban and rural communities, including the Health ABC Study, the Cardiovascular Health Study, and the Think Phresh study. These studies are important to evaluating the role of neighborhood features on cognitive aging by expanding beyond cross-sectional data and by studying residentially stable older adults most likely to be affected by their local context. Those neighborhood factors that impact individual activity, cognitive aging, and Alzheimer’s disease risk will be further discussed for differences by race/ethnicity.

Examining the impact of neighborhood environment factors on residents’ emotions during COVID-19 lockdown and reopening: A Wuhan study on mediation and moderation

Due to COVID-19, the urban lockdown has caused a significant impact on the mental health of residents. However, limited research investigates the role of neighborhood factors on residents’ mental health during and after the lockdown. This study examines Wuhan, the first city to experience the COVID-19 outbreak, employing multiple linear regression and XGBoost algorithms to analyze the emotional status and distribution of Wuhan residents. The goal of this study is to identify the moderating effect of the neighborhood environment scale on emotional positivity and the marginal effect of the neighborhood environment on residents’ emotions. The results of the study indicate that specific neighborhood environmental characteristics have varying effects on residents’ positive emotions, both before and after the COVID-19 lockdown. The green space ratio, attraction density, waterfront space density, and service facility density all positively affected mood within different distance ranges. Shopping facilities, on the other hand, had mainly positive effects during the open period, with negative effects during the closed period. Furthermore, this study determined scale thresholds where neighborhood environments had a positive effect on mood. For instance, attractions and waterfront areas improved the mood of residents in residential areas, up to at least 3 km away. Medical facilities had a positive effect on residents’ mood beyond 2.2 km. This study highlights crucial implications for planning and managing neighborhoods to promote resilience during future public health crises.

Abstract B089: Understanding the relationship between neighborhood disorder, racial segregation, and ovarian cancer survival in African American women

Abstract Black women have a 10% lower 5-year survival of epithelial ovarian cancer (EOC) than White women, despite having a 25% lower incidence of OC than White women. Evidence suggests that these health disparities can be partially explained by neighborhood social and environmental factors such as disorder. We used Google Street View (GSV) imagery to estimate a measure of neighborhood disorder (ND) at the block group level within the largest multi-state cohort study of Black women diagnosed with EOC (AACES) between 2010 and 2015. 592 AACES participants were enrolled and geocoded residing in 544 unique block groups. We used the online Computer Assisted Neighborhood Visual Assessment System (CANVAS), to conduct virtual audits at 5 street address locations in each block group. These audits included questions related to the presence of different types of land use, the quality of the built structures, and the presence of other markers of ND. Factor analysis identified 5 distinct neighborhood factors: developmental intensity, development age, neighborhood disorder, land use, and green/blue space. An ND score was calculated for each block group audited based on the ND factor, which included the condition of residential units and yards, and assigned to the residents of that block group. Initial analyses indicated that this score did not impact EOC survival. We conducted Weibull AFT survival analyses with frailty to assess the impact of racial segregation on the relationship between ND and EOC survival. An Isolation Index was calculated to quantify the segregation of non-Hispanic Blacks compared to other racial groups. Increased racial isolation was associated with decreased survival (HR: 1.234, 95%CI: 1.03-1.60), after adjustment. Additionally, to understand the impact of the social aspects of disadvantage compared to the built aspects of our disorder score, we examined ADI as a predictor of EOC survival. Increasing ADI was associated with marginally decreased survival (HR: 1.002, 95%CI: 1.00-1.01), after adjustment. The lack of association between our disorder score and EOC survival and the presence of an association between the measures of racial isolation and ADI and EOC survival could indicate that it is the social aspects of an environment, not the built factors, that are driving EOC survival. Future research should explore the impacts of racial segregation and individual-level perceived racism on EOC survival. Citation Format: Christopher Pierson, Steve J. Mooney, Andrew B. Lawson, Joellen M. Schildkraut, Edward S. Peters. Understanding the relationship between neighborhood disorder, racial segregation, and ovarian cancer survival in African American women [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B089.

