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14 pages, 383 KiB

Open AccessArticle

Clinical Manifestations and Changes of Haematological Markers among Active People Living in Polluted City: The Case of Douala, Cameroon

by Tiekwe Joseph Eloge, Ongbayokolak Nadine, Dabou Solange, Phélix Bruno Telefo and Isabella Annesi-Maesano

Int. J. Environ. Res. Public Health 2021, 18(2), 665; https://doi.org/10.3390/ijerph18020665 - 14 Jan 2021

Cited by 1 | Viewed by 2738

Abstract

Urban air pollution, despite its dangerous health impact, is poorly studied in sub-Saharan Africa (sSA). Epidemiological data on this silent killer are almost non-existent for cities of Cameroon, which seems to be one of the sSA countries where populations are highly exposed to [...] Read more.

Urban air pollution, despite its dangerous health impact, is poorly studied in sub-Saharan Africa (sSA). Epidemiological data on this silent killer are almost non-existent for cities of Cameroon, which seems to be one of the sSA countries where populations are highly exposed to air pollutants. Objective: The present study was conducted in Douala city, and aimed at determining the association of urban air quality degradation with respiratory and systemic health in active populations exposed to air pollutants on a daily basis. Methods: A cross-sectional study was conducted from 2017 to 2019 in 1182 active people consisting of motorbikes drivers (MD), outdoor urban workers (UW), and fuel station sellers (FSS). A standardized questionnaire was used to document participants’ data. One hundred and twenty-six (126) motorbike drivers were selected to evaluate the relationship between haematological (white blood cells, platelets) and inflammatory (C-reactive protein—CRP) biomarkers, and air pollution; compared with those of a sixty-five (65) motorbike drivers’ control group enrolled in Dschang, another town situated at about 216.3 km from Douala. Results: Among those recruited in urban Douala, some respiratory disorders such as running nostrils, colds, common fever, sore throats, dry cough, wheezing, chest pain, shortness of breath and systemic symptoms such as headaches, eye irritation, conjunctivitis, watery eyes and general tiredness were very common among MD, UW, and FSS. Regarding biological data, blood monocytes, lymphocytes and CRP were found to be significantly increased among selected MD in Douala, compared to control groups in Dschang. Conversely, a more significant decrease in blood neutrophil level was observed among MD in Douala than control groups in Dschang. These changes of haematological markers were significantly associated with place of residence, site of activity, and daily duration. Conclusion: Our results suggest the risk of suffering from respiratory impairments and systemic symptoms with exposure to urban air pollution among active people working near highways in Douala. Full article

(This article belongs to the Special Issue Urban Environment and Health)

10 pages, 1179 KiB

Open AccessArticle

Lack of Pregraduate Teaching on the Associations between the Built Environment, Physical Activity and Health in Swiss Architecture and Urban Design Degree Programs

by Matthias Zedi and Bengt Kayser

Int. J. Environ. Res. Public Health 2021, 18(1), 15; https://doi.org/10.3390/ijerph18010015 - 22 Dec 2020

Viewed by 2693

Abstract

Background: Lack of physical activity (PA) is the fourth risk factor for all-cause mortality. Regular PA reduces noncommunicable disease (NCD) and mortality risk. The built environment (BE) is a determinant of spontaneous daily PA. Professionals who plan and build the BE therefore affect [...] Read more.

Background: Lack of physical activity (PA) is the fourth risk factor for all-cause mortality. Regular PA reduces noncommunicable disease (NCD) and mortality risk. The built environment (BE) is a determinant of spontaneous daily PA. Professionals who plan and build the BE therefore affect public health. We tested the hypothesis of a lack of formal pregraduate training about associations between the BE, PA and health in architecture, landscape architecture, and urban design academic degree programs (DPs) in Switzerland. Methods: We reached out to all DPs in Switzerland to ask if and how these associations are taught. For those declaring to teach the topic, the program syllabus and course material were inspected. Results and discussion: For 30 out of 33 identified programs, information for the analysis was obtained. A total of 18 declared teaching the BE, PA and health associations, but this could be confirmed for only 5 after verifying the course content. Teaching principles of building PA-promoting BE represents an underutilized potential for public health promotion. Conclusions: There is a need to introduce formal learning objectives in architecture, landscape architecture, and urban design DPs in Switzerland on the associations between BE, PA and health. It is likely that similar needs exist in other countries. Full article

(This article belongs to the Special Issue Urban Environment and Health)

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12 pages, 318 KiB

Open AccessArticle

Comparison Study of Perceived Neighborhood-Built Environment and Elderly Leisure-Time Physical Activity between Hangzhou and Wenzhou, China

by Jiabin Yu, Chen Yang, Shen Zhang, Diankai Zhai and Jianshe Li

Int. J. Environ. Res. Public Health 2020, 17(24), 9284; https://doi.org/10.3390/ijerph17249284 - 11 Dec 2020

Cited by 14 | Viewed by 3042

Abstract

Physical activity and health are of significant importance for the rapid aging population in China. Built environment has been suggested to be associated with elderly physical activity and health. However, the association differences between cities remain unclear. Perceived built environment scores and elderly [...] Read more.

