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Built environment characteristics and related environmental exposures and behaviors have been, separately, implicated in the development of poor mental health. However, it is unclear how these factors act together in relation to mental health. We studied these factors simultaneously to evaluate the impact of the built environment, and the mediating role of environmental exposures and physical activity, on mental health, while also studying moderation by sex, age, and length of residence. We used a cross-sectional population-based sample of 3145 individuals aged 15-97 years from Barcelona, Spain. Time spent walking and mental health status were assessed with validated questionnaires, administered through a face-to-face interview. We characterized the built environment (e.g., building, population and intersection density and green space), road traffic noise, and ambient air pollution at the residential level using land cover maps, remote sensing, noise maps and land use regression models. Adjusted regression models accounting for spatial clustering were analyzed to study associations between built environment attributes and mental health, and mediation and moderation effects. Density attributes were directly or indirectly, through air pollution and less consistently through walking, associated with poor mental health. Green space indicators were associated with lower prevalence of poor mental health, partly through lower air pollution exposure and more walking. In some cases, these associations differed by sex, age or length of residence. Non-linear associations of density indicators with environmental exposures, and of particulate matter with poor mental health indicated threshold effects. We conclude that living in dense areas with high air pollution concentrations was associated with poor mental health. On the other hand, green areas with lower air pollution concentrations were protective against poor mental health. Greater urban density might benefit health, but might only do so when air pollution concentrations are low.
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Poluentes Atmosféricos , Poluição do Ar , Humanos , Poluentes Atmosféricos/análise , Cidades , Saúde Mental , Estudos Transversais , Poluição do Ar/análise , Exposição Ambiental/análise , Material Particulado/análise , Ambiente Construído , Estilo de VidaRESUMO
INTRODUCTION: In the past, health inequalities were not prioritised in the political agenda of Barcelona. The change of city government (2015) was an opportunity to develop a Surveillance System for Social Health Inequalities in the city, which is described in this article. METHODS: The design of the Surveillance System formed part of the Joint Action for Health Equity in Europe (JAHEE), funded by the European Union. Various steps were considered by the experts to set up the System: define its objectives, target population, domains and indicators, and sources of information; perform data analysis; implement and disseminate the system; define the evaluation; and perform regular data updates. RESULTS: The System considers the following domains: social determinants of health, health-related with behaviours, use of healthcare, and health outcomes, and includes eight indicators. As axes of inequality, the experts chose sex, age, social class, country of origin, and geographical area. The Surveillance System for Social Health Inequalities is presented on a website including different types of figures. CONCLUSION: The methodology used to implement the Surveillance System can be used to implement similar systems in other urban areas around the world.
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Desigualdades de Saúde , Classe Social , Humanos , Fatores Socioeconômicos , Cidades , Europa (Continente) , Disparidades nos Níveis de SaúdeRESUMO
BACKGROUND: The new WHO air quality guidelines indicate that the air pollution disease burden is greater than previously reported. We aimed to estimate the air pollution disease burden and its economic cost in Barcelona to inform local action. METHODS: We used a quantitative health impact assessment to estimate the non-accidental mortality and incidence of childhood asthma and lung cancer attributable to long-term air pollution exposure in the city of Barcelona (Spain) in 2018-2019. We used the population weighted mean of PM2.5 and NO2 assigned at the geocoded address during the study period and the 2021 WHO air quality guidelines as counterfactual scenario to estimate new annual cases attributable to each pollutant separately and combined. We estimated the social cost of attributable deaths and the health care cost of childhood asthma and lung cancer attributable cases. We also estimated attributable mortality by city district and the mortality avoidable by achieving the WHO air quality interim targets. RESULTS: Mean exposure was 17 µg/m3 for PM2.5 and 39 µg/m3 for NO2. Total combined air pollution attributable mortality was 13% (95%CI = 9%-17%), corresponding to 1,886 deaths (95%CI = 1,296-2,571) and a social cost of 1,292 million (95%CI = 888-1,762) annually. Fifty-one percent (95%CI = 21%-71%) and 17% (95%CI = 7%-29%) of new cases of childhood asthma and lung cancer were attributable to air pollution with a health care cost of 4.3 and 2.7 million, respectively. Achieving the first unmet WHO air quality interim targets for PM2.5 and for NO2 would avoid 410 deaths and 281 million annually. CONCLUSION: Air pollution in Barcelona represents a huge disease and economic burden, which is greater than previous estimates. Much stronger measures to reduce PM2.5 and NO2 levels are urgently needed. Until the WHO air quality guidelines are met in the city, achieving each WHO air quality interim targets would avoid hundreds of deaths each year.
