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Special Issue "Space, Place and Health Outcomes"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Environmental Health".

Deadline for manuscript submissions: closed (31 October 2020).

Special Issue Editors

Dr. Ofer Amram
E-Mail Website
Guest Editor
Elson S. Floyd College of Medicine, Washington State University, 412 E. Spokane Falls Blvd. Spokane, WA 99202-2131, USA
Interests: spatial epidemiology; geographic information systems; exposure assessment; public health
Prof. Dr. Blake Walker
E-Mail Website
Guest Editor
Institut für Geographie, Friedrich-Alexander-Universität Erlangen-Nürnberg, Wetterkreuz 15, D-91058 Erlangen, Raum 3.045, Germany
Interests: digital health geography; spatial epidemiology; quantitative analysis; geoinformatics and critical geoinformation processing

Special Issue Information

Dear colleagues,

The environment in which we live, work, and spend our time can have a direct impact on our health. Contextual factors, like social and economic features of neighborhoods, have been shown to have a significant impact on an array of health outcomes, including mortality, chronic conditions, mental health, injuries, violence, and other important health indicators. The physical and social environments of neighborhoods can shape our behavior, thus having a direct impact on our health. For example, unsafe neighborhoods can affect our overall wellbeing by denying us the opportunity to have physical activity and spend time outdoors. On the other hand, walkable neighborhoods, access to playgrounds, and affordable, nutritious food can encourage healthy behaviors and lifestyles. Moreover, individuals are more likely to have convenient access to health facilities when they are located within close proximity to their residence or if appropriate forms of transportation are available within their neighborhood.

This Special Issue of IJERPH focuses on the links between space, place, and health outcomes. We are happy to accept manuscripts from different disciplines. We are particularly interested in studies that advance the understanding of the causal mechanisms linking environments and health outcomes or associated behavioral risk factors. We encourage studies utilizing novel methodologies to assess and derive exposure and neighborhood characteristics.

Dr. Ofer Amram
Prof. Dr. Blake Walker
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2300 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Exposure assessment
  • Healthy environments
  • Neighbourhoods
  • Socioeconomic status
  • Epidemiology

Published Papers (11 papers)

