Influence of built environment on quality of life changes in African-American patients with non-metastatic breast cancer.
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ABSTRACT:
SUBMITTER: Schootman M
PROVIDER: S-EPMC7676919 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Obesity is a public health problem that is due in part to low levels of physical activity. Physical activity levels are influenced by the built environment. We examined how changes in the built environment affected residents' physical activity levels in a low-income, primarily African American neighborhood in New Orleans.We built a 6-block walking path and installed a school playground in an intervention neighborhood. We measured physical activity levels in this neighborhood and in 2 matched comparison neighborhoods by self-report, using door-to-door surveys, and by direct observations of neighborhood residents outside before (2006) and after (2008) the interventions. We used Pearson ?² tests of independence to assess bivariate associations and logistic regression models to assess the effect of the interventions.Neighborhoods were comparable at baseline in demographic composition, choice of physical activity locations, and percentage of residents who participated in physical activity. Self-reported physical activity increased over time in most neighborhoods. The proportion of residents observed who were active increased significantly in the section of the intervention neighborhood with the path compared with comparison neighborhoods. Among residents who were observed engaging in physical activity, 41% were moderately to vigorously active in the section of the intervention neighborhood with the path compared with 24% and 38% in the comparison neighborhoods at the postintervention measurement (P < .001).Changes to the built environment may increase neighborhood physical activity in low-income, African American neighborhoods.
| S-EPMC3359102 | biostudies-other
Project description:Previous research has shown that the built environment plays a crucial role for health-related quality of life (HRQoL) and health care utilization. But, there is limited evidence on the independence of this association from lifestyle and social environment. The objective of this cross-sectional study was to investigate these associations, independent of the social environment, physical activity and body mass index (BMI). We used data from the third follow-up of the Swiss study on Air Pollution and Lung and Heart diseases In Adults (SAPALDIA), a population based cohort with associated biobank. Covariate adjusted multiple quantile and polytomous logistic regressions were performed to test associations of variables describing the perceived built environment with HRQoL and health care utilization. Higher HRQoL and less health care utilization were associated with less reported transportation noise annoyance. Higher HRQoL was also associated with greater satisfaction with the living environment and more perceived access to greenspaces. These results were independent of the social environment (living alone and social engagement) and lifestyle (physical activity level and BMI). This study provides further evidence that the built environment should be designed to integrate living and green spaces but separate living and traffic spaces in order to improve health and wellbeing and potentially save health care costs.
| S-EPMC8101743 | biostudies-literature
Project description:The built environment of cities is complex and influences social and environmental determinants of health. In this study we, 1) identified city profiles based on the built landscape and street design characteristics of cities in Latin America and 2) evaluated the associations of city profiles with social determinants of health and air pollution. Landscape and street design profiles of 370 cities were identified using finite mixture modeling. For landscape, we measured fragmentation, isolation, and shape. For street design, we measured street connectivity, street length, and directness. We fitted a two-level linear mixed model to assess the association of social and environmental determinants of health with the profiles. We identified four profiles for landscape and four for the street design domain. The most common landscape profile was the "proximate stones" characterized by moderate fragmentation, isolation and patch size, and irregular shape. The most common street design profile was the "semi-hyperbolic grid" characterized by moderate connectivity, street length, and directness. The "semi-hyperbolic grid", "spiderweb" and "hyperbolic grid" profiles were positively associated with higher access to piped water and less overcrowding. The "semi-hyperbolic grid" and "spiderweb" profiles were associated with higher air pollution. The "proximate stones" and "proximate inkblots" profiles were associated with higher congestion. In conclusion, there is substantial heterogeneity in the urban landscape and street design profiles of Latin American cities. While we did not find a specific built environment profile that was consistently associated with lower air pollution and better social conditions, the different configurations of the built environments of cities should be considered when planning healthy and sustainable cities in Latin America.
