The neighborhood food environment modifies the association between infant feeding and childhood obesity.

BACKGROUND: The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) issues infant formula to infants who are not fully breastfed, and prior research found elevated obesity risk among children receiving lactose-reduced infant formula with corn syrup solids (CSSF) issued by WIC. This study was conducted to evaluate associations between a broader set of specialty infant formulas issued by WIC and child obesity risk, whether neighborhood context (e.g. neighborhood food environment) modifies associations, and whether racial/ethnic disparities in obesity are partly explained by infant formula exposure and neighborhood context. METHODS: WIC administrative data, collected from 2013-2020 on issued amount (categorical: fully formula fed, mostly formula fed, mostly breastfed, fully breastfed) and type of infant formula (standard cow's milk formula, and three specialty formulas: any CSSF, any soy-based formula, and any cow's milk-based formula with added rice starch) and obesity at ages 2-4 years (defined as a Body Mass Index z-score ≥ 95th percentile according to World Health Organization growth standard) were used to construct a cohort (n = 59,132). Associations of infant formula exposures and race/ethnicity with obesity risk were assessed in Poisson regression models, and modification of infant feeding associations with obesity by neighborhood context was assessed with interaction terms. RESULTS: Any infant formula exposure was associated with significantly higher obesity risk relative to fully breastfeeding. Receipt of a CSSF was associated with 5% higher obesity risk relative to the standard and other specialty infant formulas (risk ratio 1.05, 95% confidence interval 1.02, 1.08) independent of breastfeeding duration and receipt of other specialty infant formulas. The association between CSSF and obesity risk was stronger in neighborhoods with healthier food environments (10% higher risk) compared to less healthy food environments (null). Racial/ethnic disparities in obesity risk were robust to adjustment for infant formula exposure and neighborhood environment. CONCLUSIONS: Among specialty infant formulas issued by WIC, only CSSFs were associated with elevated obesity risk, and this association was stronger in healthier food environments. Future research is needed to isolate the mechanism underlying this association.

Association between school context and occurrence of multiple sexual partners: cross-sectional study with multilevel analysis. / Associação entre o contexto escolar e a ocorrência de múltiplos parceiros sexuais: um estudo transversal com análise multinível.

The objective was to investigate the association between the school context and the occurrence of multiple partners among adolescents, considering individual variables (age, gender, Bolsa Família, LGB, early sexual initiation and use of alcohol or drugs in the last sex). Cross-sectional study with multilevel analysis carried out in 2018 with adolescent students from Olinda, Brazil. The variable (multiple partners) was collected based on the 'Youth Risk Behavior Survey' questionnaire. School context variables were time in school (regular school vs. full/semi-full school) and the Social Vulnerability Index of the school district. Of 2,500 participants, 1,044 were analyzed for being sexually active and most had two or more partners (63.89%). Regular school students were more likely (OR 1.47, CI 1.10-1.97) to have multiple sexual partners compared to those in full-day schools/half-day schools. However, no association was found in relation to the SVI of the schools' neighborhoods (OR 1.18, IC 0.82-1.70). More time spent at school was associated with fewer chances of multiple sexual partners, while studying in schools located in highly vulnerable neighborhoods was not associated with the occurrence of multiple sexual partners among adolescents.

O estudo investiga a associação entre o contexto escolar e a ocorrência de múltiplos parceiros entre adolescentes, considerando as variáveis individuais. Estudo transversal com análise multinível, realizado no período de fevereiro a junho de 2018 com estudantes de 14 a 19 anos. A variável desfecho (múltiplos parceiros sexuais) foi coletada com base no questionário Youth Risk Behavior Survey (YRBS). As variáveis do contexto escolar foram tempo na escola (escola regular vs escola integral/semi-integral) e índice de vulnerabilidade social (IVS) do bairro onde a escola está localizada. De 2.500 participantes, 1.044 foram analisados por serem sexualmente ativos. A maioria dos adolescentes (63,89%) teve dois ou mais parceiros. Estudantes de escola regular (mínimo de 4h diárias) tiveram mais chances (OR 1.47, IC 1.10-1.97) de terem múltiplos parceiros sexuais quando comparados àqueles de escola integral/semi-integral (mínimo de 7h diárias). Porém, não houve associação em relação ao IVS dos bairros das escolas (OR 1.18, IC 0.82-1.70). Maior tempo na escola esteve associado a menor chance de múltiplos parceiros sexuais, enquanto estudar em escolas localizadas em bairro de alta vulnerabilidade não esteve associado à ocorrência de múltiplos parceiros sexuais entre adolescentes.

