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BACKGROUND: Child pedestrian injury is a public health and health equality challenge worldwide, including in high-income countries. However, child pedestrian safety is less-understood, especially over long time spans. The intent of this study is to understand factors affecting child pedestrian safety in England over the period 2011-2020. METHODS: We conducted an area-level study using a Bayesian space-time interaction model to understand the association between the number of road crashes involving child pedestrians in English Local Authorities and a host of socio-economic, transport-related and built-environment variables. We investigated spatio-temporal trends in child pedestrian safety in England over the study period and identified high-crash local authorities. RESULTS: We found that child pedestrian crash frequencies increase as child population, unemployment-related claimants, road density, and the number of schools increase. Nevertheless, as the number of licensed vehicles per capita and zonal-level walking/cycling increase, child pedestrian safety increases. Generally, child pedestrian safety has improved in England since 2011. However, the socio-economic inequality gap in child pedestrian safety has not narrowed down. In addition, we found that after adjusting for the effect of covariates, the rate of decline in crashes varies between local authorities. The presence of localised risk factors/mitigation measures contributes to variation in the spatio-temporal patterns of child pedestrian safety. CONCLUSIONS: Overall, southern England has experienced more improvement in child pedestrian safety over the last decade than the northern regions. Our study revealed socio-economic inequality in child pedestrian safety in England. To better inform safety and public health policy, our findings support the importance of a targeted system approach, considering the identification of high-crash areas while keeping track of how child pedestrian safety evolves over time.
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Peatones , Humanos , Niño , Teorema de Bayes , Ciclismo , Inglaterra/epidemiología , Análisis Espacio-TemporalRESUMEN
Experiencing outdoor space, especially natural space, during childhood and adolescence has beneficial physical and mental health effects, including improved cognitive and motor skills and a lower risk of obesity. Since school-age children typically spend 35-40 hours per week at schools, we quantified their access to open (non-built-up) space and green space at schools in Greater London. We linked land use information from the UK Ordnance Survey with school characteristics from the Department for Education (DfE) for schools in Greater London. We estimated open space by isolating land and water features within school boundaries and, as a subset of open space, green space defined as open space covered by vegetation. We examined the relationship of both school open and green space with distance to Central London, whether the school was fee-paying, and the percentage of pupils eligible for free school meals (as a school-level indicator of socioeconomic status). Almost 400,000 pupils (30% of all pupils in London) attended schools with less than ten square metre per pupil of open space-the minimum recommended area by DfE-and 800,000 pupils attended schools with less than ten square metre per pupil of green space. Of the latter, 70% did not have any public parks in the immediate vicinity of their schools. School green space increased with distance from Central London. There was a weak association between the school-level socioeconomic indicator and the amount of open and green space. Fee-paying schools provided less open space compared to non-fee-paying schools in central parts of London, but the provision became comparable in suburban London. Many London schools do not provide enough open and green space. There is a need to ensure regular contact with green space through safeguarding school grounds from sales, financially supporting disadvantaged schools to increase their outdoor space and providing access to off-site facilities such as sharing outdoor space with other schools.
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Parques Recreativos , Instituciones Académicas , Adolescente , Niño , Humanos , Londres , Clase Social , Factores SocioeconómicosRESUMEN
INTRODUCTION: Child pedestrian safety remains a challenge despite the remarkable progress that has been attained in recent years, particularly, in high income jurisdictions such as London. This study sought to identify and quantify the magnitude of the effects of various explanatory variables, from the domains of transport, built and natural environment, socio-demographic and economic factors, on ward level child pedestrian injury frequencies in Greater London. METHOD: We adopted a multilevel random parameters model to investigate the factors associated with child pedestrian injuries given the hierarchical nature of the data comprising of wards nested within boroughs. RESULTS: We found that crime, the Black, Asian, and Minority Ethnic (BAME) population, school enrollment, and the proportion of the population who walk five times a week had an increasing effect on the number of child pedestrian casualties. Conversely, the proportion of the population with a level 4 qualification and the number of cars per household had a decreasing effect. CONCLUSIONS: Our study identified high child pedestrian injury frequency wards and boroughs: Stratford and New Town had the highest expected child pedestrian injury frequencies followed by Selhurst, Westend, and Greenford Broadway. Some inner London boroughs are among the highest injury frequency areas; however, a higher number of high child pedestrian injury boroughs are in outer London. PRACTICAL APPLICATIONS: The paper provides recommendations for policy makers for targeted child pedestrian safety improvement interventions and prioritization to optimize the utilization of often constrained resources. The study also highlights the importance of considering social inequities in policies that aim at improving child traffic safety.
