Search Results (318)

This research addresses urban inequality by focusing on the rehabilitation of communal rooftops in Ciutat Vella, Barcelona, the city’s historic district, where residential vulnerability is concentrated in a particularly dense heritage urban environment with a shortage of outdoor spaces. Using participatory methodologies, this research develops low-cost, removable, and recyclable prototypes aimed at improving social interaction, technical performance, and environmental conditions. The focus is on vulnerable populations, particularly the elderly. The approach integrates a bottom–up process and scalable solutions presented as a Toolkit of micro-projects. These micro-projects are designed to improve issues related to health, safety, durability, accessibility, energy savings, and acoustics. In addition, several possible material solutions for micro-projects are examined in terms of sustainability and cost. These plug-in interventions are designed for adaptability and replication throughout similar urban contexts and can significantly improve the quality of life for people, especially the elderly, in dense historic environments. Full article

Today, ‘social sustainability’ is a key feature of many organisations’ environmental, social, and governance strategies, as well as underpinning sustainable development goals. The term refers to the implementation of targets such as reduced societal inequalities, the promotion of social well-being, and the practice of positive community relations. Building a meaningful, accountable, and quantifiable evidence-base from which to translate these high-level concepts into tangible and achievable goals is, however, challenging. The complexities of measuring social capital—often described as a building block of social sustainability—have been documented. The challenge lies in measuring the person, group, or collective in interaction with the context under investigation, whether that be a climate goal, an institution, or a national policy. Social identity theory is a social psychological approach that articulates the processes through which an individual internalises the values, norms, and behaviours of their contexts. Levels of social identification—a concept capturing the state of internalisation—have been shown to be predictive of outcomes as diverse as communication and cognition, trust and citizenship, leadership and compliance, and health and well-being. Applying this perspective to the articulation and measurement of social sustainability provides an opportunity to build an empirical approach with which to reliably translate this high-level concept into achievable outcomes. Full article

Tuberculosis (TB) remains a leading cause of death in Bangladesh, disproportionately affecting low socio-economic status (SES) populations. This review, guided by the WHO Social Determinants of Health framework and Rockefeller-Lancet Planetary Health Report, examined how social, economic, and ecological factors link SES to TB burden. The first literature search identified 28 articles focused on SES-TB relationships in Bangladesh. A second search through snowballing and conceptual mapping yielded 55 more papers of diverse source types and disciplines. Low-SES groups face elevated TB risk due to smoking, biomass fuel use, malnutrition, limited education, stigma, financial barriers, and hazardous housing or workplaces. These factors delay care-seeking, worsen outcomes, and fuel transmission, especially among women. High-SES groups more often face comorbidities like diabetes, which increase TB risk. Broader contextual drivers include urbanisation, weak labour protections, cultural norms, and poor governance. Recommendations include housing and labour reform, gender parity in education, and integrating private providers into TB programmes. These align with the WHO End TB Strategy, UN SDGs and Planetary Health Quadruple Aims, which expand the traditional Triple Aim for health system design by integrating environmental sustainability alongside improved patient outcomes, population health, and cost efficiency. Future research should explore trust in frontline workers, reasons for consulting informal carers, links between makeshift housing and TB, and integrating ecological determinants into existing frameworks. Full article

Art therapy serves as a crucial intervention modality for children with autism spectrum disorder (ASD), demonstrating unique value in emotional expression, sensory integration, and social communication. However, current practice presents critical challenges, including the disconnect between design expertise and clinical needs, unclear mechanisms of environmental factors’ impact on therapeutic outcomes, and insufficient evidence-based support for technology integration. Purpose: This study aimed to construct an evidence-based theoretical framework for art therapy environment design for children with autism, clarifying the relationship between environmental design elements and therapeutic effectiveness. Methodology: Based on the Web of Science database, this study employed a dual-track approach comprising bibliometric analysis and micro-qualitative content analysis to systematically examine the knowledge structure and developmental trends. Research hotspots were identified through keyword co-occurrence network analysis using CiteSpace, while 24 representative design cases were analyzed to gain insights into design concepts, emerging technologies, and implementation principles. Key Findings: Through keyword network visualization analysis, this study identified ten primary research clusters that were systematically categorized into four core design elements: sensory feedback design, behavioral guidance design, emotional resonance design, and therapeutic support design. A responsive therapeutic environment conceptual framework was proposed, encompassing four interconnected components based on the ABC model from positive psychology: emotional, sensory, environmental, and behavioral dimensions. Evidence-based design principles were established emphasizing child-centeredness, the promotion of multisensory expression, the achievement of dynamic feedback, and appropriate technology integration. Research Contribution: This research establishes theoretical connections between environmental design elements and art therapy effectiveness, providing a systematic design guidance framework for interdisciplinary teams, including environmental designers, clinical practitioners, technology developers, and healthcare administrators. The framework positions technology as a therapeutic mediator rather than a driver, ensuring technological integration supports rather than interferes with children’s natural creative impulses. This contributes to creating more effective environmental spaces for art therapy activities for children with autism while aligning with SDG3 goals for promoting mental health and reducing inequalities in therapeutic access. Full article

