Road Network Buffers Research Articles

Defining neighborhood walkability for children in the ELFE cohort study

Abstract Background Although walkability is known to be associated with obesity in adults, there is a paucity of data evaluating the association of walkability and health outcomes in children. In particular, little is known regarding the possible association with children’s mental health. Methods We used data from the Etude Longitudinale Française depuis l’Enfance (ELFE) cohort study. Participating mothers gave birth in 2011 in a representative sample of 320 maternity hospitals in mainland France. This pilot study is limited to participants in Paris and children at 5.5 years old. Walkability is defined by three parameters: population density (defined by census data), street connectivity (defined by intersection density), and land-use mix (entropy index). To approximate walkable areas, 500-meter street-network buffer zones were created around each participants address using a geographic information system. Children’s mental health was assessed using parent-reported Strengths and Difficulties Questionnaire at age 5.5 years. Results There was a total of 280 children in this pilot study. On measures of land-use mix, we found a mean of 0.79 (SD: 0.12), representing high accessibility. Residential and intersection density were highly correlated (p < 0.01). The walkability index demonstrated high variability among participants (mean: 10.6; SD: 10.44; range: -1.67 - 30.59). Conclusions Developing a walkability index is a multifactorial measure to describe a children’s neighborhood environment. Future work includes determining the association with children’s mental health disorders, while accounting for individual and neighborhood variables. This ecological model can inform social epidemiology and contextual disparities in children’s health. Key messages • Little is known about neighborhood walkability and the association with children’s mental health. • Using objective measures to calculate neighborhood composition and help elucidate this relationship.

When does greener mean slimmer? Longitudinal analysis of green space, trees, grass, and body mass index in a cohort of 50,672 Australians: Exploring potential non-linearities and modifying influences of household relocation and gender

Studies of associations between green space and overweight/obesity are often agnostic to green space type and potential contingencies by gender and household relocation. We investigated associations between total green space, tree canopy, and open grass within 1.6 km road network buffers, on body mass index (BMI) at baseline (n = 110,234; 2005–2009) and follow-up (n=50,672; 2012–2015) using data from the Sax’s Institute’s 45 and Up Study (NSW, Australia). Analyses considered potential non-linearities in these associations and the possibility for effect modification by gender and household relocation. Models were adjusted for age, couple status, region of birth, household income, employment status, educational attainment and housing status. Results revealed that 20 % or more tree canopy, compared to 0–10 % tree canopy was associated with lower BMI. Comparable findings were not observed for open grass or total green space. Nonlinear associations were observed, with a rapid decrease in odds of being overweight/obese at baseline with 20 % tree canopy, that became more stable by 30 % tree canopy. This non-linearity was stronger in females than males. By follow-up, associations indicated potential protective effects with 20 % or more tree canopy for overweight/obesity in females. Logistic regression models examined the odds of becoming a healthy weight at follow-up in overweight/obese individuals at baseline. Results indicated a potentially protective influence of tree canopy on overweight/obesity for people who did not move home (odds ratio (OR) = 1.06, 95 % confidence interval (CI) = 1.01–1.12), but not those who relocated (OR = 0.97, 95 % CI = 0.83–1.11). In sum, conserving and restoring urban tree canopy to at least 20% to 30% of nearby land-use may help to reduce levels of overweight and obesity in the community These benefits may be particularly potent for females and for people who are residentially stable. More open grass, or green space in general, may not have the same benefits for adult overweight/obesity as tree canopy.