Multidimensional Approach to Exploring Neighborhood Determinants and Symptom Severity Among Individuals With Psychosis.

Importance: The impact of cumulative exposure to neighborhood factors on psychosis, depression, and anxiety symptom severity prior to specialized services for psychosis is unknown. Objective: To identify latent neighborhood profiles based on unique combinations of social, economic, and environmental factors, and validate profiles by examining differences in symptom severity among individuals with first episode psychosis (FEP). Design, Setting, and Participants: This cohort study used neighborhood demographic data and health outcome data for US individuals with FEP receiving services between January 2017 and August 2022. Eligible participants were between ages 14 and 40 years and enrolled in a state-level coordinated specialty care network. A 2-step approach was used to characterize neighborhood profiles using census-tract data and link profiles to mental health outcomes. Data were analyzed March 2023 through October 2023. Exposures: Economic and social determinants of health; housing conditions; land use; urbanization; walkability; access to transportation, outdoor space, groceries, and health care; health outcomes; and environmental exposure. Main Outcomes and Measures: Outcomes were Community Assessment of Psychic Experiences 15-item, Patient Health Questionnaire 9-item, and Generalized Anxiety Disorder 7-item scale. Results: The total sample included 225 individuals aged 14 to 36 years (mean [SD] age, 20.7 [4.0] years; 152 men [69.1%]; 9 American Indian or Alaska Native [4.2%], 13 Asian or Pacific Islander [6.0%], 19 Black [8.9%], 118 White [55.1%]; 55 Hispanic ethnicity [26.2%]). Of the 3 distinct profiles identified, nearly half of participants (112 residents [49.8%]) lived in urban high-risk neighborhoods, 56 (24.9%) in urban low-risk neighborhoods, and 57 (25.3%) in rural neighborhoods. After controlling for individual characteristics, compared with individuals residing in rural neighborhoods, individuals residing in urban high-risk (mean estimate [SE], 0.17 [0.07]; P = .01) and urban low-risk neighborhoods (mean estimate [SE], 0.25 [0.12]; P = .04) presented with more severe psychotic symptoms. Individuals in urban high-risk neighborhoods reported more severe depression (mean estimate [SE], 1.97 [0.79]; P = .01) and anxiety (mean estimate [SE], 1.12 [0.53]; P = .04) than those in rural neighborhoods. Conclusions and Relevance: This study found that in a cohort of individuals with FEP, baseline psychosis, depression, and anxiety symptom severity differed by distinct multidimensional neighborhood profiles that were associated with where individuals reside. Exploring the cumulative effect of neighborhood factors improves our understanding of social, economic, and environmental impacts on symptoms and psychosis risk which could potentially impact treatment outcomes.

Social isolation and mental well-being among Korean older adults: a focus on living arrangements.

