RESUMO
In an increasingly urbanized world, where cardiometabolic issues in cities have raised public health concerns, urban greenness is known to be beneficial for some of the most common health issues. However, the examination of the contribution of sex and gender regarding the benefits of urban greenness for people's cardiometabolic health is lacking. For that reason, we conducted a systematic review of previous literature on the topic following the PRISMA methodology. Additionally, we assessed the quality of the included articles, which we found satisfactory as most papers were of very good or good quality. We explored the relationship between urban greenness exposure and cardiovascular risk factors, cardiovascular diseases, and mortality from cardiovascular diseases. Results suggest that urban greenness is protective against cardiovascular risk factors, diseases, and mortality. When stratifying results by sex and gender, findings point to urban greenness being more beneficial for women and females in stroke and cardiovascular risk factors, except for hypertension and lipid accumulation product. On the other hand, males were more protected by urban greenness in terms of cardiovascular diseases and CVD-related mortality, thus proving that sex and gender health inequalities exist. Furthermore, looking towards the future, research needs to use the proper terminology for sex and gender and policy makers should design urban greenness with a gender perspective.
Assuntos
Doenças Cardiovasculares , Feminino , Humanos , Doenças Cardiovasculares/epidemiologia , CidadesRESUMO
BACKGROUND: In recent years, research has been increasingly devoted to understanding the complex human health-environment relationship. Nevertheless, many different measurements have been applied to characterize the environment. Among them, the application of Land Use and Land Cover (LULC) data is becoming more noticeable over time. AIMS: This research aims to analyse the reliability of Land Use and Land Cover data (LULC) data as a suitable describer of the environment in studies relating human health to the environment. With a specific focus on the methodologies using LULC data, we also examine the study designs and analytical methods that have been commonly performed so far. MATERIALS AND METHODS: We gathered studies relating human health outcomes to Land Use and Land Cover (LULC) data. A Boolean search limited to reviews was conducted in February 2019 using Web of Science Core Collection search engines. Five reviews were selected as our preliminary starting set of literature and from those, two backward snowballing searches were conducted. The first backward snowballing search used the reference lists of the first 5 reviews and revealed 17 articles. From these, the second search gathered 24 new articles also fulfilling the inclusion criteria established. In total, 41 articles were examined. RESULTS: Our main results reported that Land Use and Land Cover (LULC) data national level data was preferred over LULC international level data. However, this tendency seems to be strongly related to the specific aims of the articles. They essentially defined the living environment either through buffer zones, using the administrative boundaries wherein the individuals reside, or using the specific location of the individuals assessed. As for the characterization of the environment, authors performed 4 principal methodologies: extracting the percentage of green space, computing the "Land Use mix", recording the type of land cover, and using the percentage of tree canopy. Besides, all the articles included measurements in urban contexts and most of them evaluated the accessibility of individuals to their surroundings. Furthermore, it was clearly stated that the complexity of the topic and the challenging data leads authors to carry out advanced statistical methods and mostly cross-sectional designs with no causal relations. DISCUSSION AND CONCLUSIONS: Land Use and Land Cover (LULC) data has been demonstrated to be a versatile tool supporting both local-focused studies with few individuals involved and broad territorial-scoped studies with huge populations. Promising synergy has been highlighted between Electronic Health Records (EHR) and LULC data in studies dealing with massive information and broader scopes with regards to the assessment of territorial realities. As this emerging topic matures, investigators should (1) elucidate subjects of ongoing debate such as the measurement of the living environment and its characterization; (2) explore the whole potential of LULC data, using methodologies that encompass both their biophysical and socioeconomic information; (3) perform innovative designs that are able to establish causal relationships among the studied variables (for example, Cellular Automata models), and (4) expand the current set of studied health outcomes leveraging comprehensive and trustworthy health data sources such as EHR.
Assuntos
Meio Ambiente , Estudos Transversais , Humanos , Reprodutibilidade dos TestesRESUMO
There is mounting scientific evidence that greenness is associated with improved cardiovascular health. However, few studies have distinguished between vegetation type, measured perceived green space access, or investigated heterogeneity of associations across categories of neighborhood sociodemographic and racial/ethnic composition. We conducted an ecologic spatial analysis of associations of three objective measures of greenness (percent vegetation cover, percent tree canopy cover, and greenness density), and one measure of perceived access to green spaces with census tract level percentages of the adult population who were obese, ever had a high blood pressure diagnosis, and ever had a diabetes diagnosis, in the city of Philadelphia, PA, year 2013. We explored effect modification by census-tract level percent living in poverty and percent non-Hispanic Black categories. We used data from the Southeastern Pennsylvania Household Health Survey (SEPAHH) linked with high-resolution landcover, remotely sensed, and American Community Survey data and estimated associations using spatial lag models. We observed modest protective associations between percent of the adult population reporting perceived access to green spaces and percent with the cardiovascular risk factors, particularly in moderate and high poverty census tracts. Percent tree canopy cover was also protective against the cardiovascular risk factors, particularly in census tracts with low percentages of the population living in poverty and with low percent non-Hispanic Black populations. These results suggest that perceived access to green spaces and objectively measured high tree canopy cover, may protect against cardiovascular disease, but associations may vary across neighborhood sociodemographic categories.