Longitudinal study of changes in greenness exposure, physical activity and sedentary behavior in the ORISCAV-LUX cohort study

BackgroundGreenness exposure has been associated with many health benefits, for example through the pathway of providing opportunities for physical activity (PA). Beside the limited body of longitudinal research, most studies overlook to what extent different types of greenness exposures may be associated with varying levels of PA and sedentary behavior (SB). In this study, we investigated associations of greenness characterized by density, diversity and vegetation type with self-reported PA and SB over a 9-year period, using data from the ORISCAV-LUX study (2007–2017, n = 628).MethodsThe International Physical Activity Questionnaire (IPAQ) short form was used to collect PA and SB outcomes. PA was expressed as MET-minutes/week and log-transformed, and SB was expressed as sitting time in minutes/day.Geographic Information Systems (ArcGIS Pro, ArcMap) were used to collect the following exposure variables: Tree Cover Density (TCD), Soil-adjusted Vegetation Index (SAVI), and Green Land Use Mix (GLUM). The exposure variables were derived from publicly available sources using remote sensing and cartographic resources. Greenness exposure was calculated within 1000m street network buffers around participants’ exact residential address.ResultsUsing Random Effects Within-Between (REWB) models, we found evidence of negative within-individual associations of TCD with PA (β = − 2.60, 95% CI − 4.75; − 0.44), and negative between-individual associations of GLUM and PA (β = − 2.02, 95% CI − 3.73; − 0.32). There was no evidence for significant associations between greenness exposure and SB. Significant interaction effects by sex were present for the associations between TCD and both PA and SB. Neighborhood socioeconomic status (NSES) did not modify the effect of greenness exposure on PA and SB in the 1000 m buffer.DiscussionOur results showed that the relationship between greenness exposure and PA depended on the type of greenness measure used, which stresses the need for the use of more diverse and complementary greenness measures in future research. Tree vegetation and greenness diversity, and changes therein, appeared to relate to PA, with distinct effects among men and women. Replication studies are needed to confirm the relevance of using different greenness measures to understand its’ different associations with PA and SB.

Associations between green space availability and youth’s physical activity in urban and rural areas across Germany

Green space may be an important physical activity facilitator for children and adolescents. However, to date, most studies focused on urban green space, and few studies investigated associations between green space and physical activity across urban and rural areas, which was the goal of this study. Data were obtained from a German cohort study, including 1,211 youth aged 6–17 years. Residential green space was assessed within a 1000 m street-network buffer using land cover and land use data and divided into quartiles, urbanicity using the European Urbanization Degree, and moderate-to-vigorous physical activity (MVPA) using accelerometers. Associations were investigated via linear regression analysis stratified by urbanicity degree, controlling for relevant confounders. We found that in rural areas, compared to youth in the bottom green quartile, those within the middle (2nd) and upper (3rd) green quartiles engaged in less MVPA. This relationship was not observed for youth in towns and cities. Interactions occurred between green space and socio-demographic characteristics for children and adolescents in cities: Compared to the bottom green quartile, boys or younger children within the middle green quartile engaged in more MVPA. However, socially disadvantaged children and adolescents in cities engaged in less MVPA in the upper compared to the bottom green quartile. Our results show that associations between green space and MVPA do not only differ between urban and rural areas but also among youth sub-populations. These findings are important to consider for planning policies to create inclusive active living environments across urban and rural areas.

Urban school neighbourhoods dominated by unhealthy food retailers and advertisements in Greater Tunis: a geospatial study in the midst of the nutrition transition.

Food environments are a major determinant of children's nutritional status. Scarce evidence on food environments exists in low- and middle-income countries (LMIC). This study aims to fill this gap by documenting the obesogenicity of food environments around schools in Greater Tunis, Tunisia - an LMIC of the Middle East and North Africa region with an ongoing nutrition transition and increasing rates of childhood obesity. In this cross-sectional study, we assessed built food environments around fifty primary schools. Ground-truthing was performed to collect geographic coordinates and pictures of food retailers and food advertisement sets within an 800-m road network buffer of each school. Retailers and advertisement sets were categorised as healthy or unhealthy according to a NOVA-based classification. Associations between school characteristics and retailers or advertisement sets were explored using multinomial regression models. Greater Tunis, Tunisia. Random sample of fifty (thirty-five public and fifteen private) primary schools. Overall, 3621 food retailers and 2098 advertisement sets were mapped. About two-thirds of retailers and advertisement sets were labelled as unhealthy. Most retailers were traditional corner stores (22 %) and only 6 % were fruit and vegetable markets. The prevailing food group promoted was carbonated and sugar-sweetened beverages (22 %). The proportion of unhealthy retailers was significantly higher in the richest v. poorest areas. School neighbourhood food environments included predominantly unhealthy retailers and advertisements. Mapping of LMIC food environments is crucial to document the impact of the nutrition transition on children's nutritional status. This will inform policies and interventions to curb the emergent childhood obesity epidemic.