| S-EPMC8547632 | biostudies-literature
Project description:Urban environments are associated with a higher risk of adverse mental health outcomes; however, it is unclear which specific components of the urban environment drive these associations.Using data collected in 2002-2009 from 73,225 low-income, racially diverse individuals across the Southeastern U.S., analyses evaluated the cross-sectional relationship between a walkability index and depression. Walkability was calculated from population density, street connectivity, and destination count in the 1,200-meter area around participants' homes, and depression was measured using the Center for Epidemiologic Studies Depression Scale for depression symptomatology and questionnaire responses regarding doctor-diagnosed depression and antidepressant use. Data were analyzed in 2015.Participants living in neighborhoods with the highest walkability index had 6% higher odds of moderate or greater depression symptoms (score ?15, 95% CI=0.99, 1.14), 28% higher odds of doctor-diagnosed depression (95% CI=1.20, 1.36), and 16% higher odds of current antidepressant use (95% CI=1.08, 1.25), compared with those in the lowest walkability index. Higher walkability was associated with higher odds of depression symptoms in the most deprived neighborhoods only, whereas walkability was associated with lower odds of depression symptoms in the least deprived neighborhoods.Living in a more walkable neighborhood was associated with modestly higher levels of doctor-diagnosed depression and antidepressant use, and walkability was associated with greater depression symptoms in neighborhoods with higher deprivation. Although dense urban environments may provide opportunities for physical activity, they may also increase exposure to noise, air pollution, and social stressors that could increase levels of depression.
| S-EPMC5167658 | biostudies-literature
Project description:The development of supportive and committed romantic relationships during emerging adulthood forecasts relationship quality later in adulthood. Many emerging adult African American men are exposed to challenging socioeconomic environments that are known to undermine romantic relationships. Studies of African American men's romantic relationship quality and its antecedents during this developmental period are scarce. The present study investigates longitudinal trajectories of romantic relationship quality among African American emerging adult men and then tests a model linking them to adverse childhood experiences, socioeconomic instability, community disadvantage, and defensive relational schemas. The analytic sample included 331 African American men who reported having a romantic partner, observed during three waves of data collection from ages 19 to age 26. Using men's reports of romantic relationship support, conflict, and dyadic trust, parallel growth mixture modeling was conducted to identify romantic relationship trajectory profiles. We identified three romantic relationship trajectory profiles: Normative, Uncertain, and Conflictual. Structural equation analyses revealed that adverse childhood experiences were associated positively with contemporaneous contextual risk factors (i.e., socioeconomic instability and community disadvantage), which in turn, were associated significantly with membership in Uncertain and Conflictual trajectories through defensive relational schemas. The present study reveals heterogeneous romantic relationships among African American emerging adult men. Findings support the conjoint influences of early adversity and contemporaneous stressors as robust antecedents of African American men's romantic relationship behaviors over time. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
| S-EPMC7423756 | biostudies-literature
Project description:The built environment microbiota initially resembles the outdoors before human associated interventions drive development toward functionally specific communities
| PRJEB58762 | ENA
Project description:BACKGROUND:Perceived neighborhood characteristics, including satisfaction with one's neighborhood as a place to live, are associated with lower obesity rates and more favorable cardiovascular risk factor profiles. Yet, few studies have evaluated whether changes in perceived neighborhood characteristics over time may be associated with cardiometabolic health indicators. METHODS:Changes in perception of one's neighborhood (2013-2016) were determined from a cohort of residents who lived in one of two low-income urban neighborhoods. Changes were categorized into the following: improvement vs. no change or worsening over the three-year time-period. Multivariable linear regression was used to measure the association between perceived improvement in each of the neighborhood characteristics with cardiometabolic outcomes (BMI, SBP, DBP, HbA1c, HDL-c) that were assessed in 2016, and compared with those who perceived no change or worsening of neighborhood characteristics. Models were adjusted for age, sex, income, education, marital status, physical function, neighborhood, and years spent in neighborhood. To examine potential sex differences, follow-up models were conducted and stratified by sex. RESULTS:Among the 622 individuals who remained in the same neighborhood during the time period, 93% were African American, 80% were female, and the mean age was 58?years. In covariate-adjusted models, those who perceived improvement in their neighborhood safety over the time period had a significantly higher BMI (kg/m2) than those who perceived no improvement or worsening (??=?1.5, p?=?0.0162); however, perceived improvement in safety was also significantly associated with lower SBP (mmHg) (??=?-?3.8, p?=?0.0361). When results were stratified by sex, the relationship between improved perceived neighborhood safety and BMI was only evident in females. CONCLUSIONS:These findings suggest that perceived neighborhood characteristics may impact cardiometabolic outcomes (BMI, SBP), but through differing pathways. This highlights the complexity of the associations between neighborhood characteristics and underscores the need for more longitudinal studies to confirm the associations with cardiometabolic health in African American populations.