Physical activity and health are of significant importance for the rapid aging population in China. Built environment has been suggested to be associated with elderly physical activity and health. However, the association differences between cities remain unclear. Perceived built environment scores and elderly leisure-time physical activity (LTPA) of 308 elderly in Hangzhou and 304 elderly in Wenzhou were collected using Neighborhood Environment Walkability Scale and International Physical Activity Questionnaire, respectively. A multivariate linear regression method and T-test were used to analyze of the associations between elderly LTPA and built environment and the differences between the two cities, respectively. The results showed that LTPA was positively associated with walking/cycling facilities and crime safety in both cities. LTPA was positively correlated with residential density, aesthetics, pedestrian/traffic safety in Wenzhou and negatively correlated with access to services in Hangzhou. The perceived scores of aesthetics (2.71 vs. 2.45) and pedestrian/traffic safety (2.11 vs. 1.71) in Hangzhou were significantly higher than those in Wenzhou. The results suggested that built environment elements like higher walking/cycling facilities and crime safety may motivate elderly engaging LTPA in both cities. However, LTPA was affected by different factors in these two cities. In the urban redevelopment, survey conducted in its own city would provide meaningful information and cannot be neglected. Full article

(This article belongs to the Special Issue Urban Environment and Health)

17 pages, 4616 KiB

Open AccessArticle

The Impact of the Environment on the Quality of Life and the Mediating Effects of Sleep and Stress

by Katherine Ka Pik Chang, Frances Kam Yuet Wong, Ka Long Chan, Fiona Wong, Hung Chak Ho, Man Sing Wong, Yuen Shan Ho, John Wai Man Yuen, Judy Yuen-man Siu and Lin Yang

Int. J. Environ. Res. Public Health 2020, 17(22), 8529; https://doi.org/10.3390/ijerph17228529 - 17 Nov 2020

Cited by 19 | Viewed by 5662

Abstract

(1) Background: Environment is an independent factor that affects one’s quality of life (QoL), where studies suggest that health behaviours also affect one’s quality of life. The purpose of the present study was to examine the association between environmental conditions and QoL [...] Read more.

(1) Background: Environment is an independent factor that affects one’s quality of life (QoL), where studies suggest that health behaviours also affect one’s quality of life. The purpose of the present study was to examine the association between environmental conditions and QoL and how individual health behaviours affect this association. (2) Methods: Participants aged 20 or above were recruited from 11 tertiary planning units in the central part of Kowloon. These tertiary planning units were selected as they represented the overall living environment in Hong Kong, with a mix of the poorer urban areas alongside relatively affluent districts. A mediation analysis was implemented using multiple linear regressions to examine the effects of environmental conditions on QoL. (3) Results: Of the 607 eligible participants included for analysis, 390 were female and 217 were male, with a mean age of 47.4 years. Living within 500 m of a green space area had benefits on the physical aspect of QoL and physical activity but no effect on the psychological aspect of QoL. Moderate satisfaction with public spaces affected QoL positively. In contrast, less satisfaction with public spaces affected QoL negatively in both physical and psychological aspects through the mediating effect of stress. Poor environmental quality affected all domains of QoL negatively through the mediating effects of increased stress and poor sleep. (4) Conclusions: Environment is an important factor that affects individuals’ overall well-being. The interaction between environmental conditions and individual variables, especially perceived stress and sleep, is extremely important when assessing its impact on QoL. The findings of this study support the importance of individual stress and sleep in mediating the relationship between the environment and QoL for health. Further studies should be conducted to include objective measurements, such as those of cortisol levels for stress and physical fitness tests. Full article

(This article belongs to the Special Issue Urban Environment and Health)

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13 pages, 1089 KiB

Open AccessArticle

Municipal Residence Level of Long-Term PM₁₀ Exposure Associated with Obesity among Young Adults in Seoul, Korea

by Jayeun Kim and Kyuhyun Yoon

Int. J. Environ. Res. Public Health 2020, 17(19), 6981; https://doi.org/10.3390/ijerph17196981 - 24 Sep 2020

Cited by 3 | Viewed by 2076

Abstract

Background: long-term effects of ambient pollutants used to be defined in cohort studies using biomarkers. Health effects on young adults from long-term exposure to particulate matters (PM) in residential ambiance have received less attention. Methods: using the data of population-representative aged 19–29 in [...] Read more.