Obesogenic neighborhood environment is associated with body fat and low-grade inflammation in Brazilian children: could the mother's BMI be a mediating factor?

To evaluate the direct and indirect associations of obesogenic and leptogenic neighborhood environments with body fat, and pro- and anti-inflammatory adipokines in Brazilian children. Cross-sectional study. The body fat distribution was assessed using dual-energy X-ray absorptiometry (DXA). Concentrations of leptin and adiponectin were measured. Four hundred meters (0·25 miles) road network buffer was the neighborhood unit used to assess the environmental characteristics around households. Obesogenic and leptogenic environments were the latent variables obtained from the observed characteristics. The mother's BMI, ultra-processed food consumption, and physical activity before and after school, were tested as mediating variables. A hybrid model of structural equations was used to test the direct and indirect associations of obesogenic and leptogenic environments with body fat, leptin and adiponectin concentrations. Urban area of Viçosa, Minas Gerais, Brazil. Children aged 8- and 9-years (n 367). Obesogenic environment was directly associated with the mother's BMI (β: 0·24, P = 0·02) and the child's body fat (β: 0·19, P = 0·02). The mother's BMI and body fat mediated the association of the obesogenic environment with leptin concentrations (β: 0·05, P = 0·02). Obesogenic neighborhood environment was directly associated with body fat and mother's BMI, and indirectly associated with leptin concentrations in Brazilian children, mediated by the mother's BMI and body fat.

Greenspace exposure may increase life expectancy of elderly adults, especially for those with low socioeconomic status

With an increasing aging population in many cities worldwide, promoting and maintaining the health of elderly individuals has become a pressing public health issue. Although greenspaces may deliver many health outcomes for the elderly population, existing evidence remains inconsistent, partly due to discrepancies in the measure of greenspace and health outcomes. In addition, few studies examined the effect of greenspace exposure on life expectancy at the individual level. Thus, this study comprehensively investigated the association between greenspace exposure and life expectancy among elderly adults in Guangzhou, China, based on the individual-level mortality dataset. The data were analyzed at both the individual level and aggregate level, and two types of buffers (straight-line vs. street-network buffer) were used to define individual greenspace exposure. After controlling for the random effects and multiple types of covariates, we found that 1) elderly individuals with higher greenspace exposure were associated with an increased life expectancy; 2) elderly individuals with lower socioeconomic status benefit more from greenspace (i.e., equigenesis hypothesis); 3) different greenspace measurements lead to different results; 4) greenspace had the highest effects on life expectancy and equigenesis within the street-network buffer distances of 3000 m and 2500 m, respectively. This study underscores the potential health benefits of greenspace exposure on elderly individuals and the importance of provision and upkeep of greenspace, especially among socially disadvantaged groups.

Assessing the association between food environment and dietary inflammation by community type: a cross-sectional REGARDS study