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Peatones , Heridas y Lesiones , Niño , Humanos , Accidentes de Tránsito , Londres , Etnicidad , Hospitales , Caminata/lesiones , Heridas y Lesiones/epidemiologíaRESUMEN
Urban environments influence child behaviours, exposures and experiences and may affect health, development, achievement and realization of fundamental human rights. We examined the status of eleven UN Convention on the Rights of the Child articles, in a multi-case study across four global cities. Within all study cities, children experienced unequal exposure to urban environmental risks and amenities. Many violations of child rights are related to car-based transportation systems and further challenged by pressures on urban systems from rapid population increases in the context of climate change. A child rights framework provides principles for a collective, multi-sectoral re-imagination of urban environments that support the human rights of all citizens.
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Cambio Climático , Niño , Humanos , CiudadesRESUMEN
Creating healthy environments around schools is important to promote healthy childhood development and is a critical component of public health. In this paper we present a tool to characterize exposure to multiple urban environment features within 400 m (5-10 min walking distance) of schools in Greater London. We modelled joint exposure to air pollution (NO2 and PM2.5), access to public greenspace, food environment, and road safety for 2,929 schools, employing a Bayesian non-parametric approach based on the Dirichlet Process Mixture modelling. We identified 12 latent clusters of schools with similar exposure profiles and observed some spatial clustering patterns. Socioeconomic and ethnicity disparities were manifested with respect to exposure profiles. Specifically, three clusters (containing 645 schools) showed the highest joint exposure to air pollution, poor food environment, and unsafe roads and were characterized with high deprivation. The neighbourhood of the most deprived cluster of schools had a median of 2.5 ha greenspace, 29.0 µg/m3 of NO2, 19.3 µg/m3 of PM2.5, 20 fast food retailers, and five child pedestrian crashes over a three-year period. The neighbourhood of the least deprived cluster of schools had a median of 21.8 ha greenspace, 15.6 µg/m3 of NO2, 15.1 µg/m3 of PM2.5, 2 fast food retailers, and one child pedestrian crash over a three-year period. To have a school-level understanding of exposure levels, we then benchmarked schools based on the probability of exceeding the median exposure to various features of interest. Our study accounts for multiple exposures, enabling us to highlight spatial distribution of exposure profile clusters, and to identify predominant exposure to urban environment features for each cluster of schools. Our findings can help relevant stakeholders, such as schools and public health authorities, to compare schools based on their exposure levels, prioritize interventions, and design local policies that target the schools most in need.
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Contaminantes Atmosféricos , Contaminantes Atmosféricos/análisis , Teorema de Bayes , Niño , Humanos , Londres , Dióxido de Nitrógeno/análisis , Material Particulado/análisis , Instituciones AcadémicasRESUMEN
Despite several national and local policies towards cleaner air in England, many schools in London breach the WHO-recommended concentrations of air pollutants such as NO2 and PM2.5. This is while, previous studies highlight significant adverse health effects of air pollutants on children's health. In this paper we adopted a Bayesian spatial hierarchical model to investigate factors that affect the odds of schools exceeding the WHO-recommended concentration of NO2 (i.e., 40 µg/m3 annual mean) in Greater London (UK). We considered a host of variables including schools' characteristics as well as their neighbourhoods' attributes from household, socioeconomic, transport-related, land use, built and natural environment characteristics perspectives. The results indicated that transport-related factors including the number of traffic lights and bus stops in the immediate vicinity of schools, and borough-level bus fuel consumption are determinant factors that increase the likelihood of non-compliance with the WHO guideline. In contrast, distance from roads, river transport, and underground stations, vehicle speed (an indicator of traffic congestion), the proportion of borough-level green space, and the area of green space at schools reduce the likelihood of exceeding the WHO recommended concentration of NO2. We repeated our analysis under a hypothetical scenario in which the recommended concentration of NO2 is 35 µg/m3 - instead of 40 µg/m3. Our results underscore the importance of adopting clean fuel technologies on buses, installing green barriers, and reducing motorised traffic around schools in reducing exposure to NO2 concentrations in proximity to schools. Also, our findings highlight the presence of environmental inequalities in the Greater London area. This study would be useful for local authority decision making with the aim of improving air quality for school-aged children in urban settings.