Background: long-term effects of ambient pollutants used to be defined in cohort studies using biomarkers. Health effects on young adults from long-term exposure to particulate matters (PM) in residential ambiance have received less attention. Methods: using the data of population-representative aged 19–29 in Seoul, the relationship between obesity and PM₁₀ levels of the living district was examined. We defined obesity as Body Mass Index (BMI) 25 kg/m² and more. Survey logistic regression was conducted according to individual residence periods in the current municipality. Individual characteristics were adjusted overall and were age-specific; aged 19–24 and 25–29. Results: study population was 3655 (1680 (46%) men and 1933 aged 19–24 (52.9%)) individuals. Relationship between length of residence in municipalities with a greater level of PM₁₀ from 2001–2005 and obesity was increased over the residing period; 10 years ≤ (odds ratio (OR) 1.071, 95% confidence interval (CI) 0.969–1.185), 15 years ≤ (1.120, 1.006–1.247), and 20 years ≤ (1.158, 1.034–1.297) in aged 19–29. Age-specific effects showed slight differences. Conclusions: Although PM₁₀ levels are currently decreasing, higher levels of PM₁₀ exposure in the residential area during the earlier lifetime may contribute to obesity increase among young adults. Full article

(This article belongs to the Special Issue Urban Environment and Health)

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16 pages, 349 KiB

Open AccessArticle

Validation of the Urban Walkability Perception Questionnaire (UWPQ) in the Balearic Islands

by Guillem Artigues, Sara Mateo, Maria Ramos and Elena Cabeza

Int. J. Environ. Res. Public Health 2020, 17(18), 6631; https://doi.org/10.3390/ijerph17186631 - 11 Sep 2020

Cited by 5 | Viewed by 2496

Abstract

Within the context of promoting the “healthy routes” program, the aim of this study was to validate the urban walkability perception questionnaire (UWPQ) in the Balearic Islands to determine the characteristics of the urban environment that promote walking among the population. The UWPQ [...] Read more.

Within the context of promoting the “healthy routes” program, the aim of this study was to validate the urban walkability perception questionnaire (UWPQ) in the Balearic Islands to determine the characteristics of the urban environment that promote walking among the population. The UWPQ measures pedestrian facilities, infrastructures of the environment, perception of safety and a participant’s general opinion. This process was performed in 12 routes predefined by a community participation program and set around the primary health centers. Degree of correlation between the items was calculated. The final internal consistency was 0.8 in all blocks according to the Cronbach’s alpha test (p < 0.01). Goodman and Kruskal–gamma correlation coefficient (γ) between the item measuring the general opinion and the rest of the items was significant. The items from the perception of safety and pedestrian facilities blocks were the ones that most affected the final assessment. Those regarding the pedestrian-only pavements, clearly marked pavements, noise, traffic density and parks condition obtained the lowest coefficients. To conclude, the results showed that the UWPQ is a suitable instrument to assess the degree of adequacy of the urban environment for walking. It could contribute to create healthy environments as well as to improve public policies. Full article

(This article belongs to the Special Issue Urban Environment and Health)

11 pages, 1381 KiB

Open AccessArticle

Neighborhood Violent Crime and Perceived Stress in Pregnancy

by Megan M. Shannon, Jane E. Clougherty, Clare McCarthy, Michal A. Elovitz, Max Jordan Nguemeni Tiako, Steven J. Melly and Heather H. Burris

Int. J. Environ. Res. Public Health 2020, 17(15), 5585; https://doi.org/10.3390/ijerph17155585 - 3 Aug 2020

Cited by 36 | Viewed by 4874

Abstract

Stress has been shown to adversely affect pregnancy outcomes. Neighborhood crime rates may serve as one publicly available social determinant of health for pregnancy studies that use registry or electronic health record datasets in which individual-level stress data are not available. We sought [...] Read more.

Stress has been shown to adversely affect pregnancy outcomes. Neighborhood crime rates may serve as one publicly available social determinant of health for pregnancy studies that use registry or electronic health record datasets in which individual-level stress data are not available. We sought to determine whether neighborhood violent crime incidents were associated with measured perceived stress in a largely minority, urban pregnancy cohort. We performed a secondary analysis of the 1309 Philadelphia residents participating in the Motherhood and Microbiome cohort (n = 2000) with both neighborhood violent crime and Cohen’s Perceived Stress Scale (PSS-14) data. Generalized linear mixed models accounting for confounding variables and geographic clustering demonstrated that, regardless of race, women with the highest quartile of neighborhood violent crime had significantly elevated odds of high stress compared to women with lower crime. We also found that Black women were more likely to have both the highest quartile of neighborhood violent crime and high stress than non-Black women. Overall, this study demonstrates that neighborhood violent crime is associated with perceived stress in pregnancy. Given disparate exposure to crime and prenatal stress by race, future work is warranted to determine whether urban neighborhood violence and/or stress reduction strategies would improve birth outcome racial disparities. Full article

(This article belongs to the Special Issue Urban Environment and Health)

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13 pages, 526 KiB

Open AccessArticle

Characterizing Urban Home Gardening and Associated Factors to Shape Fruit and Vegetable Consumption among Non-Farmers in Thailand

by Sirinya Phulkerd, Sasinee Thapsuwan, Rossarin Soottipong Gray and Aphichat Chamratrithirong

Int. J. Environ. Res. Public Health 2020, 17(15), 5400; https://doi.org/10.3390/ijerph17155400 - 27 Jul 2020

Cited by 13 | Viewed by 3447

Abstract

The purpose of this study was to investigate the association between home gardening and sufficient fruit and vegetable (FV) intake among non-farmers in Thailand, and examine the influence of socio-demographic characteristics and other associated factors on home gardening among non-farmers in urban areas. [...] Read more.