Introduction: The aging population in South Korea, characterized by an increasing number of older adults living alone, has raised concerns about its implications on mental health, specifically social isolation and loneliness that accompanies solitary living arrangements. This study explores the impact of living arrangements on the mental well-being of Korean older adults by focusing on the prevalence of depression and the role of social isolation in the context of evolving family structures and the COVID-19 pandemic. Methods: This cross-sectional study analyzed the responses of older adults aged 65 years and above (mean: 73.1, SD: 5.1) by using data from the Korea National Health and Nutrition Examination Survey conducted in 2018 and 2020. In total, responses from 3,365 older adults (1,653 in 2018 and 1,712 in 2020) were employed in this research. The participants' mental health status was assessed using the Patient Health Questionnaire-9, with living arrangements categorized by household size. A zero-inflated Poisson regression analysis was employed to investigate the relationship between living arrangements and depression severity, controlling for demographic, socioeconomic, and psychological factors. Results: The study found that older adults living with others exhibited a lower depression severity than those living alone. Notably, the severity of depression decreased as the number of household members increased up to a certain threshold. Socio-economic factors, such as income level, marital status, and psychological stress were also identified as significant predictors of depression severity. However, the COVID-19 pandemic did not have a statistically significant impact on depression rates among older adults during the study period. Conclusion: Living arrangements play a critical role in the mental health of Korean older adults, with solitary living being associated with higher levels of depression. These findings underscore the importance of social support systems and suggest the need for policies and interventions that promote social connectivity and address the challenges of loneliness faced by them. Future research should explore longitudinal and qualitative studies to further understand causal relationships and develop targeted interventions to improve the mental well-being of the aging population.

Association between residential environment and emotional wellbeing among older adults in China: the mediating effect of health lifestyle.

Introduction: The association between the residential environment and emotional wellbeing (EWB) in older adults has received extensive attention from gerontologists, especially during the COVID-19 pandemic; however, the mediating mechanism of how residential environment affects emotional wellbeing has not been fully explored. This study examined the effects of the residential environment on EWB and the mediating role of health lifestyle. Methods: This study analyzed the survey data of 493 rural and 515 urban older adults from 2021 Chinese General Social Survey. General linear regression and structural equation models were used to examine the effects of residential environment and health lifestyle. Results: Urban participants exhibited clear advantages in EWB, residential environment, and physical activity. Residential environment significantly affected the EWB of older adults, and health lifestyle played a mediating role in this relationship. The residential environment and health lifestyle did not significantly affect EWB in rural participants. Discussion: This study revealed differences in the effects of health lifestyles and residential environments on EWB among older adults in rural and urban settings in China. This study provided empirical evidence of mental health disparities between older rural and urban Chinese residents.

Spatial pattern analysis of the impact of community food environments on foetal macrosomia, preterm births and low birth weight.

Community food environments (CFEs) have a strong impact on child health and nutrition and this impact is currently negative in many areas. In the Republic of Argentina, there is a lack of research evaluating CFEs regionally and comprehensively by tools based on geographic information systems (GIS). This study aimed to characterize the spatial patterns of CFEs, through variables associated with its three dimensions (political, individual and environmental), and their association with the spatial distribution in urban localities in Argentina. CFEs were assessed in 657 localities with ≥5,000 inhabitants. Data on births and CFEs were obtained from nationally available open-source data and through remote sensing. The spatial distribution and presence of clusters were assessed using hotspot analysis, purely spatial analysis (SaTScan), Moran's Index, semivariograms and spatially restrained multivariate clustering. Clusters of low risk for LBW, macrosomia, and preterm births were observed in the central-east part of the country, while high-risk clusters identified in the North, Centre and South. In the central-eastern region, low-risk clusters were found coinciding with hotspots of public policy coverage, high night-time light, social security coverage and complete secondary education of the household head in areas with low risk for negative outcomes of the birth variables studied, with the opposite with regard to households with unsatisfied basic needs and predominant land use classes in peri-urban areas of crops and herbaceous cover. These results show that the exploration of spatial patterns of CFEs is a necessary preliminary step before developing explanatory models and generating novel findings valuable for decision-making.

Longitudinal Impacts of Precision Greenness on Alzheimer's Disease.