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Poluentes Atmosféricos , Poluição do Ar , Asma , Neoplasias Pulmonares , Humanos , Poluentes Atmosféricos/análise , Material Particulado , Dióxido de Nitrogênio , Poluição do Ar/análise , Efeitos Psicossociais da Doença , Asma/epidemiologia , Neoplasias Pulmonares/epidemiologia , Exposição Ambiental/análiseRESUMO
BACKGROUND AND AIMS: Urban green space has many health benefits, but it is still unclear how much actually is needed for better health. Recently a new 3-30-300 rule of thumb for urban forestry and urban greening has been proposed, but this rule has not been evaluated for benefits on health. The rule requires that every citizen should be able to see at least three trees from their home, have 30 percent tree canopy cover in their neighbourhood and not live more than 300 m away from the nearest park or green space. The aim of this study was to evaluate the relationship between the 3-30-300 green space rule and its components in relation to mental health. METHODS: We conducted a cross-sectional study based on a population-based sample of 3145 individuals aged 15-97 years from in Barcelona, Spain who participated in the Barcelona Health Survey (2016-2017). We created 3-30-300 green space indicators using questionnaire data, GIS, remote sensing and land cover maps. Mental health status was assessed with the 12-item General Health Questionnaire (GHQ-12) and also the use of tranquilizer/sedatives or antidepressants and psychiatrist or psychologist visits. Analyses were conducted using mixed effects logistic regression models with districts as the random effect, adjusted for relevant covariates. RESULTS: We found that people in Barcelona had relatively little exposure to green space, whether through window view, living in an area with sufficient greenness, or access to a major green space, and only 4.7% met a surrogate 3-30-300 green space rule. Residential surrounding greenness, but not tree window view or access to major green space, was significantly associated with better mental health, less medication use, and fewer psychologist or psychiatrist visits. Meeting the full surrogate 3-30-300 green space rule was associated with better mental health, less medication use, and fewer psychologist or psychiatrist visits, but only for the latter combined the association was statistically significant (Odds ratio = 0.31, 95% CI: 0.11, 0.91). CONCLUSION: Few people achieved the 3-30-300 green space in Barcelona and we used a surrogate measure. We observed health benefits when the full surrogate rule was met.
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Saúde Mental , Parques Recreativos , Estudos Transversais , Humanos , Hipnóticos e Sedativos , Características de Residência , ÁrvoresRESUMO
Purpose: The aim of this study was to assess health inequalities by sexual attraction in the 2016-2017 Barcelona population, stratifying by sex. Methods: Data came from the 2016-2017 Barcelona Health Survey, where 3362 adults answered among other instruments the EuroQol-5 dimensions-5 levels (EQ-5D-5L), which measures five dimensions and summarizes health-related quality of life into a single utility index score. To assess health differences by sexual attraction, we constructed Tobit models for the EQ-5D index score and Poisson regression models for the EQ-5D dimensions. Nested models were constructed to examine the mediating role of discrimination and health-related variables. Results: After adjusting for sociodemographic variables, women feeling attraction to more than one sex showed a lower EQ-5D index score (worse health) than those with only other sex attraction (-0.042, p = 0.012), and higher prevalence of problems with mobility, usual activities, and anxiety/depression with the following adjusted prevalence ratios (aPR) and confidence intervals (CIs): 1.79 (95% CI 1.05-3.05), 1.84 (95% CI 1.05-3.21), and 1.76 (95% CI 1.27-2.43). Women feeling attraction only to their same sex also presented higher prevalence of anxiety/depression (aPR = 1.46, CI 95% 1.10-1.92). In contrast, differences were not observed for men. Conclusion: Women, but not men, feeling attraction to more than one sex and only same-sex attraction in Barcelona in 2016-2017 presented worse health than those feeling only other sex attraction, with discrimination playing a mediating role in explaining such inequalities. These results among women indicate the need to develop public health strategies in Barcelona addressed to lesbian and bisexual women, considering the intersection of gender and sexual orientation.
