Relationship between urban green space and mental health in older adults: mediating role of relative deprivation, physical activity, and social trust.

Introduction: The importance of improving older adults' mental health is increasing worldwide with the rapid development of the aging process. Green space is an important part of the urban built environment, demonstrates a deep connection with the mental health of older adults, and its internal mechanisms have been widely studied. This study analyzed the influence of urban green spaces on the mental health of older adults via three factors: relative deprivation, physical activity, and social trust. Methods: Based on the 2018 China Labor Dynamics Survey, a multi-level structural equation model was used to explore the mediating roles of relative deprivation, physical activity, social trust in urban green spaces, and the mental health of older adults. Results: Urban green space was positively correlated with the mental health of older adults. Relative deprivation and physical activities played a mediating role between urban green space and the mental health of older adults. Discussion: An increase in urban green spaces can help increase the number of older adults obtaining green space resources, and help them maintain good mental health. Secondly, older adults with a relatively homogeneous environment have more equal opportunities to obtain urban green space resources, which helps to reduce the comparison of older adults in access to green space resources and reduce the adverse impact of relative deprivation on their mental health. Additionally, increasing urban green spaces can encourage older adults to engage in physical activities and improve their mental health. Finally, we suggest improving the accessibility, fairness, and quality of green spaces, paying attention to the psychological needs of older adults, encouraging older adults to engage in physical activities in green spaces, and taking various measures to enhance the positive role of green space on the mental health of older adults.

Monitoring day and dark traffic collisions in Toronto neighbourhoods with implications for injury reduction and Vision Zero initiatives: A spatial analysis approach.

The City of Toronto adopted a Vision Zero strategy in 2016 that aims to eliminate deaths and serious injuries from vehicular collisions. The strategy includes policies to improve lighting to reduce collision risks, and past research has suggested lighting as a road safety factor. We apply Bayesian spatial analysis (including Poisson log-normal regression modelling, shared component spatial modelling, and Bayesian spatiotemporal modelling) to publicly available data on traffic collisions where persons are killed or seriously injured (KSI) based on Day/Dark conditions. We assess (1) links between KSI risk and socioeconomic and built environment factors, (2) spatial distributions of relative Day & Dark KSI risk, and (3) area-specific trends in space and time for Day-Dark KSI risk change across Toronto neighbourhoods. Our analysis does not find significant associations between socioeconomic/built environment factors and KSI risk, but we uncover neighbourhoods with heightened Dark KSI risk and pronounced Day-Dark KSI changes compared to Toronto's mean area trend. Findings highlight the need for increased policy attention for impacts of lighting on collisions and provide insight for focus regions for improved Vision Zero policy development.

Spatial analysis of the impact of urban built environment on cardiovascular diseases: a case study in Xixiangtang, China.

BACKGROUND: The built environment, as a critical factor influencing residents' cardiovascular health, has a significant potential impact on the incidence of cardiovascular diseases (CVDs). METHODS: Taking Xixiangtang District in Nanning City, Guangxi Zhuang Autonomous Region of China as a case study, we utilized the geographic location information of CVD patients, detailed road network data, and urban points of interest (POI) data. Kernel density estimation (KDE) and spatial autocorrelation analysis were specifically employed to identify the spatial distribution patterns, spatial clustering, and spatial correlations of built environment elements and diseases. The GeoDetector method (GDM) was used to assess the impact of environmental factors on diseases, and geographically weighted regression (GWR) analysis was adopted to reveal the spatial heterogeneity effect of environmental factors on CVD risk. RESULTS: The results indicate that the built environment elements and CVDs samples exhibit significant clustering characteristics in their spatial distribution, with a positive correlation between the distribution density of environmental elements and the incidence of CVDs (Moran's I > 0, p < 0.01). Further factor detection revealed that the distribution of healthcare facilities had the most significant impact on CVDs (q = 0.532, p < 0.01), followed by shopping and consumption (q = 0.493, p < 0.01), dining (q = 0.433, p < 0.01), and transportation facilities (q = 0.423, p < 0.01), while the impact of parks and squares (q = 0.174, p < 0.01) and road networks (q = 0.159, p < 0.01) was relatively smaller. Additionally, the interaction between different built environment elements exhibited a bi-factor enhancement effect on CVDs. In the local analysis, the spatial heterogeneity of different built environment elements on CVDs further revealed the regional differences and complexities. CONCLUSIONS: The spatial distribution of built environment elements is significantly correlated with CVDs to varying degrees and impacts differently across regions, underscoring the importance of the built environment on cardiovascular health. When planning and improving urban environments, elements and areas that have a more significant impact on CVDs should be given priority consideration.