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Research

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Article
Towards a Situated Spatial Epidemiology of Violence: A Placially-Informed Geospatial Analysis of Homicide in Alagoas, Brazil
Int. J. Environ. Res. Public Health 2020, 17(24), 9283; https://doi.org/10.3390/ijerph17249283 - 11 Dec 2020
Cited by 1 | Viewed by 1103
Abstract
This paper presents an empirically grounded call for a more nuanced engagement and situatedness with placial characteristics within a spatial epidemiology frame. By using qualitative data collected through interviews and observation to parameterise standard and spatial regression models, and through a critical interpretation [...] Read more.
This paper presents an empirically grounded call for a more nuanced engagement and situatedness with placial characteristics within a spatial epidemiology frame. By using qualitative data collected through interviews and observation to parameterise standard and spatial regression models, and through a critical interpretation of their results, we present initial inroads for a situated spatial epidemiology and an analytical framework for health/medical geographers to iteratively engage with data, modelling, and the context of both the subject and process of analysis. In this study, we explore the socioeconomic factors that influence homicide rates in the Brazilian state of Alagoas from a critical public health perspective. Informed by field observation and interviews with 24 youths in low-income neighbourhoods and prisons in Alagoas, we derive and critically reflect on three regression models to predict municipal homicide rates from 2016–2020. The model results indicate significant effects for the male population, persons without elementary school completion, households with reported income, divorced persons, households without piped water, and persons working outside their home municipality. These results are situated in the broader socioeconomic context, trajectories, and cycles of inequality in the study area and underscore the need for integrative and contextually engaged mixed method study design in spatial epidemiology. Full article
(This article belongs to the Special Issue Space, Place and Health Outcomes)
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Article
Associations between Neighborhood Walkability, Physical Activity, and Chronic Disease in Nova Scotian Adults: An Atlantic PATH Cohort Study
Int. J. Environ. Res. Public Health 2020, 17(22), 8643; https://doi.org/10.3390/ijerph17228643 - 20 Nov 2020
Viewed by 1020
Abstract
Background: While neighborhood walkability has been shown to positively influence health behaviors, less is known about its impact on chronic disease. Our aim was to examine the association between walkability and self-reported physical activity in relation to chronic health conditions in an [...] Read more.
Background: While neighborhood walkability has been shown to positively influence health behaviors, less is known about its impact on chronic disease. Our aim was to examine the association between walkability and self-reported physical activity in relation to chronic health conditions in an Atlantic Canadian population. Methods: Using data from the Atlantic Partnership for Tomorrow’s Health, a prospective cohort study, we employed both a cross-sectional and a prospective analytical approach to investigate associations of walkability and physical activity with five prevalent chronic diseases and multimorbidity. Results: The cross-sectional data show that participants with the lowest neighborhood walkability were more likely to have reported a pre-existing history of cancer and depression and least likely to report chronic respiratory conditions. Participants with low physical activity were more likely to have a pre-existing history of diabetes, chronic respiratory disease, and multimorbidity. Follow-up analyses showed no significant associations between walkability and chronic disease incidence. Low levels of physical activity were significantly associated with diabetes, cancer and multimorbidity. Conclusions: Our data provides evidence for the health protective benefits of higher levels of physical activity, and a reduction in prevalence of some chronic diseases in more walkable communities. Full article
(This article belongs to the Special Issue Space, Place and Health Outcomes)
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Article
Fisher’s Linear Discriminant Function Analysis and its Potential Utility as a Tool for the Assessment of Health-and-Wellness Programs in Indigenous Communities
Int. J. Environ. Res. Public Health 2020, 17(21), 7894; https://doi.org/10.3390/ijerph17217894 - 28 Oct 2020
Viewed by 699
Abstract
Diabetes mellitus is a growing public health problem affecting persons in both developed and developing nations. The prevalence of type 2 diabetes mellitus (T2DM) is reported to be several times higher among Indigenous populations compared to their non-Indigenous counterparts. Discriminant function analysis (DFA) [...] Read more.
Diabetes mellitus is a growing public health problem affecting persons in both developed and developing nations. The prevalence of type 2 diabetes mellitus (T2DM) is reported to be several times higher among Indigenous populations compared to their non-Indigenous counterparts. Discriminant function analysis (DFA) is a potential tool that can be used to quantitatively evaluate the effectiveness of Indigenous health-and-wellness programs (e.g., on-the-land programs, T2DM interventions), by creating a type of pre-and-post-program scoring system. As the communities of the Eeyou Istchee territory, subarctic Quebec, Canada, have varying degrees of isolation, we derived a DFA tool for point-of-contact evaluations to aid in monitoring and assessment of health-and-wellness programs in rural and remote locations. We developed several DFA models to discriminate between those with and without T2DM status using age, fasting blood glucose, body mass index, waist girth, systolic and diastolic blood pressure, high-density lipoprotein, triglycerides, and total cholesterol in participants from the Eeyou Istchee. The models showed a ~97% specificity (i.e., true positives for non-T2DM) in classification. This study highlights how varying risk factor models can be used to discriminate those without T2DM with high specificity among James Bay Cree communities in Canada. Full article
(This article belongs to the Special Issue Space, Place and Health Outcomes)
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Article
Neighborhood Social and Built Environment and Disparities in the Risk of Hypertension: A Cross-Sectional Study
Int. J. Environ. Res. Public Health 2020, 17(20), 7696; https://doi.org/10.3390/ijerph17207696 - 21 Oct 2020
Cited by 2 | Viewed by 1118
Abstract
Citizens’ participation in urban environmental quality assessment is important when identifying local problems in the sustainable development and environmental planning policy. The principal aim of this study was to analyze whether any social differences exist between the joint effect of built neighborhood quality [...] Read more.