BACKGROUND: The potential for greenness as a novel protective factor for Alzheimer's disease (AD) requires further exploration. OBJECTIVES: This study assesses prospectively and longitudinally the association between precision greenness - greenness measured at the micro-environmental level, defined as the Census block - and AD incidence. DESIGN: Older adults living in consistently high greenness Census blocks across 2011 and 2016 were compared to those living in consistently low greenness blocks on AD incidence during 2012-2016. SETTING: Miami-Dade County, Florida, USA. PARTICIPANTS: 230,738 U.S. Medicare beneficiaries. MEASUREMENTS: U.S. Centers for Medicare and Medicaid Services Chronic Condition Algorithm for AD based on ICD-9 codes, Normalized Difference Vegetation Index, age, sex, race/ethnicity, neighborhood income, and walkability. RESULTS: Older adults living in the consistently high greenness tertile, compared to those in the consistently low greenness tertile, had 16% lower odds of AD incidence (OR=0.84, 95% CI: 0.76-0.94, p=0.0014), adjusting for age, sex, race/ethnicity, and neighborhood income. Age, neighborhood income and walkability moderated greenness' relationship to odds of AD incidence, such that younger ages (65-74), lower-income, and non-car dependent neighborhoods may benefit most from high greenness. CONCLUSIONS: High greenness, compared to low greenness, is associated with lower 5-year AD incidence. Residents who are younger and/or who reside in lower-income, walkable neighborhoods may benefit the most from high greenness. These findings suggest that consistently high greenness at the Census block-level, may be associated with reduced odds of AD incidence at a population level.

The Spatio-Temporal Distribution of Suicide-related Emergency Calls in a European City: Age and Gender Patterns, and Neighborhood Influences.

Objective: The aim of this study was to conduct a comprehensive spatio-temporal analysis of suicide-related emergency calls in the city of Valencia (Spain) over a six-year period. To this end we first examined age and gender patterns and, second, the influence of neighborhood characteristics on general and gender-specific spatio-temporal patterns of suicide-related emergency calls. Method: Geocoded data on suicide-related emergency calls between 2017 and 2022 (N = 10,030) were collected from the 112 emergency service in Valencia. Data were aggregated at the census block group level, used as a proxy for neighborhoods, and trimesters were considered as the temporal unit. Two set of analyses were performed: (1) demographic (age and gender) and temporal descriptive analyses and (2) general and gender-specific Bayesian spatio-temporal autoregressive models. Results: Descriptive analyses revealed a higher incidence of suicide-related emergency calls among females and an increase in calls among the 18-23 age group from 2020 onwards. The general spatio-temporal model showed higher levels of suicide-related emergency calls in neighborhoods characterized by lower education levels and population density, and higher residential mobility, aging population, and immigrant concentration. Relevant gender differences were also observed. A seasonal effect was noted, with a peak in calls during spring for females and summer for males. Conclusions: These findings highlight the need for comprehensive mental health targeted interventions and preventive strategies that account for gender-specific disparities, age-related vulnerabilities, and the specific characteristics of neighborhoods.

Association between self-perception of the neighborhood environment and sleep problems in older Brazilian adults: findings from ELSI-Brazil.

This study aimed to investigate associations between neighborhood perception and sleep problems in older Brazilian adults. A cross-sectional study was conducted with 5,719 community-dwelling older adults (≥ 60 years) from the Brazilian Longitudinal Study of Aging (ELSI-Brazil, 2019-2021). The outcomes were self-reported sleep problems: poor sleep quality, daytime sleepiness, primary insomnia complaints, difficulty staying asleep, and waking up at dawn. The exposure variables were questions about the perception of participants about the physical and social environment of the neighborhood. Logistic regression was used in data analysis. Garbage, rubbish, or tall grass on the streets and the desire to move were associated with higher odds of poor sleep quality. Concern about falling due to damaged sidewalks, concern about having difficulties taking transportation, and concern about having difficulties crossing the street were associated with higher odds of all sleep problems. Sound/noise of buses and cars was associated with higher odds of some sleep problems. Perceiving the neighborhood as a good place to live was associated with lower odds of daytime sleepiness and primary insomnia complaints. Trusting most people in the neighborhood and perceiving that kids and younger people treat adults with respect were associated with lower odds of daytime sleepiness, primary insomnia complaints, and waking up at dawn. Being a good place for kids to play and raise teenagers was associated with lower odds of daytime sleepiness. These results can assist public administrators in creating urban planning policies aimed at improving neighborhood environments as a means of health promotion.

