•Suboptimal urban and transport planning causes morbidity and premature mortality.•Air pollution, noise, heat island, green space and physical activity play a role.•Land use changes, reducing cars, ...more public and active transportation, and greening are needed.•Health impact assessment studies provide evidence on how to make cities healthier.•Better urban and transport planning leads to more carbon neutral, liveable and healthier cities.
Half the world population lives in cities and this is likely to increase to 70% over the next 20 years. Suboptimal urban and transport planning has led to e.g. high levels of air pollution and noise, heat island effects and lack of green space and physical activity and thereby an increase in morbidity and premature mortality. How can better urban and transport planning improve public health?
A narrative meta-review around a number of cutting edge and visionary studies and practices on how to improve public health through better urban and transport planning reported in the literature and from meetings over the past few years.
We describe the latest quantitative evidence of how cities can become healthier through better urban and transport planning. It focuses and provides evidence for important interventions, policies and actions that can improve public health, including the need for land use changes, reduce car dependency and move towards public and active transportation, greening of cities, visioning, citizen involvement, collaboration, leadership and investment and systemic approaches. Health impact assessment studies have recently provided new powerful quantitative evidence on how to make cities healthier and will be used as examples. At the same time these measures make also our cities more sustainable (i.e. carbon neutral) and liveable creating multiple benefits.
Better urban and transport planning can lead to carbon neutral, more liveable and healthier cities, particularly through land use changes, a move from private motorised transportation to public and active transportation and greening of cities.
•New urban models reduce air pollution and noise, and heat island effects.•New urban models increase green space and physical activity levels.•New urban models reduce the health burden related to ...current planning practices.•They lack evaluation of the impacts, effectiveness and acceptability of the schemes.•The COVID19 pandemic may accelerate these new urban models.
Cities are centres of innovation and wealth creation, but also hotspots of air pollution and noise, heat island effects and lack of green space, which are all detrimental to human health. They are also hotspots of COVID19. COVID19 has led to a rethink of urban public space. Therefore, is it time to re-think our urban models and reduce the health burden?
We provide a narrative meta-review around a number of cutting edge and visionary urban models that that may affect health and that have been reported over the past few years.
New urban concepts such as the Superblocks, the low traffic neighbourhood, 15 Minute city, Car free city or a mixture of these that may go some way in reducing the health burden related to current urban and transport practices. They will reduce air pollution and noise, heat island effects and increase green space and physical activity levels. What is still lacking though is a thorough evaluation of the effectiveness and acceptability of the schemes and the impacts on not only health, but also liveability and sustainability, although they are expected to be positive.
Finally, the COVID19 pandemic may accelerate these developments and stimulus funding like the EU Next Generation funding should be used to make these changes.
Green Infrastructure and Health Nieuwenhuijsen, Mark J
Annual review of public health,
04/2021, Letnik:
42, Številka:
1
Journal Article
Recenzirano
Odprti dostop
The health benefits of green space are well known, but the health effects of green infrastructure less so. Green infrastructure goes well beyond the presence of green space and refers more to a ...strategically planned network of natural and seminatural areas, with other environmental features designed and managed to deliver a wide range of ecosystem services and possibly to improve human health. In this narrative review, we found that small green infrastructure, such as green roofs and walls, has the potential to mitigate urban flooding, attenuate indoor temperatures and heat islands, improve air quality, and muffle noise, among other benefits, but these effects have not been linked directly to health. Larger green infrastructure has been associated with reduced temperatures, air pollution, and crimes and violence, but less so with health, although some evidence suggests that it may be beneficial for health (e.g., good health, decreased mortality). Finally, parks and street trees show many health benefits, but it is not clear if they can always be considered green infrastructure.
The majority of people live in cities and urbanization is continuing worldwide. Cities have long been known to be society's predominant engine of innovation and wealth creation, yet they are also a ...main source of pollution and disease.
We conducted a review around the topic urban and transport planning, environmental exposures and health and describe the findings.