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Disparidades nos Níveis de Saúde , Qualidade de Vida , Adulto , Depressão/epidemiologia , Feminino , Nível de Saúde , Inquéritos Epidemiológicos , Humanos , Masculino , Comportamento Sexual , Inquéritos e QuestionáriosRESUMO
Greenspace is widely related to mental health benefits, but this relationship may vary by social group. Gentrification, as linked to processes of unequal urban development and conflict, potentially impacts health outcomes. This study explores the relationships between greenspace and mental health and between gentrification and mental health associations. It also further examines gentrification as an effect modifier in the greenspace-mental health association and SES as an effect modifier in the gentrification-mental health association. We used cross-sectional Barcelona (Spain) data from 2006, which included perceived mental health status and self-reported depression/anxiety from the Barcelona Health Survey. Greenspace exposure was measured as residential access to (1) all greenspace, (2) greenways and (3) parks in 2006. Census-tract level gentrification was measured using an index including changes in sociodemographic indicators between 1991 and 2006. Logistic regression models revealed that only greenways were associated with better mental health outcomes, with no significant relationship between mental health and parks or all greenspace. Living in gentrifying neighborhoods was protective for depression/anxiety compared to living in non-gentrifying neighborhoods. However, only residents of gentrifiable census tracts benefited from the exposure to greenways. SES was not found to be an effect modifier in the association between gentrification and mental health. Future research should tackle this study's limitations by incorporating a direct measure of displacement in the gentrification status indicator, accounting for qualitative aspects of greenspace and user's perceptions. Gentrification may undermine the health benefits provided by greenspace interventions.
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Parques Recreativos , Mudança Social , Estudos Transversais , Humanos , Avaliação de Resultados em Cuidados de Saúde , Características de ResidênciaRESUMO
The quality characteristics of urban green spaces (UGS) have been suggested to play a critical role in their use and their potentials to exert health effects. However, epidemiological studies evaluating such a role are scarce. These studies have generally focused on a limited number of quality dimensions. We studied the association between 10 UGS quality dimensions, assessed through a comprehensive multidimensional tool, and physical activity, overweight/obesity, and UGS use. Our study was based on 2053 adults participating in the Barcelona Health Survey (2016) and the quality of 149 UGS located in Barcelona, Spain. For each participant, we abstracted the average and maximum quality score separately for each of the 10 quality dimensions and an overall quality score for the UGS within 300 m of the participant's residential address. Data on the study outcomes were obtained through face-to-face interviews. We developed logistic regression and negative binomial models to assess our evaluated associations and conducted mediation analyses between the different outcomes. We observed that the overall quality of UGS was associated with higher likelihood of engaging in moderate-to-vigorous physical activity (OR:1.13; 95% CI:1.00-1.27), lower risk of overweight/obesity (OR: 0.88; 95% CI: 0.79-0.98), and increased use of UGS (exponentiated regression coefficient: 1.08; 95% CI:1.01-1.15). For the quality dimensions, we observed different patterns of associations depending on the outcome; however, bird biodiversity and amenities seem to be relevant to all of our evaluated outcomes. The mediation analysis suggested that UGS use mediate the association between quality and physical activity, while physical activity mediates the association between quality and overweight/obesity. The novel results from this study will allow decision-makers better design UGS and directly pinpoint relevant quality dimensions to promote physical activity, reduce the risk of overweight/obesity and boost the use of UGS amongst citizens.
