Association between area-level walkability and glycated haemoglobin: a Portuguese population-based study.

Diabetes poses a substantial disease burden, prompting preventive interventions. Physical inactivity, a major risk factor for type 2 diabetes, can potentially be mitigated by enhancing area-level walkability. Despite this, limited population-based studies have investigated the link between walkability and objective diabetes measures. Our study aims to estimate the association between area-level walkability and individual glycated haemoglobin levels in the Portuguese adult population without the diagnosis of diabetes. Data from the 2011 census and an updated street map were obtained to construct a walkability index based on residential density, land-use mix, and street connectivity. Individual health data were sourced from The National Health Examination Survey (INSEF) 2015, a representative survey of the Portuguese adult population. Gamma regression was employed for estimation of the main associations, revealing that residing in moderately walkable areas significantly reduced average glycated haemoglobin levels (Exp(ß) = 0.906; 95% CI: 0.821, 0.999) compared to the least walkable areas. The association was less pronounced and not statistically significant for the third tertile of walkability (Exp(ß) = 0.919; 95% CI: 0.822, 1.028). Our findings highlight a nonlinear protective association between walkability and glycated haemoglobin, emphasizing the potential policy implications for urban planning, diabetes prevention, and health promotion.

Environmental and Mobility Strategies During Early COVID-19: Insights From an Empirical Study Focusing on Park Visitations in El Paso, TX.

OBJECTIVES: We explored the importance of environmental and mobility strategies during early COVID-19 by age and ethnicity and investigated predictors of park visitations considering the COVID-19 impacts. BACKGROUND: Parks are safe and accessible venues to stay active and reduce social isolation, which is especially important considering COVID-19 and the associated lockdowns. METHODS: We analyzed online survey data from 683 residents (collected July 2020) of El Paso, TX, and objective measures of neighborhood park characteristics. Chi-square tests and mixed-effects logistic regression analyses were performed to examine the environmental/mobility strategies, personal and environmental factors, and park visitations, considering the COVID-19 impacts. RESULTS: The percentage of those who visited (1+ times/week) parks or trails/paths in the neighborhood dropped from 41.7% to 19.5% since the start of COVID-19 (OR = 0.015, p < .001). Before COVID-19, middle-aged and older adults were less likely to visit parks than younger adults, while this difference became insignificant during early COVID-19. Hispanic adults were more likely to visit parks than non-Hispanics both before and during early COVID-19. Positive environmental predictors of park visitations included park availability in the neighborhood, proximity to the closest park, seeing people being physically active in the neighborhood, and neighborhood aesthetics. CONCLUSIONS: Proximately located parks, trails, and paths well integrated into residential communities, and high aesthetic quality of the neighborhood are the potential features of pandemic-resilient communities and should be considered an important national priority to maintain and promote the health and well-being of the population, especially during pandemics like COVID-19.

Associations of neighborhood walkability with moderate to vigorous physical activity: an application of compositional data analysis comparing compositional and non-compositional approaches.

BACKGROUND: We compared the relation between neighborhood features and moderate to vigorous physical activity (MVPA) using linear regression analysis and the more novel compositional data analysis (CoDA). Compositional data analysis allows us to take the time children allocate to different movement behaviours during a 24-hour time period into account. METHODOLOGY: Data from youth participants (n = 409) in the QUALITY (QUebec Adipose and Lifestyle InvesTigation in Youth) cohort were included. Time spent in MVPA, light physical activity, sedentary behavior, and sleep ("24-hour movement behaviours") was measured using accelerometers. Neighborhood data were collected using a geographic information system and through direct observation. In CoDA models, we used orthogonal logratio coordinates, which allows for the association of neighbourhood walkability with MVPA to be estimated with respect to the average composition of all other behaviours within a 24-hour time frame. In baseline linear regression models, MVPA was regressed cross-sectionally on neighborhood walkability. All models were stratified by sex, and controlled for BMI z-scores, pubertal development, seasonal variation, parental education, and neighbourhood safety. RESULTS: Based on CoDA, girls who lived in more walkable neighborhoods had 10% higher daily MVPA (95% CI: 2%, 19%), taking into account all other movement behaviours. Based on linear regression, girls who resided in more walkable neighborhoods engaged in 4.2 (95% confidence interval [CI]: 1.2, 6.6) more minutes of MVPA per day on average than girls residing in less walkable neighborhoods. CONCLUSIONS: Unlike with traditional linear models, all movement behaviours were included in a single model using CoDA, allowing for a more complete picture of the strength and direction of the association between neighbourhood Walkability and MVPA. Application of CoDA to investigate determinants of physical activity provides additional insight into potential mechanisms and the ways in which people allocate their time.