Building running-friendly cities: effects of streetscapes on running using 9.73 million fitness tracker data in Shanghai, China.

The association between built environment and physical activity has been recognized. However, how and to what extent microscale streetscapes are related to running activity remains underexplored, partly due to the lack of running data in large urban areas. Moreover, few studies have examined the interactive effects of macroscale built environment and microscale streetscapes. This study examines the main and interactive effects of the two-level environments on running intensity, using 9.73 million fitness tracker data from Keep in Shanghai, China. Results of spatial error model showed that: 1) the explanatory power of microscale streetscapes was higher than that of macroscale built environment with R2 of 0.245 and 0.240, respectively, which is different from the prior finding that R2 is greater for macroscale built environment than for microscale streetscape; 2) sky and green view indexes were positively associated with running intensity, whereas visual crowdedness had a negative effect; 3) there were negative interactions of land use Herfindahl-Hirschman index with sky and green view indexes, while a positive interaction was observed for visual crowdedness. To conclude, greener, more open and less visually crowded streetscapes, can promote running behavior and enhance the benefits of land use mix as well. The findings highlight the importance of streetscapes in promoting running behavior, instead of a supplement to macroscale built environment.

Built Environment and Gender-Based Vulnerability as Key Drivers of Food Insecurity in Allegheny County.

Food insecurity is pervasive in Allegheny County, as one in five residents experiences food insecurity. Food insecurity is linked to chronic health conditions like heart disease and hypertension and disproportionately affects women in the United States, particularly women who are head of household. There are multiple dimensions used to measure regional disparities in food accessibility. Prior research has examined the linkages between food access and food insecurity, and this study aims to explore further the relationship between equitable access to sustainable and affordable food sources. This study examines food outlets in Allegheny County to determine if there is a significant relationship between food outlet availability and food insecurity. Both the presence and accessibility of these food outlets were examined. To measure accessibility, the walking distance to the nearest public transportation stop was calculated for each public transportation stop. The minimum distance to each food outlet was compared to food insecurity rates on a census tract level. Results showed that communities without grocery stores had lower access to healthy and affordable food sources. Also, communities with a higher proportion of female-headed households experienced greater food insecurity, regardless of access to food outlets. There was no statistically significant relationship between the distance from public transportation stops to grocery stores and rates of food insecurity overall and in low-income communities. However, communities with inaccessible grocery stores, either absent in the census tract or without close public transport stops, did have even greater average rates of food insecurity if there was an above-average proportion of female-headed households. Based on these findings, it is evident there exist structural elements of the built environment that correspond with disproportionate rates of food insecurity experienced by communities with households that are predominately female headed. In addition to resource support for these marginalized groups, we suggest that sole reliance on distance as an indicator of food insecurity can be misleading. There should be a greater focus on walkability aggregated on a household or individual level within the community instead of physical distance alone at a general scale.

Moderation Effects of Streetscape Perceptions on the Associations Between Accessibility, Land Use Mix, and Bike-Sharing Use: Cross-Sectional Study.