The purpose of this study was to investigate the association between home gardening and sufficient fruit and vegetable (FV) intake among non-farmers in Thailand, and examine the influence of socio-demographic characteristics and other associated factors on home gardening among non-farmers in urban areas. Data were collected by a cross-sectional survey of a sample of Thai non-farmers (N = 5634). Information on self-reported home gardening, FV intake, health-related behaviors, and socio-demographic characteristics was collected via questionnaire. The findings show that home gardening is significantly associated with sufficient FV intake among non-farmers (p < 0.001). Within the non-farmer group who lived in urban areas, 9% gardened FV at home. Home gardening was significantly associated with socio-demographic characteristics (sex, age and occupation), physical activity, fear of pesticide contamination of FV, and FV safety awareness among the urban non-farmers. Respondents who were female, in the middle-adulthood group, practiced regular physical activity, feared pesticide contamination, and had high awareness of FV safety had the highest probability of gardening at home (p < 0.05, p < 0.001, p < 0.01, p < 0.001 and p < 0.05, respectively). The Thai government should pay more attention to factors that influence urban home gardening by providing support, building local capacity, and implementing effective interventions with the urban population. Full article

(This article belongs to the Special Issue Urban Environment and Health)

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23 pages, 1627 KiB

Open AccessArticle

Noncommunicable Diseases, Park Prescriptions, and Urban Green Space Use Patterns in a Global South Context: The Case of Dhaka, Bangladesh

by S.M. Labib, Faysal Kabir Shuvo, Matthew H. E. M. Browning and Alessandro Rigolon

Int. J. Environ. Res. Public Health 2020, 17(11), 3900; https://doi.org/10.3390/ijerph17113900 - 31 May 2020

Cited by 16 | Viewed by 6790

Abstract

Urban green space use is often associated with improved physical and mental health and lower noncommunicable disease (NCDs) burdens. Factors that influence green space visits have been documented in cities of the Global North, but evidence of urban green space use patterns for [...] Read more.

Urban green space use is often associated with improved physical and mental health and lower noncommunicable disease (NCDs) burdens. Factors that influence green space visits have been documented in cities of the Global North, but evidence of urban green space use patterns for cities in the Global South is scarce. The aim of this study is to investigate factors influencing urban green space use patterns in Dhaka, Bangladesh, a megacity of the Global South, with a particular focus on how poor health condition and healthcare professionals’ prescriptions to exercise outdoors (park prescriptions—ParkRx) impact the green space use of middle-aged adults. We collected green space characteristics and use factors (i.e., availability, accessibility, attractiveness, and attachment), health condition, ParkRx, and urban green space use intensity (i.e., frequency and duration) via a self-reported questionnaire from 169 middle-aged residents of Dhaka. We used multivariate modeling to estimate the association of green space characteristics, health condition, and ParkRx with use intensity. We further applied a mediation analysis to determine the influence of ParkRx on the relationship between residents’ poor health conditions and use intensity. We found that green space availability and accessibility did not significantly influence use intensity, but attractiveness was negatively associated with use intensity. Green space use intensity was significantly and positively associated with attachment to the green space, poor health condition (i.e., having noncommunicable diseases), and ParkRx. ParkRx significantly mediated the relationship between health condition and use intensity. We observed limited supply, poor access, and low attractiveness when studying the urban green spaces in Dhaka, but these qualities did not affect use intensity, as found in many case studies in the Global North. In contrast, urban green space use intensity in our case study is mostly dependent on poor health condition and park prescriptions. Full article

(This article belongs to the Special Issue Urban Environment and Health)

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12 pages, 1969 KiB

Open AccessArticle

Individual Aircraft Noise Exposure Assessment for a Case-Crossover Study in Switzerland

by Apolline Saucy, Beat Schäffer, Louise Tangermann, Danielle Vienneau, Jean-Marc Wunderli and Martin Röösli

Int. J. Environ. Res. Public Health 2020, 17(9), 3011; https://doi.org/10.3390/ijerph17093011 - 26 Apr 2020

Cited by 7 | Viewed by 3164

Abstract

Accurate exposure assessment is essential in environmental epidemiological studies. This is especially true for aircraft noise, which is characterized by a high spatial and temporal variation. We propose a method to assess individual aircraft noise exposure for a case-crossover study investigating the acute [...] Read more.

