Search

PurposeThis study estimated associations between neighborhood socioeconomic status (NSES), walkability, green space, and incident falls among postmenopausal women and evaluated modifiers of these associations, including study arm, race and ethnicity, baseline household income, baseline walking, age at enrollment, baseline low physical functioning, baseline fall history, climate region, and urban-rural residence.MethodsThe Women's Health Initiative recruited a national sample of postmenopausal women (50-79 years) across 40 U.S. clinical centers and conducted yearly assessments from 1993 to 2005 (n = 161,808). Women reporting a history of hip fracture or walking limitations were excluded, yielding a final sample of 157,583 participants. Falling was reported annually. NSES (income/wealth, education, occupation), walkability (population density, diversity of land cover, nearby high-traffic roadways), and green space (exposure to vegetation) were calculated annually and categorized into tertiles (low, intermediate, high). Generalized estimating equations assessed longitudinal relationships.ResultsNSES was associated with falling before adjustment (high vs. low, odds ratio, 1.01; 95% confidence interval, 1.00-1.01). Walkability was significantly associated with falls after adjustment (high vs. low, odds ratio, 0.99; 95% confidence interval, 0.98-0.99). Green space was not associated with falling before or after adjustment. Study arm, race and ethnicity, household income, age, low physical functioning, fall history, and climate region modified the relationship between NSES and falling. Race and ethnicity, age, fall history, and climate region modified relationships between walkability and green space and falling.ConclusionsOur results did not show strong associations of NSES, walkability, or green space with falling. Future research should incorporate granular environmental measures that may directly relate to physical activity and outdoor engagement.

Longitudinal studies can help us understand the effects of long-term neighborhood changes, as these can capture individual self-appraisal of current and future circumstances. We analyzed the association between neighborhood changes and health-related quality of life (HRQoL) outcomes among older women from the Women's Health Initiative (WHI) study. We used a subset (n = 49,254) of the longitudinal WHI dataset of female participants, aged 50-79 at baseline, recruited from 40 clinical centers across the U.S. beginning in 1993. Two HRQoL outcomes were explored: self-rated quality of life (SRQoL), and physical functioning-related quality of life (PFQoL). We used U.S. census tract-level changes in median household income between the 2000 census and 2007-2011 American Community Survey to classify neighborhoods as "upgrading," "declining," or "stable." Multi-level models were used to identify significant associations between neighborhood change and HRQoL outcomes over time. Compared to participants residing in upgrading neighborhoods, participants in stable and declining neighborhoods reported significantly lower PFQoL. A significant interaction was observed with income such that the effect of neighborhood change was greater at lower levels of income.

(1) Background: Findings from observational studies of relations between neighborhood environments and health outcomes underscore the importance of both objective and perceived experiences of those environments. A clearer understanding of the factors associated with discrepancies between these two assessment approaches is needed to tailor public health interventions to specific populations. This study examined how individual and neighborhood characteristics affect perceptions of supermarket distance, particularly when perceptions do not match objective measures. (2) Methods: Participants were older adults (n = 880) participating in the Senior Neighborhood Quality of Life Study in the Seattle/King County, WA or Baltimore/Washington, DC regions. Two main analyses were conducted. The primary outcome for Analysis I was participants' geographic information systems (GIS)-based objective network distance to the closest supermarket. Generalized linear mixed models with block group-level random effects were used to assess associations between objective supermarket distance and individual/neighborhood characteristics. The primary outcome for Analysis II was a categorical "accuracy" variable, based on participants' perceived distance to the nearest supermarket/grocery store relative to the objective distance, assuming a walking speed of 1.0 m/s. Multivariate log-linear models fit neural networks were used to assess influential covariates. (3) Results: Several significant associations with objective distance to the nearest supermarket were observed, including a negative relationship with body mass index (BMI) (95% CI = -45.56, -0.23), having walked to the supermarket in the last 30 days (-174.86, -59.42), living in a high-walkability neighborhood, and residing in Seattle/King County (-707.69, -353.22). In terms of participants' distance accuracy, 29% were classified as accurate, 33.9% were "Underestimators", 24.0% "Overestimators", and 13.2% responded "Don't Know". Compared to Accurate participants, Overestimators were significantly less likely to have walked to the supermarket in the last 30 days, and lived objectively closer to a supermarket; Underestimators perceived significantly higher pedestrian safety and lived objectively further from a supermarket; and Don't Know were more likely to be women, older, not living independently, and not having recently walked to the supermarket. (4) Conclusions: Both modifiable and nonmodifiable factors influence the accuracy of older adults' perceptions of their proximity to the nearest supermarket. Recent experience in walking to the closest supermarket, along with personal safety, represent potentially modifiable perceived environmental factors that were related to older adults' accuracy of perceptions of their neighborhood food environment.