Background: Cycling is known to be beneficial for human health. Studies have suggested significant associations of physical activity with macroscale built environments and streetscapes. However, whether good streetscapes can amplify the benefits of a favorable built environment on physical activity remains unknown. Objective: This study examines whether streetscape perceptions can modify the associations between accessibility, land use mix, and bike-sharing use. Methods: This cross-sectional study used data from 18,019,266 bike-sharing orders during weekends in Shanghai, China. A 500 × 500 m grid was selected as the analysis unit to allocate data. Bike-sharing use was defined as the number of bike-sharing origins. Street view images and a human-machine adversarial scoring framework were combined to evaluate lively, safety, and wealthy perceptions. Negative binomial regression was developed to examine the independent effects of the three perceptual factors in both the univariate model and fully adjusted model, controlling for population density, average building height, distance to nearest transit, number of bus stations, number of points of interest, distance to the nearest park, and distance to the central business district. The moderation effect was then investigated through the interaction term between streetscape perception and accessibility and land use mix, based on the fully adjusted model. We also tested whether the findings of streetscape moderation effects are robust when examinations are performed at different geographic scales, using a small-sample statistics approach and different operationalizations of land use mix and accessibility. Results: High levels of lively, safety, and wealthy perceptions were correlated with more bike-sharing activities. There were negative effects for the interactions between the land use Herfindahl-Hirschman index with the lively perception (ß=-0.63; P=.01) and safety perception (ß=-0.52; P=.001). The interaction between the lively perception and road intersection density was positively associated with the number of bike-sharing uses (ß=0.43; P=.08). Among these, the lively perception showed the greatest independent effect (ß=1.29; P<.001), followed by the safety perception (ß=1.22; P=.001) and wealthy perception (ß=0.72; P=.001). The findings were robust in the three sensitivity analyses. Conclusions: A safer and livelier streetscape can enhance the benefits of land use mix in promoting bike-sharing use, with a safer streetscape also intensifying the effect of accessibility. Interventions focused on streetscape perceptions can encourage cycling behavior and enhance the benefits of accessibility and land use mix. This study also contributes to the literature on potential moderators of built environment healthy behavior associations from the perspective of microscale environmental perceptions.

Cycling safely: Examining the factors associated with bicycle accidents in Seoul, South Korea.

This study investigates the factors contributing to bicycle accidents, focusing on four types of bicycle lanes and other exposure and built environment characteristics of census blocks. Using Seoul as a case study, three years of bicycle accident spot data from 2018 to 2020 was collected, resulting in 1,330 bicycle accident spots and a total of 2,072 accidents. The geographically weighted Poisson regression (GWPR) model was used as a methodological approach to investigate the spatially varying relationships between the accident frequency and explanatory variables across the space, as opposed to the Poisson regression model. The results indicated that the GWPR model outperforms the global Poisson regression model in capturing unobserved spatial heterogeneity. For example, the value of deviance that determines the goodness of fit for a model was 0.244 for the Poisson regression model and 0.500 for the far better-fitting GWPR model. Further findings revealed that the factors affecting bicycle accidents have varying impacts depending on the location and distribution of accidents. For example, despite the presence of bicycle lanes, some census blocks, particularly in the northeast part of the city, still pose a risk for bicycle accidents. These findings can provide valuable insights for urban planners and policymakers in developing bicycle safety measures and regulations.

Disaggregation of Green Space Access, Walkability, and Behavioral Risk Factor Data for Precise Estimation of Local Population Characteristics.

BACKGROUND: Social and Environmental Determinants of Health (SEDH) provide us with a conceptual framework to gain insights into possible associations among different human behaviors and the corresponding health outcomes that take place often in and around complex built environments. Developing better built environments requires an understanding of those aspects of a community that are most likely to have a measurable impact on the target SEDH. Yet data on local characteristics at suitable spatial scales are often unavailable. We aim to address this issue by application of different data disaggregation methods. METHODS: We applied different approaches to data disaggregation to obtain small area estimates of key behavioral risk factors, as well as geospatial measures of green space access and walkability for each zip code of Allegheny County in southwestern Pennsylvania. RESULTS: Tables and maps of local characteristics revealed their overall spatial distribution along with disparities therein across the county. While the top ranked zip codes by behavioral estimates generally have higher than the county's median individual income, this does not lead them to have higher than its median green space access or walkability. CONCLUSION: We demonstrated the utility of data disaggregation for addressing complex questions involving community-specific behavioral attributes and built environments with precision and rigor, which is especially useful for a diverse population. Thus, different types of data, when comparable at a common local scale, can provide key integrative insights for researchers and policymakers.

Patterns and sources of spatial inequity in freight crashes: An application of decomposition analysis.