Built and natural environment correlates of physical activity of adults living in rural areas: a systematic review.

BACKGROUND: According to social-ecological models, the built and natural environment has the potential to facilitate or hinder physical activity (PA). While this potential is well researched in urban areas, a current systematic review of how the built and natural environment is related to PA in rural areas is lacking. METHODS: We searched five databases and included studies for adults (18-65 years) living in rural areas. We included quantitative studies investigating the association between any self-reported or objectively measured characteristic of the built or natural environment and any type of self-reported or objectively measured PA, and qualitative studies that reported on features of the built or natural environment perceived as barriers to or facilitators of PA by the participants. Screening for eligibility and quality assessment (using the Standard Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields) were done in duplicate. We used a narrative approach to synthesize the results. RESULTS: Of 2432 non-duplicate records, 51 quantitative and 19 qualitative studies were included. Convincing positive relationships were found between the availability and accessibility of places for exercise and recreation and leisure-time PA as well as between the overall environment and leisure-time PA. Possible positive associations were found between the overall environment and total and transport-related PA, between greenness/natural environment and total PA, between cycling infrastructure and aesthetics and MVPA, and between pedestrian infrastructure and total walking. A possible negative relationship was found between safety and security and total walking. Qualitative studies complemented several environmental facilitators (facilities for exercise and recreation, sidewalks or streets with low traffic, attractive natural environment) and barriers (lack of facilities and destinations, lack of sidewalks, speeding traffic and high traffic volumes, lack of street lighting). CONCLUSIONS: Research investigating the relationship between the built and natural environment and PA behaviors of adults living in rural areas is still limited and there is a need for more high-quality and longitudinal studies. However, our most positive findings indicate that investing in places for exercise and recreation, a safe infrastructure for active transport, and nature-based activities are possible strategies that should be considered to address low levels of PA in rural adults. TRIAL REGISTRATION: PROSPERO: CRD42021283508.

Association between Flavonoid Intake and Cognitive Executive Function among African American and White Adults in the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) Study.

Healthy dietary patterns rich in flavonoids may benefit cognitive performance over time. Among socioeconomically disadvantaged groups, the association between flavonoid intake and measures of cognition is unclear. This study sought to identify associations between flavonoid intake and cognitive performance among Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study participants (n = 1947) across three study visits. Flavonoid intakes were assessed via two 24-h dietary recalls. Cognitive performance was assessed via the Trail Making Test (TMT)-A and TMT-B, which provide measures of attention and executive function, respectively. Mixed effects linear regression was used to model TMT scores over three study visits against visit 1 (v1) flavonoid intake, time (years from v1), and the interaction between v1 flavonoid intake and time, capturing both the cross-sectional association between flavonoid intake and time at v1 as well as the longitudinal association between v1 flavonoid intake and the change in TMT scores over time. Prior to adjustment, inverse cross-sectional associations at v1 were observed between (1) anthocyanidin intake and TMT-A scores for the overall sample and (2) total flavonoid, anthocyanidin, flavan-3-ol, flavone, and flavonol intake and TMT-B scores for the overall sample and among White adults. Only the association between anthocyanidin intake and TMT-B at v1 among White adults persisted after adjustment (for demographic characteristics such as age). One possible explanation for the few significant associations is universally low flavonoid intakes resulting from the consumption of an unhealthy dietary pattern.

Unpacking Neighborhood Socioeconomic Status in Children's Health Research from an Environmental Justice Perspective: A Scoping Review.