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Exercício Físico , Parques Recreativos , Adulto , Humanos , Obesidade/epidemiologia , EspanhaRESUMO
BACKGROUND: Living in green areas has been associated with several health benefits; however, the available evidence on such benefits for hypertension is still limited. This study aimed to investigate and compare the association between residential exposure to greenspace and hypertension in Barcelona, Spain and Brussels, Belgium. METHODS: This cross-sectional study was based on data from the 2016 Barcelona Health Interview Survey (HIS) (n = 3400) and the 2013 Belgian HIS (n = 2335). Both surveys were harmonized in terms of outcomes, confounders and exposure assessment. Residential exposure to greenspace was characterized as 1) surrounding greenspace (normalized difference vegetation index (NDVI) and modified soil-adjusted vegetation index 2 (MSAVI2)) across buffers of 100 m, 300 m, and 500 m; 2) surrounding green space across 300 m and 500 m buffers; and 3) Euclidean distance to the nearest green space. Our outcome was self-reported hypertension. We developed logistic regression models to evaluate the city-specific association between each greenspace measure and hypertension, adjusting for relevant covariates. RESULTS: One interquartile range (IQR) increase in residential distance to the nearest green space was associated with higher risk of hypertension in Barcelona [odds ratio (OR): 1.15; 95%CI 1.03-1.29 (IQR: 262.2)], but not in Brussels [OR: 0.95; 95%CI 0.77-1.17 (IQR: 215.2)]. Stratified analyses suggested stronger associations in older participants (≥65 years) for both cities. Findings for residential surrounding green space and greenspace were not conclusive. However, in Brussels, we found protective associations in older participants for both residential surrounding greenspace metrics [NDVI 300 m buffer OR: 0.51; 95%CI 0.32-0.81 (IQR: 0.21) and MSAVI2 300 m buffer OR: 0.51; 95%CI 0.32-0.83 (IQR: 0.18)]. We did not find any indication for the modification of our evaluated associations by sex and education level. CONCLUSION: Our study suggests that living closer to greenspace could be associated with lower risk of hypertension, particularly in older age. Future research is needed to replicate our findings in other settings and shed light on potential underlying mechanism(s).
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Hipertensão , Parques Recreativos , Idoso , Bélgica/epidemiologia , Cidades , Estudos Transversais , Humanos , Hipertensão/epidemiologia , Espanha/epidemiologiaRESUMO
Superblocks are currently being introduced in Barcelona to respond to the city's scarcity of green spaces and high levels of air pollution, traffic injuries, and sedentariness. The aim is to calm the streets by reducing the number of square meters dedicated to private vehicles and to reclaim part of this public space for people. Salut als Carrers (Health in the Streets) is a project to evaluate the potential environmental and health effects of the superblock model with an equity perspective in Barcelona. This study aims to explain the various interventions implemented in different neighborhoods in Barcelona and the methods that will be used to evaluate them in a quasi-experimental and health impact assessment (HIA) approaches. Given the complexity of the intervention evaluated, the project employs mixed methodologies. Quantitative methods include: (a) a pre-post health survey of 1200 people randomly selected from the municipal register asked about self-perceived health and quality of life, social support, mental health, mobility, physical activity, neighborhood characteristics, and housing; (b) pre-post environmental measurements, mainly of nitrogen dioxide (NO2), particulate matter of less than 10 µm (PM10), and particulate matter of less than 2.5 µm (PM2.5) and black carbon; (c) pre-post environmental walkability measures using the Microscale Audit of Pedestrian Streetscapes (MAPS) tool; (d) use of public space and physical activity levels using the System for Observing Play and Recreation in Communities (SOPARC), a validated observation tool; (e) pre-post traffic injury measures with a comparison group; and (f) the comparison and integration of pre-post assessment with previous HIAs and the improvement of future HIAs. Qualitative studies will be performed to analyze residents' perception of these effects by using: (a) various focus groups according to different participant characteristics who are more or less likely to use the superblocks; and (b) a guerrilla ethnography, which is a method that combines ethnographic observation and semi-structured interviews. This study, which evaluates the impact of an ambitious urban-renewal program on health, will help to assess the effectiveness of public policy in terms of health and health inequalities.
