Association of neighborhood parks with child health in the United States.
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ABSTRACT:
SUBMITTER: Reuben A
PROVIDER: S-EPMC8034548 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:The United States lacks surveillance to monitor park use and conditions. The purpose of this study was to use the System for Observing Play and Recreation in Communities (SOPARC) as a surveillance tool to describe the conditions, user characteristics, and physical activity of a national sample of neighborhood parks at two time points. Using a stratified multistage sampling strategy, a representative sample of 174 neighborhood parks in 25 major United States' cities were selected. During 2014 and 2016, park-related use, conditions, and physical activity were assessed using SOPARC in 169 parks. Overall, 74,106 park users were observed at baseline and 69,150 park users were observed two years later (p = 0.37). There were persistent disparities in park use by gender and age, with disproportionately more male than female users in each age group (child, teenager, adult, older adult). Older adults used the park less than other age groups. Almost two-thirds of park users were observed being sedentary (61.9% in 2014, 60.7% in 2016), followed by moderate (30.8%, 32.0%) and vigorous (7.3%, 7.3%) activity. Empty target areas increased over two years (75.3%, 77.6%; p = 0.01) and those that were equipped (2.6%, 1.2%; p = 0.0003), accessible (95.4%, 94.3%; p = 0.01), and organized (2.6%, 1.7%; p = 0.01) decreased. Areas that were usable (97.5%, 97.4%) or provided supervised activities (2.0%, 2.4%) did not change significantly. The findings demonstrate the value of SOPARC as a surveillance tool, identify user groups under represented at parks, and suggest an opportunity to encourage more park-based physical activity among park visitors.
| S-EPMC6534437 | biostudies-literature
Project description:PurposeTo identify how child health status differs by mother's educational attainment for the overall US population and by race/ethnicity and to assess whether these disparities have changed from 2000 to 2017.DesignRepeated cross-sectional data from the 2000-2017 National Health Interview Survey (NHIS).SettingUnited States.ParticipantsChildren aged 1 to 17 years from a nationally representative sample of the noninstitutionalized US population (N = 199 427).MeasuresReported child health status, mother's educational attainment, child's race/ethnicity, and control variables were measured using the NHIS.AnalysisUsing logistic regression models, we assessed the relationship between maternal education and child health. Missing data were imputed.ResultsChildren whose mothers had less than a high school education (odds ratio [OR] = 3.84, 95% confidence interval [CI]: 3.62-4.07), high school diploma or equivalent (OR = 2.57, 95% CI: 2.44-2.70), or some college (OR = 1.90, 95% CI: 1.80-2.00) had worse reported health status compared to children whose mothers graduated college. These associations were strongest among non-Hispanic white children, with significantly (P < .05) smaller associations observed for non-Hispanic black, Mexican origin, and other Hispanic children. The associations were smaller but persisted with inclusion of controls. From 2000 to 2017, child health disparities slightly narrowed or remained stagnant among white, non-Hispanic black, and other Hispanic children but widened for Mexican origin children (P < .05).ConclusionMaternal education disparities in child health are wide and have persisted.
