This study systematically reviewed the evidence pertaining to socioeconomic inequalities in different domains of physical activity (PA) by European region.
Studies conducted between January 2000 and ...December 2010 were identified by a systematic search in Pubmed, Embase, Web of Science, Psychinfo, Sportdiscus, Sociological Abstracts, and Social Service Abstracts. English-language peer-reviewed studies undertaken in the general population of adults (18-65 years) were classified by domain of PA (total, leisure-time including sport, occupational, active transport), indicator of socioeconomic position (education, income, occupation), and European region. Distributions of reported positive, negative, and null associations were evaluated.
A total of 131 studies met the inclusion criteria. Most studies were conducted in Scandinavia (n = 47). Leisure-time PA was the most frequently studied PA outcome (n = 112). Considerable differences in the direction of inequalities were seen for the different domains of PA. Most studies reported that those with high socioeconomic position were more physically active during leisure-time compared to those with low socioeconomic position (68% positive associations for total leisure-time PA, 76% for vigorous leisure-time PA). Occupational PA was more prevalent among the lower socioeconomic groups (63% negative associations). Socioeconomic differences in total PA and active transport PA did not show a consistent pattern (40% and 38% positive associations respectively). Some inequalities differed by European region or socioeconomic indicator, however these differences were not very pronounced.
The direction of socioeconomic inequalities in PA in Europe differed considerably by domain of PA. The contradictory results for total PA may partly be explained by contrasting socioeconomic patterns for leisure-time PA and occupational PA.
Age-friendly cities: challenges for future research Noordzij, J Mark; Beenackers, Mariëlle A; Diez Roux, Ana V ...
Bulletin of the World Health Organization,
06/2019, Letnik:
97, Številka:
6
Journal Article
Recenzirano
Odprti dostop
The development of age-friendly cities and communities has become an important area of work in the fields of public health, ageing and public policy. This development reflects several larger trends ...including the complexity of demographic change and the recognition of the role of the environment in healthy ageing. In 2017, there were an estimated 962 million people aged 60 years or older worldwide, that is, around 13% of the global population. This part of the population is growing at an annual rate of about 3% and further growth is almost inevitable. An increasing part of this population lives in cities, where the combination of urbanization and ageing leads to new public health challenges, such as a higher risk of mental disorders, resulting in impairments in the ability to function socially. However, while cities pose major challenges for older citizens, they also offer opportunities for the implementation of policies and interventions that promote public health. In 2006, the World Health Organization (WHO) initiated a programme specifically targeting the health of urban residents aged 60 years and older, linking the challenges of urbanization and ageing. This collaborative programme aimed to identify which features of the built and social urban environment are essential in creating sustainable and supportive environments for older residents, and culminated in the publication of the Age-friendly city guide in 2006. An age-friendly city was defined as a place that encourages active ageing by optimizing opportunities for health, participation and security to enhance quality of life as people age. Starting with 33 cities, WHO built on the guide by launching the Global Network for Age-friendly Cities and Communities in 2010, currently consisting of more than 500 cities where more than 155 million people live. The network has reached several of the guide’s objectives, such as generating greater recognition of the implications of population ageing on urban planning and involving stakeholders at multiple governmental levels. At the same time, some of the network’s limitations must be considered, as age-friendly initiatives often compete with wider objectives associated with economic growth and development. Furthermore, exchange between the age-friendly city movement and related debates in urban geography, sociology and other social sciences remains limited. This gap is most notable around research on structural urban changes, such as the rise of global cities, widening socioeconomic inequalities, and the impact of rural migration. With increasing population ageing and urbanization, the development of age-friendly environments is a topic that demands the attention of both researchers and policy-makers. Two approaches hold the potential to move age-friendly city research forward: integration of determinants of ageing at multiple levels and the dynamics of urban environments.
BackgroundUrban green spaces have been linked to different health benefits, but longitudinal studies on the effect of green spaces on mental health are sparse and evidence often inconclusive. Our ...objective was to study the effect of changes in green spaces in the residential environment on changes in mental health using data with 10 years of follow-up (2004–2014).MethodsData from 3175 Dutch adults were linked to accessibility and availability measures of green spaces at three time points (2004/2011/2014). Mental health was measured with the Mental Health Inventory-5. Fixed effects analyses were performed to assess the effect of changes in green spaces on mental health.ResultsCross-sectional analysis of baseline data showed significant associations between Euclidean distances to the nearest green space and mental health, with an increase of 100 m correlating with a lower mental health score of approximately 0.5 (95% CI −0.87 to −0.12) on a 0–100 scale. Fixed effects models showed no evidence for associations between changes in green spaces and changes in mental health both for the entire sample as well as for those that did not relocate during follow-up.ConclusionsDespite observed cross-sectional correlations between the accessibility of green space in the residential environment and mental health, no evidence was found for an association between changes in green spaces and changes in mental health. If mental health and green spaces are indeed causally linked, then changes in green spaces in the Eindhoven area between 2004 and 2014 are not enough to produce a significant effect.