BackgroundCommunities in the United States (US) exist on a continuum of urbanicity, which may inform how individuals interact with their food environment, and thus modify the relationship between food access and dietary behaviors.ObjectiveThis cross-sectional study aims to examine the modifying effect of community type in the association between the relative availability of food outlets and dietary inflammation across the US.MethodsUsing baseline data from the REasons for Geographic and Racial Differences in Stroke study (2003–2007), we calculated participants’ dietary inflammation score (DIS). Higher DIS indicates greater pro-inflammatory exposure. We defined our exposures as the relative availability of supermarkets and fast-food restaurants (percentage of food outlet type out of all food stores or restaurants, respectively) using street-network buffers around the population-weighted centroid of each participant’s census tract. We used 1-, 2-, 6-, and 10-mile (~ 2-, 3-, 10-, and 16 km) buffer sizes for higher density urban, lower density urban, suburban/small town, and rural community types, respectively. Using generalized estimating equations, we estimated the association between relative food outlet availability and DIS, controlling for individual and neighborhood socio-demographics and total food outlets. The percentage of supermarkets and fast-food restaurants were modeled together.ResultsParticipants (n = 20,322) were distributed across all community types: higher density urban (16.7%), lower density urban (39.8%), suburban/small town (19.3%), and rural (24.2%). Across all community types, mean DIS was − 0.004 (SD = 2.5; min = − 14.2, max = 9.9). DIS was associated with relative availability of fast-food restaurants, but not supermarkets. Association between fast-food restaurants and DIS varied by community type (P for interaction = 0.02). Increases in the relative availability of fast-food restaurants were associated with higher DIS in suburban/small towns and lower density urban areas (p-values < 0.01); no significant associations were present in higher density urban or rural areas.ConclusionsThe relative availability of fast-food restaurants was associated with higher DIS among participants residing in suburban/small town and lower density urban community types, suggesting that these communities might benefit most from interventions and policies that either promote restaurant diversity or expand healthier food options.

O.2.2-4 Longitudinal associations between residential greenness exposure, physical activity and sedentary behavior levels: a country-wide study in Luxembourg

Abstract Greenness exposure has been associated with many health benefits, by providing opportunities for physical activity. Longitudinal studies are lacking, and most studies overlook the varying effects of different greenness types on physical activity (PA) and sedentary behavior (SB). We investigated 9-year associations of greenness characterized by overall greenness, vegetation type, and mix, with PA and SB using data from the ORISCAV-LUX study and the MET’HOOD project. The PA and SB outcomes were measured using the International Physical Activity Questionnaire (IPAQ) short form. PA is expressed as MET-minutes/week and log-transformed, and SB is expressed as sitting time in minutes/day. The exposure variables were Tree Cover Density (TCD), Soil-adjusted Vegetation Index (SAVI), and Green Land Use Mix (GLUM). The study population consisted of 628 adults, who completed the questionnaires between January 2007-2009 and January 2016-July 2017. Missing data were imputed. Greenness exposure was collected within 800-meter street network buffers based on participants’ exact residential address. Associations between TCD, SAVI and GLUM and PA and SB were estimated using a Random Effects Within-Between (REWB) model. Interaction by gender and SES were explored. Sensitivity analyses were performed on smaller (500 meter buffer) and larger (1000, 2000 meter buffers) definitions of the residential neighborhood. We found evidence of between-individual associations of GLUM and PA (β = 0.17, 95% CI: 0.03; 0.91), and within-individual associations of TCD with PA (β = 0.03, 95% CI: 0.002; 0.438) (in 800 meter buffers). There was no evidence for associations between greenness exposure and SB. Sensitivity analysis using varying buffer sizes showed similar associations. Our study found evidence of associations of GLUM and TCD with PA, and no associations between greenness exposure and SB. Promoting different types of greenness may result in different PA levels and behaviors. Replication studies are needed to inform urban planning interventions. This study is funded by the EU Horizon2020 Program under grant agreement number 956780 (SURREAL). The ORISCAV-LUX study is funded by the Luxembourg Ministry of Health and Ministry of Higher Education and Research. The MET'HOOD project is funded by the Luxembourg National Research Fund as part of the CORE 2020 programme (C20/BM/14787166).