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Contaminantes Atmosféricos , Contaminación del Aire , Contaminantes Atmosféricos/análisis , Contaminación del Aire/análisis , Teorema de Bayes , Niño , Exposición a Riesgos Ambientales/análisis , Monitoreo del Ambiente , Humanos , Londres , Dióxido de Nitrógeno/análisis , Material Particulado/análisis , Instituciones Académicas , Organización Mundial de la SaludRESUMEN
Visiting parks and gardens supports physical and mental health. We quantified access to public parks and gardens in urban areas of England and Wales, and the potential for park crowdedness during periods of high use. We combined data from the Office for National Statistics and Ordnance Survey to quantify (i) the number of parks within 500 and 1,000 metres of urban postcodes (i.e., availability), (ii) the distance of postcodes to the nearest park (i.e., accessibility), and (iii) per-capita space in each park for people living within 1,000m. We examined variability by city and share of flats. Around 25.4 million people (~87%) can access public parks or gardens within a ten-minute walk, while 3.8 million residents (~13%) live farther away; of these 21% are children and 13% are elderly. Areas with a higher share of flats on average are closer to a park but people living in these areas visit parks that are potentially overcrowded during periods of high use. Such disparity in urban areas of England and Wales becomes particularly evident during COVID-19 pandemic and lockdown when local parks, the only available out-of-home space option, hinder social distancing requirements. Cities aiming to facilitate social distancing while keeping public green spaces safe might require implementing measures such as dedicated park times for different age groups or entry allocation systems that, combined with smartphone apps or drones, can monitor and manage the total number of people using the park.
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Betacoronavirus , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Planificación Ambiental , Jardines , Control de Infecciones/métodos , Pandemias/prevención & control , Parques Recreativos , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Adolescente , Adulto , Anciano , COVID-19 , Niño , Preescolar , Ciudades/epidemiología , Infecciones por Coronavirus/virología , Inglaterra/epidemiología , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Neumonía Viral/virología , Instalaciones Públicas , SARS-CoV-2 , Población Urbana , Gales/epidemiología , Caminata , Adulto JovenRESUMEN
Various statistical tests on concentration data serve to support decision-making regarding characterization and monitoring of contaminated media, assessing exposure to a chemical, and quantifying the associated risks. However, the routine statistical protocols cannot be directly applied because of challenges arising from nondetects or left-censored observations, which are concentration measurements below the detection limit of measuring instruments. Despite the existence of techniques based on survival analysis that can adjust for nondetects, these are seldom taken into account properly. A comprehensive review of the literature showed that managing policies regarding analysis of censored data do not always agree and that guidance from regulatory agencies may be outdated. Therefore, researchers and practitioners commonly resort to the most convenient way of tackling the censored data problem by substituting nondetects with arbitrary constants prior to data analysis, although this is generally regarded as a bias-prone approach. Hoping to improve the interpretation of concentration data, the present article aims to familiarize researchers in different disciplines with the significance of left-censored observations and provides theoretical and computational recommendations (under both frequentist and Bayesian frameworks) for adequate analysis of censored data. In particular, the present article synthesizes key findings from previous research with respect to 3 noteworthy aspects of inferential statistics: estimation of descriptive statistics, hypothesis testing, and regression analysis. Environ Toxicol Chem 2018;37:643-656. © 2017 SETAC.