PURPOSE OF REVIEW: Clearly defining and measuring neighborhood socioeconomic status (nSES) is a key first step in achieving environmental justice, as the disproportionate distribution of environmental hazards and access to resources is heavily influenced by socioeconomic factors. This scoping review explores the definition of neighborhoods, measurement of neighborhood socioeconomic status (nSES), and studies that evaluated the association between nSES and child health in accordance with PRISMA guidelines. RECENT FINDINGS: We identified 4112 articles published on US pediatric populations between 2013 and 2022. We identified 170 distinct indicators across seven broad domains of nSES used to create 121 different measures of nSES across the 206 publications included in this review. While there is considerable interest in nSES and children's health, there is also substantial variation in the measurement of neighborhood as a geographic unit and nSES as a construct. We observed methodological challenges related to the identification of neighborhood boundaries, indicator selection, and nSES measure definition(s). We discuss common pitfalls in neighborhood research that can complicate identifying, targeting, and resolving environmental injustices. Lastly, we put forward a series of recommendations to reduce measurement error and improve inference, in addition to reporting recommendations for neighborhoods and health research that can aid in improving our understanding of pathways between neighborhood context and child health, inform policy development, and allocate resources to achieve environmental justice.

Social cohesion and associations with sedentary time, physical activity and dietary quality in The Maastricht Study.

INTRO: We aim to investigate the relationship between social cohesion and sedentary behavior (SB), total physical activity (PA), moderate-to-vigorous PA (MVPA), and dietary quality. Additionally, we assess whether these associations are independent of neighborhood walkability and the food environment. METHODS: A total of 7641 participants from The Maastricht Study in the Netherlands between the ages of 40 and 75 years were analyzed. Neighborhood social cohesion was obtained by participant questionnaire completed at baseline and measured by the Dutch Livability meter. Home addresses were linked to geographic information system (GIS) data from the Geoscience and Health Cohort Consortium (GECCO) to create neighborhood exposures of walkability and food environment. A thigh worn accelerometer collected data to measure sedentary time, total daily PA, and MVPA. Dietary quality was measured with a food frequency questionnaire. Multivariate linear regression analyses were adjusted for age, sex, socioeconomic position, neighborhood walkability, and food environment. RESULTS: Those living in the highest quartile area of perceived social cohesion had statistically significant lower levels of SB (Q4 B: -13.04; 95% CI = -20.23, -5.85), higher total PA (Q4 B: 4.39; 95% CI = 1.69, 7.10), and higher MVPA (Q4 B: 2.57; 95% CI = 0.83, 4.31) and better diet quality (Q4 B: 1.12; 95% CI = 0.24, 2.01) compared to the lowest quartile independent of walkability and food environment. Similar results were found using the Livability meter. CONCLUSION: We discovered neighborhood social cohesion as an important obesogenic determinant that should be considered in policymaking to encourage higher levels of PA and higher diet quality.

Experiences of a Community-Based Digital Intervention Among Older People Living in a Low-Income Neighborhood: Qualitative Study.

BACKGROUND: Older adults worldwide experienced heightened risks of depression, anxiety, loneliness, and poor mental well-being during the COVID-19 pandemic. During this period, digital technology emerged as a means to mitigate social isolation and enhance social connectedness among older adults. However, older adults' behaviors and attitudes toward the adoption and use of digital technology are heterogeneous and shaped by factors such as age, income, and education. Few empirical studies have examined how older adults experiencing social and economic disadvantages perceive the learning of digital tools. OBJECTIVE: This study aims to examine the motivations, experiences, and perceptions toward a community-based digital intervention among older adults residing in public rental flats in a low-income neighborhood. Specifically, we explored how their attitudes and behaviors toward learning the use of smartphones are shaped by their experiences related to age and socioeconomic challenges. METHODS: This study adopted a qualitative methodology. Between December 2020 and March 2021, we conducted semistructured in-depth interviews with 19 participants aged ≥60 years who had completed the community-based digital intervention. We asked participants questions about the challenges encountered amid the pandemic, their perceived benefits of and difficulties with smartphone use, and their experiences with participating in the intervention. All interviews were audio recorded and analyzed using a reflexive thematic approach. RESULTS: Although older learners stated varying levels of motivation to learn, most expressed ambivalence about the perceived utility and relevance of the smartphone to their current needs and priorities. While participants valued the social interaction with volunteers and the personalized learning model of the digital intervention, they also articulated barriers such as age-related cognitive and physical limitations and language and illiteracy that hindered their sustained use of these digital devices. Most importantly, the internalization of ageist stereotypes of being less worthy learners and the perception of smartphone use as being in the realm of the privileged other further reduced self-efficacy and interest in learning. CONCLUSIONS: To improve learning and sustained use of smartphones for older adults with low income, it is essential to explore avenues that render digital tools pertinent to their daily lives, such as creating opportunities for social connections and relationship building. Future studies should investigate the relationships between older adults' social, economic, and health marginality and their ability to access digital technologies. We recommend that the design and implementation of digital interventions should prioritize catering to the needs and preferences of various segments of older adults, while working to bridge rather than perpetuate the digital divide.