The COVID‐19 pandemic control measures substantially impacted the life of university students in the UK. While multiple studies investigated early stages of the pandemic, focusing on risk factors for depression and anxiety, fewer studies assessed later phases of the pandemic or examined positive protective factors for mental wellbeing. Our longitudinal study investigated changes and associations between COVID‐19 experiences, lifestyle behaviours, social connectedness and mental wellbeing in the second year of the pandemic. The validated Warwick–Edinburgh Mental Wellbeing Scale was used to measure the primary outcome mental wellbeing. Self‐reported data from 161 university students (18–35‐year‐old) in England was obtained. Data collection took place across two time points with contrasting COVID‐19 epidemiological and countermeasure attributes. T1 occurred in the spring of 2021, during the tail end of the third national lockdown when indoor household mixing was prohibited and vaccination rates were low among 18–35 year olds. T2 took place 6 months later, in the autumn of 2021, when restrictions had ended and vaccination rates were high. Within‐participant changes in students showed that mental wellbeing significantly improved over 6 months, suggesting positive adjustment. Fear of COVID‐19 and engagement in COVID‐19 protective behaviours significantly decreased as pandemic restrictions eased. Physical activity levels were high and did not change over time, while greenspace visits significantly diminished. Social support remained the same and group membership significantly increased over time. Hierarchal regressions revealed that social support was the most critical contributor to mental wellbeing. We discuss lessons for mental wellbeing promotion strategies: encouraging the use of greenspace as locations for distanced social interaction and physical activity in times of lockdown constraints. [ABSTRACT FROM AUTHOR]

The article discusses the potential reimagining of the U.S. Supplemental Nutrition Assistance Program (SNAP) as a nutrition-focused intervention. Some proposals in Congress suggest adding nutrition-based restrictions to SNAP, while others argue for cash-transfer programs. The article highlights the importance of considering global evidence and the potential impact on health outcomes. It also raises questions about the effectiveness and ethical implications of restrictions on SNAP. The article suggests that policymakers should carefully consider the evidence and global trends before making any major changes to SNAP. [Extracted from the article]

Many planning and health collaborations name the built environment as an "upstream" factor for health disparities. Though some give mention to the structural dimensions of inequality (e.g., unequal distribution of income, discriminatory policies and practices), these are rarely the focus of planning–health study. Though this narrower approach is pragmatic, it restricts the policymaking discourse to potential built environment solutions that tend not to affect structural inequalities. I argue that equity planning can help focus research and practice on the root causes of unhealthy urban forms and unequal opportunities and engage directly with the challenging redistributional questions they require. [ABSTRACT FROM AUTHOR]

Colombia's Recreovía program offers community-based free physical activity (PA) classes in parks. We evaluated built and social environmental factors influencing Recreovía local park environments, and facilitated a consensus-building and advocacy process among community members, policymakers and academic researchers aimed at improving uptake and impact of the Recreovía program. We used a mixed-methods approach, with individual and contextual PA measurements and a resident-enabled participatory approach (the Our Voice citizen science engagement model). Recreovía participants were likely to be women meeting PA recommendations, and highly satisfied with the Recreovía classes. Reported facilitators of the Recreovía included its role in enhancing social and individual well-being through PA classes. Reported barriers to usage were related to park maintenance, cleanliness and safety. The Our Voice process elicited community reflection, empowerment, advocacy and action. Our Voice facilitated the interplay among stakeholders and community members to optimize the Recreovía program as a facilitator of active living, and to make park environments more welcoming. [ABSTRACT FROM AUTHOR]

Interdisciplinary food-related research and study is a growing field in academia. Each year, more universities add departments, courses, majors, and minors focused on studying food and society and the complexities of growing, processing, distributing, accessing, and consuming food. In this commentary, we present our exploratory findings about interdisciplinary food-related academic programs, including food studies and food systems programs in the United States. This cross-sectional research developed a snapshot of the 2015 landscape of interdisciplinary food-related academic programs, provided a preliminary examination of their educational offerings, and will inform future research opportunities. In this formative study, we found 82 interdisciplinary food-related undergraduate programs focused on food. Nineteen program majors, minors, or concentrations had a core disciplinary focus on sustainable agriculture. “Food studies” and “food systems” were the primary focus of 15 undergraduate programs. We found 58 interdisciplinary food-related graduate programs and extracted information on their course offerings. Organizing courses into nine course categories, 78 percent of the programs offered courses in two to five categories, and 22 percent offered courses in six to eight categories. Few courses integrated material from multiple disciplines into a single course, suggesting that these interdisciplinary programs stemmed from traditional academic silos. Based on this preliminary work, we propose to further investigate the interdisciplinary nature of food-related academic programs, map their growth trajectory, and solicit feedback from faculty and administrators about their challenges in establishing and maintaining these programs. In future research, we are also interested in exploring job options for graduates of food-related academic programs to inform recruitment strategies and courses of study. [ABSTRACT FROM AUTHOR]

Motivated by disparate healthy food access in neighborhoods across the US, federal, state, and local initiatives have emerged to develop supermarkets in "food deserts." Differences in the implementation of these initiatives are evident, including the presence of health programming, yet no comprehensive inventory of projects exists to assess their impact. Using interviews, public databases, and media archives, I collected details (project location, financing, development, health promotion efforts) about all supermarket developments under "fresh food financing" regimes in the US, 2004-2015. In total, I identified 126 projects. Projects have been developed in a majority of states, with concentrations in the mid-Atlantic and Southern California regions. Average store size was approximately 28,100 square feet, and those receiving financial assistance from local sources and New Markets Tax Credits were significantly larger, while those receiving assistance from other federal sources were significantly smaller. About 24 percent included health-oriented features; of these, over 80 percent received federal financing. If new supermarkets alone are insufficient for health behavior change, greater attention to these nuances is needed from program designers, policymakers, and advocates who seek to continue fresh food financing programs. Efforts to reduce rates of diet-related disease by expanding food access can be improved by taking stock of existing efforts., Competing Interests: I declare no conflict of interest.