Within cities there is considerable variation in the levels of environmental exposures such as air pollution, noise, temperature and green space. Emerging evidence suggests that urban and transport planning indicators such as road network, distance to major roads, and traffic density, household density, industry and natural and green space explain a large proportion of the variability. Personal behavior including mobility adds further variability to personal exposures, determines variability in green space and UV exposure, and can provide increased levels of physical activity. Air pollution, noise and temperature have been associated with adverse health effects including increased morbidity and premature mortality, UV and green space with both positive and negative health effects and physical activity with many health benefits. In many cities there is still scope for further improvement in environmental quality through targeted policies. Making cities 'green and healthy' goes far beyond simply reducing CO2 emissions. Environmental factors are highly modifiable, and environmental interventions at the community level, such as urban and transport planning, have been shown to be promising and more cost effective than interventions at the individual level. However, the urban environment is a complex interlinked system. Decision-makers need not only better data on the complexity of factors in environmental and developmental processes affecting human health, but also enhanced understanding of the linkages to be able to know at which level to target their actions. New research tools, methods and paradigms such as geographical information systems, smartphones, and other GPS devices, small sensors to measure environmental exposures, remote sensing and the exposome paradigm together with citizens observatories and science and health impact assessment can now provide this information.
While in cities there are often silos of urban planning, mobility and transport, parks and green space, environmental department, (public) health department that do not work together well enough, multi-sectorial approaches are needed to tackle the environmental problems. The city of the future needs to be a green city, a social city, an active city, a healthy city.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Many cities across the world are beginning to shift their mobility solution away from the private cars and towards more environmentally friendly and citizen-focused means. Hamburg, Oslo, Helsinki, ...and Madrid have recently announced their plans to become (partly) private car free cities. Other cities like Paris, Milan, Chengdu, Masdar, Dublin, Brussels, Copenhagen, Bogota, and Hyderabad have measures that aim at reducing motorized traffic including implementing car free days, investing in cycling infrastructure and pedestrianization, restricting parking spaces and considerable increases in public transport provision. Such plans and measures are particularly implemented with the declared aim of reducing greenhouse gas emissions. These reductions are also likely to benefit public health.
We aimed to describe the plans for private car free cities and its likely effects on public health.
We reviewed the grey and scientific literature on plans for private car free cities, restricted car use, related exposures and health.
An increasing number of cities are planning to become (partly) private car free. They mainly focus on the reduction of private car use in city centers. The likely effects of such policies are significant reductions in traffic-related air pollution, noise, and temperature in city centers. For example, up to a 40% reduction in NO2 levels has been reported on car free days. These reductions are likely to lead to a reduction in premature mortality and morbidity. Furthermore the reduction in the number of cars, and therefore a reduction in the need for parking places and road space, provides opportunities to increase green space and green networks in cities, which in turn can lead to many beneficial health effects. All these measures are likely to lead to higher levels of active mobility and physical activity which may improve public health the most and also provide more opportunities for people to interact with each other in public space. Furthermore, such initiatives, if undertaken at a sufficiently large scale can result in positive distal effects and climate change mitigation through CO2 reductions. The potential negative effects which may arise due to motorized traffic detouring around car free zone into their destinations also need further evaluation and the areas in which car free zones are introduced need to be given sufficient attention so as not to become an additional way to exacerbate socioeconomic divides. The extent and magnitude of all the above effects is still unclear and needs further research, including full chain health impact assessment modeling to quantify the potential health benefits of such schemes, and exposure and epidemiological studies to measure any changes when such interventions take place.
The introduction of private car free cities is likely to have direct and indirect health benefits, but the exact magnitude and potential conflicting effects are as yet unclear. This paper has overviewed the expected health impacts, which can be useful to underpin policies to reduce car use in cities.
•Hamburg and Oslo recently announced their plans to become (partly) private car free.•This is likely to reduce greenhouse gases, air pollution, noise, and temperature.•This can provide opportunities to increase green space and social interactions.•This is likely to lead to higher levels of active transport and physical activity.•All of which are likely to improve public health.
Fifty Shades of Green: Pathway to Healthy Urban Living Nieuwenhuijsen, Mark J; Khreis, Haneen; Triguero-Mas, Margarita ...
