NDVI is often used as a marker of surrounding greenness in epidemiological studies.We evaluated the relationship between built environment characteristics and NDVI.Natural and urban green ...explained more than 50% of NDVI variability.It is important to understand what NDVI means in a particular area of study.NDVI might not be the best green exposure indicator for certain epidemiological aims.
The normalized difference vegetation index (NDVI) is often used as a marker of surrounding greenness in epidemiological studies aiming to evaluate the health effects of green space in urban settings. However, it is not clear the relationship between built environment characteristics, including green space, and NDVI. We aimed to evaluate the relationship between built environment characteristics, based on land-use and land-cover maps, and NDVI as a marker of surrounding greenness in the city of Barcelona. We used data from an already existing cohort of pregnant women in Barcelona (N=8402). NDVI was derived and averaged within buffers of 100m and 300m for each participant, and categories of the built environment (m2) were derived from land-use and land-cover maps of Barcelona. We conducted ANOVA models to calculate the contribution (R2) of each land-use (or land-cover) category. The variability in NDVI in Barcelona was mainly explained by urban green (R2 between 0.32 and 0.53) and natural green areas (R2 between 0.19 and 0.52), although for the latter less than 4% of the participants were exposed to this. Both land-use and land-cover maps explained NDVI at 300m better (full models explaining 76% and 78%, respectively) than at 100m buffers (full models explaining 55% and 54%, respectively). Results of the present study indicate that NDVI can be a useful greenness metric depending on the hypothesis and area of study. However, for certain sizes of study areas (buffers smaller than 100m), NDVI might have a lower predictive value. Results of the present study should be replicated in studies from other cities with different urban characteristics and climate conditions.
By 2050, nearly 70% of the global population is projected to live in urban areas. Because the environments we inhabit affect our health, urban and transport designs that promote healthy living are ...needed.
We estimated the number of premature deaths preventable under compliance with international exposure recommendations for physical activity (PA), air pollution, noise, heat, and access to green spaces.
We developed and applied the Urban and TranspOrt Planning Health Impact Assessment (UTOPHIA) tool to Barcelona, Spain. Exposure estimates and mortality data were available for 1,357,361 residents. We compared recommended with current exposure levels. We quantified the associations between exposures and mortality and calculated population attributable fractions to estimate the number of premature deaths preventable. We also modeled life-expectancy and economic impacts.
We estimated that annually, nearly 20% of mortality could be prevented if international recommendations for performance of PA; exposure to air pollution, noise, and heat; and access to green space were followed. Estimations showed that the greatest portion of preventable deaths was attributable to increases in PA, followed by reductions of exposure to air pollution, traffic noise, and heat. Access to green spaces had smaller effects on mortality. Compliance was estimated to increase the average life expectancy by 360 (95% CI: 219, 493) days and result in economic savings of 9.3 (95% CI: 4.9, 13.2) billion EUR/year.
PA factors and environmental exposures can be modified by changes in urban and transport planning. We emphasize the need for a) the reduction of motorized traffic through the promotion of active and public transport and b) the provision of green infrastructure, both of which are suggested to provide opportunities for PA and for mitigation of air pollution, noise, and heat. Citation: Mueller N, Rojas-Rueda D, Basagaña X, Cirach M, Cole-Hunter T, Dadvand P, Donaire-Gonzalez D, Foraster M, Gascon M, Martinez D, Tonne C, Triguero-Mas M, Valentín A, Nieuwenhuijsen M. 2017. Urban and transport planning related exposures and mortality: a health impact assessment for cities. Environ Health Perspect 125:89-96; http://dx.doi.org/10.1289/EHP220.
There is increasing evidence of the health benefits of exposure to natural environments, including green and blue spaces. The association with physical functioning and its decline at older age ...remains to be explored. The aim of the present study was to investigate the longitudinal association between the natural environment and the decline in physical functioning in older adults. We based our analyses on three follow-ups (2002−2013) of the Whitehall II study, including 5759 participants (aged 50 to 74 years at baseline) in the UK. Exposure to natural environments was assessed at each follow-up as (1) residential surrounding greenness across buffers of 500 and 1000 m around the participants' address using satellite-based indices of greenness (Enhanced Vegetation Index (EVI) and Normalized Difference Vegetation Index (NDVI)) and (2) the distance from home to the nearest natural environment, separately for green and blue spaces, using a land cover map. Physical functioning was characterized by walking speed, measured three times, and grip strength, measured twice. Linear mixed effects models were used to quantify the impact of green and blue space on physical functioning trajectories, controlled for relevant covariates.