Despite considerable increases in road freight traffic and associated crashes over the past decade, our understanding of their spatial distribution remains limited. This is concerning because freight vehicle crashes often lead to fatal and severe injuries. This study focuses on Seoul, South Korea and contributes to the literature by investigating the patterns and sources of spatial inequity in freight crashes. Specifically, it examines whether socioeconomically disadvantaged neighborhoods experience a higher concentration of freight crashes. Using the Gelbach's decomposition technique, this study also aims to identify the factors contributing to differences in freight crashes between disadvantaged and less-disadvantaged neighborhoods and quantify their relative contributions. The regression results show that severe freight crashes are more prevalent in disadvantaged neighborhoods before adjusting for other factors-a pattern not observed in non-severe crashes. The decomposition analysis reveals that the observed disparities in severe freight crashes between disadvantaged and less-disadvantaged neighborhoods are fully explained by differences in several neighborhood characteristics, including local road density, truck traffic volume density, proximity to logistics terminals, and off-road bicycle lane density, between neighborhood types. Interestingly, differences in built environment characteristics between neighborhood types not only fail to explain but instead counteract the disparities in severe freight crashes. The findings of this study suggest detailed policy implications for mitigating freight crash occurrences and addressing related spatial inequities.

Prospective associations between neighborhood features and body mass index in Montreal adolescents.

PURPOSE: To investigate the association between the neighborhood built environment and trajectories of body mass index (BMI) in youth. METHODS: Data were collected in a prospective study of 1293 adolescents in Montreal. Built environment variables were obtained from public databases for road networks, land use, and the Canadian Census. Anthropometric data were collected when participants were ages 12.5, 15 and 17 years. We undertook hierarchical cluster analysis to identify contrasting neighborhood types based on features of the built environment (e.g., vegetation, population density, walkability). Associations between neighborhood type and trajectories of BMI z-score (BMIz) were estimated using multivariable linear mixed regression analyses, stratified by sex. RESULTS: We identified three neighborhood types: Urban, Suburban, and Village. In contrast to the Urban type, the Suburban type was characterized by more vegetation, few services and low population density. Village and Suburban types were similar, but the former had greater land use diversity, population density with more parks and a denser food environment. Among girls, living in Urban types was associated with decreasing BMIz trajectories. Living in Village types was associated with increasing BMIz trajectories. No associations were observed among boys. CONCLUSIONS: Neighborhoods characterized by greater opportunities for active living appear to be less obesogenic, particularly among girls.

Investigating the role of the built environment, socio-economic status, and lifestyle factors in the prevalence of chronic diseases in Mashhad: PLS-SEM model.

Background: Chronic diseases remain a significant contributor to both mortality and disability in our modern world. Physical inactivity and an unhealthy diet are recognized as significant behavioral risk factors for chronic diseases, which can be influenced by the built environment and socio-economic status (SES). This study aims to investigate the relationship between the built environment, SES, and lifestyle factors with chronic diseases. Methods: The current study was conducted in Mashhad's Persian cohort, which included employees from Mashhad University of Medical Sciences (MUMS). In the study, 5,357 participants from the cohort were included. To assess the state of the built environment in Mashhad, a Geographic Information System (GIS) map was created for the city and participants in the Persian Mashhad study. Food intake and physical exercise were used to assess lifestyle. A food frequency questionnaire (FFQ) was used to assess food intake. To assess food intake, the diet quality index was computed. To assess the link between variables, the structural model was created in accordance with the study's objectives, and partial least square structural equation modeling (PLS-SEM) was utilized. Results: The chronic diseases were positively associated with male sex (p < 0.001), married (p < 0.001), and higher age (p < 0.001). The chronic diseases were negatively associated with larger family size (p < 0.05), higher SES (p < 0.001), and higher diet quality index (DQI) (p < 0.001). No significant relationship was found between chronic disease and physical activity. Conclusion: Food intake and socioeconomic status have a direct impact on the prevalence of chronic diseases. It seems that in order to reduce the prevalence of chronic diseases, increasing economic access, reducing the class gap and increasing literacy and awareness should be emphasized, and in the next step, emphasis should be placed on the built environment.

Changes in neighbourhood walkability and body mass index: An analysis of residential mobility from a longitudinal multilevel study in Brisbane, Australia.

This study examined associations between changes in neighbourhood walkability and body mass index (BMI) among 1041 residents who relocated within Brisbane, Australia between 2007 and 2016 over five waves of the HABITAT study. Measures included spatially-derived neighbourhood walkability (dwelling density, street connectivity, and land use mix) and self-reported height and weight. No associations were found between any neighbourhood walkability characteristics and BMI. Examining these associations over the life course, and the impact of residential relocation in the younger years, remains a priority for future research.