| S-EPMC7033002 | biostudies-literature
Project description:Importance:An association between social and neighborhood characteristics and health outcomes has been reported but remains poorly understood owing to complex multidimensional factors that vary across geographic space. Objectives:To quantify social determinants of health (SDOH) as multiple dimensions across the continental United States (the 48 contiguous states and the District of Columbia) at a small-area resolution and to examine the association of SDOH with premature mortality within Chicago, Illinois. Design, Setting, and Participants:In this cross-sectional study, census tracts from the US Census Bureau from 2014 were used to develop multidimensional SDOH indices and a regional typology of the continental United States at a small-area level (n?=?71?901 census tracts with approximately 312 million persons) using dimension reduction and clustering machine learning techniques (unsupervised algorithms used to reduce dimensions of multivariate data). The SDOH indices were used to estimate age-adjusted mortality rates in Chicago (n?=?789 census tracts with approximately 7.5 million persons) with a spatial regression for the same period, while controlling for violent crime. Main Outcomes and Measures:Fifteen variables, measured as a 5-year mean, were selected to characterize SDOH as small-area variations for demographic characteristics of vulnerable groups, economic status, social and neighborhood characteristics, and housing and transportation availability at the census-tract level. This SDOH data matrix was reduced to 4 indices reflecting advantage, isolation, opportunity, and mixed immigrant cohesion and accessibility, which were then clustered into 7 distinct multidimensional neighborhood typologies. The association between SDOH indices and premature mortality (defined as death before age 75 years) in Chicago was measured by years of potential life lost and aggregated to a 5-year mean. Data analyses were conducted between July 1, 2018, and August 30, 2019. Results:Among the 71?901 census tracts examined across the continental United States, a median (interquartile range) of 27.2% (47.1%) of residents had minority status, 12.1% (7.5%) had disabilities, 22.9% (7.6%) were 18 years and younger, and 13.6% (8.1%) were 65 years and older. Among the 789 census tracts examined in Chicago, a median (interquartile range) of 80.4% (56.3%) of residents had minority status, 10.2% (8.2%) had disabilities, 23.2% (10.9%) were 18 years and younger, and 9.5% (7.1%) were 65 years and older. Four SDOH indices accounted for 71% of the variance across all census tracts in the continental United States in 2014. The SDOH neighborhood typology of extreme poverty, which is of greatest concern to health care practitioners and policy advocates, comprised only 9.6% of all census tracts across the continental United States but characterized small areas of known public health crises. An association was observed between all SDOH indices and age-adjusted premature mortality rates in Chicago (R2?=?0.63; P?<?.001), even after accounting for violent crime and spatial structures. Conclusions and Relevance:The modeling of SDOH as multivariate indices rather than as a singular deprivation index may better capture the complexity and spatial heterogeneity underlying SDOH. During a time of increased attention to SDOH, this analysis may provide actionable information for key stakeholders with respect to the focus of interventions.
| S-EPMC6991288 | biostudies-literature
Project description:Sustainable development efforts in urban areas often focus on understanding and managing factors that influence all aspects of health and wellbeing. Research has shown that public parks and green space provide a variety of physical, psychological, and social benefits to urban residents, but few studies have examined the influence of parks on comprehensive measures of subjective wellbeing at the city level. Using 2014 data from 44 U.S. cities, we evaluated the relationship between urban park quantity, quality, and accessibility and aggregate self-reported scores on the Gallup-Healthways Wellbeing Index (WBI), which considers five different domains of wellbeing (e.g., physical, community, social, financial, and purpose). In addition to park-related variables, our best-fitting OLS regression models selected using an information theory approach controlled for a variety of other typical geographic and socio-demographic correlates of wellbeing. Park quantity (measured as the percentage of city area covered by public parks) was among the strongest predictors of overall wellbeing, and the strength of this relationship appeared to be driven by parks' contributions to physical and community wellbeing. Park quality (measured as per capita spending on parks) and accessibility (measured as the overall percentage of a city's population within ½ mile of parks) were also positively associated with wellbeing, though these relationships were not significant. Results suggest that expansive park networks are linked to multiple aspects of health and wellbeing in cities and positively impact urban quality of life.
