Social integration as a determinant of inequalities in green space usage: Insights from a theoretical agent-based model.

Visiting urban green spaces (UGS) benefits physical and mental health. However, socio-economic and geographical inequalities in visits persist and their causes are under-explored. Perceptions of, and attitudes to, other UGS users have been theorised as a determinant of visiting. In the absence of data on these factors, we created a spatial agent-based model (ABM) of four cities in Scotland to investigate intra- and inter-city inequalities in UGS visiting. The ABM focused on the plausibility of a 'social integration hypothesis' whereby the primary factor in decisions to visit UGS is an assessment of who else is likely to be using the space. The model identified the conditions under which this mechanism was sufficient to reproduce the observed inequalities. The addition of environmental factors, such as neighbourhood walkability and green space quality, increased the ability of the model to reproduce observed phenomena. The model identified the potential for unanticipated adverse effects on both overall visit numbers and inequalities of interventions targeting those in lower socio-economic groups.

Situating agent-based modelling in population health research.

Today's most troublesome population health challenges are often driven by social and environmental determinants, which are difficult to model using traditional epidemiological methods. We agree with those who have argued for the wider adoption of agent-based modelling (ABM) in taking on these challenges. However, while ABM has been used occasionally in population health, we argue that for ABM to be most effective in the field it should be used as a means for answering questions normally inaccessible to the traditional epidemiological toolkit. In an effort to clearly illustrate the utility of ABM for population health research, and to clear up persistent misunderstandings regarding the method's conceptual underpinnings, we offer a detailed presentation of the core concepts of complex systems theory, and summarise why simulations are essential to the study of complex systems. We then examine the current state of the art in ABM for population health, and propose they are well-suited for the study of the 'wicked' problems in population health, and could make significant contributions to theory and intervention development in these areas.

Exploring the effectiveness of a COVID-19 contact tracing app using an agent-based model.

A contact-tracing strategy has been deemed necessary to contain the spread of COVID-19 following the relaxation of lockdown measures. Using an agent-based model, we explore one of the technology-based strategies proposed, a contact-tracing smartphone app. The model simulates the spread of COVID-19 in a population of agents on an urban scale. Agents are heterogeneous in their characteristics and are linked in a multi-layered network representing the social structure-including households, friendships, employment and schools. We explore the interplay of various adoption rates of the contact-tracing app, different levels of testing capacity, and behavioural factors to assess the impact on the epidemic. Results suggest that a contact tracing app can contribute substantially to reducing infection rates in the population when accompanied by a sufficient testing capacity or when the testing policy prioritises symptomatic cases. As user rate increases, prevalence of infection decreases. With that, when symptomatic cases are not prioritised for testing, a high rate of app users can generate an extensive increase in the demand for testing, which, if not met with adequate supply, may render the app counterproductive. This points to the crucial role of an efficient testing policy and the necessity to upscale testing capacity.