We found higher residential surrounding greenness (EVI and NDVI) to be associated with slower 10-year decline in walking speed. Furthermore, proximity to natural environments (green and blue spaces combined) was associated with slower decline in walking speed and grip strength. We observed stronger associations between distance to natural environments and decline in physical functioning in areas with higher compared to lower area-level deprivation. However, no association was observed with distance to green or blue spaces separately. The associations with decline in physical functioning were partially mediated by social functioning and mental health.
Our results suggest that higher residential surrounding greenness and living closer to natural environments contribute to better physical functioning at older ages.
•Higher greenness was associated with slower age-related decline in walking speed.•Higher greenness was associated with higher grip strength at baseline.•Proximity to natural environments was associated with slower decline in walking speed.•Proximity to natural environments was more beneficial in areas with higher compared to lower deprivation.•Proximity to blue space was not significantly associated with physical functioning.
Natural environments, including green spaces, may have beneficial impacts on brain development. However, longitudinal evidence of an association between long-term exposure to green spaces and ...cognitive development (including attention) in children is limited.
We evaluated the association between lifelong residential exposure to green space and attention during preschool and early primary school years.
This longitudinal study was based on data from two well-established population-based birth cohorts in Spain. We assessed lifelong exposure to residential surrounding greenness and tree cover as the average of satellite-based normalized difference vegetation index and vegetation continuous fields, respectively, surrounding the child's residential addresses at birth, 4-5 y, and 7 y. Attention was characterized using two computer-based tests: Conners' Kiddie Continuous Performance Test (K-CPT) at 4-5 y (n=888) and Attentional Network Task (ANT) at 7 y (n=987). We used adjusted mixed effects models with cohort random effects to estimate associations between exposure to greenness and attention at ages 4-5 and 7 y.
Higher lifelong residential surrounding greenness was associated with fewer K-CPT omission errors and lower K-CPT hit reaction time-standard error (HRT-SE) at 4-5 y and lower ANT HRT-SE at 7 y, consistent with better attention. This exposure was not associated with K-CPT commission errors or with ANT omission or commission errors. Associations with residential surrounding tree cover also were close to the null, or were negative (for ANT HRT-SE) but not statistically significant.
Exposure to residential surrounding greenness was associated with better scores on tests of attention at 4-5 y and 7 y of age in our longitudinal cohort. https://doi.org/10.1289/EHP694.
Background: Maternal residential proximity to roads has been associated with adverse pregnancy outcomes. However, there is no study investigating mediators or buffering effects of road-adjacent trees ...on this association. We investigated the association between mothers' residential proximity to major roads and term low birth weight (LBW), while exploring possible mediating roles of air pollution (PM2.5, PM2.5–10, PM10, PM2.5 absorbance, nitrogen dioxide, and nitrogen oxides), heat, and noise and buffering effect of road-adjacent trees on this association. Methods: This cohort study was based on 6438 singleton term births in Barcelona, Spain (2001–2005). Road proximity was measured as both continuous distance to and living within 200 m from a major road. We assessed individual exposures to air pollution, noise, and heat using, respectively, temporally adjusted land-use regression models, annual averages of 24-hour noise levels across 50 m and 250 m, and average of satellite-derived land-surface temperature in a 50-m buffer around each residential address. We used vegetation continuous fields to abstract tree coverage in a 200-m buffer around major roads. Results: Living within 200 m of major roads was associated with a 46% increase in term LBW risk; an interquartile range increase in heat exposure with an 18% increase; and third-trimester exposure to PM2.5, PM2.5–10, and PM10 with 24%, 25%, and 26% increases, respectively. Air pollution and heat exposures together explained about one-third of the association between residential proximity to major roads and term LBW. Our observations on the buffering of this association by road-adjacent trees were not consistent between our 2 measures of proximity to major roads. Conclusion: An increased risk of term LBW associated with proximity to major roads was partly mediated by air pollution and heat exposures.
•Conducted ecological momentary assessment with residents of four European cities.•Positive mood improved within 10 min of natural environment exposure.•Findings varied by city, gender, age and ...residential green space exposure.•Negative mood declined within 10 min of natural environment exposure.•Weaker associations were found within 30 min of natural environment exposure.