How equitable are the distributions of the physical activity and accessibility benefits of bicycle infrastructure?

BACKGROUND: Cycling for transport provides many health and social benefits - including physical activity and independent access to jobs, education, social opportunities, health care and other services (accessibility). However, some population groups have less opportunity to reach everyday destinations, and public transport stops, by bicycle - owing in part to their greater aversion to riding amongst motor vehicle traffic. Health equity can therefore be improved by providing separated cycleway networks that give more people the opportunity to access places by bicycle using traffic-free routes. The aim of this study was to assess the health equity benefits of two bicycle infrastructure development scenarios - a single cycleway, and a complete network of cycleways - by examining the distributions of physical activity and accessibility benefits across gender, age and income groups. METHODS: Travel survey data collected from residents in Sydney (Australia) were used to train a predictive transport mode choice model, which was then used to forecast the impact of the two intervention scenarios on transport mode choice, physical activity and accessibility. The latter was measured using a utility-based measure derived from the mode choice model. The distributions of the forecast physical activity and accessibility benefits were then calculated across gender, age and income groups. RESULTS: The modelled physical activity and accessibility measures improve in both intervention scenarios. However, in the single cycleway scenario, the benefits are greatest for the male, high-income and older age groups. In the complete network scenario, the benefits are more equally distributed. Forecast increases in cycling time are largely offset by decreases in walking time - though the latter is typically low-intensity physical activity, which confers a lesser health benefit than moderate-intensity cycling. CONCLUSIONS: Separated cycleway infrastructure can be used to improve health equity by providing greater opportunities for transport cycling in population groups more averse to riding amongst motor vehicle traffic. Disparities in the opportunity to access services and economic/social activities by bicycle - and incorporate more physical activity into everyday travel - could be addressed with connected, traffic-free cycleway networks that cater to people of all genders, ages and incomes.

Effect of pavement condition and geometrics at signalised intersections on casualty crashes.

INTRODUCTION: This study investigated the effects of pavement surface condition and other control factors on casualty crashes at signalized intersections. It involved conducting a before and after study for road surface condition and situational factors. It also included assessing the effects of geometric characteristics on safety performance of signalized intersections post resurfacing to control for the effect of pavement surface condition. Pavement surface condition included roughness, rutting, and skid resistance. The control factors included traffic volume, light and surface moisture condition, and speed limit. The geometric characteristics included approach width, number of lanes, intersection depth, presence of median, presence of shared lane, and presence of bus stop. METHOD: To account for the repeated observations of the effect of light and surface moisture conditions in four occasions (day-dry, day-wet, night-dry and night-wet) Generalized Estimating Equation (GEE) with Negative Binomial (NB) and log link function was applied. For each signalized intersection in the sample, condition data are collected for the year before and after the year of surface treatment. Crash data, however, are collected for a minimum of three and maximum of five years before and after treatment years. RESULTS: The results show that before treatment, light condition, road surface moisture condition, and skid resistance interaction with traffic volume are the significant contributors to crash occurrence. For after treatment; light condition, road surface moisture condition, their interaction product, and roughness interaction with light condition, surface moisture condition, and traffic volume are the significant contributors. The geometric variables that were found to have significant effects on crash frequency post resurfacing were approach width interactions with presence of shared lane, bus stop, or median. CONCLUSIONS: The findings confirm that resurfacing is significant in reducing crash frequency and severity levels. Practical Applications: The study findings would help for better understanding of how geometric characteristics can be improved to reduce crash occurrence.