The relationship between green spaces and health is attracting more and more societal and research interest. The research field is however still suffering from its differing monodisciplinary origins. ...Now in a multidisciplinary environment on its way to a truly interdisciplinary field, there is a need for a common understanding, precision in green space indicators, and coherent assessment of the complexity of daily living environments. In several reviews, common protocols and open-source scripts are considered a high priority to advance the field. Realizing these issues, we developed PRIGSHARE (Preferred Reporting Items in Greenspace Health Research). It is accompanied by an open-source script that supports non-spatial disciplines in assessing greenness and green space on different scales and types. The PRIGSHARE checklist contains 21 items that have been identified as a risk of bias and are necessary for understanding and comparison of studies. The checklist is divided into the following topics: objectives (3 items), scope (3 items), spatial assessment (7 items), vegetation assessment (4 items), and context assessment (4 items). For each item, we include a pathway-specific (if relevant) rationale and explanation. The PRIGSHARE guiding principles should be helpful to support a high-quality assessment and synchronize the studies in the field while acknowledging the diversity of study designs.
•Guiding principles to ensure high-quality assessment in green space-health research.•Providing a guided flow of assessment decisions and reporting guidance.•Highlighting differences in green space feature assessment by theoretical pathway.•Discussing different scales of context variables and their pathway-specific influence.
Research evidence on the association between neighbourhood characteristics and individual mental health at older ages is inconsistent, possibly due to heterogeneity in the measurement of ...mental-health outcomes, neighbourhood characteristics and confounders. Register-based data enabled us to avoid these problems in this longitudinal study on the associations between socioeconomic and physical neighbourhood characteristics and individual antidepressant use in three national contexts.
We used register-based longitudinal data on the population aged 50+ from Turin (Italy), Stockholm (Sweden), and the nine largest cities in Finland linked to satellite-based land-cover data. This included individual-level information on sociodemographic factors and antidepressant use, and on neighbourhood socioeconomic characteristics, levels of urbanicity, green space and land-use mix (LUM). We assessed individual-level antidepressant use over 6 years in 2001-2017 using mixed-effects logistic regression.
A higher neighbourhood proportion of low-educated individuals predicted lower odds for antidepressant use in Turin and Stockholm when individual-level sociodemographic factors were controlled for. Urbanicity predicted increased antidepressant use in Stockholm (OR=1.02; 95% CI 1.01 to 1.03) together with more LUM (OR=1.03; 1.01-1.05) and population density (OR=1.08; 1.05-1.10). The two latter characteristics also predicted increased antidepressant use in the Finnish cities (OR=1.05; 1.02-1.08 and OR=1.14; 1.02-1.28, respectively). After accounting for all studied neighbourhood and individual characteristics of the residents, the neighbourhoods still varied by odds of antidepressant use.
Overall, the associations of neighbourhood socioeconomic and physical characteristics with older people's antidepressant use were small and inconsistent. However, we found modest evidence that dense physical urban environments predicted higher antidepressant use among older people in Stockholm and the Finnish cities.
Non-communicable diseases are the global disease burden of our time, with physical inactivity identified as one major risk factor. Green spaces are associated with increased physical activity of ...nearby residents. But there are still gaps in understanding which proximity and what characteristics of green spaces can trigger physical activity. This study aims to unveil these differences with a rigorous sensitivity analysis.
We gathered data on self-reported health and physical activity from 1365 participants in selected neighbourhoods in Porto, Nantes, Sofia, and Høje-Taastrup. Spatial data were retrieved from OpenStreetMap. We followed the PRIGSHARE guidelines to control for bias. Around the residential addresses, we generated seven different green space indicators for 15 distances (100-1500 m) using the AID-PRIGSHARE tool. We then analysed each of these 105 green space indicators together with physical activity and health in 105 adjusted structural equation models.
Green space accessibility and green space uses indicators showed a pattern of significant positive associations to physical activity and indirect to health at distances of 1100 m or less, with a peak at 600 m for most indicators. Greenness in close proximity (100 m) had significant positive effects on physical activity and indirect effects on health. Surrounding greenness showed positive direct effects on health at 500-1100 m and so do green corridors in 800 m network distance. In contrast, a high quantity of green space uses, and surrounding greenness measured in a larger radius (1100-1500 m) showed a negative relationship with physical activity and indirect health effects.