Exposure to natural outdoor environments (NOE) has been shown in population-level studies to reduce anxiety and psychological distress. This study investigated how exposure to one’s everyday natural outdoor environments over one week influenced mood among residents of four European cities including Barcelona (Spain), Stoke-on-Trent (United Kingdom), Doetinchem (The Netherlands) and Kaunas (Lithuania). Participants (n = 368) wore a smartphone equipped with software applications to track location and mood (using mobile ecological momentary assessment (EMA) software), for seven consecutive days. We estimated random-effects ordered logistic regression models to examine the association between mood (positive and negative affect), and exposure to green space, represented by two binary variables indicating exposure versus no exposure to NOE using GPS tracking and satellite and aerial imagery, 10 and 30 min prior to participants’ completing the EMA. Models were adjusted for home city, day of the week, hour of the day, EMA survey type, residential NOE exposure, and sex, age, education level, mental health status and neighbourhood socioeconomic status. In addition, we tested for heterogeneity of effect by city, sex, age, residential NOE exposure and mental health status. Within 10 min of NOE exposure, compared to non-exposure, we found that overall there was a positive relationship with positive affect (OR: 1.39, 95% CI: 1.06, 1.81) of EMA surveys, and non-significant negative association with negative affect (OR: 0.80, 95% CI: 0.58, 1.10). When stratifying, associations were consistently found for Stoke-on-Trent inhabitants and men, while findings by age group were inconsistent. Weaker and less consistent associations were found for exposure 30 min prior to EMA. Our findings support increasing evidence of psychological and mental health benefits of exposure to natural outdoor environments, especially among urban populations such as those included in our study.
•Road traffic noise is the main environmental noise source in Europe.•Research on noise exposure and cognitive and motor function in children is sparse.•Road traffic noise exposure was not related to ...child’s cognitive or motor function.•More comprehensive noise exposure assessments are needed in future studies.
Exposure to environmental noise is increasing in recent years but most of the previous literature in children has evaluated the effect of aircraft noise exposure at schools on cognition.
To assess whether residential exposure to road traffic noise during pregnancy and childhood is associated with cognitive and motor function in children and preadolescents.
The study involved 619 participants from the Spanish INMA-Sabadell cohort and 7,115 from the Dutch Generation R Study. We used noise maps to estimate the average day-evening-night road traffic noise levels at each participant’s residential address during pregnancy and childhood periods. Validated tests were administered throughout childhood in both cohorts to assess non-verbal and verbal intelligence, memory, processing speed, attentional function, working memory, cognitive flexibility, risky decision-making, and fine and gross motor function. Linear models, linear mixed models, and negative binomial models were run depending on the outcome in cohort-specific analysis and combined with a random-effects meta-analysis. All models were adjusted for several socioeconomic and lifestyle variables and results corrected for multiple testing.
Average road traffic noise exposure levels during pregnancy and childhood were 61.3 (SD 6.0) and 61.5 (SD 5.4) dB for the INMA-Sabadell cohort and 54.6 (SD 7.9) and 53.5 (SD 6.5) dB for the Generation R Study, respectively. Road traffic noise exposure during pregnancy and childhood was not related to any of the cognitive and motor function outcomes examined in this study (e.g. −0.92 (95 % CI −2.08; 0.24) and 0.20 (95 % CI −0.96; 1.35) in overall estimates of memory and fine motor function, respectively, when road traffic noise increases by 10 dB during childhood).
These findings suggest that child’s cognitive or motor functions are not affected by residential exposure to road traffic noise. However, more studies evaluating this association at school and home settings as well as noise events are needed.
Metabolic syndrome is an important risk factor for non-communicable diseases, particularly type 2 diabetes, coronary heart disease, and stroke. Long-term exposure to greenspace could be protective of ...metabolic syndrome, but evidence for such an association is lacking. Accordingly, we investigated the association between long-term exposure to greenspace and risk of metabolic syndrome.
The present longitudinal study was based on data from four clinical examinations between 1997 and 2013 in 6076 participants of the Whitehall II study, UK (aged 45–69 years at baseline). Long-term exposure to greenspace was assessed by satellite-based indices of greenspace including Normalized Difference Vegetation Index (NDVI) and Vegetation Continuous Field (VCF) averaged across buffers of 500 and 1000 m surrounding the participants’ residential location at each follow-up. The ascertainment of metabolic syndrome was based on the World Health Organization (WHO) definition. Hazard ratios for metabolic syndrome were estimated using Cox proportional hazards regression models, controlling for age, sex, ethnicity, lifestyle factors, and socioeconomic status.
Higher residential surrounding greenspace was associated with lower risk of metabolic syndrome. An interquartile range increase in NDVI and VCF in the 500 m buffer was associated with 13% (95% confidence interval (CI): 1%, 23%) and 14% (95% CI: 5%, 22%) lower risk of metabolic syndrome, respectively. Greater exposure to greenspace was also associated with each individual component of metabolic syndrome, including a lower risk of high levels of fasting glucose, large waist circumference, high triglyceride levels, low HDL cholesterol, and hypertension. The association between residential surrounding greenspace and metabolic syndrome may have been mediated by physical activity and exposure to air pollution.