Accurate exposure assessment is essential in environmental epidemiological studies. This is especially true for aircraft noise, which is characterized by a high spatial and temporal variation. We propose a method to assess individual aircraft noise exposure for a case-crossover study investigating the acute effects of aircraft noise on cardiovascular deaths. We identified all cases of cardiovascular death (24,886) occurring near Zürich airport, Switzerland, over fifteen years from the Swiss National Cohort. Outdoor noise exposure at the home address was calculated for the night preceding death and control nights using flight operations information from Zürich airport and noise footprints calculated for major aircraft types and air routes. We estimated three different noise metrics: mean sound pressure level (L_Aeq), maximum sound pressure level (L_Amax), and number above threshold 55 dB (NAT₅₅) for different nighttime windows. Average nighttime aircraft noise levels were 45.2 dB, 64.6 dB, and 18.5 for L_Aeq, L_Amax, and NAT₅₅ respectively. In this paper, we present a method to estimate individual aircraft noise exposure with high spatio-temporal resolution and a flexible choice of exposure events and metrics. This exposure assessment will be used in a case-crossover study investigating the acute effects of noise on health. Full article

(This article belongs to the Special Issue Urban Environment and Health)

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18 pages, 5378 KiB

Open AccessArticle

Does the Presence of Birdsongs Improve Perceived Levels of Mental Restoration from Park Use? Experiments on Parkways of Harbin Sun Island in China

by Xun Zhu, Ming Gao, Wei Zhao and Tianji Ge

Int. J. Environ. Res. Public Health 2020, 17(7), 2271; https://doi.org/10.3390/ijerph17072271 - 27 Mar 2020

Cited by 37 | Viewed by 4551

Abstract

Green spaces in cities and urban parks serve as central areas for mental restoration and relieving pressure, and attention to soundscapes for their mental health benefits has become more prevalent. Birdsongs are perceived to enhance the restorative benefits of urban parks. This study [...] Read more.

Green spaces in cities and urban parks serve as central areas for mental restoration and relieving pressure, and attention to soundscapes for their mental health benefits has become more prevalent. Birdsongs are perceived to enhance the restorative benefits of urban parks. This study examines Harbin Sun Island Park, the main bird habitat in the city of Harbin with numerous types of landscapes. We used space syntax to select the appropriate path space as a carrier and the pixel grid method to quantify path space shapes. A correlation analysis of field data was also used to explore the perceived restorative effects of birdsongs heard in urban parks using scales detailing the perceived restorative effects of various visual and auditory stimuli. The results show that soundscapes can significantly improve perceived recovery benefits, and that hearing birdsongs can significantly improve the perceived restorative benefits of wetland paths; the sky index of a tour path showed a significantly negative correlation with each feature (i.e., the four featured dimensions of “charm”, “escape”, “ductility” and “compatibility” included in the recovery scale), and the soft/hard ratio showed a significantly negative correlation with each studied feature. When the sky index ranged from 13–36%, tree coverage of the vertical coverage range was 30.28–38.6%, and when the soft/hard ratio ranged from 5–21, the perceived recovery benefit was strongest. Full article

(This article belongs to the Special Issue Urban Environment and Health)

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14 pages, 978 KiB

Open AccessArticle

The Effects of Risk Perceptions Related to Particulate Matter on Outdoor Activity Satisfaction in South Korea

by Bomi Kim, Eun Joo Yoon, Songyi Kim and Dong Kun Lee

Int. J. Environ. Res. Public Health 2020, 17(5), 1613; https://doi.org/10.3390/ijerph17051613 - 2 Mar 2020

Cited by 14 | Viewed by 4303

Abstract

In recent years, the Korean public has become aware of the form of air pollution known as particulate matter, with a consequent growth of public anxiety causing a negative risk perception about outdoor activity. This study aims at determining the causal relationship between [...] Read more.

In recent years, the Korean public has become aware of the form of air pollution known as particulate matter, with a consequent growth of public anxiety causing a negative risk perception about outdoor activity. This study aims at determining the causal relationship between risk perceptions about particulate matter and outdoor activity satisfaction in South Korea. An Internet survey was conducted with 412 people, and a structural equation model was used to perform confirmatory factor analysis. The statistically significant results show that the perceived risk of particulate matter is higher when people do not show interest in or trust public opinion or policy on the subject. This increases people’s perceptions of health risks, which in turn lowers their satisfaction with outdoor activity. Although trust levels in public opinion or policy had a positive impact on outdoor activity satisfaction, this was not statistically significant. These results are expected to contribute to risk communication guidelines in public opinion reporting and to the direction of environmental health policies in developing countries with high levels of air pollution, such as particulate matter. Full article

(This article belongs to the Special Issue Urban Environment and Health)

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23 pages, 5475 KiB

Open AccessArticle

Independent or Influential? Spatial-Temporal Features of Coordination Level between Urbanization Quality and Urbanization Scale in China and Its Driving Mechanism

by Yijun Shi, Quan Zhu, Lihua Xu, Zhangwei Lu, Yaqi Wu, Xiangbin Wang, Yang Fei and Jinyang Deng

Int. J. Environ. Res. Public Health 2020, 17(5), 1587; https://doi.org/10.3390/ijerph17051587 - 1 Mar 2020

Cited by 25 | Viewed by 3034

Abstract

The quality and scale of urbanization development are the two main aspects in China’s current urbanization process. By measuring and analyzing the level differences in these two aspects, the healthy development of China’s urbanization and urban–rural integration will be promoted. Based on the [...] Read more.