Inequalities in neighbourhood features within children's 20-minute neighbourhoods and variation in time spent locally, measured using GPS

There has been a growing interest in policies that encourage local living by promoting accessible and walkable communities, such as the 20-minute neighborhood concept. Despite the widespread adoption of this policy worldwide, little research has been conducted on the characteristics of children's 20-minute neighborhoods and their association with time spent locally.This study aimed to explore the features of Scottish children's 20-minute neighborhoods by analysing an 800 m road and path network buffer surrounding 687 children's homes. Based on existing literature, the study identified key features associated with children's time spent locally and the 20-minute neighborhood policy. The study then examined variations in these features by socioeconomic status, urbanicity, and gender.The findings revealed significant inequalities in the presence of health-benefiting (e.g., green spaces, recreational facilities, healthy food outlets) and health-harming (e.g., major roads, unhealthy commodity retailers) environments within children's 20-minute neighborhoods. Children from more deprived areas had access to more of both types of environments. The study also found that having a school within a 20-minute neighborhood was associated with an increased amount of time spent locally (IRR 1.62, 95% CI 1.5 to 1.8, p<0.001).The study suggests that the 20-minute neighborhood policy should extend beyond mere access to local amenities and prioritise creating healthy 20-minute neighborhoods, particularly in socioeconomically deprived areas. The research highlights the importance of promoting equal access to quality local environments, which can contribute to improved health and well-being outcomes for children.

The moderating impact of neighborhood walkability on mHealth interventions to increase moderate to vigorous physical activity for insufficiently active adults in a randomized trial

BackgroundEcological models suggest that interventions targeting specific behaviors are most effective when supported by the environment. This study prospectively examined the interactions between neighborhood walkability and an mHealth intervention in a large-scale, adequately powered trial to increase moderate-to-vigorous physical activity (MVPA).MethodsHealthy, insufficiently active adults (N = 512) were recruited purposefully from census block groups ranked on walkability (high/low) and socioeconomic status (SES, high/low). Participants were block-randomized in groups of four to WalkIT Arizona, a 12-month, 2 × 2 factorial trial evaluating adaptive versus static goal setting and immediate versus delayed financial reinforcement delivered via text messages. Participants wore ActiGraph GT9X accelerometers daily for one year. After recruitment, a walkability index was calculated uniquely for every participant using a 500-m street network buffer. Generalized linear mixed-effects hurdle models tested for interactions between walkability, intervention components, and phase (baseline vs. intervention) on: (1) likelihood of any (versus no) MVPA and (2) daily MVPA minutes, after adjusting for accelerometer wear time, neighborhood SES, and calendar month. Neighborhood walkability was probed at 5th, 25th, 50th, 75th, and 95th percentiles to explore the full range of effects.ResultsAdaptive goal setting was more effective in increasing the likelihood of any MVPA and daily MVPA minutes, especially in lower walkable neighborhoods, while the magnitude of intervention effect declined as walkability increased. Immediate reinforcement showed a greater increase in any and daily MVPA compared to delayed reinforcement, especially relatively greater in higher walkable neighborhoods.ConclusionsResults partially supported the synergy hypotheses between neighborhood walkability and PA interventions and suggest the potential of tailoring interventions to individuals’ neighborhood characteristics.Trial RegistrationPreregistered at clinicaltrials.gov (NCT02717663).

Characteristics of the obesogenic environment around schools are associated with body fat and low-grade inflammation in Brazilian children.

To assess the association of obesogenic environmental characteristics around schools with body adiposity and adipokine concentrations in Brazilian children. Cross-sectional study. Body adiposity was assessed using the dual-energy X-ray absorptiometry (DXA). Concentrations of leptin, adiponectin, retinol-binding protein 4 (RBP4), and chemerin were measured. Predominantly ultra-processed food (UPF) stores, public physical activity (PA) facilities, green spaces, walkability, traffic accidents, and crime were evaluated. The neighborhood unit was the 400 m (0.25 miles) road network buffer around schools. The association of environmental characteristics with body adiposity and adipokine concentrations was assessed by linear regression models using Generalize Estimating Equations (GEE). Urban schools (n=24), Viçosa, Minas Gerais, Brazil. Children aged 8 and 9 years (n=378). A higher density of predominantly UPF stores and a lower percentage of green space were associated with higher total (β: 0.12; 95%CI: 0.06, 0.18; and β: -0.10; 95%CI: -0.16, -0.04, respectively) and android body fat (β: 0.28; 95%CI: 0.13, 0.43 and β: -0.18; 95%CI: -0.32, -0.04, respectively). In addition, the densities of PA facilities and crime were inversely associated with leptin concentrations. Traffic accidents density and percentage of green spaces around schools had, respectively, a positive and an inverse association with concentrations of adiponectin and RBP4. Obesogenic environmental characteristics around schools were associated with total and android body fat, as well as with pro-inflammatory adipokine concentrations in Brazilian children from a medium-sized city.