The findings of the present study suggest that middle-aged and older adults living in greener neighbourhoods are at lower risk of metabolic syndrome than those living in neighbourhoods with less greenspace.
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•We investigated the longitudinal association between greenspace exposure and risk of metabolic syndrome.•More residential surrounding greenspace was associated with lower risk of metabolic syndrome.•Our findings suggest that greenspace may protect cardio-metabolic health.
Our findings suggested that long-term exposure to greenspace may play a role in the prevention of metabolic syndrome in middle-aged and older adults, which could subsequently reduce the burden of non-communicable diseases.
Until now, estimates of the Global Burden of Disease (GBD) have mainly been produced on national or regional levels. These general estimates, however, are less useful for city governments who have to ...take decisions on local scales. To address this gap, we focused on the city-level burden of disease (BD) due to exposures affected by urban and transport planning. We conducted a BD assessment using the Urban and Transport Planning Health Impact Assessment (UTOPHIA) tool to estimate annual preventable morbidity and disability-adjusted life-years (DALYs) under compliance with international exposure recommendations for physical activity (PA), exposure to air pollution, noise, heat, and access to green spaces in Barcelona, Spain.
Exposure estimates and morbidity data were available for 1,357,361 Barcelona residents ≥20years (2012). We compared recommended with current exposure levels to estimate the associated BD. We quantified associations between exposures and morbidities and calculated population attributable fractions to estimate the number of attributable cases. We calculated DALYs using GBD Study 2015 background DALY estimates for Spain, which were scaled to Barcelona considering differences in population size, age and sex structures. We also estimated annual health costs that could be avoided under compliance with exposure recommendations.
Not complying with recommended levels for PA, air pollution, noise, heat and access to green spaces was estimated to generate a large morbidity burden and resulted in 52,001 DALYs (95% CI: 42,866–61,136) in Barcelona each year (13% of all annual DALYs). From this BD 36% (i.e. 18,951 DALYs) was due to traffic noise with sleep disturbance and annoyance contributing largely (i.e. 10,548 DALYs). Non-compliance was estimated to result in direct health costs of 20.10 million € (95% CI: 15.36–24.83) annually.
Non-compliance of international exposure recommendations was estimated to result in a considerable BD and in substantial economic expenditure each year in Barcelona. Our findings suggest that (1) the reduction of motor traffic together with the promotion of active transport and (2) the provision of green infrastructure would result in a considerable BD avoided and substantial savings to the public health care system, as these measures can provide mitigation of noise, air pollution and heat as well as opportunities for PA promotion.
•Failure to meet recommended levels of physical activity, air pollution, noise, heat and green spaces linked to poor health.•Compliance with recommendations was estimated to prevent >50,000 DALYs each year in Barcelona, Spain.•Compliance was also estimated to result in direct health care cost savings of >20 million € annually.•The largest share in burden of disease was attributable to traffic noise exposure.•Especially noise related annoyance and sleep disturbance contributed largely to the burden of disease (>10,000 DALYs).
Better mental health has been associated with exposure to natural outdoor environments (NOE). However, comprehensive studies including several indicators of exposure and outcomes, potential effect ...modifiers and mediators are scarce.
We used novel, objective measures to explore the relationships between exposure to NOE (i.e. residential availability and contact) and different indicators of mental health, and possible modifiers and mediators.
A nested cross-sectional study was conducted in: Barcelona, Spain; Stoke-on-Trent, United Kingdom; Doetinchem, Netherlands; Kaunas, Lithuania. Participants’ exposure to NOE (including both surrounding greenness and green and/or blue spaces) was measured in terms of (a) amount in their residential environment (using Geographical Information Systems) and (b) their contact with NOE (using smartphone data collected over seven days). Self-reported information was collected for mental health (psychological wellbeing, sleep quality, vitality, and somatisation), and potential effect modifiers (gender, age, education level, and city) and mediators (perceived stress and social contacts), with additional objective NOE physical activity (potential mediator) derived from smartphone accelerometers.
Analysis of data from 406 participants showed no statistically significant associations linking mental health and residential NOE exposure. However, NOE contact, especially surrounding greenness, was statistically significantly tied to better mental health. There were indications that these relationships were stronger for males, younger people, low-medium educated, and Doetinchem residents. Perceived stress was a mediator of most associations, and physical activity and social contacts were not.
Our findings indicate that contact with NOE benefits mental health. Our results also suggest that having contact with NOE that can facilitate stress reduction could be particularly beneficial.
•Mental health was not associated with residential natural outdoor environments.•Mental health was associated with natural outdoor environments contact.•Associations were especially consistent for surrounding greenness.•Stress and social contacts were mediators of most of the found associations.•Males, low-medium educated, younger, and Doetinchem inhabitants benefited more.
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