Influence of parental nativity and perceived neighborhood environment on physical activity and screen time of United States youth.

OBJECTIVE: This study assessed how parental nativity and perceived environment are associated with physical activity and screen time of U.S. children and adolescents. METHODS: Data originated from the 2020-21 U.S. National Survey of Children's Health. We conducted multivariable Poisson regression to assess the cross-sectional association of parental nativity and perceived neighborhood environment variables on parental reports of youth meeting national physical activity and screen time guidelines. We tested interactions of parental nativity and neighborhood environment variables on both outcomes. Analyses were conducted using STATA v17 and p < 0.05 indicated statistical significance. RESULTS: The sample of 24,928 children and 30,951 adolescents was 11.6 years of age, on average, with approximately 39% under 200% of the federal poverty level. About one-third of the sample (27.5%) had foreign-born parents. In adjusted models, we found that compared to youth with U.S.-born parents, those with foreign-born parents had a lower prevalence of meeting physical activity guidelines. Youth whose parents reported living in safe neighborhoods had a higher prevalence of meeting guidelines for physical activity (children: PR = 1.20, 95%CI 1.14, 1.27; adolescents: PR = 1.23, 95%CI 1.14, 1.32) and screen time (children: PR = 1.19, 95%CI 1.13, 1.26; adolescents: PR = 1.16, 95%CI 1.06, 1.28) than youth whose parents reported unsafe neighborhoods. We found similar associations between neighborhoods considered supportive or with many amenities and meeting physical activity and screen time guidelines. CONCLUSIONS: Youth whose parents are foreign-born have a lower prevalence of sufficient activity, and perceived parental neighborhood safety and support may be significant influences on youth physical activity and screen time.

Short-term health effects of an urban regeneration programme in deprived neighbourhoods of Barcelona.

Urban regeneration programmes are interventions meant to enhance the wellbeing of residents in deprived areas, although empirical evidence reports mixed results. We evaluated the health impact of a participatory and neighbourhood-wide urban regeneration programme, Pla de Barris 2016-2020, in Barcelona. A pre-post with a comparison group study design. Using data from a cross-sectional survey performed in 2016 and 2021. The health outcomes analysed were mental health, alcohol and psychotropic drug use, perceived health status, physical activity and obesity. Depending on the investment, two intervention groups were defined: moderate- and high-intensity intervention groups. The analysis combined difference-in-difference estimation with an inverse weighting derived from a propensity score to reduce potential biases. The impact of the intervention in percentages and its confidence interval were estimated with a linear probability model with clustered adjusted errors. The intervention had a positive impact on health outcomes in women in the high-intensity intervention group: a reduction of 15.5% in the relative frequency of those experiencing poor mental health, and of 21.7% in the relative frequency of those with poor self-perceived health; and an increase of 13.7% in the relative frequency of those doing physical activity. No positive impact was observed for men, but an increase of 10.3% in the relative frequency of those using psychotropic drugs in the high-intensity intervention group. This study shows positive short-term effects of the urban regeneration programme Pla de Barris 2016-2020 on health outcomes in women in the high-intensity intervention group. These results can guide future interventions in other areas.