The quality and scale of urbanization development are the two main aspects in China’s current urbanization process. By measuring and analyzing the level differences in these two aspects, the healthy development of China’s urbanization and urban–rural integration will be promoted. Based on the quality of urbanization and the scale of urbanization, this paper constructs an evaluation index system for urbanization coordination level. On this basis, this paper analyzes the spatial correlation, spatial difference, and spatial pattern evolution characteristics of urbanization coordination level in 286 sample cities nationwide from 2005 to 2015. Then, by introducing the spatial econometric regression model, this paper discusses the driving mechanism of the spatial and temporal evolution of urbanization coordination level. The results show that: (1) The level of coordination between urbanization quality and urbanization scale shows a strong spatial correlation in space, which is consistent with the actual development status; (2) the level of urbanization coordination shows a trend of evolution from northeast to southwest in the evolution of spatial pattern, but the extent of change is small; and (3) the spatial and temporal pattern of urbanization coordination level is affected by different driving forces, of which internal source is the primary impact factor, followed by administrative level and investment level. In addition, the level of urbanization coordination has a positive spillover effect on the level of urbanization coordination in adjacent areas. Full article

(This article belongs to the Special Issue Urban Environment and Health)

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18 pages, 1839 KiB

Open AccessArticle

Examining the Urban and Rural Healthcare Progress in Big Cities of China: Analysis of Monitoring Data in Dalian from 2008 to 2017

by Yukun Qiu, Wei Lu, Jianke Guo, Caizhi Sun and Xinyu Liu

Int. J. Environ. Res. Public Health 2020, 17(4), 1148; https://doi.org/10.3390/ijerph17041148 - 12 Feb 2020

Cited by 17 | Viewed by 3178

Abstract

How to effectively reduce the disparity between urban and rural medical healthcare has become a major global concern. In China, the government has issued a series of reform measures to address the gap between urban and rural medical care. To explore the impact [...] Read more.

How to effectively reduce the disparity between urban and rural medical healthcare has become a major global concern. In China, the government has issued a series of reform measures to address the gap between urban and rural medical care. To explore the impact of China’s medical system reforms in improving health services in urban and rural areas and understand the factors promoting and hindering progress, we evaluated the healthcare system in Dalian City, China, from 2008 to 2017. The weighted TOPSIS (technique for order preference by similarity to ideal solution) model was used to assess the development of the healthcare system in the different districts and employed the obstacle model to identify and analyze indicators that hinder progress in health services. Using the local spatial clustering function, we categorized the districts in terms of the hindrance type that significantly hamper the growth of the healthcare system. Our results show the healthcare system in Dalian’s urban areas has steadily increased, while development in rural areas has been erratic. Although the urban–rural healthcare disparity has narrowed distinctly, sustained progress is not guaranteed. Based on the location theory, residents in urban areas are more affected by economic factors, while those in rural areas are more influenced by time considerations. When initiating healthcare reforms in urban areas, the impact of varying land prices and per capita disposable income should be considered. For rural areas, constructing more medical institutions to reduce the impact of time costs should be considered. We also found different factors that hinder the growth of the healthcare system for urban and rural areas. To address these impediments to progress, urban areas should pay more attention to coordinated development, while rural areas should address specific concerns based on local needs and conditions. More research on the progress in medical reform is crucial to provide reference and policy-guidance for countries facing similar concerns. Full article

(This article belongs to the Special Issue Urban Environment and Health)

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19 pages, 3590 KiB

Open AccessArticle

Spatial Econometric Analysis of the Impact of Socioeconomic Factors on PM_2.5 Concentration in China’s Inland Cities: A Case Study from Chengdu Plain Economic Zone

by Ye Yang, Haifeng Lan and Jing Li

Int. J. Environ. Res. Public Health 2020, 17(1), 74; https://doi.org/10.3390/ijerph17010074 - 20 Dec 2019

Cited by 21 | Viewed by 3379

Abstract

Particulate matter with a diameter less than 2.5 µm (PM_2.5), one of the main sources of air pollution, has increasingly become a concern of the people and governments in China. Examining the socioeconomic factors influencing on PM_2.5 concentration is important [...] Read more.

Particulate matter with a diameter less than 2.5 µm (PM_2.5), one of the main sources of air pollution, has increasingly become a concern of the people and governments in China. Examining the socioeconomic factors influencing on PM_2.5 concentration is important for regional prevention and control. Previous studies mainly concentrated on the economically developed eastern coastal cities, but few studies focused on inland cities. This study selected Chengdu Plain Economic Zone (CPEZ), an inland region with heavy smog, and used spatial econometrics methods to identify the spatiotemporal distribution characteristics of PM_2.5 concentration and the socioeconomic factors underlying it from 2006 to 2016. Moran’s index indicates that PM_2.5 concentration in CPEZ does have spatial aggregation characteristics. In general, the spatial clustering from the fluctuation state to the stable low state decreased by 1% annually on average, from 0.190 (p < 0.05) in 2006 to 0.083 (p < 0.1) in 2016. According to the results of the spatial Durbin model (SDM), socioeconomic factors including population density, energy consumption per unit of output, gross domestic product (GDP), and per capita GDP have a positive effect on PM_2.5 concentration, while greening rate and per capita park space have a negative effect. Additionally, those factors have identified spatial spillover effects on PM_2.5 concentration. This study could be a reference and support for the formulation of more efficient air pollution control policies in inland cities. Full article