The relationship of single-family detached house prices with neighborhood walkability and disaster risk.

People's preferences regarding their neighborhood environment can vary depending on their socioeconomic status and the cities where they live. This study aims to discern the relationship between neighborhood environment factors and single-family detached house sales by sale price and by central and noncentral cities. We analyzed sale prices in the Tokyo Metropolitan Area from 2015 to 2020. The neighborhood environment was assessed using flood/sediment risk and neighborhood walkability measured by net residential density, intersection density, and facility density (walking opportunity). Flood and sediment risk is a major concern that restricts the available land and is included as a negative aspect of the neighborhood environment, taking the topographic features into consideration. A comparison of the results showed that the preference for neighborhood walkability varies by socioeconomic status as well as by target cities. For most facility types, the number of walking opportunities within walking distance from houses was found to be positively related to the sale price of single-family detached houses in all quantiles. The relationship of house price with population and intersection density was found to vary depending on the price level, with a negative relationship with the sale price of relatively more expensive houses being exhibited. People who considered buying houses with relatively higher sale prices were found to devalue houses located in flood/sediment-hazardous areas more. However, it was also found that the negative relationship was slightly mitigated in the highest quantile of sale prices for houses in areas with a moderate flood risk (maximum flooding depth: 3-5 m). Plains near rivers with amenities offer high walkability but pose a flood risk, resulting in a trade-off between flood risk and neighborhood walkability. The findings suggest the use of indices representing diverse preferences in accordance with the target socioeconomic status when policymakers assess the neighborhood environment.

Outdoor Physical Activity and Play Among Canadian Children and Youth With Disabilities During the COVID-19 Pandemic: Findings From the National Physical Activity Measurement Study.

This study explored the association between socioecological factors and outdoor physical activity (PA) and play in children with disabilities during the COVID-19 pandemic. Parents (N = 133) completed a survey to report changes in their child's outdoor PA and play during the pandemic (from prepandemic levels), and child, household, and neighborhood environment factors. Children with a PA-supporting parent and from multichild and White households had lower odds of reporting decreased outdoor PA. Children from multichild, higher income, married couple households and a PA-supporting parent had lower odds of decreased outdoor play. Living in neighborhoods with higher urbanization (i.e.,high dwelling density, street intersections, and land-use mix) was associated with greater odds of decreased outdoor PA and play. Future research that uses larger and more representative samples of children with disabilities is needed to test for the multivariate effects of socioecological variables on outdoor PA and play.

Invasion dynamics of the European Collared-Dove in North America are explained by combined effects of habitat and climate

Abstract Global biodiversity is increasingly threatened by the spread of invasive species. Understanding the mechanisms influencing the initial colonization and persistence of invaders is therefore needed if conservation actions are to prevent new invasions or strive to slow their spread. The Eurasian Collared-Dove (Streptopelia decaocto, EUCO) is one of the most successful avian invasive species in North America; however, to our knowledge, no study has simultaneously examined the role that climate-matching, human activity, directional propagation, and local density have in this invasion process. Our research expands upon a cellular-automata-based hierarchical model developed to assess directional invasion dynamics to further quantify the impacts of climate, elevation, and land cover type on the spread of EUCO in North America. Our results suggest that EUCO’s dispersal patterns can largely be explained by the effects of habitat, climate, and environmental conditions at different stages of the invasion process rather than some innate preferred north-westerly spread. Specifically, EUCO initially colonized warm and wet grassland habitats and tended to persist in urban areas. We also found that while EUCO were more likely to spread to the northeast of existing habitats, directional preference did not drive persistence and recolonization events. These findings highlight the importance of incorporating both neighborhood effects and environmental factors in the modelling of range-expanding species, adding to the toolset available to researchers to model invasive species spread. Further, our research demonstrates that historical records of invasive species occurrences can provide the data resources needed to disentangle the characteristics driving species invasion and enable predictions that are of critical importance to resource managers.