Micro urban spaces and mental well-being: Measuring the exposure to urban landscapes along daily mobility paths and their effects on momentary depressive symptomatology among older population

The urban environment plays an important role for the mental health of residents. Researchers mainly focus on residential neighbourhoods as exposure context, leaving aside the effects of non-residential environments. In order to consider the daily experience of urban spaces, a people-based approach focused on mobility paths is needed. Applying this approach, (1) this study investigated whether individuals’ momentary mental well-being is related to the exposure to micro-urban spaces along the daily mobility paths within the two previous hours; (2) it explored whether these associations differ when environmental exposures are defined considering all location points or only outdoor location points; and (3) it examined the associations between the types of activity and mobility and momentary depressive symptomatology. Using a geographically-explicit ecological momentary assessment approach (GEMA), momentary depressive symptomatology of 216 older adults living in the Ile-de-France region was assessed using smartphone surveys, while participants were tracked with a GPS receiver and an accelerometer for seven days. Exposure to multiple elements of the streetscape was computed within a street network buffer of 25 m of each GPS point over the two hours prior to the questionnaire. Mobility and activity type were documented from a GPS-based mobility survey. We estimated Bayesian generalized mixed effect models with random effects at the individual and day levels and took into account time autocorrelation. We also estimated fixed effects. A better momentary mental wellbeing was observed when residents performed leisure activities or were involved in active mobility and when they were exposed to walkable areas (pedestrian dedicated paths, open spaces, parks and green areas), water elements, and commerce, leisure and cultural attractors over the previous two hours. These relationships were stronger when exposures were defined based only on outdoor location points rather than all location points, and when we considered within-individual differences compared to between-individual differences.

Neighborhood walkability, neighborhood social health, and self-selection among U.S. adults

Neighborhood walkability is favorably related to multiple physical health outcomes, but associations with social health are less clear. Present analyses examined how neighborhood walkability was related to neighborhood social health and explored the potential confounding role of neighborhood self-selection. Cross-sectional data were analyzed for 1745 adults, ages 20-66, recruited from two US regions. We created a walkability index around each participant's home (1km street network buffer) based on residential density, street intersection density, mixed land use, and retail floor area ratio. Neighborhood social health outcomes included reported social interactions with neighbors and sense of community. Two mixed model regressions were conducted for each outcome, with and without adjusting for walkability-related reasons for moving to the neighborhood (self-selection). Covariates included sex, age, socioeconomic status, white/nonwhite race/ethnicity, marital status, and time living in the neighborhood. Neighborhood walkability was positively related to social interactions with neighbors, both without (b=0.13, p<.001) and with adjustment for self-selection (b=0.09, p=.008). Neighborhood walkability was positively associated with sense of community, but only before adjusting for self-selection (b=0.02, p=.009). Neighborhood walkability may promote specific aspects of neighborhood social health, which together are beneficial for physical and mental health. These findings provide additional impetus for enhancing walkability of US communities.