Sense of neighborhood belonging and health: geographic, racial, and socioeconomic variation in Wisconsin.

Background: Individuals' sense of belonging (SoB) to their neighborhood is an understudied psychosocial factor that may influence the association between neighborhood characteristics, health, and disparities across socio-demographic groups. Methods: Using 2014-2016 data from the Survey of the Health of Wisconsin (SHOW, N = 1,706), we conduct a detailed analysis of SoB and health in an American context. We construct OLS and logistic regressions estimating belonging's association with general, physical, and mental health. We explore geographic, racial, and socioeconomic variation to understand both the differential distribution of SoB and its heterogeneous relationship with health. Results: A higher SoB is positively associated with better physical, mental, and general health. White participants report higher SoB than Black participants, yet the association between SoB and mental health is strongest among participants of color and urban residents. Conclusion: Sense of belonging to neighborhood significantly predicts many facets of health, with place and individual characteristics appearing to moderate this relationship. Racial, geographic, and socioeconomic disparities in belonging-health associations raise important questions about who benefits from the social, economic, and physical aspects of local communities.

Greenspaces And Cardiovascular Health.

Accumulating evidence suggests that living in areas of high surrounding greenness or even brief exposures to areas of high greenery is conducive to cardiovascular health, which may be related to the environmental, social, psychological, and physiological benefits of greenspaces. Recent data from multiple cross-sectional, longitudinal, and cohort studies suggest that living in areas of high surrounding greenness is associated with a lower risk of all-cause and cardiovascular mortality. High levels of neighborhood greenery have been linked also to a decrease in the burden of cardiovascular disease risk factors as reflected by lower rates of hypertension, dyslipidemia, and diabetes. Those who live in greener environments report better mental health and more frequent social interactions, which can benefit cardiovascular health as well. In this narrative review, we discuss evidence linking greenspaces to cardiovascular health as well as the potential mechanisms underlying the beneficial effects of greenspaces, including the impact of vegetation on air, noise and light pollution, ambient temperature, physical activity, mental health, and biodiversity. We review literature on the beneficial effects of acute and chronic exposure to nature on cardiovascular disease risk factors, inflammation and immune function, and we highlight the potential cardiovascular effects of biogenic volatile organic compounds that are emitted by trees and shrubs. We identify current knowledge gaps in this area and underscore the need for additional population studies to understand more clearly and precisely the link between greenness and health. Such understanding is urgently needed to fully redeem the promise of greenspaces in preventing adverse environmental exposures, mitigating the effects of climate change, and creating healthier living environments.

Food deserts exposure, density of fast-food restaurants, and park access: Exploring the association of food and recreation environments with obesity and diabetes using global and local regression models.

To prevent obesity and diabetes environmental interventions such as eliminating food deserts, restricting proliferation of food swamps, and improving park access are essential. In the United States, however, studies that examine the food and park access relationship with obesity and diabetes using both global and local regression are lacking. To guide county, state, and federal policy in combating obesity and diabetes, there is a need for cross-scale analyses to identify that relationship at national and local levels. This study applied spatial regression and geographically weighted regression to the 3,108 counties in the contiguous United States. Global regression show food deserts exposure and density of fast-food restaurants have non-significant association with obesity and diabetes while park access has a significant inverse association with both diseases. Geographically weighted regression that takes into account spatial heterogeneity shows that, among southern states that show high prevalence of obesity and diabetes, Alabama and Mississippi stand out as having opportunity to improve park access. Results suggest food deserts exposure are positively associated with obesity and diabetes in counties close to Alabama, Georgia, and Tennessee while density of fast-food restaurants show positive association with two diseases in counties of western New York and northwestern Pennsylvania. These findings will help policymakers and public health agencies in determining which geographic areas need to be prioritized when implementing public interventions such as promoting healthy food access, limiting unhealthy food options, and increasing park access.