| S-EPMC4824524 | biostudies-literature
Project description:IntroductionUrban neighborhood parks are designed to provide easy access to recreation and physical activity. We analyzed data from the first National Study of Neighborhood Parks, which assessed the characteristics and use of a representative sample of U.S. urban neighborhood parks. This article compares factors associated with active commuting (e.g., walking) to parks among men and women and park characteristics associated with observed moderate-to-vigorous physical activity (MVPA) within neighborhood parks.MethodsWe used systematic direct observation to quantify parks visitors of all ages in 162 U.S. neighborhood parks in 25 cities in 2016 and surveyed a sample of adult visitors (877 women and 793 men). We used descriptive statistics to identify park facilities, amenities, and park management practices associated with park use. We also conducted multivariate regressions to identify factors most closely associated with observed park-based MVPA among all age groups and with self-reported levels of active commuting to parks among adults.ResultsReasons to visit parks varied by gender, with women more likely than men to bring children (59% vs 42% for men; p < .001), and men more likely than women to go to parks to relax (38% vs 29%; p = .01). Bringing children to parks was associated with more motorized transport among women, but not among men. Active commuting to parks was associated with living closer to parks (β = -0.92; p < .0001), a greater frequency of park use (β = 0.99; p < .0001), and the park having a working drinking fountain (β = 0.62; p = .01), with no significant differences between men and women. Men and boys used park facilities very differently than women and girls. Men and boys engaged in the most MVPA in soccer fields, gyms, and skate parks, whereas for women and girls the top three sites were pools, playgrounds, and walking paths.ConclusionsSignificant gender differences in why men and women visit parks and how parks are used likely reflect cultural determinants of gender roles. Our findings suggest that park management practices should be adjusted to mitigate the lower use of parks and lower levels of park-based MVPA among women and girls compared with men and boys.
| S-EPMC8154653 | biostudies-literature
Project description:The current study examined racial/ethnic differences in use of parks and park facilities and features and self-reported park use and perceptions. We conducted observations in a nationally representative sample of 193 neighborhood parks in 27 US cities over a 1-week period between April and August of 2016 using the System of Observing Play and Recreation in Communities (SOPARC). To determine the propensity of different racial/ethnic groups to use parks relative to expectation based on their representation in the surrounding neighborhood, we calculated the percentages of park users of each race/ethnicity and compared these to the percentages of racial/ethnic groups residing in the neighborhood within a 1-mile radius of the park based on 2010 U.S. Census data. In the same parks, we administered an intercept survey to assess park users' self-reported use and perceptions of the park (N = 1872). We examined racial/ethnic differences in self-reported use and perceptions of parks using GEE models that adjusted for several individual- and park-level covariates. Hispanics comprised a disproportionate percentage of observed park users. Racial/ethnic groups generally did not differ in their self-reported park use and perceptions, except for the social context of park visits. In adjusted models, Hispanics had significantly higher odds of visiting with a child family member (OR = 1.44) and lower odds of visiting alone than non-Hispanic whites (OR = .55). Findings highlight Hispanics' greater propensity to use parks and indicate that parks may serve a communal purpose for Hispanics that they do not serve for other racial/ethnic groups.
| S-EPMC6181824 | biostudies-other
Project description:BackgroundFew studies have examined the association of neighborhood environment and mortality among community-dwelling older populations. Geographic Information Systems-based measures of neighborhood physical environment may provide new insights on the health effects of the social and built environment.MethodWe studied 4 379 community-dwelling older adults in the United States aged 65 years and older from the Cardiovascular Health Study. Principal component analysis was used to identify neighborhood components from 48 variables assessing facilities and establishments, demographic composition, socioeconomic status, and economic prosperity. We used a Cox model to evaluate the association of neighborhood components with 5-year mortality. Age, sex, race, education, income, marital status, body mass index, smoking status, disability, coronary heart disease, and diabetes were included as covariates. We also examined the interactions between neighborhood components and sex and race (Black vs White or other).ResultsWe identified 5 neighborhood components, representing facilities and resources, immigrant communities, community-level economic deprivation, resident-level socioeconomic status, and residents' age. Communities' economic deprivation and residents' socioeconomic status were significantly associated with 5-year mortality. We did not find interactions between sex or race and any of the 5 neighborhood components. The results were similar in a sensitivity analysis where we used 10-year mortality as the outcome.ConclusionsWe found that communities' economic status but not facilities in communities was associated with mortality among older adults. These findings revealed the importance and benefits living in a socioeconomically advantaged neighborhood could have on health among older residents with different demographic backgrounds.