Prospective associations of neighborhood healthy food access and walkability with weight status in a regional pediatric health system

BackgroundMost neighborhood food and activity related environment research in children has been cross-sectional. A better understanding of prospective associations between these neighborhood environment factors and children’s weight status can provide stronger evidence for informing interventions and policy. This study examined associations of baseline and changes in neighborhood healthy food access and walkability with changes in children’s weight status over 5 years.MethodsHeight, weight, and home address were obtained for 4,493 children (> 75% were Black or Latinx) from primary care visits within a large pediatric health system. Eligible participants were those who had measures collected during two time periods (2012–2014 [Time 1] and 2017–2019 [Time 2]). Data were integrated with census tract-level healthy food access and walkability data. Children who moved residences between the time periods were considered ‘movers’ (N = 1052; 23.4%). Mixed-effects models, accounting for nesting of children within census tracts, were conducted to model associations of baseline and changes in the neighborhood environment variables with Time 2 weight status (BMIz and overweight or obese vs. healthy weight). Models adjusted for weight status and child and neighborhood sociodemographics at baseline.ResultsChildren living in a neighborhood with [ample] healthy food access at Time 1 had a lower BMIz at Time 2, regardless of mover status. A decrease in healthy food access was not significantly associated with children’s weight status at Time 2. Baseline walkability and improvements in walkability were associated with a lower BMIz at Time 2, regardless of mover status.ConclusionsFindings provide evidence that residing in a neighborhood with healthy food access and walkability may support a healthy weight trajectory in children. Findings on changes in the neighborhood environment suggested that improved walkability in the neighborhood may support children’s healthy weight. The greater and more consistent findings among movers may be due to movers experiencing greater changes in neighborhood features than the changes that typically occur within a neighborhood over a short period of time. Future research is needed to investigate more robust environmental changes to neighborhoods.

Association of Neighborhood Environment with the Outcomes of Childhood Glaucoma

To determine the association between different neighborhood environment factors and the outcomes of childhood glaucoma. A retrospective cohort. Childhood glaucoma patients ≤ 18 years of age at the time of diagnosis. A retrospective chart review of childhood glaucoma patients who presented to Boston Children's Hospital between 2014 and 2019. Data collected included etiology, intraocular pressure (IOP), management, and visual outcomes. Child Opportunity Index (COI) was used as a metric of neighborhood quality. The association of visual acuity (VA) and IOP with COI scores using linear mixed-effect models, adjusting for individual demographics. A total of 221 eyes (149 patients) were included. Of these, 54.36% were male and 56.4% were non-Hispanic Whites. The median age at the time of presentation was 5 months for primary glaucoma and 5 years for secondary glaucoma. The median age at the last follow-up was 6 and 13 years for primary and secondary glaucoma, respectively. A chi-square test revealed that the COI, health and environment, social and economic, and education indexes between primary and secondary glaucoma patients were comparable. For primary glaucoma, the overall COI and a higher education index were associated with a lower final IOP (P<0.05), and higher education index was associated with a lower number of glaucoma medications at the last follow-up (P<0.05). For secondary glaucoma, higher overall COI, health and environment, social and economic, and education indices were associated with better final VA (lower logarithms of the minimum angle of resolution VA) (P<0.001). Neighborhood environment quality is a potentially important variable for predicting outcomes in childhood glaucoma. Lower COI scores were associated with worse outcomes. Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Linking social and built environmental factors to leisure-time physical activity in rural cancer survivors.

This study explored associations between social and built environmental factors and leisure-time physical activity (LTPA) in rural cancer survivors (RCS) and whether these associations differed by exercise stage of change (SOC). RCS (n = 219) completed questionnaires assessing LTPA, SOC, and social (social status, connectedness, support) and environmental (home environment, neighborhood environment) factors. Linear regression models examined associations between social and built environmental factors and LTPA and tested for moderation by SOC. Half (50.7%) of RCS were physically active, and 49.3% were not active. Social factors positively associated with LTPA included subjective social status in the community (B = 89.0, P = .014) and in the United States (B = 181.3, P < .001), social connectedness (B = 122.3, P = .024), and social support for physical activity from family (B = 41.9, P < .001) and friends (B = 44.3, P < .001). Environmental factors positively associated with LTPA included the home environment (B = 111.2, P < .001), perceived environmental support for PA (B = 355.4, P = .004), and neighborhood attributes, including bicycling infrastructure (B = 191.3, P = .003), proximity to recreation facilities (B = 140.1, P = .021), traffic safety (B = 184.5, P = .025), and aesthetics (B = 342.6, P < .001). SOC statistically significantly moderated the association between social status in the United States and LTPA (B = 160.3, P = .031). Social and built environmental factors were consistently linked with LTPA and provide context for multilevel interventions promoting LTPA in RCS.