Citizens’ participation in urban environmental quality assessment is important when identifying local problems in the sustainable development and environmental planning policy. The principal aim of this study was to analyze whether any social differences exist between the joint effect of built neighborhood quality and exposure to urban green spaces and the risk of hypertension. The study sample consisted of 580 participants residing in 11 districts in Kaunas city, Lithuania. Using geographic information systems (GIS), individual data on the socioeconomic status (SES) and health were linked to the participants’ perceptions of the environmental quality and exposure to green spaces (NDVI). We used multivariate logistic regression to estimate associations as odds ratios (OR). Those study participants with lower education and those study participants with higher education on low incomes rated their health significantly worse. Low SES persons residing in areas with low exposure to green spaces had a significantly higher risk of hypertension when sex, age, family status, smoking, and income were accounted for (OR 1.83, 95% CI 1.01–3.36). This citizen science study provided evidence that the social environment and the quality of the built environment had a complex effect on disparities in the risk of hypertension. Full article
(This article belongs to the Special Issue Space, Place and Health Outcomes)
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Article
Effect of an Additional 30 Minutes Spent Outdoors during Summer on Daily Steps and Individually Experienced Heat Index
Int. J. Environ. Res. Public Health 2020, 17(20), 7558; https://doi.org/10.3390/ijerph17207558 - 17 Oct 2020
Cited by 2 | Viewed by 737
Abstract
Spending time outdoors is associated with increased physical activity; however, high ambient temperature/humidity, together with built environment features in urban versus rural environments, may influence physical activity. We conducted an intervention trial with 89 urban and 88 rural participants performing normal activities on [...] Read more.
Spending time outdoors is associated with increased physical activity; however, high ambient temperature/humidity, together with built environment features in urban versus rural environments, may influence physical activity. We conducted an intervention trial with 89 urban and 88 rural participants performing normal activities on Days 1–2 (baseline) and spending an additional 30 min outdoors on Days 3–7 (intervention) in the summer. Participants wore a pedometer with real-time visual feedback to track daily steps taken and a thermometer clipped to their shoe to track temperatures experienced individually. Hygrometer–thermometers were deployed in participants’ neighborhoods to collect finer resolution ambient heat indexes in addition to regional weather station measurements. Using linear mixed effects models and adjusting for ambient conditions and individual-level factors, participants on average walked 637 (95%CI (83, 1192)) more steps and had a 0.59 °C (95%CI (0.30, 0.88)) lower daily mean individually experienced heat index during intervention days compared to baseline days. The intervention benefit of increased physical activity was greater in rural residents who were less active at baseline, compared to urban residents. Our results suggest adding a small amount of additional time outdoors may improve physical activity without increasing participants’ heat exposure, even during summer in a humid subtropical climate. Full article
(This article belongs to the Special Issue Space, Place and Health Outcomes)
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Article
Changes in Socioeconomic Inequalities in Amenable Mortality after the Economic Crisis in Cities of the Spanish Mediterranean Coast
Int. J. Environ. Res. Public Health 2020, 17(18), 6489; https://doi.org/10.3390/ijerph17186489 - 06 Sep 2020
Cited by 1 | Viewed by 938
Abstract
Several studies have described a decreasing trend in amenable mortality, as well as the existence of socioeconomic inequalities that affect it. However, their evolution, particularly in small urban areas, has largely been overlooked. The aim of this study is to analyse the socioeconomic [...] Read more.
Several studies have described a decreasing trend in amenable mortality, as well as the existence of socioeconomic inequalities that affect it. However, their evolution, particularly in small urban areas, has largely been overlooked. The aim of this study is to analyse the socioeconomic inequalities in amenable mortality in three cities of the Valencian Community, namely, Alicante, Castellon, and Valencia, as well as their evolution before and after the start of the economic crisis (2000–2007 and 2008–2015). The units of analysis have been the census tracts and a deprivation index has been calculated to classify them according to their level of socioeconomic deprivation. Deaths and population were also grouped by sex, age group, period, and five levels of deprivation. The specific rates by sex, age group, deprivation level, and period were calculated for the total number of deaths due to all causes and amenable mortality and Poisson regression models were adjusted in order to estimate the relative risk. This study confirms that the inequalities between areas of greater and lesser deprivation in both all-cause mortality and amenable mortality persisted along the two study periods in the three cities. It also shows that these inequalities appear with greater risk of death in the areas of greatest deprivation, although not uniformly. In general, the risks of death from all causes and amenable mortality have decreased significantly from one period to the other, although not in all the groups studied. The evolution of death risks from before the onset of the crisis to the period after presented, overall, a general pro-cyclical trend. However, there are population subgroups for which the trend was counter-cyclical. The use of the deprivation index has made it possible to identify specific geographical areas with vulnerable populations in all three cities and, at the same time, to identify the change in the level of deprivation (ascending or descending) of the geographical areas throughout the two periods. It is precisely these areas where more attention is needed in order to reduce inequalities. Full article
(This article belongs to the Special Issue Space, Place and Health Outcomes)
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Article
Effect of Viewing Video Representation of the Urban Environment and Forest Environment on Mood and Level of Procrastination
Int. J. Environ. Res. Public Health 2020, 17(14), 5109; https://doi.org/10.3390/ijerph17145109 - 15 Jul 2020
Cited by 3 | Viewed by 1792
Abstract
A common problem among students is the problem of delaying important work activities, which is conceptualized as procrastination. Since procrastination can cause considerable costs for society, we would like to find a method to effectively alleviate the symptoms of this conditioning. It has [...] Read more.
A common problem among students is the problem of delaying important work activities, which is conceptualized as procrastination. Since procrastination can cause considerable costs for society, we would like to find a method to effectively alleviate the symptoms of this conditioning. It has been proven in an earlier study that staying in the forest environment increases vitality and reduces anxiety, and the negative state of these features can be associated with the intensification of procrastination symptoms. Therefore, it is likely that watching a forest video may decrease the probability or intensity of procrastination. To measure the impact of the forest environment on the level of procrastination of the subjects, a randomized experiment was carried out, in which the subjects watched in random order (on different days) one of two 15-min videos: one showing a walk in the forest area and one showing a walk in an urban environment (control). We measured the level of so-called ‘fluid procrastination’ including three aspects: ‘lack of energy to do the work’, ‘inability to get to work’ and ’pessimistic attitude to do the work’ with a set of questions the respondents completed before and after the experiment. The results showed that one aspect of fluid procrastination (‘pessimistic attitude to do the work’) can be effectively lowered by watching a video showing the forest environment. In contrast, watching a video of an urban environment increased the procrastination levels for two other aspects of procrastination (‘lack of energy to do the work’, ‘inability to get to work’). We also measured three other parameters before and after the experiment: mood state, restoration and vitality. Watching the video from forest area raised mood and restoration and watching the video from urban area, decreased mood, vitality and restoration. The study suggests that watching a video showing forest landscapes could be used as an effective remedy for problems related to procrastination among students. Full article