Our results provide insight into how green space characteristics can influence health at different scales, with important implications for urban planners on how to integrate accessible green spaces into urban structures and public health decision-makers on the ability of green spaces to combat physical inactivity.
The MINDMAP project implemented a multinational data infrastructure to investigate the direct and interactive effects of urban environments and individual determinants of mental well-being and ...cognitive function in ageing populations. Using a rigorous process involving multiple teams of experts, longitudinal data from six cohort studies were harmonised to serve MINDMAP objectives. This article documents the retrospective data harmonisation process achieved based on the Maelstrom Research approach and provides a descriptive analysis of the harmonised data generated.
A list of core variables (the DataSchema) to be generated across cohorts was first defined, and the potential for cohort-specific data sets to generate the DataSchema variables was assessed. Where relevant, algorithms were developed to process cohort-specific data into DataSchema format, and information to be provided to data users was documented. Procedures and harmonisation decisions were thoroughly documented.
The MINDMAP DataSchema (v2.0, April 2020) comprised a total of 2841 variables (993 on individual determinants and outcomes, 1848 on environmental exposures) distributed across up to seven data collection events. The harmonised data set included 220 621 participants from six cohorts (10 subpopulations). Harmonisation potential, participant distributions and missing values varied across data sets and variable domains.
The MINDMAP project implemented a collaborative and transparent process to generate a rich integrated data set for research in ageing, mental well-being and the urban environment. The harmonised data set supports a range of research activities and will continue to be updated to serve ongoing and future MINDMAP research needs.
Studies on associations between urban green space and mental health have yielded mixed results. This study examines associations of green space exposures with subjective health and depressed affect ...of middle-aged and older adults in four European cohorts.
Data came from four Western-European and Central-European ageing cohorts harmonised as part of the Mindmap project, comprising 16 189 adults with an average age of 50-71 years. Green space exposure was based on the distance to the nearest green space and the amount of green space within 800 m buffers around residential addresses. Cohort-specific and one-step individual participant data (IPD) meta-analyses were used to examine associations of green space exposures with subjective health and depressed affect.
The amount of green spaces within 800 m buffers was lowest for Residential Environment and CORonary heart Disease (Paris, 15.0 hectares) and highest for Health, Alcohol and Psychosocial factors In Eastern Europe (Czech Republic, 35.9 hectares). IPD analyses indicated no evidence of an association between the distance to the nearest green space and depressed affect (OR 0.98, 95% CI 0.96 to 1.00) or good self-rated health (OR 1.01, 95% CI 0.99 to 1.02). Likewise, the amount of green space within 800 m buffers did not predict depressed affect (OR 0.98, 95% CI 0.96 to 1.00) or good self-rated health (OR 1.01, 95% CI 0.99 to 1.02). Findings were consistent across all cohorts.
Data from four European ageing cohorts provide no support for the hypothesis that green space exposure is associated with subjective health or depressed affect. While longitudinal evidence is required, these findings suggest that green space may be less important for older urban residents.
INTRODUCTIONThis cross-sectional study uses an adaptation of a social–ecological model on the hierarchy of walking needs to explore direct associations and interactions of urban-form characteristics ...and individual psychosocial factors for leisure-time walking.
METHODSQuestionnaire data (n = 736) from adults (25–74 yr) and systematic field observations within 14 neighborhoods in Eindhoven (the Netherlands) were used. Multilevel logistic regression models were used to relate the urban-form characteristics (accessibility, safety, comfort, and pleasurability) and individual psychosocial factors (attitude, self-efficacy, social influence, and intention) to two definitions of leisure-time walking, that is, any leisure-time walking and sufficient leisure-time walking according to the Dutch physical activity norm and to explore their interactions.
RESULTSLeisure-time walking was associated with psychosocial factors but not with characteristics of the urban environment. For sufficient leisure-time walking, interactions between attitude and several urban-form characteristics were found, indicating that positive urban-form characteristics contributed toward leisure-time walking only in residents with a less positive attitude toward physical activity. In contrast, living in a neighborhood that was accessible for walking was stronger associated with leisure-time walking among residents who experienced a positive social influence to engage in physical activity compared with those who reported less social influence.
CONCLUSIONSThis study showed some evidence for an interaction between the neighborhood environment and the individual psychosocial factors in explaining leisure-time walking. The specific mechanism of interaction may depend on the specific combination of psychosocial factor and environmental factor. The lack of association between urban form and leisure-time walking could be partly due to the little variation in urban-form characteristics between neighborhoods.
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