Associations of perceived built environment characteristics using NEWS questionnaires with all-cause mortality and major cardiovascular diseases: The prospective urban rural epidemiology (PURE)-China study.

BACKGROUND: Despite increased literature focusing on the role of the built environment (BE) in health, few cohort studies have quantitatively analyzed neighborhood walkability environment in relation to the risk of death and cardiovascular disease (CVD). This longitudinal study aimed at evaluating the association between perceived BE attributeswith mortality and major CVD based on the Prospective Urban Rural Epidemiology study in China (PURE-China). METHODS: The PURE-China study recruited 47,931 participants aged 35-70 years from 12 provinces of China between 2005 and 2009. The perceived BE information, including land use, street, aesthetics, and safety, was collected using the neighborhood environment walkability scale (NEWS) questionnaire, with higher scores indicating a more favorable rating. Two primary outcomes are all-cause mortality and major CVD event. The Cox frailty model with random intercepts was used to assess the association between the perceived total BE/subscales score and outcomes. RESULTS: Of 32,163 participants included in this study, 19,253 (59.9 %) were women, and the mean (SD) age was 51.0 (9.5) years. After a median follow-up period of 11.7 years (IQR 9.4 - 12.2), we observed that one standard deviation higher of combined BE scores was related to a lower risk of all-cause mortality (HR = 0.85; 95 %CI, 0.80-0.90), and major CVD events (HR = 0.95; 95 %CI, 0.90-0.99). The subscales of perceived BE were related to a lower risk, although a few were not significant. Land use mix-diversity and safety from crime were the two most significant subscales. Stronger risks were observed among urban and female participants. CONCLUSION: Favorable perceived BE characteristics were linked with a lower risk of all-cause mortality and major CVD events in Chinese population, especially in urban areas and females. Our findings can be used by policymakers to take action to mitigate the adverse effect of poor community conditions on health, such as improving local amenities and transport connectivity, providing building paths for walking, running and cycling.

Making cities mental health friendly for adolescents and young adults.

Urban life shapes the mental health of city dwellers, and although cities provide access to health, education and economic gain, urban environments are often detrimental to mental health1,2. Increasing urbanization over the next three decades will be accompanied by a growing population of children and adolescents living in cities3. Shaping the aspects of urban life that influence youth mental health could have an enormous impact on adolescent well-being and adult trajectories4. We invited a multidisciplinary, global group of researchers, practitioners, advocates and young people to complete sequential surveys to identify and prioritize the characteristics of a mental health-friendly city for young people. Here we show a set of ranked characteristic statements, grouped by personal, interpersonal, community, organizational, policy and environmental domains of intervention. Life skills for personal development, valuing and accepting young people's ideas and choices, providing safe public space for social connection, employment and job security, centring youth input in urban planning and design, and addressing adverse social determinants were priorities by domain. We report the adversities that COVID-19 generated and link relevant actions to these data. Our findings highlight the need for intersectoral, multilevel intervention and for inclusive, equitable, participatory design of cities that support youth mental health.

Rising wildfire risk to houses in the United States, especially in grasslands and shrublands.

Wildfire risks to homes are increasing, especially in the wildland-urban interface (WUI), where wildland vegetation and houses are in close proximity. Notably, we found that more houses are exposed to and destroyed by grassland and shrubland fires than by forest fires in the United States. Destruction was more likely in forest fires, but they burned less WUI. The number of houses within wildfire perimeters has doubled since the 1990s because of both housing growth (47% of additionally exposed houses) and more burned area (53%). Most exposed houses were in the WUI, which grew substantially during the 2010s (2.6 million new WUI houses), albeit not as rapidly as before. Any WUI growth increases wildfire risk to houses though, and more fires increase the risk to existing WUI houses.

Identifying urban built environment factors in pregnancy care and maternal mental health outcomes.