Epidemiology (Cambridge, Mass.),
2017-January, 2017-01-00, 20170101, Letnik:
28, Številka:
1
Journal Article
Recenzirano
Currently half the world population lives in cities, and this proportion is expected to increase rapidly to 70% over the next years. Over the years, we have created large, mostly grey cities with ...many high-rise buildings and little green space. Disease rates tend to be higher in urban areas than in rural areas. More green space in cities could reduce these rates. Here, we describe the importance of green space for health, and make recommendations for further research. Green space has been associated with many beneficial health effects, including reduced all-cause and cardiovascular mortality and improved mental health, possibly through mediators, such as reduced air pollution, temperature and stress, and increased physical activity, social contacts, and restoration. Additional studies are needed to strengthen the evidence base and provide further guidelines to transport planners, urban planners, and landscape architects. We need more longitudinal studies and intervention studies, further understanding of the contribution of various mechanisms toward health, and more information on susceptible populations and on where, when, how much, and what type of green space is needed. Also needed are standardized methods for green space quality assessments and evaluations of effectiveness of green prescriptions in clinical practice. Many questions are ideally suited for environmental epidemiologists, who should work with other stakeholders to address the right questions and translate knowledge into action. In conclusion, a growing evidence base supports the hypothesis that greener cities are healthier cities.
Three recent systematic reviews suggested a relationship between noise exposure and adverse birth outcomes. The aim of this review was to evaluate the evidence for the World Health Organization (WHO) ...noise guidelines and conduct an updated systematic review of environmental noise, specifically aircraft and road traffic noise and birth outcomes, such as preterm birth, low birth weight, being small for gestational age and congenital malformations.
: We reviewed again all the papers on environmental noise and birth outcomes included in the previous three systematic reviews and conducted a systematic search on noise and birth outcomes to update previous reviews. Web of Science, PubMed and Embase electronic databases were searched for papers published between June 2014 (end date of previous systematic review) and December 2016 using a list of specific search terms. Studies were also screened in the reference list of relevant reviews/articles. Further inclusion and exclusion criteria for the studies provided by the WHO expert group were applied. Risk of bias was assessed according to criteria from the Newcastle-Ottawa quality assessment scale for case-control and cohort studies. Finally, we applied the GRADE principles to our systematic review in a reproducible and appropriate way for judgment about quality of evidence.
In total, 14 studies are included in this review, six studies on aircraft noise and birth outcomes, five studies (two with more or less the same population) on road traffic noise and birth outcomes and three related studies on total ambient noise that is likely to be mostly traffic noise that met the criteria. The number of studies on environmental noise and birth outcomes is small and the quality of evidence generally ranges from very low to low, particularly in case of the older studies. The quality is better for the more recent traffic noise and birth outcomes studies. As there were too few studies, we did not conduct meta-analyses.
This systematic review is supported by previous systematic reviews and meta-analyses that suggested that there may be some suggestive evidence for an association between environmental noise exposure and birth outcomes, although they pointed more generally to a stronger role of occupational noise exposure, which tends to be higher and last longer. Very strict criteria for inclusion and exclusion of studies, performance of quality assessment for risk of bias, and finally applying GRADE principles for judgment of quality of evidence are the strengths of this review.
We found evidence of very low quality for associations between aircraft noise and preterm birth, low birth weight and congenital anomalies, and low quality evidence for an association between road traffic noise and low birth weight, preterm birth and small for gestational age. Further high quality studies are required to establish such associations. Future studies are recommended to apply robust exposure assessment methods (e.g., modeled or measured noise levels at bedroom façade), disentangle associations for different sources of noise as well as daytime and nighttime noise, evaluate the impacts of noise evens (that stand out of the noise background), and control the analyses for confounding factors, such as socioeconomic status, lifestyle factors and other environmental factors, especially air pollution.