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Interpretación Estadística de Datos , Límite de Detección , Teorema de Bayes , Humanos , Análisis de Regresión , Proyectos de InvestigaciónRESUMEN
In a typical data collection process for the purpose of characterizing contaminated sites, boreholes are usually drilled in different locations based on a sampling plan; and consequently, multiple samples are collected from each borehole. As a result, it is quite plausible that a certain degree of dependency or similarity exists among observations nested within a borehole. However, when classical regression models are employed, such dependencies are often ignored, resulting in biased estimates. In site characterization studies, further complication arises due to the presence of left-censored observations, those falling below the detection limit of measuring instruments. To overcome the above issues, this paper employs a mixed effects model that allows accounting for the within-borehole data dependency while accommodating left-censored concentrations. The benefits of the adopted methodology are explored by analyzing concentration data obtained from characterization study of a brownfield site located in Montreal, Canada. This paper illustrates that the estimated within-borehole correlation can be used to determine the optimal number of boreholes as well as the sample size to be collected from each borehole. Such correlation is underestimated when censored values are not accommodated in the model but substituted with a constant prior to data analysis. In addition, the adopted methodology provides an accurate insight into the vertical extent of contamination that can result in different compliance decisions when compared with classical approach.
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Interpretación Estadística de Datos , Monitoreo del Ambiente/métodos , Contaminantes Ambientales/análisis , Modelos Teóricos , Canadá , Simulación por Computador , Humanos , Límite de DetecciónRESUMEN
Left-censored concentration data are frequently encountered because measuring instruments cannot detect concentrations below the instrument detection limit. For statistical analysis of left-censored data, the environmental literature mainly refers to the following methods: maximum likelihood estimator, regression on order statistics using log-normal and gamma assumption (rROS and GROS, respectively), and Kaplan-Meier. A number of simulation experiments examined the performance of these methods in terms of bias and/or mean square error. However, no matter which method is adopted, some uncertainty is introduced into outcomes because all that is known about a left-censored observation is that the concentration falls between 0 and the detection limit. The data used in the present study come from analysis of soil samples collected for a site characterization in Montreal, Canada. Employing nonparametric bootstrap, the authors quantify the uncertainty and bias in the mean and standard deviation estimates obtained by the maximum likelihood estimation (under log-normal, Weibull, and gamma distributions), rROS, GROS, and Kaplan-Meier methods. First, the authors demonstrate that the highest uncertainty is associated with the maximum likelihood estimator under log-normality and Weibull assumptions, whereas a gamma assumption leads to estimates with less uncertainty. Second, the authors show that although an increase in sample size improves the uncertainty, it reduces the bias only in the rROS, GROS, and Kaplan-Meier methods. Finally, comparing percentage uncertainty in the mean of contaminant data, the authors illustrate that adopting an inappropriate estimator results in large uncertainties. Environ Toxicol Chem 2016;35:2623-2631. © 2016 SETAC.
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Monitoreo del Ambiente/estadística & datos numéricos , Contaminantes del Suelo/análisis , Suelo/química , Canadá , Interpretación Estadística de Datos , Funciones de Verosimilitud , Límite de Detección , Tamaño de la Muestra , Suelo/normas , IncertidumbreRESUMEN
In environmental studies, concentration measurements frequently fall below detection limits of measuring instruments, resulting in left-censored data. Some studies employ parametric methods such as the maximum likelihood estimator (MLE), robust regression on order statistic (rROS), and gamma regression on order statistic (GROS), while others suggest a non-parametric approach, the Kaplan-Meier method (KM). Using examples of real data from a soil characterization study in Montreal, we highlight the need for additional investigations that aim at unifying the existing literature. A number of studies have examined this issue; however, those considering data skewness and model misspecification are rare. These aspects are investigated in this paper through simulations. Among other findings, results show that for low skewed data, the performance of different statistical methods is comparable, regardless of the censoring percentage and sample size. For highly skewed data, the performance of the MLE method under lognormal and Weibull distributions is questionable; particularly, when the sample size is small or censoring percentage is high. In such conditions, MLE under gamma distribution, rROS, GROS, and KM are less sensitive to skewness. Related to model misspecification, MLE based on lognormal and Weibull distributions provides poor estimates when the true distribution of data is misspecified. However, the methods of rROS, GROS, and MLE under gamma distribution are generally robust to model misspecifications regardless of skewness, sample size, and censoring percentage. Since the characteristics of environmental data (e.g., type of distribution and skewness) are unknown a priori, we suggest using MLE based on gamma distribution, rROS and GROS.