Investigating the impacts of crash prediction models on quantifying safety effectiveness of Adaptive Signal Control Systems.

INTRODUCTION: Adaptive Signal Control System (ASCS) can improve both operational and safety benefits at signalized corridors. METHODS: This paper develops a series of models accounting for model forms and possible predictors and implements these models in Empirical Bayes (EB) and Fully Bayesian (FB) frameworks for ASCS safety evaluation studies. Different models are validated in terms of the ability to reduce the potential bias and variance of prediction and improve the safety effectiveness estimation accuracy using real-world crash data from non-ASCS sites. This paper then develops the safety effectiveness of ASCS at six different corridors with a total of 65 signalized intersections with the same type of ASCS, in South Carolina. RESULTS: Validation results show that the FB model that accounts for traffic volume, roadway geometric features, year factor, and spatial effects shows the best performance among all models. The study findings reveal that ASCS reduces crash frequencies in the total crash, fatal and injury crash, and angle crash for most of the intersections. The safety effectiveness of ASCS varies with different intersection features (i.e., AADT at major streets, number of legs at an intersection, the number of through lanes on major streets, the number of access points on minor streets, and the speed limit at major streets). CONCLUSIONS: ASCS is associated with crash reductions, and its safety effects vary with different intersection features. Practical Applications: The findings of this research encourage more ASCS deployments and provide insights into selecting ASCS deployment sites for reducing crashes considering the variation of the safety effectiveness of ASCS.

Assessing the likelihood of secondary crashes on freeways with Adaptive Signal Control System deployed on alternate routes.

INTRODUCTION: Reducing the likelihood of freeway secondary crashes will provide significant safety, operational and environmental benefits. This paper presents a method for assessing the likelihood of freeway secondary crashes with Adaptive Signal Control Systems (ASCS) deployed on alternate routes that are typically used by diverted freeway traffic to avoid any delay or congestion due to a freeway primary crash. METHOD: The method includes four steps: (1) identification of secondary crashes, (2) verification of alternate routes, (3) assessment of the likelihood of secondary crashes for freeways with ASCS deployed on alternate routes and non-ASCS (i.e. pre-timed, semi- or fully-actuated) alternate routes, and (4) investigation of unobserved heterogeneity of the likelihood of freeway secondary crashes. Four freeway sections (i.e., two with ASCS deployed on alternate routes and two non-ASCS alternate routes) in South Carolina are considered. RESULTS AND CONCLUSIONS: Findings from the logistic regression modeling reveal significant reduction in the likelihood of secondary crashes for one freeway section (i.e., Charleston I-26 E) with ASCS deployed on alternate route. Other factors such as rear-end crash, dark or limited light, peak period, and annual average daily traffic contribute to the likelihood of freeway secondary crashes. Furthermore, random-parameter logistic regression model results for Charleston I-26 E reveal that unobserved heterogeneity of ASCS effect exists across the observations and ASCS are associated with the reduction of the likelihood of freeway secondary crashes for 84% of the observations (i.e., primary crashes). Location of the primary crash on the freeway is observed to affect the benefit of ASCS toward freeway secondary crash reduction as the primary crash's location determines how many upstream freeway vehicles will be able to take the alternate route. Practical Applications: Based on the findings, it is recommended that the South Carolina Department of Transportation (SCDOT) considers deploying ASCS on alternate routes parallel to freeway sections where high percentages of secondary crashes are found.

Neighborhood Sidewalk Environment and Incidence of Dementia in Older Japanese Adults.