BACKGROUNDS: Risk factors related to the built environment have been associated with women's mental health and preventive care. This study sought to identify built environment factors that are associated with variations in prenatal care and subsequent pregnancy-related outcomes in an urban setting. METHODS: In a retrospective observational study, we characterized the types and frequency of prenatal care events that are associated with the various built environment factors of the patients' residing neighborhoods. In comparison to women living in higher-quality built environments, we hypothesize that women who reside in lower-quality built environments experience different patterns of clinical events that may increase the risk for adverse outcomes. Using machine learning, we performed pattern detection to characterize the variability in prenatal care concerning encounter types, clinical problems, and medication prescriptions. Structural equation modeling was used to test the associations among built environment, prenatal care variation, and pregnancy outcome. The main outcome is postpartum depression (PPD) diagnosis within 1 year following childbirth. The exposures were the quality of the built environment in the patients' residing neighborhoods. Electronic health records (EHR) data of pregnant women (n = 8,949) who had live delivery at an urban academic medical center from 2015 to 2017 were included in the study. RESULTS: We discovered prenatal care patterns that were summarized into three common types. Women who experienced the prenatal care pattern with the highest rates of PPD were more likely to reside in neighborhoods with homogeneous land use, lower walkability, lower air pollutant concentration, and lower retail floor ratios after adjusting for age, neighborhood average education level, marital status, and income inequality. CONCLUSIONS: In an urban setting, multi-purpose and walkable communities were found to be associated with a lower risk of PPD. Findings may inform urban design policies and provide awareness for care providers on the association of patients' residing neighborhoods and healthy pregnancy.

The indicators and methods used for measuring urban liveability: a scoping review.

OBJECTIVES: Liveability is a multi-dimensional and hierarchical concept which consists of various criteria and sub-criteria and may be evaluated in different ways. The aim of this study was to systematically review indicators and methods used for the evaluation of urban liveability in literature. CONTENT: The five-stage methodological framework of Arksey and O'Malley was used to conduct this scoping review. A systematic search of electronic databases, including Scopus, Medline (via PubMed), Embase, Web of Science and EBSCO was done until May 29, 2019. Web searching, searching reference lists and hand searching was also conducted to retrieve more relevant articles. Two reviewers screened the papers for eligibility based on the inclusion criteria and extracted their key data and reported them descriptively. SUMMARY: Sixty seven (67) out of 3,599 papers met the selection criteria. This review showed five distinct domains considered to be important components of liveability. These were Economical, Environmental, Institutional, Social, and Governance (Political) domains. The most important subdomains (indices) which were frequently applied in various studies were Environmental friendliness and Sustainability, Socio-Cultural Conditions and Economic Vibrancy and Competitiveness. We also identified seven different methodologies and six ranking tools used for assessing urban liveability. Among the quantitative methods, three methods accounted for 89.6% of the articles. These methods were the Analytical hierarchy process and entropy (AHP; n=24; 50%), Factor analysis & Principle Component Analysis (FA & PCA; n=12; 25%) and Spatial Multi-criteria Decision-making Method (Spatial; n=7; 14.6%). Among the ranking tools used, three ranking tools accounted for 65.4% of the articles. These tools were the Livable City Scientific Evaluation Standards (LCSES; n=9; 34.6%), The Global Liveable Cities Index (GLCI; n=4; 15.4%) and the Economist Intelligence Unit (EIU; n=4; 15.4%). OUTLOOK: This paper discusses and summarizes the latest indicators and methods used for determining urban liveability. The information offered in the review can help future investigators to decide which method suits their purpose and situation better and measure urban liveability more systematically than before.

Longitudinal association of built environment pattern with DXA-derived body fat in elderly Hong Kong Chinese: a latent profile analysis.