| S-EPMC9678200 | biostudies-literature
Project description:Neighborhood effects on health research has grown over the past 20 years. While the substantive findings of this literature have been published in systematic reviews, meta-analyses, and commentaries, operational details of the research have been understudied. We identified 7140 multi-level neighborhoods and health papers published on US populations between 1995 and 2014, and present data on the study characteristics of the 256 papers that met our inclusion criteria. Our results reveal rapid growth in neighborhoods and health research in the mid-2000s, illustrate the dominance of observational cross-sectional study designs, and show a heavy reliance on single-level, census-based neighborhood definitions. Socioeconomic indicators were the most commonly analyzed neighborhood variables and body mass was the most commonly studied health outcome. Well-known challenges associated with neighborhood effects research were infrequently acknowledged. We discuss how these results move the agenda forward for neighborhoods and health research.
| S-EPMC5065354 | biostudies-literature
Project description:The Environmental Influences on Child Health Outcomes (ECHO) Program will evaluate environmental factors affecting children's health (perinatal, neurodevelopmental, obesity, respiratory, and positive health outcomes) by pooling cohorts composed of >50,000 children in the largest US study of its kind. Our objective was to identify opportunities for studying chemicals and child health using existing or future ECHO chemical exposure data. We described chemical-related information collected by ECHO cohorts and reviewed ECHO-relevant literature on exposure routes, sources, and environmental and human monitoring. Fifty-six ECHO cohorts have existing or planned chemical biomonitoring data for mothers or children. Environmental phenols/parabens, phthalates, metals/metalloids, and tobacco biomarkers are each being measured by ≥15 cohorts, predominantly during pregnancy and childhood, indicating ample opportunities to study child health outcomes. Cohorts are collecting questionnaire data on multiple exposure sources and conducting environmental monitoring including air, dust, and water sample collection that could be used for exposure assessment studies. To supplement existing chemical data, we recommend biomonitoring of emerging chemicals, nontargeted analysis to identify novel chemicals, and expanded measurement of chemicals in alternative biological matrices and dust samples. ECHO's rich data and samples represent an unprecedented opportunity to accelerate environmental chemical research to improve the health of US children.
| S-EPMC7183426 | biostudies-literature
Project description:Considerable research on the risk factors of obesity and chronic diseases has focused on relationships between where people live, where they shop, and the types of food they purchase. Rarely have investigators used a national sample and explicitly addressed the amount of energy-dense and nutrient-poor foods purchased in different types of neighborhood food stores. Even more rarely have studies accounted for the characteristics of the broader built environment in which food stores are located and which affect the convenience of using neighborhood food stores. We used a large population-based cohort of predominantly white U.S. households from the Nielsen Homescan Consumer Panel 2010 dataset to examine whether there were positive cross-sectional associations between availability of neighborhood convenience stores and supermarkets and self-reported household annual expenditures for snacks and beverages. We examined this relationship separately for poor and non-poor households as defined by the 2010 U.S. federal poverty threshold. We used mixed error-component regression models to examine associations between availability of neighborhood food stores and the expenditures on snacks and beverages, controlling for regional destination accessibility, availability and diversity of neighborhood destinations, and neighborhood street connectivity. In multivariate analyses, we observed that poor households in neighborhoods with few convenience stores purchased more snacks than poor households in neighborhoods with many convenience stores (b = -0.008, p < 0.05). Non-poor households in neighborhoods with many convenience stores and fewer supermarkets purchased more snacks than non-poor households in neighborhoods with few convenience stores and many supermarkets (b = 0.002, p < 0.05 for convenience stores; b = -0.027, p < 0.05 for supermarkets). Increase in number of convenience stores decreased the purchase of snacks by poor households, but increased in non-poor households. On other hand, increase in number of supermarkets discouraged purchase of snacks by non-poor households but had no effect on the purchasing behavior of the poor-households.Therefore, evaluation of access to energy-dense and nutrient-poor foods should include a consideration of geographic proximity. Local governments should consider strategies to expand the availability and access to nutrient-rich food and beverage products in convenience stores for consumers.
| S-EPMC7602560 | biostudies-literature