Exposure to ambient airborne particulate matter is a major risk factor for mortality and morbidity, associated with asthma, lung cancer, heart disease, myocardial infarction, and stroke, and more ...recently type 2 diabetes, dementia and loss of cognitive function. Less is understood about differential effects of particulate matter from different sources. Underground railways are used by millions of people on a daily basis in many cities. Poor air exchange with the outside environment means that underground railways often have an unusually high concentration of airborne particulate matter, while a high degree of railway-associated mechanical activity produces particulate matter which is physicochemically highly distinct from ambient particulate matter. The implications of this for the health of exposed commuters and employees is unclear.
A literature search found 27 publications directly assessing the potential health effects of underground particulate matter, including in vivo exposure studies, in vitro toxicology studies, and studies of particulate matter which might be similar to that found in underground railways. The methodology, findings, and conclusions of these studies were reviewed in depth, along with further publications directly relevant to the initial search results. In vitro studies suggest that underground particulate matter may be more toxic than exposure to ambient/urban particulate matter, especially in terms of endpoints related to reactive oxygen species generation and oxidative stress. This appears to be predominantly a result of the metal-rich nature of underground particulate matter, which is suggestive of increased health risks. However, while there are measureable effects on a variety of endpoints following exposure in vivo, there is a lack of evidence for these effects being clinically significant as may be implied by the in vitro evidence.
There is little direct evidence that underground railway particulate matter exposure is more harmful than ambient particulate matter exposure. This may be due to disparities between in vivo exposures and in vitro models, and differences in exposure doses, as well as statistical under powering of in vivo studies of chronic exposure. Future research should focus on outcomes of chronic in vivo exposure, as well as further work to understand mechanisms and potential biomarkers of exposure.
•We systematically reviewed the quantitative evidence on outdoor blue space exposure, health and well-being.•35 studies met the review’s inclusion criteria and most were of “good” quality.•There was ...consistent evidence of positive associations between blue space exposure and mental health and physical activity.•More longitudinal studies and natural experiments are needed to better understand issues of causality.
A growing number of quantitative studies have investigated the potential benefits of outdoor blue spaces (lakes, rivers, sea, etc) and human health, but there is not yet a systematic review synthesizing this evidence.
To systematically review the current quantitative evidence on human health and well-being benefits of outdoor blue spaces.
Following PRISMA guidelines for reporting systematic reviews and meta-analysis, observational and experimental quantitative studies focusing on both residential and non-residential outdoor blue space exposure were searched using specific keywords.
In total 35 studies were included in the current systematic review, most of them being classified as of “good quality” (N=22). The balance of evidence suggested a positive association between greater exposure to outdoor blue spaces and both benefits to mental health and well-being (N=12 studies) and levels of physical activity (N=13 studies). The evidence of an association between outdoor blue space exposure and general health (N=6 studies), obesity (N=8 studies) and cardiovascular (N=4 studies) and related outcomes was less consistent.
Although encouraging, there remains relatively few studies and a large degree of heterogeneity in terms of study design, exposure metrics and outcome measures, making synthesis difficult. Further research is needed using longitudinal research and natural experiments, preferably across a broader range of countries, to better understand the causal associations between blue spaces, health and wellbeing.
Many studies conducted during the last decade suggest the mental health benefits of green and blue spaces. We aimed to systematically review the available literature on the long-term mental health ...benefits of residential green and blue spaces by including studies that used standardized tools or objective measures of both the exposures and the outcomes of interest. We followed the PRISMA statement guidelines for reporting systematic reviews and meta-analysis. In total 28 studies were included in the systematic review. We found limited evidence for a causal relationship between surrounding greenness and mental health in adults, whereas the evidence was inadequate in children. The evidence was also inadequate for the other exposures evaluated (access to green spaces, quality of green spaces, and blue spaces) in both adults and children. The main limitation was the limited number of studies, together with the heterogeneity regarding exposure assessment. Given the increase in mental health problems and the current rapid urbanization worldwide, results of the present systematic review should be taken into account in future urban planning. However, further research is needed to provide more consistent evidence and more detailed information on the mechanisms and the characteristics of the green and blue spaces that promote better mental health. We provide recommendations for future studies in order to provide consistent and evidence-based recommendations for policy makers.
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