Mindful Eco-Wellness: Steps Toward Personal and Planetary Health.

Rising greenhouse gas levels heat the earth's surface and alter climate patterns, posing unprecedented threats to planetary ecology and human health. At the same time, obesity, diabetes, and cardiovascular disease have reached epidemic proportions across the globe, caused in part by decreases in physical activity and by over-consumption of carbon-intensive foods. Thus, interventions that support active transportation (walking or cycling rather than driving) and healthier food choices (eating plant-based rather than meat-based diets) would yield health and sustainability "co-benefits." Emerging research suggests that mindfulness-based practices might be effective means toward these ends. At the University of Wisconsin-Madison, we have developed a mindfulness-based group program, Mindful Eco-Wellness: Steps Toward Healthier Living. Loosely based on the Mindfulness-Based Stress Reduction course, our curriculum teaches mindfulness practices in tandem with sustainability principles, following weekly themes of Air, Water, Food, Energy, Transportation, Consumption, Nature Experience, and Ethics. For example, the "Air" class offers participants practice in guided breath meditations while they learn about the benefits of clean air. The theme of "Food" is presented through mindful eating, accompanied by educational videos highlighting the consequences of food production and consumption. "Transportation" includes walking/movement meditations and highlights the health benefits of physical activity and detriments of fossil-fueled transportation. Pedagogical lessons on energy, ecological sustainability, and the ethics of planetary health are intertwined with mindful nature experience and metta (loving-kindness) meditation. Curricular materials, including teaching videos, are freely available online. Pilot testing in community settings (n = 30) and in group medical visits (n = 34) has demonstrated feasibility; pilot data suggests potential effectiveness. Rigorous evaluation and testing are needed.

Imagining Eco-Wellness: A Scoping Review of Interventions Aimed at Changing Individual Behaviors to Promote Personal Health and Environmental Sustainability.

INTRODUCTION: Climate change poses enormous threats to humanity and much of life on earth. Many of the behavioral patterns that drive climate change also contribute to the epidemics of obesity, diabetes, and cardiovascular disease. OBJECTIVES: The primary objective of this study was to compile and categorize the literature on interventions aimed at modifying individual behaviors to promote both personal health and environmental sustainability. Secondary objectives were to help define the emerging field of behavioral eco-wellness and to discuss future directions, including the need for assessment tools and analytic strategies. METHODS: A scoping review was conducted to locate, categorize, and interpret current scientific studies of interventions aimed at changing individual behaviors to promote both personal health and environmental sustainability. RESULTS: Other than a pilot study that this team previously conducted, nothing was found that strictly fit the inclusion criteria. However, we did find 16 relevant studies that fit neatly within 4 broad topical areas: active transportation, dietary intake, indoor air quality, and green space immersion. DISCUSSION: While this systematic scoping review found little meeting original criteria, we did find that 4 separate fields of study are converging on a scientific area that we are calling behavioral eco-wellness, defined as the simultaneous pursuit of both personal health and environmental sustainability. The emerging field could provide a conceptual framework and methodological toolkit for those seeking to enhance sustainability while supporting health behaviors, including dietary intake. This, in turn, could help to inform and motivate the urgent action needed to confront both climate change and the epidemics of obesity, diabetes, and cardiovascular disease.

A blueprint for strengthening climate and health literacy through professional adaptability.

Responding effectively to intensifying climate change hazards to protect human health in personal and professional settings is an urgent and pressing challenge. This will require collaboration and subject matter expertise of people across the life course and occupations. In this perspective piece, we build on a previously published compilation of climate and health literacy elements to explore tangible opportunities to strengthen climate and health understanding among individuals spanning educational levels, professional settings, and societal needs. Educational materials addressing climate change and health linkages have historically focused on K-12, college, post-graduate education, and continuing medical education, with less attention devoted to reaching students in trade schools and other professional settings. Here, we outline a flexible blueprint for strengthening climate and health literacy among all people by targeting education in a way that is relevant for each age group or profession. In particular, we discuss the idea of professional adaptability as a way to design practical climate and health training for people currently in the workforce.

Developing A Definition Of Climate And Health Literacy.

A new generation of activists is calling for bold responses to the climate crisis. Although young people are motivated to act on climate issues, existing educational frameworks do not adequately prepare them by addressing the scope and complexity of the human health risks associated with climate change. We adapted the US government's climate literacy principles to propose a definition and corresponding set of elements for a concept we term climate and health literacy. We conducted a scoping review to assess how the peer-reviewed literature addresses these elements. Our analysis reveals a focus on training health professionals; more international than US domestic content; and limited information about data and models, fossil fuels, and equity. We propose developing a framework that builds on the elements to support a broader educational agenda that prepares students and future leaders to recognize the complex health ramifications of a changing climate.