Sidewalks are indispensable environmental resources for daily life in that they encourage physical activity. However, the proportion of sidewalk coverage is low even in developed countries. We examined the association between neighborhood sidewalk environment and dementia in Japan. We conducted a 3-year follow-up (2010-2013) among participants in the Japan Gerontological Evaluation Study, a population-based cohort study of community-dwelling older adults. We ascertained the incidence of dementia for 76,053 participants from the public long-term care insurance system. We calculated sidewalk coverage (sidewalk area as a percentage of road area) within 436 residential neighborhood units using geographic information systems. Multilevel survival models were used to estimate hazard ratios for the incidence of dementia. During follow-up, 5,310 dementia cases were found. In urban areas, compared with the lowest quartile of sidewalk coverage, the hazard ratio was 0.42 (95% confidence interval: 0.33, 0.54) for the highest quartile, adjusting for individual covariates. After successive adjustments for other neighborhood factors (land slope; numbers of hospitals, grocery stores, parks, railway stations, and bus stops; educational level; and unemployment rate), the hazard ratio remained statistically significant (hazard ratio = 0.71, 95% confidence interval: 0.54, 0.92). Living in a neighborhood with a high level of sidewalk installation was associated with low dementia incidence in urban areas.

Socio-economic and Regional Differences in Walkability and Greenspace Around Primary Schools: A Census of Australian Primary School Neighbourhoods.

Socio-economic inequality in the physical activity environment surrounding primary schools may contribute to socio-economic gradients in physical activity and childhood obesity levels. Using a cross-sectional study design, ordinary least squares and logistic regressions were fitted to assess variation in walkability and greenspace within 1 km of primary schools (n = 7133) according to area-level socio-economic position (SEP) and remoteness. Effect modification by school location (major cities or regional/remote) was assessed through stratified analyses. Walkability scores significantly increased from low to high school neighbourhood SEP (p < 0.01) and from remote/very remote to major city locations (p < 0.01). Greenspace area (hectares) in the school neighbourhood was greater in highest compared to lowest SEP areas (ß = 18.75, 95%CI 6.63, 30.87) and less in major cities compared to remote/very remote locations (ß = - 23.9, 95%CI - 39.7, - 8.1). Schools in highest SEP areas and major cities had higher odds of having any greenspace in their neighbourhood, compared to those in lowest SEP and remote/very remote locations (OR 5.93, (95% CI 4.50, 7.05), OR 20.19, (95% CI 16.05, 25.39) respectively). Stratified results (major cities or regional/remote locations) found the highest SEP school neighbourhoods had higher walkability scores and more greenspace compared to lowest SEP school neighbourhoods in both strata, although overall SEP gradient in walkability and greenspace area only remained in major cities. Walkability and greenspace infrastructure in the school neighbourhood could be improved in areas of lower SEP so that all school children have the opportunity for physical activity.

Influence of road types on road traffic accidents in northern Guizhou Province, China.

PURPOSE: The increasing number of deaths due to road traffic accidents (RTAs) has attracted global attention. However, the influence of road types is rarely considered in the study of RTAs. This study evaluates the influence of different road types in RTAs in northern Guizhou to provide a basis for the formulation of evidence-based policies and measures. METHODS: We obtained the data from the Zunyi Traffic Management Data Platform for the years 2009-2018. The mortality rates of RTAs were calculated. Descriptive methods and Chi-square tests were used to analyze the characteristics of road traffic collisions on different road types. We also examined the associations between the mortality rate per 10,000 vehicles and the growth of per capital gross domestic product (GDP) with Spearman's rank correlation analysis. According to the passing volume and the infrastructure, we defined different types of roads, like administrative road, functional road, general urban road and urban expressway. RESULTS: In 2012, the traffic mortality rate of administrative roads was 8.9 per 100,000 people, and the mortality rate of functional roads was 7.4 per 100,000 people, which decreased in 2018 to 6.1 deaths per 100,000 people and 5.2 deaths per 100,000 people, respectively. The mortality rate per 10,000 vehicles reached the highest level in 2011 (28.8 per 10,000 vehicles and 22.5 per 10,000 vehicles on administrative and functional roads, respectively). The death rate of county roads was the highest among administrative roads (χ2 = 17.389, p < 0.05) and that of fourth-class roads was the highest among functional roads (χ2 = 21.785, p < 0.05). The mortality rate per 10,000 vehicles was negatively correlated with per capital GDP. CONCLUSION: Although our research shows that RTAs in northern Guizhou have steadily declined in recent years, the range of decline is relatively small. Many measures and sustainable efforts are needed to control road traffic death and accelerate the progress in road traffic safety in northern Guizhou.