Individual and Neighborhood Environmental Factors Affecting Healthy Eating Among Korean Rural Adults.

Although it is recognized that social and environmental factors influence healthy eating behaviors, few studies have investigated the association between environmental factors and healthy eating among rural adults in Korea. We aimed to identify individual and neighborhood environmental factors influencing adherence to fruit and vegetable intake among adults living in rural areas using an ecological approach. The study sample comprised 1,582 adults from 38 rural areas from Chungbuk Province, South Korea in 2017 who provided individual- and neighborhood-level data. Neighborhood-level data were obtained by aggregating individual-level responses measured for each residential town resulting in an average value for each neighborhood-level variable for the 38 rural areas. The data were merged and used for a series of multilevel logistic regression analyses. Among the individual-level factors, age, alcohol drinking, physical activity, self-efficacy for healthy eating, and social support for healthy eating were significantly associated with adherence to fruit and vegetable intake. Among the neighborhood-level factors, social cohesion and perceived neighborhood safety were significantly associated with adherence to fruit and vegetable intake. Multifaceted intervention strategies to increase consumption of fruits and vegetables should include behavioral modification, social support, and improvement of neighborhood environments.

Childhood obesity inequality in northeast China: joint effect of social economic status and school neighborhood environment

BackgroundObesogenic environment is important in driving obesity epidemic. Children spend large amount of their time in schools. School neighborhood environment, as well as its interaction with socioeconomic status (SES) needs to be explored to provide evidence for children obesity prevention policies.MethodsObjective anthropometric measurement, a household structured questionnaire, and school geospatial analyses were carried out on 3670 children (aged 9–12 years) of 26 schools in northeast China. Interaction between SES inter-categorical intersectionality group and school neighborhood environment was tested for the effect on children’s body mass index z scores (z-BMI) and waist–hip ratio z scores (z-WHR), following formulation of SES inter-categorical intersectionality group based on household wealth, parental education, and parental occupation.ResultsSES groups formed by household wealth, parental education and parental occupation was associated with z-BMI and z-WHR for girls. Those from moderate wealth & self-employed (M&S) families had the highest adjusted z-BMI and z-WHR among all SES groups. School neighborhood environment factors interacted with SES groups in association with WHR for girls. Number of school neighborhood supermarkets and residential sites were negatively associated with z-WHR for girls from M&S families (β= -0.45 (95%CI: -0.76, -0.15) for supermarkets; β= -0.01 (95%CI: -0.03, 0.00) for residential sites). Number of school neighborhood convenience stores and public transport stops were positively associated with z-WHR for girls from M&S families (β = 0.02 (95%CI: 0.00, 0.03) for convenience stores; β = 0.23 (95%CI: 0.15, 0.31) for public transport stops). While non-significant association was found for number of vegetable stores.ConclusionGirls from moderate wealth & self-employed families may be the group susceptible to school neighborhood environment. Local policies targeted at improving the school neighborhood environment may be one avenue for reducing socioeconomic disparities in obesity especially for girls.