(This article belongs to the Special Issue Space, Place and Health Outcomes)
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Article
Environmental Correlates of Reaching a Centenarian Age: Analysis of 144,665 Deaths in Washington State for 2011−2015
Int. J. Environ. Res. Public Health 2020, 17(8), 2828; https://doi.org/10.3390/ijerph17082828 - 20 Apr 2020
Cited by 6 | Viewed by 8595
Abstract
Objective: This study examined the association of several social and environmental factors on the likelihood of reaching centenarian age for older adults in Washington State. Methods: A survival analysis of reaching centenarian age for older adults aged 75 years and above was performed [...] Read more.
Objective: This study examined the association of several social and environmental factors on the likelihood of reaching centenarian age for older adults in Washington State. Methods: A survival analysis of reaching centenarian age for older adults aged 75 years and above was performed using Washington State mortality data from 2011−2015. Models were adjusted for sex, race, education, marital status, and neighborhood level social and environmental variables at the block group level. Geographic clusters of increased chance of becoming a centenarian were also mapped. Results: In the adjusted model, increased neighborhood walkability, lower education level, higher socioeconomic status, and a higher percent of working age population were positively associated with reaching centenarian age. Being widowed, divorced/separated, or never married were also positively correlated compared to being married. Additionally, being white or female were positively correlated with reaching centenarian status. Discussion: Several social and environmental factors are correlated with becoming a centenarian in Washington State. In this study, we explore findings that are consistent with previous research, as well as some that have not been previously explained. More research is needed to expand upon these findings in this rapidly growing field. Full article
(This article belongs to the Special Issue Space, Place and Health Outcomes)
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Article
Proximity to Screening Site, Rurality, and Neighborhood Disadvantage: Treatment Status among Individuals with Sexually Transmitted Infections in Yakima County, Washington
Int. J. Environ. Res. Public Health 2020, 17(8), 2679; https://doi.org/10.3390/ijerph17082679 - 14 Apr 2020
Cited by 4 | Viewed by 1013
Abstract
Background: Early sexually transmitted infections (STIs) diagnosis facilitates prompt treatment initiation and contributes to reduced transmission. This study examined the extent to which contextual characteristics such as proximity to screening site, rurality, and neighborhood disadvantage along with demographic variables, may influence treatment [...] Read more.
Background: Early sexually transmitted infections (STIs) diagnosis facilitates prompt treatment initiation and contributes to reduced transmission. This study examined the extent to which contextual characteristics such as proximity to screening site, rurality, and neighborhood disadvantage along with demographic variables, may influence treatment seeking behavior among individuals with STIs (i.e., chlamydia, gonorrhea, and syphilis). Methods: Data on 16,075 diagnosed cases of STIs between 2007 and 2018 in Yakima County were obtained from the Washington State Department of Health Database Surveillance System. Multilevel models were applied to explore the associations between contextual and demographic characteristics and two outcomes: (a) not receiving treatment and (b) the number of days to receiving treatment. Results: Contextual risk factors for not receiving treatment or having increased number of days to treatment were living ≥10 miles from the screening site and living in micropolitan, small towns, or rural areas. Older age was a protective factor and being female was a risk for both outcomes. Conclusions: Healthcare providers and facilities should be made aware of demographic and contextual characteristics that can impact treatment seeking behavior among individuals with STIs, especially among youth, females, and rural residents. Full article
(This article belongs to the Special Issue Space, Place and Health Outcomes)
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Article
Qualitative Field Observation of Pedestrian Injury Hotspots: A Mixed-Methods Approach for Developing Built- and Socioeconomic-Environmental Risk Signatures
Int. J. Environ. Res. Public Health 2020, 17(6), 2066; https://doi.org/10.3390/ijerph17062066 - 20 Mar 2020
Cited by 1 | Viewed by 2006
Abstract
Road traffic injuries constitute a significant global health burden; the World Health Organization estimates that they result in 1.35 million deaths annually. While most pedestrian injury studies rely predominantly on statistical modelling, this paper argues for a mixed-methods approach combining spatial analysis, environmental [...] Read more.
Road traffic injuries constitute a significant global health burden; the World Health Organization estimates that they result in 1.35 million deaths annually. While most pedestrian injury studies rely predominantly on statistical modelling, this paper argues for a mixed-methods approach combining spatial analysis, environmental scans, and local knowledge for assessing environmental risk factors. Using data from the Nova Scotia Trauma Registry, severe pedestrian injury cases and ten corresponding hotspots were mapped across the Halifax Regional Municipality. Using qualitative observation, quantitative environmental scans, and a socioeconomic deprivation index, we assessed hotspots over three years to identify key social- and built-environmental correlates. Injuries occurred in a range of settings; however, clear patterns were not observed based on land use, age, or socio-economic status (SES) alone. Three hotspots revealed an association between elevated pedestrian injury and a pattern of geographic, environmental, and socio-economic factors: low- to middle-SES housing separated from a roadside attraction by several lanes of traffic, and blind hills/bends. An additional generalized scenario was constructed representing common risk factors across all hotspots. This study is unique in that it moves beyond individual measures (e.g., statistical, environmental scans, or geographic information systems (GIS) mapping) to combine all three methods toward identifying environmental features associated with pedestrian motor vehicle crashes (PMVC). Full article
(This article belongs to the Special Issue Space, Place and Health Outcomes)
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Review