(This article belongs to the Special Issue Urban Environment and Health)

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12 pages, 4826 KiB

Open AccessArticle

Spatiotemporal Distribution of Tuberculosis during Urbanization in the New Urban Area of Nanchang City, China, 2010–2018

by Shu Yang, Yuan Gao, Wei Luo, Longfu Liu, Yuanhua Lei and Xiaoling Zhang

Int. J. Environ. Res. Public Health 2019, 16(22), 4395; https://doi.org/10.3390/ijerph16224395 - 11 Nov 2019

Cited by 11 | Viewed by 3572

Abstract

Background: Urbanization will play a key role in ending the tuberculosis (TB) epidemic by 2030, but understanding the relationship between urbanization and the health threats posed by TB is incomplete. Therefore, this study aimed to explore the spatiotemporal distribution of TB at the [...] Read more.

Background: Urbanization will play a key role in ending the tuberculosis (TB) epidemic by 2030, but understanding the relationship between urbanization and the health threats posed by TB is incomplete. Therefore, this study aimed to explore the spatiotemporal distribution of TB at the township level during urbanization in the new urban area of Nanchang. Methods: Seasonal-trend decomposition of time series analysis was used to explore the seasonal distribution and trend analysis. Global and local spatial autocorrelation statistics, and space–time scan statistics were performed to detect the spatiotemporal clusters of TB cases in the new urban area of Nanchang from 2010 to 2018. Results: A total of 3245 TB cases were reported in the study area from 2010 to 2018. Of all the TB cases, 68% occurred in individuals older than 40 years old, 73.2% were male cases, and 56.6% were farmers. The primary seasonal peak was in late spring (April), and a smaller peak was in early autumn (September). The results of local indicators of spatial association showed that Jiaoqiao town and Changleng town might be “High–High” clusters. The most likely spatiotemporal cluster was located in the southwest of the study area in 2010, which included five towns, and then shifted to the northeast gradually. Across 2010 to 2018, nine spatiotemporal clusters were identified. The most likely cluster was located at the northeast of the study area. The center of this area was in Nanji town with a circle radius of 43.74 kilometers. Conclusions: The spatial clusters of TB incidence shifted to the rural region and the fringe of the new urban area of Nanchang. Targeted management strategies for urban migrants in the process of urbanization should be strengthened. Full article

(This article belongs to the Special Issue Urban Environment and Health)

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Review

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18 pages, 1359 KiB

Open AccessReview

Green Space Exposure Association with Type 2 Diabetes Mellitus, Physical Activity, and Obesity: A Systematic Review

by Felipe De la Fuente, María Angélica Saldías, Camila Cubillos, Gabriela Mery, Daniela Carvajal, Martín Bowen and María Paz Bertoglia

Int. J. Environ. Res. Public Health 2021, 18(1), 97; https://doi.org/10.3390/ijerph18010097 - 25 Dec 2020

Cited by 86 | Viewed by 10647

Abstract

Type 2 diabetes mellitus (T2DM) is a public health challenge that must be addressed considering the large number of risk factors involved in its appearance. Some environmental risk factors are currently described as predictors of diabetes, with access to green spaces being an [...] Read more.

Type 2 diabetes mellitus (T2DM) is a public health challenge that must be addressed considering the large number of risk factors involved in its appearance. Some environmental risk factors are currently described as predictors of diabetes, with access to green spaces being an element to consider in urban settings. This review aims to study the association between exposure to green spaces and outcomes such as diabetes, obesity, and physical activity in the general population. A systematic review was carried out using the PubMed, Embase, and LILACS databases and other sources. The search strategy was carried out from October 2019 to October 2020. Cross-sectional and cohort studies were included. The article selection was made by a pair of reviewers, and data extraction was carried out using a data extraction sheet. The quality assessment of the included studies was carried out using a validated tool. Finally, 19 scientific articles were included in this review. Evidence supports that people and communities exposed to green spaces, especially in their neighborhood, reduce the risk of T2DM and reduce the risk of being obese and increase the likelihood of physical activity. The onset of T2DM can be moderated by using green spaces, improving physical activity levels, and reducing the risk of being overweight and obese. Full article

(This article belongs to the Special Issue Urban Environment and Health)

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22 pages, 1582 KiB

Open AccessReview

Urban Noise and Psychological Distress: A Systematic Review

by Nicola Mucci, Veronica Traversini, Chiara Lorini, Simone De Sio, Raymond P. Galea, Guglielmo Bonaccorsi and Giulio Arcangeli

Int. J. Environ. Res. Public Health 2020, 17(18), 6621; https://doi.org/10.3390/ijerph17186621 - 11 Sep 2020

Cited by 26 | Viewed by 5047

Abstract

Chronic exposure to urban noise is harmful for auditory perception, cardiovascular, gastrointestinal and nervous systems, while also causing psychological annoyance. Around 25% of the EU population experience a deterioration in the quality of life due to annoyance and about 5–15% suffer from sleep [...] Read more.