Abstract C094: The impact of neighborhood disorder on ovarian cancer survival in African American women

Abstract Ovarian cancer (OC) is the fifth-leading cause of cancer deaths in women in the US. While the incidence of ovarian cancer in Black women is 25% lower than in White women, the 5-year survival for Black women is 10% lower than in White women. Recent evidence suggests that health disparities can be partly explained by neighborhood social and environmental factors such as disadvantage or disorder. To test whether objective neighborhood (dis)order is associated with OC survival we developed a novel approach using Google Street View (GSV) to estimate a measure of neighborhood disorder (ND) at the block group level within the largest multi-site cohort study of Black women diagnosed with OC (AACES) between 2010 and 2015. 592 AACES participants were enrolled and geocoded residing in 544 unique block groups largely concentrated in the southern US at their time of diagnosis. We randomly sampled 5 unique street address locations in each block group and adapted an online application, the Computer Assisted Neighborhood Visual Assessment System (CANVAS), that uses Google Street View to conduct virtual audits of the neighborhood environment at these points. We trained and standardized auditors to conduct two independent audits per location, for a total of 5,440 audits. Audit questions assessed the presence of different types of land use, quality of the built structures, and presence of other markers of ND. To understand the underlying patterns in the audit data, we conducted an exploratory factor analysis that identified 5 distinct neighborhood factors: developmental intensity, development age, neighborhood order, land use, and green/blue space. A score for each block group was calculated for each factor and assigned to residents of that block group. The neighborhood order factor included the condition of residential units and yards, as well as the presence of abandoned residential units and empty alcohol containers. The blue/green-space element included the presence of open spaces, recreational facilities, agricultural and waterfront land uses, and trees lining the streets. Survival analysis using Cox Proportional Hazards models was completed, focused on the neighborhood disorder and green/blue-space scores. After adjusting for age, income, education, comorbidity, and state of residence, higher neighborhood order scores were non-significantly associated with longer survival among participants (Hazard Ratio (HR): 0.95, 95% CI: 0.84-1.08). Similarly, higher green/blue space scores were also non-significantly associated with longer survival (HR: 0.92, 95%CI: 0.74-1.15), after adjustment. We observed that OC survival was longer among residents of block groups with higher neighborhood order scores and higher blue/green space scores, though we cannot rule out chance in these associations. Future research should explore mechanisms by which neighborhood features might affect ovarian cancer survival. Citation Format: Christopher Pierson, Steve J. Mooney, Andrew B. Lawson, Joellen M. Schildkraut, Edward S. Peters. The impact of neighborhood disorder on ovarian cancer survival in African American women [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr C094.

Influence of neighborhood environment and social support on physical activity among patients with diabetes mellitus

This study was aimed to determine the relationship of physical activity (PA) with the neighborhood environment and social support for PA among patients with diabetes mellitus (DM).&lt;b&gt; &lt;/b&gt;A total of 193 consenting individuals with DM attending endocrinology clinic in a Nigerian tertiary hospital participated in this cross-sectional study. The&lt;b&gt; &lt;/b&gt;international physical activity questionnaire short form, physical activity neighborhood environment scale (PANES), and physical activity and social support scale (PASSS) were used to assess the PA level (low, moderate, and high), neighborhood environment and social support for PA, respectively. The results of bivariate analyses showed that all elements of built environment and social support were significantly associated with PA. Regression model analyses indicate that PANES score was associated with moderate (adjusted odds ratio [aOR]: 10.76; 95% confidence interval [CI]: 3.82-30.32) to high (aOR: 45.73; 95% CI: 12.14-172.27) PA. In addition, easy access to quality walking facilities (aOR: 46.53; 95% CI: 3.89-557.32; aOR: 46.13; 95% CI: 2.65-802.40) and easy access to recreation infrastructure (aOR: 46.89; 95% CI: 3.95-487.83; aOR: 17.99; 95% CI: 1.28-252.98) were associated with moderate to high PA, respectively, while safety from crime (aOR: 0.21; 95% CI: 0.07-0.64) and easy access to services and shops (aOR: 21.90; 95% CI: 1.83-262.59) were associated with moderate and high PA. Informational social support was associated with moderate PA (aOR: 1.44; 95% CI: 1.04-2.00). In conclusion, the neighborhood environmental and social support factors were associated with the PA activity level among Nigerian patients with DM.

Nonlinear Effects of the Neighborhood Environments on Residents' Mental Health.