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Poluentes Atmosféricos , Poluição do Ar , Planejamento Ambiental , Qualidade de Vida , Cidades , Saúde Ambiental , Humanos , Veículos Automotores , Material ParticuladoRESUMO
OBJECTIVE: We aim to estimate the association between working hour mismatches and mental well-being. We also investigate the confounding and moderating role of job quality in this association. METHODS: We use cross-sectional data from the European Working Conditions Survey of 2015 in the analysis. The sample includes 9345 male and 10,998 female employees in 28 countries. We run a multilevel linear regression accounting for the clustering of countries with mental well-being assessed by the World Health Organization Index. We compute mismatches in working hours as the difference between desired and actual hours of work, categorized as underemployed, unconstrained, and overemployed. The main dependent variable is the combination of these mismatches for each of the following working schedules: ≤ 20; 21-34; 35-40; 41-47; and ≥ 48 h/week (h/w). RESULTS: The adverse association of short and long hours with well-being is mostly attributable to mismatches in working hours (except for men in the 41-47 h/w group). Once we adjust for job quality, overemployed men ≥ 48 h/w experience a reduction in mental well-being of - 5.2 (95 CI % - 7.04 to - 3.76) with respect to the unconstrained base category 35-40 h/w. Overemployed women experience a reduction in mental well-being ranging from - 4.94 (95 CI % - 6.54 to - 3.34) in the ≥ 48 h/w schedule to - 11.11 (95 CI % - 17.35 to - 4.87) in the ≤ 20 h/w schedule. We observe a confounding role of job quality across most working hour schedules, but the interaction effects are modest. CONCLUSION: Employee control over working hours is associated with mental well-being with differences by gender. Labour policies aimed at promoting flexibility on the employee side could be favoured to improve workers' mental well-being.
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Saúde Mental , Admissão e Escalonamento de Pessoal , Adulto , União Europeia , Feminino , Humanos , Satisfação no Emprego , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Saúde Ocupacional , Caracteres SexuaisRESUMO
BACKGROUND: The "Employment in the neighbourhoods" program is an innovative, tailor-made Active Labour Market Program that has been implemented in 12 neighbourhoods in Barcelona (Spain). Its goal is to get people from deprived, high-unemployment neighbourhoods back to work. The aim of this study was to describe the effects of the program on participants' quality of life, and identify the mechanisms underlying these effects, according to their own perception and the perception of technical staff who assisted them. METHODS: We used Concept Mapping, a mixed methods approach combining qualitative and quantitative analysis, to develop a conceptual map of the participants' and technical staffs' perceptions about changes in the participants' quality of life. Data collection occurred within the generation and structuring steps where participants brainstormed answers to a focus question, and then rated and sorted the responses. To create maps, we used Concept Systems Incorporated software, which conducted two main forms of analysis, a multidimensional scaling analysis, and a hierarchical cluster analysis. RESULTS: Study participants reported several positive effects on mental health and emotional wellbeing, including self-esteem and empowerment, and considered that this was achieved through strengthened social networks, skills acquisition, emotional coaching, and personalized technical assistance. They also described some negative impacts, mainly related to the labour market situation. We observed marked gender differences in the discourses of program participants. CONCLUSIONS: The results obtained have allowed us to identify different perceived effects and mechanisms by which the "Employment in the Neighbourhoods" Active Labour Market Programme can influence quality of life of participants from the most deprived areas of Barcelona.
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Qualidade de Vida , Retorno ao Trabalho/psicologia , Desemprego/psicologia , Adulto , Feminino , Humanos , Masculino , Saúde Mental , Pessoa de Meia-Idade , Avaliação de Programas e Projetos de Saúde , Pesquisa Qualitativa , Características de Residência , Autoimagem , Fatores Sexuais , EspanhaRESUMO
BACKGROUND: The aim of this study was to analyze the trend in socioeconomic inequalities in mortality in small areas due to several specific causes before (2001-2004, 2005-2008) and during (2009-2012) the economic crisis in seven Spanish cities. METHODS: This ecological study of trends, with census tracts as the areas of analysis, was based on three periods. Several causes of death were studied. A socioeconomic deprivation index was calculated for each census tract. For each small area, we estimated standardized mortality ratios, and controlled for their variability using Bayesian models (sSMR). We also estimated the relative risk of mortality according to deprivation in the different cities, periods, and sexes. RESULTS: In general, a similar geographical pattern was found for the socioeconomic deprivation index and sSMR. For men, there was an association in all cities between the deprivation index and all-cause mortality that remained stable over the three periods. For women, there was an association in Barcelona, Granada, and Sevilla between the deprivation index and all-cause mortality in the third period. Patterns by causes of death were more heterogeneous. CONCLUSIONS: After the start of the financial crisis, socioeconomic inequalities in total mortality in small areas of Spanish cities remained stable in most cities, although several causes of death showed a different pattern.