Benefits of 8-wk Mindfulness-based Stress Reduction or Aerobic Training on Seasonal Declines in Physical Activity.

Mindfulness-based stress reduction (MBSR) and aerobic exercise training (AET) programs improve health and well-being. Exercise participation has been related to mindfulness and may be altered by MBSR training. PURPOSE: This study aimed to compare 8 wk of MBSR, AET, and no-treatment control during the fall season on objectively measured physical activity in healthy adults. METHODS: Participants (n = 66) wore an ActiGraph GT3X+ accelerometer for 7 d prerandomization and after 8 wk MBSR or AET interventions, or neither (control). Mean daily minutes (min) of moderate-to-vigorous physical activities (MVPA) were calculated along with weekly time spent in bouts of MVPA ≥10 min (MVPABouts) to assess physical activity sufficient to meet national guidelines. Groups were compared on pairwise changes in outcomes across time. Effect sizes were calculated using Cohen's d. RESULTS: Sufficient data (≥3 weekdays, ≥1 weekend day, and ≥10 h·d) were obtained from 49 participants (18 MBSR, 14 AET, and 17 control). Daily MVPA decreased in all groups from prerandomization to postintervention (August to November); control decreased 17.9 ± 25.7 min·d, MBSR decreased 5.7 ± 7.5 min·d, and AET decreased 7.4 ± 14.3 min·d (mean ± SD), without significant differences among the groups (all P > 0.05). MVPABouts decreased 77.3 ± 106.6 min·wk in control and 15.5 ± 37.0 min·wk in MBSR (between-group difference: P = 0.08; d = 0.86), whereas it increased by 5.7 ± 64.1 min·wk in AET (compared with control: P = 0.029; d = 0.97; compared with MBSR; P = 0.564; d = 0.29). CONCLUSION: Data from participants in a randomized controlled trial showed that although AET increases MVPA bouts compared with no treatment, MBSR training may also mitigate the influence of shorter day length and cooler weather on participation in physical activities. Future research is needed to determine how MBSR affects exercise to inform interventions. Interventions combining MBSR and exercise may be particularly successful at increasing physical activity participation.

Ancillary health effects of climate mitigation scenarios as drivers of policy uptake: a review of air quality, transportation and diet co-benefits modeling studies.

Background: Significant mitigation efforts beyond the Nationally Determined Commitments (NDCs) coming out of the 2015 Paris Climate Agreement are required to avoid warming of 2°C above pre-industrial temperatures. Health co-benefits represent selected near term, positive consequences of climate policies that can offset mitigation costs in the short term before the beneficial impacts of those policies on the magnitude of climate change are evident. The diversity of approaches to modeling mitigation options and their health effects inhibits meta-analyses and syntheses of results useful in policy-making. Methods/Design: We evaluated the range of methods and choices in modeling health co-benefits of climate mitigation to identify opportunities for increased consistency and collaboration that could better inform policy-making. We reviewed studies quantifying the health co-benefits of climate change mitigation related to air quality, transportation, and diet published since the 2009 Lancet Commission 'Managing the health effects of climate change' through January 2017. We documented approaches, methods, scenarios, health-related exposures, and health outcomes. Results/Synthesis: Forty-two studies met the inclusion criteria. Air quality, transportation, and diet scenarios ranged from specific policy proposals to hypothetical scenarios, and from global recommendations to stakeholder-informed local guidance. Geographic and temporal scope as well as validity of scenarios determined policy relevance. More recent studies tended to use more sophisticated methods to address complexity in the relevant policy system. Discussion: Most studies indicated significant, nearer term, local ancillary health benefits providing impetus for policy uptake and net cost savings. However, studies were more suited to describing the interaction of climate policy and health and the magnitude of potential outcomes than to providing specific accurate estimates of health co-benefits. Modeling the health co-benefits of climate policy provides policy-relevant information when the scenarios are reasonable, relevant, and thorough, and the model adequately addresses complexity. Greater consistency in selected modeling choices across the health co-benefits of climate mitigation research would facilitate evaluation of mitigation options particularly as they apply to the NDCs and promote policy uptake.

When it rains, it pours: future climate extremes and health.