BACKGROUND: One major limitation of prior studies regarding the associations between built environment (BE) and obesity has been the use of anthropometric indices (e.g., body mass index [BMI]) for assessing obesity status, and there has been limited evidence of associations between BE and body fat. This study aimed to explore the longitudinal association between BE and body fat in a cohort of elderly Hong Kong Chinese and examine whether the BE-body fat associations differed by BMI categories. METHODS: Between 2001 and 2003, 3944 participants aged 65-98 years were recruited and followed for a mean of 6.4 years. BE characteristics were assessed via Geographic Information System. Body fat (%) at whole body and regional areas (trunk, limbs, android, and gynoid) were assessed by dual energy X-ray absorptiometry at baseline and three follow-ups. Latent profile analysis was used to derive BE class, and linear mixed-effects models were used to investigate the associations of BE class with changes in body fat. Stratified analyses by BMI categories were also conducted. RESULTS: Three BE classes were identified. Participants in Class 2 (characterized by greater open space and proportion of residential land use) had a slower increase in whole body fat (B = -0.403, 95% confidence interval [CI]: -0.780, -0.014) and limbs fat (-0.471, 95% CI: -0.870, -0.071) compared with participants in Class 1 (characterized by high proportion of commercial land use). There were significant interactions of BE class with BMI, and participants in Class 2 had a slower increase in whole body fat and regional fat compared with participants in Class 1 (B ranging from -0.987 [limbs] to -0.523 [gynoid]) among overweight and obese participants only. CONCLUSIONS: We found that those who resided in the areas characterized by greater open space and proportion of residential land use had a slower body fat increase.

Land use and semen quality: A fertility center cohort study.

This study explored the association between built environment and semen parameters among men who sought fertility evaluation. We used a data of 5,886 men living in the Seoul capital area whose semen was tested at a single fertility center during 2016-2018. Distance to fresh water, the coast, major roadways, and neighborhood greenness measured by Normalized Difference Vegetation Index (NDVI) were evaluated. Outcome indicators were semen volume, sperm concentration, percentage of progressive motility, vitality, normal morphology, and total motile sperm count. Linear regression models were fitted to standardized values of six semen indicators. Majority of men were white-collar, clerical, and service workers. Linear associations between built environment features and semen quality indicators were not evident except for NDVI within 500 m and sperm vitality (ß = 0.05; 95% confidence interval (CI): 0.01, 0.09). The 2nd quartile of distance to fresh water was associated with lower progressive motility compared to the 1st quartile (ß = -0.10; 95% CI: -0.17, -0.03). Proportion of vitality was higher among men in the 2nd quartile of distance to roadways than those in the 1st quartile (0.08; 95% CI: 0.01, 0.15). Men in the 2nd quartile of NDVI had higher total motile sperm count (0.09; 95% CI: 0.01, 0.17). In the multi-exposure model, the positive association between NDVI and vitality remained (0.03; 95% CI: 0.00, 0.06). We observed potential evidence regarding the impact of built environment on male fertility, specifically a positive association between residential greenness and sperm vitality among men with a history of infertility.

Differential associations of the built environment on weight gain by sex and race/ethnicity but not age.

OBJECTIVE: To explore the built environment (BE) and weight change relationship by age, sex, and racial/ethnic subgroups in adults. METHODS: Weight trajectories were estimated using electronic health records for 115,260 insured Kaiser Permanente Washington members age 18-64 years. Member home addresses were geocoded using ArcGIS. Population, residential, and road intersection densities and counts of area supermarkets and fast food restaurants were measured with SmartMaps (800 and 5000-meter buffers) and categorized into tertiles. Linear mixed-effect models tested whether associations between BE features and weight gain at 1, 3, and 5 years differed by age, sex, and race/ethnicity, adjusting for demographics, baseline weight, and residential property values. RESULTS: Denser urban form and greater availability of supermarkets and fast food restaurants were associated with differential weight change across sex and race/ethnicity. At 5 years, the mean difference in weight change comparing the 3rd versus 1st tertile of residential density was significantly different between males (-0.49 kg, 95% CI: -0.68, -0.30) and females (-0.17 kg, 95% CI: -0.33, -0.01) (P-value for interaction = 0.011). Across race/ethnicity, the mean difference in weight change at 5 years for residential density was significantly different among non-Hispanic (NH) Whites (-0.47 kg, 95% CI: -0.61, -0.32), NH Blacks (-0.86 kg, 95% CI: -1.37, -0.36), Hispanics (0.10 kg, 95% CI: -0.46, 0.65), and NH Asians (0.44 kg, 95% CI: 0.10, 0.78) (P-value for interaction <0.001). These findings were consistent for other BE measures. CONCLUSION: The relationship between the built environment and weight change differs across demographic groups. Careful consideration of demographic differences in associations of BE and weight trajectories is warranted for investigating etiological mechanisms and guiding intervention development.