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Recessão Econômica , Mortalidade , Fatores Socioeconômicos , Causas de Morte , Cidades , Feminino , Geografia , Humanos , Masculino , Fatores Sexuais , EspanhaRESUMO
BACKGROUND: Since the last Western great recession of 2008, an increasing interest on the effects of Active Labour Market Policies (ALMPs) on improving health has emerged. The aim of our review is to synthesize evidence on the effectiveness of ALMPs and whether some types of ALMP are more effective. METHODS: Using the Scoping review methodology, we conducted a literature review in PubMed/MEDLINE, Scopus and Web of Science and selected articles published between 1990 and 2017 in high income countries. We applied four sequential phases of document screening to the list of retrieved articles. RESULTS: Of the 416 documents detected in the search, 36 documents were finally selected. Most of them focused on mental health and related components (72.2%) and found positive results at least in one outcome (80.6%). The ALMPs reported mainly attempt to build capacity through job search assistance (31.6%) with a component on mental health, showing positive results on health; some offer job training (16.7%) and few subsidized employment (8.3%), showing more controversial results, although mostly positive. The rest include a combination of different types of ALMPs. CONCLUSIONS: This review shows that ALMPs have a positive impact on health and quality of life. There are relatively few studies of the impact of ALMPs on general health, and most of the studies found are focused on Anglo-Saxon and Nordic countries. The most significant knowledge gaps are the mechanisms involved in achieving this improvement, and above all the differential health impacts according to axes of inequality and welfare state.
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Emprego , Qualidade de Vida , Humanos , Saúde Mental , Políticas , Países Escandinavos e NórdicosRESUMO
BACKGROUND: The aim of this study was to analyze the changes in self-perceived health status and mental health among participants in an active labour market policy (ALMP) of Barcelona, and to assess whether the results differed according to the participants' social characteristics and their program trajectories. METHODS: A pre-post intervention study was designed, including unemployed people participating in a return-to-work ALMP in 13 deprived neighborhoods of Barcelona; using one survey upon entering the program (pre), and another 1 year later (post). We assessed the prevalence of poor self-perceived health status and poor mental health (Goldberg-12 questionnaire) in both periods of time. We fit five Poisson regression models using generalized estimating equations (GEE) to measure changes in self-perceived health and mental health between pre- and post-intervention. RESULTS: About 696 individuals (48% women) participated in the study, mainly manual workers. In both sexes, mental health improved (prevalence ratio [PR]-comparing post- and pre-periods for women: 0.49, 95% confidence interval [CI]: 0.39-0.61 and men: PR: 0.41, 95% CI: 0.32-0.53), whereas self-perceived health status remained stable or worsened. Men who remained unemployed reported poorer self-perceived health status, while no such association was observed among women. CONCLUSIONS: This study shows a mental health improvement among male and female participants.
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Emprego , Saúde Mental , Desemprego , Europa (Continente) , Feminino , Nível de Saúde , Humanos , MasculinoRESUMO
BACKGROUND: Car-dependent city planning has resulted in high levels of environmental pollution, sedentary lifestyles and increased vulnerability to the effects of climate change. The Barcelona Superblock model is an innovative urban and transport planning strategy that aims to reclaim public space for people, reduce motorized transport, promote sustainable mobility and active lifestyles, provide urban greening and mitigate effects of climate change. We estimated the health impacts of implementing this urban model across Barcelona. METHODS: We carried out a quantitative health impact assessment (HIA) study for Barcelona residents ≥20â¯years (Nâ¯=â¯1,301,827) on the projected Superblock area level (Nâ¯=â¯503), following the comparative risk assessment methodology. We 1) estimated expected changes in (a) transport-related physical activity (PA), (b) air pollution (NO2), (c) road traffic noise, (d) green space, and (e) reduction of the urban heat island (UHI) effect through heat reductions; 2) scaled available risk estimates; and 3) calculated attributable health impact fractions. Estimated endpoints were preventable premature mortality, changes in life expectancy and economic impacts. RESULTS: We estimated that 667 premature deaths (95% CI: 235-1,098) could be prevented annually through implementing the 503 Superblocks. The greatest number of preventable deaths could be attributed to reductions in NO2 (291, 95% PI: 0-838), followed by noise (163, 95% CI: 83-246), heat (117, 95% CI: 101-137), and green space development (60, 95% CI: 0-119). Increased PA for an estimated 65,000 persons shifting car/motorcycle trips to public and active transport resulted in 36 preventable deaths (95% CI: 26-50). The Superblocks were estimated to result in an average increase in life expectancy for the Barcelona adult population of almost 200â¯days (95% CI: 99-297), and result in an annual economic impact of 1.7 billion EUR (95% CI: 0.6-2.8). DISCUSSION: The Barcelona Superblocks were estimated to help reduce harmful environmental exposures (i.e. air pollution, noise, and heat) while simultaneously increase PA levels and access to green space, and thereby provide substantial health benefits. For an equitable distribution of health benefits, the Superblocks should be implemented consistently across the entire city. Similar health benefits are expected for other cities that face similar challenges of environmental pollution, climate change vulnerability and low PA levels, by adopting the Barcelona Superblock model.