In the context of rapid urbanization and the "Healthy China" strategy, neighborhood environments play an important role in improving mental health among urban residents. While an increasing number of studies have explored the linear relationships between neighborhood environments and mental health, much remains to be revealed about the nonlinear health effects of neighborhood environments, the thresholds of various environmental factors, and the optimal environmental exposure levels for residents. To fill these gaps, this paper collected survey data from 1003 adult residents in Guangzhou, China, and measured the built and social environments within the neighborhoods. The random forest model was then employed to examine the nonlinear effects of neighborhood environments on mental health, evaluate the importance of each environmental variable, as well as identify the thresholds and optimal levels of various environmental factors. The results indicated that there are differences in the importance of diverse neighborhood environmental factors affecting mental health, and the more critical environmental factors included greenness, neighborhood communication, and fitness facility density. The nonlinear effects were shown to be universal and varied among neighborhood environmental factors, which could be classified into two categories: (i) higher exposure levels of some environmental factors (e.g., greenness, neighborhood communication, and neighborhood safety) were associated with better mental health; (ii) appropriate exposure levels of some environmental factors (e.g., medical, fitness, and entertainment facilities, and public transport stations) had positive effects on mental health, whereas a much higher or lower exposure level exerted a negative impact. Additionally, this study identified the exact thresholds and optimal exposure levels of neighborhood environmental factors, such as the threshold (22.00%) and optimal exposure level (>22.00%) of greenness and the threshold (3.80 number/km2) and optimal exposure level (3.80 number/km2) of fitness facility density.

How neighborhood environment modified the effects of power outages on multiple health outcomes in New York state?

BackgroundAlthough power outage (PO) is one of the most important consequences of increasing weather extremes and the health impact of POs has been reported previously, studies on the neighborhood environment underlying the population vulnerability in such situations are limited. This study aimed to identify dominant neighborhood environmental predictors which modified the impact of POs on multiple health outcomes in New York State. MethodsWe applied a two-stage approach. In the first stage, we used time series analysis to determine the impact of POs (versus non-PO periods) on multiple health outcomes in each power operating division in New York State, 2001-2013. In the second stage, we classified divisions as risk-elevated and non-elevated, then developed predictive models for the elevation status based on 36 neighborhood environmental factors using random forest and gradient boosted trees. ResultsConsistent across different outcomes, we found predictors representing greater urbanization, particularly, the proportion of residents having access to public transportation (importance ranging from 4.9–15.6%), population density (3.3–16.1%), per capita income (2.3–10.7%), and the density of public infrastructure (0.8–8.5%), were associated with a higher possibility of risk elevation following power outages. Additionally, the percent of minority (-6.3–27.9%) and those with limited English (2.2–8.1%), the percent of sandy soil (6.5–11.8%), and average soil temperature (3.0–15.7%) were also dominant predictors for multiple outcomes. Spatial hotspots of vulnerability generally were located surrounding New York City and in the northwest, the pattern of which was consistent with socioeconomic status. ConclusionPopulation vulnerability during power outages was dominated by neighborhood environmental factors representing greater urbanization.

Neighborhood environmental factors linked to hospitalizations of older people for viral lower respiratory tract infections in Spain: a case-crossover study