| S-EPMC6961335 | biostudies-literature
Project description:Outcomes of behavioral lifestyle interventions for promoting weight loss vary widely across participants. The effectiveness of a weight management intervention may depend on a person's environmental context. This study compared short- and longer-term effects of a structured nationwide weight management program for people living in neighborhoods with different levels of walkability and different access to recreational places (parks, fitness facilities). Drawing on the health production model, we tested competing hypotheses for whether treatment effects of the program complement environmental supports or substitute for environmental constraints. We studied the US Department of Veterans Affairs (VA) MOVE! weight management program using VA electronic heath record data (2009-2014) and a difference-in-differences design with an inverse propensity score matched comparison group. A total of 114,256 program participants and 498,494 non-participants comprised the sample. Built environment features were measured within one-mile of each person's home. We estimated program effects on body mass index (BMI) for subgroups with different built environments at 6-, 12-, 18-, and 24-month follow-up using linear regressions with person and year fixed effects. At 6?months, the program reduced BMI by 0.4-0.6?kg/m2 among men and 0.3-0.5?kg/m2 among women. The effect diminished at 12, 18, and 24?months. The program effect did not vary significantly across subgroups with different walkability, park access, or fitness facility access. The MOVE! program was not sensitive to environmental context. Results did not lend support to either hypothesis that the MOVE! program complements or substitutes for a person's built environment to affect weight management outcomes.
| S-EPMC6878977 | biostudies-literature
Project description:BackgroundFew studies have assessed the predictors of changes in commuting. This study investigated the associations between physical environmental characteristics and changes in active commuting.MethodsAdults from the population-based European Prospective Investigation into Cancer (EPIC)-Norfolk cohort self-reported commuting patterns in 2000 and 2007. Active commuters were defined as those who reported 'always' or 'usually' walking or cycling to work. Environmental attributes around the home and route were assessed using Geographical Information Systems. Associations between potential environmental predictors and uptake and maintenance of active commuting were modelled using logistic regression, adjusting for age, sex and BMI.ResultsOf the 2757 participants (62% female, median baseline age: 52, IQR: 50-56 years), most were passive commuters at baseline (76%, n = 2099) and did not change their usual commute mode over 7 years (82%, n = 2277). In multivariable regression models, participants living further from work were less likely to take up active commuting and those living in neighbourhoods with more streetlights were more likely to take up active commuting (both p < 0.05). Findings for maintenance were similar: participants living further from work (over 10 km, OR: 0.06; 95% CI: 0.25 to 0.13) and had a main or secondary road on route were more likely to maintain their active commuting (OR: 0.52; 95% CI: 0.28 to 0.98). Those living in neighbourhoods with greater density of employment locations were more likely to maintain their active commuting.ConclusionsCo-locating residential and employment centres as well as redesigning urban areas to improve safety for pedestrians and cyclists may encourage active commuting. Future evaluative studies should seek to assess the effects of redesigning the built environment on active commuting and physical activity.
| S-EPMC5527401 | biostudies-literature