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Saúde da População Urbana , Poluição do Ar , Cidades , Planejamento de Cidades , Avaliação do Impacto na Saúde , Temperatura AltaRESUMO
Objectives: Sedentary behavior is a risk factor for comorbidities independently of physical activity. Some studies have reported screen time as an unhealthier form of sedentary behavior. This study assessed the association between recreational screen-time behavior and self-perceived health. Study design: This is a cross-sectional study. Methods: As part of the Salut als Carrers Project, in 2018 a survey was conducted in a representative sample (n â= â795) of residents aged â≥ â18 years living in the borough of Horta, in Barcelona. The survey assessed self-perceived health, recreational screen-time behavior on working and non-working days (Marshall questionnaire), leisure time physical activity (International Physical Activity Questionnaire [IPAQ] long form), socioeconomic status, and age. We analyzed associations between self-perceived health and recreational screen-time sedentary behavior, with adjustment of robust Poisson models for social class, age, and leisure physical activity. All analyses were stratified by gender. Results: A total of 82.7% of men and 82.5% of women reported sedentary behavior during recreational screen time of ≥3 âh/day on working days, and 63.9% of men and 65.8% of women on non-working days. Spending ≥3 âh/day sitting in front of a screen for leisure was associated with poor self-perceived health only on working days for men [PR â= â1.87 (1.13-3.09)] but not for women [PR â= â1.32 (0.82-2.11)] regardless of leisure physical activity, age, and social class. Conclusions: In adults, sedentary behavior during recreational screen time on working days is adversely associated with perceived ill health in men, irrespective of leisure time physical activity. Public health interventions could benefit from promoting a reduction in leisure screen sitting time after working hours.
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PURPOSE: This paper analyses the effects of temporary employment on work stress and mental health before (2006/2007) and during the economic recession (2011/2012), and examines whether the economic recession worsened these two health outcomes. METHODS: To control for selection bias, propensity scores (PS) are computed separately for salaried men and women using microdata from two cross-sectional health surveys in Spain, considering temporary (treatment group) versus permanent employment (control group). Next, we use difference-in-difference estimators stratifying by age, education level, and regional unemployment differences using PS as weights. RESULTS: Our results indicate that salaried worker with a temporary labour contract tends to have similar levels of high work stress and poorer mental health (only for men) than permanent ones for both periods. The economic recession does not appear to worsen both outcomes. However, when stratifying the sample, the economic recession is responsible for increasing stress among older temporary workers and male university graduates, without affecting women. Regarding mental health, we only find evidence of a negative impact of the economic recession on male temporary workers with university education. CONCLUSION: The economic recession has not affected poor mental health, but it has accentuated the adverse effects of work stress among some specific subgroups of male workers. These subgroups require specific preventive and support actions as the Spanish firms have not substantially changed their hiring practices after the recession.
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Recessão Econômica/estatística & dados numéricos , Emprego/estatística & dados numéricos , Saúde Mental/estatística & dados numéricos , Estresse Ocupacional/epidemiologia , Adulto , Estudos Transversais , Emprego/psicologia , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Espanha/epidemiologia , Desemprego/psicologia , Desemprego/estatística & dados numéricosRESUMO
It has been highlighted that the original article.