Chronic exposure to urban noise is harmful for auditory perception, cardiovascular, gastrointestinal and nervous systems, while also causing psychological annoyance. Around 25% of the EU population experience a deterioration in the quality of life due to annoyance and about 5–15% suffer from sleep disorders, with many disability-adjusted life years (DALYs) lost annually. This systematic review highlights the main sources of urban noise, the relevant principal clinical disorders and the most effected countries. This review included articles published on the major databases (PubMed, Cochrane Library, Scopus), using a combination of some keywords. The online search yielded 265 references; after selection, the authors have analyzed 54 articles (5 reviews and 49 original articles). From the analysis, among the sources of exposure, we found the majority of items dealing with airports and wind turbines, followed by roads and trains; the main disorders that were investigated in different populations dealt with annoyance and sleep disorders, sometimes associated with cardiovascular symptoms. Regarding countries, studies were published from all over the world with a slight prevalence from Western Europe. Considering these fundamental health consequences, research needs to be extended in such a way as to include new sources of noise and new technologies, to ensure a health promotion system and to reduce the risk of residents being exposed. Full article

(This article belongs to the Special Issue Urban Environment and Health)

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27 pages, 607 KiB

Open AccessReview

Impact of the Built Environment and the Neighborhood in Promoting the Physical Activity and the Healthy Aging in Older People: An Umbrella Review

by Guglielmo Bonaccorsi, Federico Manzi, Marco Del Riccio, Nicoletta Setola, Eletta Naldi, Chiara Milani, Duccio Giorgetti, Claudia Dellisanti and Chiara Lorini

Int. J. Environ. Res. Public Health 2020, 17(17), 6127; https://doi.org/10.3390/ijerph17176127 - 23 Aug 2020

Cited by 82 | Viewed by 11499

Abstract

(1) Background: The aim of this study is to establish which specific elements of the built environment can contribute to improving the physical activity of self-sufficient, noninstitutionalized and living in the city adults > 65 years. (2) Methods: An extensive literature search was [...] Read more.

(1) Background: The aim of this study is to establish which specific elements of the built environment can contribute to improving the physical activity of self-sufficient, noninstitutionalized and living in the city adults > 65 years. (2) Methods: An extensive literature search was conducted in several database. Umbrella review methodology was used to include the reviews that presented a sufficient methodological quality. (3) Results: Eleven reviews were included. The elements positively associated with physical activity in older adults were: walkability; residential density/urbanization; street connectivity; land-use mix-destination diversity; overall access to facilities, destinations and services; pedestrian-friendly infrastructures; greenery and aesthetically pleasing scenery; high environmental quality; street lighting; crime-related safety; traffic-related safety. The elements that were negatively associated with physical activity were: poor pedestrian access to shopping centers; poor pedestrian-friendly infrastructure and footpath quality; barriers to walking/cycling; lack of aesthetically pleasing scenery; crime-related unsafety; unattended dogs; inadequate street lighting and upkeep; traffic; littering, vandalism, decay; pollution; noise. (4) Conclusions: Evidence shows that specific elements of the built environment can contribute to promoting older people’s physical activity. The city restructuring plans should take into consideration these factors. Full article

(This article belongs to the Special Issue Urban Environment and Health)

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37 pages, 1710 KiB

Open AccessReview

Environmental and Health Effects of Ventilation in Subway Stations: A Literature Review

by Yueming Wen, Jiawei Leng, Xiaobing Shen, Gang Han, Lijun Sun and Fei Yu

Int. J. Environ. Res. Public Health 2020, 17(3), 1084; https://doi.org/10.3390/ijerph17031084 - 8 Feb 2020

Cited by 74 | Viewed by 11035

Abstract

Environmental health in subway stations, a typical type of urban underground space, is becoming increasingly important. Ventilation is the principal measure for optimizing the complex physical environment in a subway station. This paper narratively reviews the environmental and health effects of subway ventilation [...] Read more.

Environmental health in subway stations, a typical type of urban underground space, is becoming increasingly important. Ventilation is the principal measure for optimizing the complex physical environment in a subway station. This paper narratively reviews the environmental and health effects of subway ventilation and discusses the relevant engineering, environmental, and medical aspects in combination. Ventilation exerts a notable dual effect on environmental health in a subway station. On the one hand, ventilation controls temperature, humidity, and indoor air quality to ensure human comfort and health. On the other hand, ventilation also carries the potential risks of spreading air pollutants or fire smoke through the complex wind environment as well as produces continuous noise. Assessment and management of health risks associated with subway ventilation is essential to attain a healthy subway environment. This, however, requires exposure, threshold data, and thereby necessitates more research into long-term effects, and toxicity as well as epidemiological studies. Additionally, more research is needed to further examine the design and maintenance of ventilation systems. An understanding of the pathogenic mechanisms and aerodynamic characteristics of various pollutants can help formulate ventilation strategies to reduce pollutant concentrations. Moreover, current comprehensive underground space development affords a possibility for creating flexible spaces that optimize ventilation efficiency, acoustic comfort, and space perception. Full article

(This article belongs to the Special Issue Urban Environment and Health)

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