Associations between residential greenspace exposure and mortality in 4 645 581 adults living in London, UK: a longitudinal study

Urban greenspaces could reduce non-communicable disease (NCD) risk. The links between greenspaces and NCD-related mortality remain unclear. We aimed to estimate associations between residential greenspace quantity and access and all-cause mortality, cardiovascular disease mortality, cancer mortality, respiratory mortality, and type 2 diabetes mortality. We linked 2011 UK Census data of London-dwelling adults (aged ≥18 years) to data from the UK death registry and the Greenspace Information for Greater London resource. We calculated percentage greenspace area, access point density (access points per km2), and distance in metres to the nearest access point for each respondent's residential neighbourhood (defined as 1000 m street network buffers) for greenspaces overall and by park type using a geographic information system. We estimated associations using Cox proportional hazards models, adjusted for a range of confounders. Data were available for 4 645 581 individuals between March 27, 2011, and Dec 31, 2019. Respondents were followed up for a mean of 8·4 years (SD 1·4). All-cause mortality did not differ with overall greenspace coverage (hazard ratio [HR] 1·0004, 95% CI 0·9996-1·0012), increased with increasing access point density (1·0076, 1·0031-1·0120), and decreased slightly with increasing distance to the nearest access point (HR 0·9993, 0·9987-0·9998). A 1 percentage point (pp) increase in pocket park (areas for rest and recreation under 0·4 hectares) coverage was associated with a decrease in all-cause mortality risk (0·9441, 0·9213-0·9675), and an increase of ten pocket park access points per km2 was associated with a decreased respiratory mortality risk (0·9164, 0·8457-0·9931). Other associations were observed, but the estimated effects were small (eg, all-cause mortality risk for increases of 1 pp in regional park area were 0·9913, 0·9861-0·9966 and increases of ten small open space access points per km2 were 1·0247, 1·0151-1·0344). Increasing the quantity of, and access to, pocket parks might help mitigate mortality risk. More research is needed to elucidate the mechanisms that could explain these associations. Health Data Research UK (HDRUK).

Exercise facility availability and incidence of type 2 diabetes and complications in Spain: A population-based retrospective cohort 2015-2018.

To study the association between exercise facility availability and type 2 diabetes incidence and its complications, and to explore effect modification by socioeconomic status (SES) and sex in the Madrid adult population. A multilevel longitudinal design, based on a population-based retrospective cohort including 1,214,281 residents of Madrid (Spain) aged 40-75 years from 2015 to 2018. Outcomes were type 2 diabetes incidence and macrovascular (cardiac ischemia and/or stroke) and microvascular (chronic kidney disease, retinopathy, and/or peripheral vascular disease) complications in those with diabetes at baseline. Exercise facility availability was defined as the count of exercise facilities in a 1000m street network buffer around each participant's residence. Poisson regression models with robust standard errors were used to estimate the risk ratios (RR). Interactions were explored with SES tertiles and by sex. Residents living in areas with lower exercise facility availability showed higher risk of type 2 diabetes (RRtertile3vs1=1.25, CI95% 1.21-1.30) as well as macrovascular (RRTertile3vs1=1.09 CI95% 1.00-1.19), and microvascular (RRTertile3vs1=1.10 CI95% 1.01-1.19) complications. Associations were strongest in low SES areas for type 2 diabetes (RRtertile3vs1-LOW-SES=1.22, CI95% 1.12-1.32; RRtertile3vs1-HIGH-SES=0.91, CI95% 0.85-0.98) and microvascular complications (RRtertile3vs1-LOW-SES=1.12, CI95% 0,94-1,33; RRtertile3vs1-HIGH-SES=0.88, CI95% 0.73-1.05). Living in areas with lower availability of exercise facilities was associated with a greater risk of type 2 diabetes and its complications. Increasing exercise opportunities, particularly in low SES areas, could help reduce the social gradient of diabetes and its complications.

The Grass is Always Greener: Analyzing Crime Concentration and Specialization in Urban Greenspace Environs

Greenspaces play an important role in the urban landscape, with prior research suggesting that they are associated with numerous health and social benefits for residents. Despite this, research conflicts regarding the relationship between greenspaces and crime, with some studies finding these locations to be criminogenic and others finding them to be protective against local crime. This study examines this relationship in Portland, Oregon, considering different greenspace types as well as different crime types. Further, this study presents a novel methodological adaption to measure crime concentration and specialization around discrete location types by integrating a street network buffer into the standard Location Quotient (LQ) metric. Results suggest that Portland’s greenspaces as a whole do not experience a concentration of crime; however, varying patterns emerge when examining different greenspace and crime types. This study identifies diverse crime concentrations in proximity to small parks, while finding other greenspace categories to be associated with crime-specific concentrations nearby. Others, still, have lower than expected counts of crime concentrating nearby, potentially demonstrating protective trends. These results highlight the importance of disaggregating both crime and location types to better understand the complex relationship between greenspaces and crime.