BackgroundLower respiratory tract viral infection (LRTI) is a significant cause of morbidity-mortality in older people worldwide. We analyzed the association between short-term exposure to environmental factors (climatic factors and outdoor air pollution) and hospital admissions with a viral LRTI diagnosis in older adults.MethodsWe conducted a bidirectional case-crossover study in 6367 patients over 65 years of age with viral LRTI and residential zip code in the Spanish Minimum Basic Data Set. Spain’s State Meteorological Agency was the source of environmental data. Associations were assessed using conditional logistic regression. P-values were corrected for false discovery rate (q-values).ResultsAlmost all were hospital emergency admissions (98.13%), 18.64% were admitted to the intensive care unit (ICU), and 7.44% died. The most frequent clinical discharge diagnosis was influenza (90.25%). LRTI hospital admissions were more frequent when there were lower values of temperature and O3 and higher values of relative humidity and NO2. The regression analysis adjusted by temperatures and relative humidity showed higher concentrations at the hospital admission for NO2 [compared to the lag time of 1-week (q-value< 0.001) and 2-weeks (q-value< 0.001)] and O3 [compared to the lag time of 3-days (q-value< 0.001), 1-week (q-value< 0.001), and 2-weeks (q-value< 0.001)] were related to a higher odds of hospital admissions due to viral LRTI. Moreover, higher concentrations of PM10 at the lag time of 1-week (q-value = 0.023) and 2-weeks (q-value = 0.002), and CO at the lag time of 3-days (q-value = 0.023), 1-week (q-value< 0.001) and 2-weeks (q-value< 0.001)], compared to the day of hospitalization, were related to a higher chances of hospital admissions with viral LRTI.ConclusionUnfavorable environmental factors (low temperatures, high relative humidity, and high concentrations of NO2, O3, PM10, and CO) increased the odds of hospital admissions with viral LRTI among older people, indicating they are potentially vulnerable to these environmental factors.Graphical

Youth Assets, Neighborhood Factors, Parental Income, and Tobacco Use: A Longitudinal Study of Health Disparities.

This study aimed to assess how the relationship between youth assets and future no-tobacco use among youth might differ according to race/ethnicity, neighborhood factors and socio-economic status. Five waves of annual data were collected from 1111 youth/parent pairs living in Oklahoma, USA who were randomly selected to participate in the Youth Asset Study (YAS). A marginal logistic regression model using all five waves of no-tobacco use, demographics, and their interaction was used to compare the change in tobacco use over time. Among 1111 youth, (Mean age = 14.3; 53% female; 39% White, 28% Hispanic, 24% Black, and 9% other), the percentage of youth tobacco use increased significantly from baseline to wave 5 (4 years after baseline) for all racial/ethnic groups and all parental income groups. Assets were prospectively associated with no tobacco use in the past 30 days for Black, White and Hispanic youth and for youth in all income categories (adjusted odds ratio range = 1.9–2.7). There was one statistically significant association between the neighborhood environment and future no tobacco use. To conclude, the protective effects of youth assets in terms of prevention of tobacco use among youth do not differ by youth race/ethnicity or parental income in the presence of neighborhood environmental factors.

Trajectories of neighborhood environmental factors and their associations with asthma symptom trajectories among children in Australia: evidence from a national birth cohort study

PurposeThis study aims to investigate the prospective associations of neighborhood environmental exposure trajectories with asthma symptom trajectories during childhood developmental stages.MethodsWe considered asthma symptom, neighborhood environmental factors, and socio-demographic data from the “Longitudinal Study of Australian Children (LSAC)”. Group-based trajectory modeling was applied to identify the trajectories of asthma symptom, neighborhood traffic conditions, and neighborhood livability scales (considered for safety and facilities). We used multivariable logistic regression models to assess associations between various neighborhood environmental factors and asthma symptom trajectories.ResultsWe included 4,174 children from the LSAC cohort in our study. Three distinct trajectories for asthma symptom were the outcome variables of this study. Among the neighborhood environmental factors, we identified two distinct trajectories for the prevalence of heavy traffic on street, and two trajectories of neighborhood liveability scale. Compared to the ‘Low/no’ asthma symptoms trajectory group, children exposed to a ‘persistently high’ prevalence of heavy traffic on street was also significantly associated with both ‘transient high’ [relative risk ratio (RRR):1.40, 95% CI:1.25,1.58) and ‘persistent high’ (RRR: 1.33, 95% CI:1.17,1.50)] asthma symptom trajectory groups. Trajectory of moderate and static neighborhood liveability score was at increased risk of being classified as ‘transient high’ (RRR:1.16, 95% CI:1.07,1.25) and ‘persistent high’ (RRR:1.38, 95% CI:1.27,1.50) trajectories of asthma symptom.ConclusionExposure to heavy traffic and poor neighborhood liveability increased the risk of having an unfavourable asthma symptom trajectory in childhood. Reducing neighborhood traffic load and improving neighborhood safety and amenities may facilitate a favorable asthma symptom trajectory among these children.