Assuntos
Doenças Cardiovasculares , Adulto , Doenças Cardiovasculares/epidemiologia , Cidades , Fatores de Risco de Doenças Cardíacas , Humanos , Philadelphia/epidemiologia , Características de Residência , Fatores de Risco , Análise EspacialRESUMO
Global change is shaping social-ecological systems, threatening both natural and socio-economic ecosystems as a whole. Landscapes with combined nature-human interactions are particularly vulnerable to changing climatic conditions. Therefore, there is a need to find viable and practical solutions for the preservation and recovery of the affected systems. A relevant way to cope with disturbances is to promote social-ecological resilience through the use of strategies targeting the social-ecological system as a whole, in order to ensure an efficient self-reorganization of a landscape. This study presents a research innovation by clarifying the concept of social-ecological resilience while being focused on providing a useful tool for landscape managers. For doing so, the research first defines social-ecological resilience and aims to give a clear idea of its characteristics and application features. Second, it explains the importance of social-ecological resilience for landscapes, focusing on the relationship of humans with nature and traditional ecological knowledge (TEK) for biodiversity conservation. Third, it proposes guidelines and measures for the promotion and enhancement of social-ecological resilience. The outcomes of the study show a broad perspective on the concept of social-ecological resilience to understand the necessary adaptation to global change. As findings, this research highlights the significance of nature-human interactions for agroforestry systems, citing also the potential contribution that digital innovation can play for the conservation of those interactions in a sustainable way. Moreover, it uncovers the key role of local communities in building social-ecological resilience through the application of a variety of described strategies that can have a relevant impact and be useful for landscape management practices to face upcoming challenges linked to climate change.
Assuntos
Mudança Climática , Ecossistema , Humanos , Conservação dos Recursos Naturais , BiodiversidadeRESUMO
The use of Land use and Land cover (LULC) data is gradually becoming more widely spread in studies relating the environment to human health. However, little research has acknowledged the compositional nature of these data. The goal of the present study is to explore, for the first time, the independent effect of eight LULC categories (agricultural land, bare land, coniferous forest, broad-leaved forest, sclerophyll forest, grassland and shrubs, urban areas, and waterbodies) on three selected common health conditions: type 2 diabetes mellitus (T2DM), asthma and anxiety, using a compositional methodological approach and leveraging observational health data of Catalonia (Spain) at area level. We fixed the risk exposure scenario using three covariates (socioeconomic status, age group, and sex). Then, we assessed the independent effect of the eight LULC categories on each health condition. Our results show that each LULC category has a distinctive effect on the three health conditions and that the three covariates clearly modify this effect. This compositional approach has yielded plausible results supported by the existing literature, highlighting the relevance of environmental heterogeneity in health studies. In this sense, we argue that different types of environment possess exclusive biotic and abiotic elements affecting distinctively on human health. We believe our contribution might help researchers approach the environment in a more multidimensional manner integrating environmental heterogeneity in the analysis.
Assuntos
Diabetes Mellitus Tipo 2 , Agricultura , Conservação dos Recursos Naturais , Monitoramento Ambiental , Humanos , EspanhaRESUMO
The heterogenous distribution of both COVID-19 incidence and mortality in Catalonia (Spain) during the firsts moths of the pandemic suggests that differences in baseline risk factors across regions might play a relevant role in modulating the outcome of the pandemic. This paper investigates the associations between both COVID-19 incidence and mortality and air pollutant concentration levels, and screens the potential effect of the type of agri-food industry and the overall land use and cover (LULC) at area level. We used a main model with demographic, socioeconomic and comorbidity covariates highlighted in previous research as important predictors. This allowed us to take a glimpse of the independent effect of the explanatory variables when controlled for the main model covariates. Our findings are aligned with previous research showing that the baseline features of the regions in terms of general health status, pollutant concentration levels (here NO2 and PM10), type of agri-food industry, and type of land use and land cover have modulated the impact of COVID-19 at a regional scale. This study is among the first to explore the associations between COVID-19 and the type of agri-food industry and LULC data using a population-based approach. The results of this paper might serve as the basis to develop new research hypotheses using a more comprehensive approach, highlighting the inequalities of regions in terms of risk factors and their response to COVID-19, as well as fostering public policies towards more resilient and safer environments.