Inclusive Parks across Ages: Multifunction and Urban Open Space Management for Children, Adolescents, and the Elderly.

In urban areas where increased density has caused loss of urban open space (UOS), there is a need for high-quality parks that are inclusive and fit for multiple user groups. To make parks more inclusive, UOS management may need to consider multifunction and the perspectives of various age groups in future development and maintenance activities. Walking interviews were conducted in a park in central Landskrona, Sweden, with children, adolescents, and elderly users, and also with the head park manager of the city. The results revealed different perspectives among the three age groups of users concerning affordances and UOS management. The manager described user-oriented management to support multifunction and inclusion, including user participation. All user groups studied showed an appreciation of liveliness, contact with nature, social places for their own age group, clean and safe parks, and a variety of different atmospheres and activities in the park. Social multifunction can be developed in programmed or non-programmed ways, but some functions interfere with each other. UOS managers can develop parks to suit different age groups, promote user participation within management, and develop social multifunction to create inclusive parks for various age groups.

Urban road space allocation incorporating the safety and construction cost impacts of lane and footpath widths.

INTRODUCTION: Walkability continues to attract great attention from urban planners, designers, and engineers as they recognize not only the merits of pedestrian facilities in terms of the health benefits but also their demerits in terms of accident risk to pedestrians. Wide footpaths improve the pedestrian environment and experience, and thereby motivate travelers to walk as much as possible. However, if footpaths are too wide, they may leave a smaller space for the roadway. On the other hand, wide road lanes may lead to higher road vehicle safety but are costly to construct and maintain and also may leave little space for the footpath. Evidently, for a fixed urban space, what is needed is an optimal balance between the vehicle lane and pedestrian path. This problem is encountered routinely in dense cities including Hong Kong where land availability is severely limited. METHOD: To address the issue, this paper first establishes safety performance functions (SPFs) for the pedestrian space and the road space, using the random-parameter negative binomial regression. The results indicate the extent to which road lane and footpath width changes are associated with changes in in-vehicle occupant and pedestrian casualties. Then the paper uses the SPFs to develop a methodology for optimizing the width allocations to the road lanes and footpaths, duly considering the user (safety) costs and agency (construction) costs associated with each candidate allocation of the widths. Finally, the paper analyzes the sensitivity of the optimal solution to the relative weights of user cost and agency cost. RESULTS: When user and agency costs are considered equally important, the optimal lane width is 5.4 m. CONCLUSION: It is observed that the road space allocation ratio used by the Hong Kong road agency suggests that the agency places a higher weight to user cost compared to agency cost. Practical Application: The findings can help incorporate design-safety relationships, and the stakeholders (agency and users) perspectives in urban road and footpath design.

The effects of left-turn traffic-calming treatments on conflicts and speeds in Washington, DC.

INTRODUCTION: Left-turning vehicles pose considerable safety risks to pedestrians at intersections. Left-turn traffic-calming treatments are designed to slow left-turn traffic. This study examined the effects of one type of left-turn calming, the hardened-centerline treatment, on the numbers of conflicts between left-turning vehicles and pedestrians and left-turn speeds in Washington, DC. METHOD: Numbers of conflicts between left-turning vehicles and pedestrians, as well as left-turn speeds, were collected at selected intersections in Washington, DC, where the hardened centerline was installed, as well as at control intersections in the city where no treatment was installed, before and after installation. Poisson regression evaluated the change in numbers of conflicts associated with the hardened-centerline treatment. The effect of the treatment on left-turn speeds was estimated by a log-linear regression model, and the effect on the odds of left-turning vehicles exceeding 15 mph was estimated by a logistic regression model. RESULTS: The treatment was associated with a 70.5% reduction in conflicts between left-turning vehicles and pedestrians, a 9.8% reduction in mean left-turn speeds, and a 67.1% reduction in the odds of left-turning vehicles exceeding 15 mph. All the reductions were statistically significant. CONCLUSIONS: The study demonstrates that the hardened-centerline treatment can reduce conflicts between left-turning vehicles and pedestrians, and slow down left-turn traffic at intersections. Practical applications: The treatment should be added to the toolbox for communities looking to improve pedestrian safety at intersections.