BACKGROUND: The accelerating accumulation of greenhouse gases in the Earth's atmosphere is changing global environmental conditions in unprecedented and potentially irreversible ways. Climate change poses a host of challenges to the health of populations through complex direct and indirect mechanisms. The direct effects include an increased frequency of heat waves, rising sea levels that threaten low-lying communities, anticipated extremes in the global hydrologic cycle (droughts, floods, and intense storms), and adverse effects on agricultural production and fisheries due to environmental stressors and changes in land use. Indirectly, climate change is anticipated to threaten health by worsening urban air pollution and increasing rates of infectious (particularly waterborne and vector-borne) disease transmission. OBJECTIVE: To provide a state-of-the-science review on the health consequences of a changing climate. FINDINGS: Environmental public health researchers have concluded that, on balance, adverse health outcomes will dominate under these changed climatic conditions. The number of pathways through which climate change can affect the health of populations makes this environmental health threat one of the largest and most formidable of the new century. Geographic location plays an influential role the potential for adverse health effects caused by climate change, and certain regions and populations are more vulnerable than others to expected health effects. Two kinds of strategies are available for responding to climate change: mitigation policies (which aim to reduce greenhouse gas emissions) and adaptation measures (relating to preparedness for anticipated impacts). CONCLUSIONS: To better understand and address the complex nature of health risks posed by climate change, interdisciplinary collaboration is critical. Efforts to move beyond our current reliance on fossil fuels to cleaner, more sustainable energy sources may offer some of the greatest health opportunities in more than a century and cobenefits beyond the health sector. Because the nations least responsible for climate change are most vulnerable to its effects, the challenge to reduce greenhouse gas emissions is not merely technical, but also moral.

The Wisconsin Assessment of the Social and Built Environment (WASABE): a multi-dimensional objective audit instrument for examining neighborhood effects on health.

BACKGROUND: Growing evidence suggests that mixed methods approaches to measuring neighborhood effects on health are needed. The Wisconsin Assessment of the Social and Built Environment (WASABE) is an objective audit tool designed as an addition to a statewide household-based health examination survey, the Survey of the Health of Wisconsin (SHOW), to objectively measure participant's neighborhoods. METHODS: This paper describes the development and implementation of the WASABE and examines the instrument's ability to capture a range of social and built environment features in urban and rural communities. A systematic literature review and formative research were used to create the tool. Inter-rater reliability parameters across items were calculated. Prevalence and density of features were estimated for strata formed according to several sociodemographic and urbanicity factors. RESULTS: The tool is highly reliable with over 81% of 115 derived items having percent agreement above 95%. It captured variance in neighborhood features in for a diverse sample of SHOW participants. Sidewalk density in neighborhoods surrounding households of participants living at less than 100% of the poverty level was 67% (95% confidence interval, 55-80%) compared to 34% (25-44%) for those living at greater than 400% of the poverty level. Walking and biking trails were present in 29% (19-39%) of participant buffer in urban areas compared to only 7% (2-12%) in rural communities. Significant environmental differences were also observed for white versus non-white, high versus low income, and college graduates versus individuals with lower level of education. CONCLUSIONS: The WASABE has strong inter-rater reliability and validity properties. It builds on previous work to provide a rigorous and standardized method for systematically gathering objective built and social environmental data in a number of geographic settings. Findings illustrate the complex milieu of built environment features found in participants neighborhoods and have relevance for future research, policy, and community engagement purposes.

Air quality and exercise-related health benefits from reduced car travel in the midwestern United States.

BACKGROUND: Automobile exhaust contains precursors to ozone and fine particulate matter (PM ≤ 2.5 µm in aerodynamic diameter; PM2.5), posing health risks. Dependency on car commuting also reduces physical fitness opportunities. OBJECTIVE: In this study we sought to quantify benefits from reducing automobile usage for short urban and suburban trips. METHODS: We simulated census-tract level changes in hourly pollutant concentrations from the elimination of automobile round trips ≤ 8 km in 11 metropolitan areas in the upper midwestern United States using the Community Multiscale Air Quality (CMAQ) model. Next, we estimated annual changes in health outcomes and monetary costs expected from pollution changes using the U.S. Environmental Protection Agency Benefits Mapping Analysis Program (BenMAP). In addition, we used the World Health Organization Health Economic Assessment Tool (HEAT) to calculate benefits of increased physical activity if 50% of short trips were made by bicycle. RESULTS: We estimate that, by eliminating these short automobile trips, annual average urban PM2.5 would decline by 0.1 µg/m3 and that summer ozone (O3) would increase slightly in cities but decline regionally, resulting in net health benefits of $4.94 billion/year [95% confidence interval (CI): $0.2 billion, $13.5 billion), with 25% of PM2.5 and most O3 benefits to populations outside metropolitan areas. Across the study region of approximately 31.3 million people and 37,000 total square miles, mortality would decline by approximately 1,295 deaths/year (95% CI: 912, 1,636) because of improved air quality and increased exercise. Making 50% of short trips by bicycle would yield savings of approximately $3.8 billion/year from avoided mortality and reduced health care costs (95% CI: $2.7 billion, $5.0 billion]. We estimate that the combined benefits of improved air quality and physical fitness would exceed $8 billion/year. CONCLUSION: Our findings suggest that significant health and economic benefits are possible if bicycling replaces short car trips. Less dependence on automobiles in urban areas would also improve health in downwind rural settings.