Assuntos
Poluentes Atmosféricos , Poluição do Ar , COVID-19 , Poluentes Atmosféricos/análise , Poluição do Ar/análise , Humanos , Incidência , Material Particulado/análise , Fatores de Risco , SARS-CoV-2 , Espanha/epidemiologia , Fatores de TempoRESUMO
The current body of literature points monoterpenes as one of the determinant factors of the interaction between forests and human health. The present study aims at analyzing the monoterpene absorption by humans during a 2 -hs forest exposure in a Mediterranean holm oak forest focusing on the four most abundant monoterpene compounds: alpha-pinene, beta-pinene, alpha-phellandrene and limonene. Participants' blood samples were collected before and after exposure to forest or urban environment (control). We conducted air and blood sampling using cartridges and head space method and determined the monoterpene compounds through CGMS. We identified the four compounds in forest air during the experimental study being alpha-pinene the monoterpene with the greatest concentration. Results show no significant changes in monoterpene blood concentrations for the forest and control group. However, a negative significant relationship between absorption and baseline blood concentration of the most abundant forest air monoterpenes, alpha-pinene and beta-pinene, was found in individuals visiting the forest, i.e. higher absorption was found the lower the baseline blood concentration was. Although no significant lineal correlation could be spotted between the vital variables and the monoterpene absorption, we found significant correlations between the absorption of the monoterpene compounds. This attempt, first in a Mediterranean holm oak forest, can serve as a starting point and constitute a valuable contribution for further research in regard to experimental design and laboratory analysis.
Assuntos
Quercus , Florestas , Humanos , MonoterpenosRESUMO
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.
Assuntos
Exercício Físico , Parques Recreativos , Adulto , Humanos , Obesidade/epidemiologia , EspanhaRESUMO
Monoterpenes have been identified as potential determinants of the human health effects induced by forest exposure. The present study characterizes the total monoterpene concentrations at nose height in a Mediterranean Holm oak forest located in North-East Iberian Peninsula during the annual emission peak (summer and autumn: June to November) using a Proton Transfer Reaction-Mass Spectrometry (PTR-MS). Results show a strong variability of the total monoterpene concentrations in season and daytime. The concentration peak appears during July and August. These two months displayed two average maxima in their diel cycles: One during early morning (from 6:00 to 8:00, 0.30 ppbv for July and 0.41 ppbv for August) and another one at early afternoon (from 13:00 to 15:00, 0.27 ppbv during July and 0.32 ppbv during August). Monoterpene concentrations were strongly related with the temperature (exponentially) and solar radiation (rectangular hyperbolic relationship). The concentrations registered here are similar or higher than in previous ex situ studies showcasing the effects of forests on human health. These findings provide relevant data for the scientific and healthcare community by improving the understanding of monoterpene dynamics at nose height and suggesting further research on the effects of forests on human health, particularly in the Mediterranean region.
Assuntos
Florestas , Monoterpenos , Monitoramento Ambiental , Europa (Continente) , Humanos , Monoterpenos/análise , Estações do Ano , ÁrvoresRESUMO
The potential of forests as a source of health has been addressed by the scientific community and is now being considered in national forest strategies, management plans and policies. Studies identifying the mechanisms by which forest characteristics may induce these effects on human health are nevertheless scarce. This systematic review of literature on forests and human health with real-life human exposure was conducted to assess the extent to which forests have been studied and described in detail and the extent to which relationships between forest variables and health effects have been reported. The analysis underlines the lack of forest descriptions in 19.35% of the 62 studies selected for review as well as the high heterogeneity of forest variables' description. Patterns among the articles could not be identified correlating the broader forest variable (forest type) and the most studied health variables identified (blood pressure, pulse rate or/and cortisol levels). These findings, together with previous ex situ researches, suggest the need to ameliorate and incorporate more accurate descriptions of forest variables within human health studies to provide data for forest management and the potential use of these habitats for preventive medicine and clinical practice guidelines.
Assuntos
Ecossistema , Florestas , Saúde , Pressão Sanguínea , Frequência Cardíaca , Humanos , Políticas , ÁrvoresRESUMO
Numerous studies show the benefits that contact with the natural environment have for human health, but there are few studies on the role of Protected Natural Areas (PNAs), either from the preventive point of view or on their potential benefits, on individuals with health problems. A study was made of the relationship between the visitation of Montseny Natural Park and Biosphere Reserve and health, from the perspective of a population group with different diseases. A total of 250 patients resident in the areas near the park were surveyed, recording their beliefs about the benefits of nature, as well as the reasons for visiting and the activities associated with health that they carried out in the park. The pure air is the most valued benefit (27.2%), particularly for those with allergies. The majority (57%) visit the park for health reasons. High levels (82%) of exercise are recorded, especially by patients with heart diseases (85%), and 65% exercised in the park. More physical activity is mentioned among those that visit the park most often, particularly among those that carried it out for health reasons. Plants were collected for medicinal use by 39.6%. The study confirmed the significant role of the Montseny Natural Park and Biosphere Reserve as a health resource for individuals with diseases that live near it. It also corroborates the beneficial effects that the PNA provide in human health.