Effects of speed humps on vehicle speed and pedestrian crashes in South Korea.

INTRODUCTION: Speeding is a crucial risk factor for pedestrian safety because it shortens reaction time while increasing the impact force in collisions. Various types of traffic calming measures to prevent speeding have been devised. A speed hump-a raised bump installed in the pavement-has been widely used for this purpose. METHOD: To evaluate the effectiveness of speed humps, the speed profiles of vehicles passing speed humps were analyzed along with pedestrian crash records near speed humps. RESULTS: The speed profiles showed that vehicles gradually diminished their speeds starting 30 m ahead of speed humps and, immediately after passing the humps, accelerated to regain their original speeds within a distance of 30 m. This speed reduction effect is substantial on both local and major roads: 18.4% and 24.0% reduction in speeds, respectively. The analysis of pedestrian crash records revealed that, inside the zones of speed reduction effect near speed humps (i.e., ±30 m from speed humps), fewer pedestrian crashes per roadway distance occurred and pedestrian injuries were less severe, compared with events outside the effect zones. This safety improvement was greater on major roads than local roads. Practical Applications: This work finds that the speed reductions that occurred near speed humps were gradual and influential ±30 m from their locations, suggesting that the hump installations should be close enough to the pedestrian crossings. It is noteworthy that, albeit that speed humps are more prevalent on local roads, the benefits of speed reduction effects from speed humps were more pronounced on major roads than on local roads. Therefore, speed humps on major roads can be considered a more effective measure for pedestrian safety.

Neighborhood's locality, road types, and residents' multimorbidity: evidence from China's middle-aged and older adults.

BACKGROUND: Neighborhood factors have gained increasing attention, while the association between the neighborhood's characteristics and multimorbidity has not been clarified. In this study, we aim to depict variations in the number of non-communicable chronic diseases (NCDs) as a function of urban vs. rural settings and road types. METHODS: The present cross-sectional study derived data from the China Health and Retirement Longitudinal Study 2011 National Baseline Survey. Negative binomial regression with clustered robust standard errors was performed to analyze variations in the number of NCDs among 13,414 Chinese middle-aged and older adults. Logistic regression models were employed to investigate the association between neighborhood-level characteristics and each NCD, respectively. RESULTS: First, over 65% of subjects had at least one NCDs, and over 35% had multimorbidity. Arthritis (33.08%), hypertension (24.54%), and digestive disease (21.98%) were the most prevalent NCDs. Urban vs. rural differences in multimorbidity were fully explained by neighborhood clustering variations (IRR = 1.02, 95% CI, 0.95-1.10). Living with paved roads was associated with a smaller number of NCDs relative to living with unpaved roads (IRR = 0.86, 95% CI, 0.78-0.95). Results from subgroup analyses suggested that in comparison with those living with unpaved roads, individuals living with paved roads respectively had lower odds of chronic lung disease (OR = 0.76, 95% CI, 0.63-0.93), chronic liver disease (OR = 0.74, 95% CI, 0.55-0.99), chronic kidney disease (OR = 0.68, 95% CI, 0.51-0.89), digestive disease (OR = 0.82, 95% CI, 0.69-0.97), arthritis or rheumatism (OR = 0.69, 95% CI, 0.55-0.87), and asthma (OR = 0.67, 95% CI, 0.51-0.88). CONCLUSIONS: Urban vs. rural disparities in multimorbidity appeared to result from within-neighborhoods characteristics. The improvement in neighborhood-level characteristics, such as road pavement, holds promise to alleviate the increasing disease burden of chronic diseases.