Mediation of an association between neighborhood socioeconomic environment and type 2 diabetes through the leisure-time physical activity environment in an analysis of three independent samples

IntroductionInequitable access to leisure-time physical activity (LTPA) resources may explain geographic disparities in type 2 diabetes (T2D). We evaluated whether the neighborhood socioeconomic environment (NSEE) affects T2D through the LTPA...

Obesogenic environment around schools is associated with atherogenic risk in Brazilian children.

Cardiometabolic risk factors often emerge in childhood, increasing the risk of cardiovascular diseases in adulthood. The school environments represent an important active space in a child's routine and may influence their health status. In this cross-sectional study, we aimed to evaluate the clustering of cardiometabolic risk factors and its association with the obesogenic and leptogenic environment around schools. A total of 378 children (181 boys; 197 girls) aged 8 and 9 years, enrolled in all urban schools of Viçosa, Minas Gerais, Brazil, were evaluated. Concentrations of high-density lipoprotein-cholesterol (HDL-c) and triglycerides (TG), and the insulin resistance (HOMA-IR), waist circumference (WC), and mean arterial pressure (MAP) were measured. The neighborhood income, walkability index, predominantly ultra-processed food stores, public spaces for leisure and/or physical activities, traffic accidents, crime and green spaces densities were assessed in 400 road network buffers around schools. To test association of the obesogenic and leptogenic environment around schools with cardiometabolic risk clustering, binary logistic regression models were performed with generalized estimating equations. "Obesogenic school environments" had greater densities of ultra-processed food stores, crime and traffic accidents, and higher walkability. The "↓ Atherogenic risk" cluster consisted of higher HDL-c values. There was an inverse association between the obesogenic environment around schools and a child's "↓ atherogenic risk" clustering (OR=0.63; p < 0.001). We concluded that public policies aimed at modifying the environment around schools, by providing healthier food options and safe conditions for active mobility, are essential to prevent child's atherogenic risk.

Neighborhood obesogenic environment and cardiometabolic risk in Brazilian children: The mediation role of the mother's body mass index.

We aimed to evaluate the association of neighborhood obesogenic and leptogenic environments with cardiometabolic risk clustering among Brazilian schoolchildren, mediated by child's ultra-processed food consumption and the mother's body mass index (BMI). A total of 367 children aged 8-9 years, enrolled in urban schools of Viçosa, Minas Gerais, Brazil, were evaluated. Waist circumference, insulin resistance, blood pressure, high-density lipoprotein-cholesterol, and triglycerides concentrations were measured. The child's ultra-processed food consumption assessment was performed by applying three 24-hour dietary recall. The mother's weight and height values were used to calculate the BMI. The neighborhood income, walkability index, predominantly ultra-processed food stores, public spaces for leisure, and/or physical activities, traffic accidents, crime, and green spaces densities were assessed in four hundred road network buffers around households. From neighborhood and cardiometabolic risk variables, four latent variables were obtained from confirmatory factor analysis: neighborhood "obesogenic", and "leptogenic" environments; "high cardiometabolic risk," and "low atherogenic risk". A structural equation model was used to test the direct and indirect associations between neighborhood environment and cardiometabolic risk clusters. The neighborhood obesogenic environment had a significant total association (Standardized Coefficient=0.172, p= .011) and was indirectly associated with the child's "high cardiometabolic risk" cluster, mediated by the mother's body mass index (Standardized Coefficient=0.066, p= .049). Our results reinforce the role of the urban environment on maternal obesity and child's cardiometabolic risk and provide evidence for public health policies aimed to prevent such conditions.