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Review
Interactions between the Physical and Social Environments with Adverse Pregnancy Events Related to Placental Disorders—A Scoping Review
Int. J. Environ. Res. Public Health 2020, 17(15), 5421; https://doi.org/10.3390/ijerph17155421 - 28 Jul 2020
Cited by 2 | Viewed by 1114
Abstract
Background: Due to different social and physical environments across Africa, understanding how these environments differ in interacting with placental disorders will play an important role in developing effective interventions. Methods: A scoping review was conducted, to identify current knowledge on interactions between the [...] Read more.
Background: Due to different social and physical environments across Africa, understanding how these environments differ in interacting with placental disorders will play an important role in developing effective interventions. Methods: A scoping review was conducted, to identify current knowledge on interactions between the physical and social environment and the incidence of placental disease in Africa. Results: Heavy metals were said to be harmful when environmental concentrations are beyond critical limits. Education level, maternal age, attendance of antenatal care and parity were the most investigated social determinants. Conclusions: More evidence is needed to determine the relationships between the environment and placental function in Africa. The results show that understanding the nature of the relationship between social determinants of health (SDH) and placental health outcomes plays a pivotal role in understanding the risk in the heterogenous communities in Africa. Full article
(This article belongs to the Special Issue Space, Place and Health Outcomes)
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