Investigating exposure measures and functional forms in urban and suburban intersection safety performance functions using generalized negative binomial - P model.

Selecting an appropriate exposure measure and functional form for Safety Performance Functions (SPFs) is critical in precisely predicting crash counts by different crash types for intersections. This study proposes a new approach, namely Generalized Negative Binomial-P (GNB-P) model, to model the complex relationship between crashes and different exposure measures by crash type for intersections, which helps not only identify the most reliable exposure measure for intersection SPFs, but also explore the most appropriate functional form of the NB models. To this end, three types of SPF functional forms, namely Power function, Hoerl function 1 and Hoerl function 2 with different exposure measures including major road AADT, minor road AADT and total AADT were estimated by crash type for stop-controlled and two types of signalized intersections. The over-dispersion of the SPF models was estimated using the exposure measures to account for crash data variation across different intersections. The SPF estimation results highlighted that the mean-variance structure of NB models is not consistent and varies by crash data. The over-dispersion of SPFs by crash type is not constant and varies across different intersections. The minor road AADT is shown to be positively correlated with the over-dispersion of SPFs in estimating crash counts for Same-Direction Crashes (SDC), Intersecting-Direction Crashes (IDC) and Single-Vehicle Crashes (SVC). Estimating the over-dispersion using exposure measures results in more reliable SPF results. Furthermore, it is found that the Power function with major road and minor road AADT as the exposure measure performs the best in estimating SPFs for Opposite-Direction Crashes (ODC). The Hoerl function 2 with total AADT and the proportion of minor road AADT over the total as the exposure measure performs the best in estimating SVC SPFs for intersections. The Hoerl function 1 with major road and minor road AADT as the exposure measure is more accurate in estimating SPFs for both SDC and IDC.

Modeling crash risk of horizontal curves using large-scale auto-extracted roadway geometry data.

Highway horizontal curves (H-curves) provide a smooth transition between two tangent sections of roadways. They allow vehicles to adjust their travel directions gradually. However, the geometry changes of the highway sections with H-curves often raise safety concerns. In order to deploy effective safety countermeasures, a critical task is to understand the risk factors associated with H-curves. Existing studies have made efforts to probe the safety issues associated with H-curves, whereas they were limited to relatively small-scale examinations because of the challenges in identifying H-curves from large road networks. In addition, due to the lack of well-archived traffic and roadway information, gathering other data associated with the H-curves is also difficult. Regarding to these gaps, this study aims to leverage open-source data to analyze the crash risk of highway sections with H-curves. In particular, the present study highlights itself from two main aspects: (i) a H-curve extraction tool was developed to facilitate large-scale curve data collection through the analytics of different open source data; and (ii) a crash modeling framework was developed to quantify H-curve crash risk. A case study based on a statewide road network was performed to test the developed crash risk models with the collected curve data. The results show the opportunities of using the developed tool for large-scale data collection and analyze the safety impacts of H-curve geometric properties, elevation change, traffic exposure, among others. Findings of this study provide insights into the improvement of H-curve data collection and safety evaluation.

Impact of limited rest areas on truck driver crashes in Saskatchewan: a mixed-methods approach.

BACKGROUND: Long-haul truck drivers (LHTDs) suffer from long work hours often resulting in fatigue. Although several studies have reported that fatigue can contribute to crashes, no study has identified the location and patterns of fatigue-related crashes and solicited truck driver feedback on potential mitigation strategies. The purpose of this study is 1) to map the location of fatigue-related crashes and 2) examine the perceptions of truck drivers concerning fatigue-related crashes. METHODS: Using databases from the Saskatchewan Government Insurance, information on LHTD demographics, crashes and their causes, as well as crash location was analyzed. All fatigue-related crashes were then documented and mapped. Additionally, we interviewed 67 LHTDs (mean age = 53.0 ± 12.9; range 23-89; 95% were men) asking questions about fatigue, access to truck stops/rest areas, and provided recommendations for improvement. All interviews were subsequently analyzed using thematic analyses. RESULTS: On average, there were 20 fatigue-related crashes per year over the 10-year period. Fatigue-related crashes were common across Saskatchewan, however, there was a concentration of crashes along major roadways between major cities. There was a significant association between crashes with age and experience. Despite many LHTDs being fatigued, there was a lack of truck stops/rest areas along highway routes. LHTDs suggested having access to truck stops/rest areas 250-400 km apart with running water and washrooms available. CONCLUSIONS: Additional truck stops and rest areas are needed in Saskatchewan to ensure LHTDs have more opportunities for rest to reduce fatigue in general, as well as to reduce the risk of fatigue-related crashes.

Environmental determinants of population health in urban settings. A systematic review.

BACKGROUND: Population health is influenced by interactions between environmental determinants, which are captured by dimensions and indicators. This study aims to systematically review key environmental determinants and respective dimensions and indicators, relevant to evaluate population health in urban settings, and to understand their potential implications into policies. METHODS: A search of literature published between 2008 and 2018 was conducted in PubMed, Web of Science, Scopus and SciELO Portugal databases, on studies with evidence on association between an environmental determinant and a health outcome in urban contexts. Health determinants, dimensions and indicators researched in the selected studies were synthetized, and associations analyzed. An independent assessment of quality of the studies was performed. Key conclusions and policy recommendations were extracted to build a framework to analyze environment related population health and policies in urban settings. RESULTS: Ninety four studies of varied methodological approaches and quality met the inclusion criteria. The review identified positive associations between all environmental determinants -socioeconomic, built environment, natural environment, healthcare, behaviors, and health outcomes - overall mortality and morbidity, in urban settings. Improvements in income, education, air quality, occupation status, mobility and smoking habits indicators have positive impact in overall mortality and chronic diseases morbidity indicators. Initiatives to improve population health in which policymakers can be more evidence-informed include socioeconomic, natural environment and built environment determinants. CONCLUSIONS: There is scope and need to further explore which environmental determinants and dimensions most contribute to population health to create a series of robust evidence-based measures to better inform urban planning policies.

Study of active neighborhoods in Detroit (StAND): study protocol for a natural experiment evaluating the health benefits of ecological restoration of parks.

BACKGROUND: Individuals living in deprived inner cities have disproportionately high rates of cancers, Type 2 diabetes and obesity, which have stress- and physical inactivity-related etiologies. This study aims to quantify effects of ecological park restoration on physical activity, stress and cardio-metabolic health outcomes. METHODS: The Study of Active Neighborhoods in Detroit is a quasi-experimental, longitudinal panel natural experiment with two conditions (restored park intervention (INT) and control (CNT)) and annual measurements at baseline and 3-years post-restoration. Individuals (sampled within 500 m of an INT/CNT park) serve as the unit of analysis. Restoration (n = 4 parks) involves replacing non-native plants and turf with native plants; creating trails; posting signage; and leading community stewardship events. The CNT condition (n = 5) is an unmaintained park, matched to INT based on specified neighborhood conditions. Recruitment involves several avenues, with a retention goal of 450 participants. Park measures include plant/avian diversity; usage of the park (SOPARC); signs of care; auditory environment recordings; and visual greenness using 360 imagery. Health outcomes include device-based physical activity behavior (primary outcome); salivary cortisol (secondary outcome); and several downstream health outcomes. Exposure to the INT will be assessed through visual contact time and time spent in the park using GPS data. Changes in health outcomes between years and INT versus CNT will be tested using generalized linear (mixed) models. DISCUSSION: Our study will examine whether restored urban greenspaces increase physical activity and lower stress, with public health planning implications, where small changes in neighborhood greenspaces may have large health benefits in low-income neighborhoods. STUDY REGISTRATION: Registration: OSF Preregistration registered March 31, 2020. Accessible from https://osf.io/surx7.