Cancer disparities in low- and middle-income countries (LMICs) arise from multifaceted interactions between environmental exposures, infectious agents, and systemic inequities, such as limited access to care. The exposome, a framework encompassing the totality of non-genetic exposures throughout life, offers a powerful lens for understanding these disparities. In LMICs, populations are disproportionately affected by air and water pollution, occupational hazards, and oncogenic infections, including human papillomavirus (HPV), hepatitis B virus (HBV), Helicobacter pylori (H. pylori), human immunodeficiency virus (HIV), and neglected tropical diseases, such as schistosomiasis. These infectious agents contribute to increased cancer susceptibility and poor outcomes, particularly in immunocompromised individuals. Moreover, climate change, food insecurity, and barriers to healthcare access exacerbate these risks. This review adopts a population-level exposome approach to explore how environmental and infectious exposures intersect with genetic, epigenetic, and immune mechanisms to influence cancer incidence and progression in LMICs. We highlight the critical pathways linking chronic exposure and inflammation to tumor development and evaluate strategies such as HPV and HBV vaccination, antiretroviral therapy, and environmental regulation. Special attention is given to tools such as exposome-wide association studies (ExWASs), which offer promise for exposure surveillance, early detection, and public health policy. By integrating exposomic insights into national health systems, especially in regions such as sub-Saharan Africa (SSA) and South Asia, LMICs can advance equitable cancer prevention and control strategies. A holistic, exposome-informed strategy is essential for reducing global cancer disparities and improving outcomes in vulnerable populations. Full article

More than 50 years ago, children were viewed as naturally resilient and often labeled invulnerable or invincible. Resilience is now understood to be the result of dynamic interactions between individual, familial, social, and environmental systems, decentralizing the focus from the individual to the global society. Experiences with adversity may emanate from the youth’s family environment, their community, the school system, and larger structural challenges related to poverty, discrimination, health disparities, and educational inequities. Youth experiences with adversity, trauma, and tragedy have the potential to negatively impact youth well-being, with consequences manifesting across the lifespan. Children and adolescents generally hold limited power to change their circumstances and are often ill-equipped to resolve the adverse or traumatic experiences occurring within their ecosystem. The value of social supports in the young person’s ability to be resilient has been affirmed. This understanding is particularly important for children growing up in poverty or in Low- and Middle-Income Countries (LMICs) where significant challenges occur as a result of economic and social disadvantage. Resilience at the individual level is unlikely to eliminate macrolevel issues. Developing and deploying strategies to enhance the ability of youth to rebound from adversity represents a positive step at the micro level, but the larger issues of economic and social disadvantage are unlikely to change without macro-level interventions. Glancing toward the future, traumatized youth may grow into traumatized adults without appropriate interventions and changes in social policies, programs, and protections. Full article

Background/Objectives: Communication disorders in childhood, including expressive, receptive, pragmatic, and fluency impairments, have been consistently linked to mental health challenges such as anxiety, depression, and behavioural difficulties. However, existing research remains fragmented across diagnostic categories and developmental stages. This scoping review aimed to synthesise empirical evidence on the relationship between communication disorders and mental health outcomes in children and adolescents and to identify key patterns and implications for practice and policy. Methods: Following the PRISMA Extension for Scoping Reviews (PRISMA-ScR) and Arksey and O’Malley’s framework, this review included empirical studies published in English between 2000 and 2024. Five databases were searched, and ten studies met the inclusion criteria. Data were charted and thematically analysed to explore associations across communication profiles and emotional–behavioural outcomes. Results: Four interconnected themes were identified: (1) emotional and behavioural manifestations of communication disorders; (2) social burden linked to pragmatic and expressive difficulties; (3) family and environmental stressors exacerbating child-level challenges; and (4) a lack of integrated care models addressing both communication and mental health needs. The findings highlight that communication disorders frequently co-occur with emotional difficulties, often embedded within broader social and systemic contexts. Conclusions: This review underscores the need for developmentally informed, culturally responsive, and interdisciplinary service models that address both communication and mental health in children. Early identification, family-centred care, and policy reforms are critical to reducing inequities and improving outcomes for this underserved population. Full article

Africa’s rapid urbanization often exceeds the capacity of governments to provide essential services and infrastructure, exacerbating structural inequalities and exposing vulnerable populations to serious health risks. This paper examines the case of Douala, Cameroon, to demonstrate that health inequities in African cities are not simply the result of urban growth but are shaped by spatial inequities, historical legacies, and systemic exclusion. Disadvantaged neighborhoods are particularly impacted, becoming epicenters of health crises. Using a mixed-methods approach combining spatial analysis, household surveys and interviews, the study identifies three key findings: (1) Healthcare services in Douala are unevenly distributed and dominated by private providers, which limits access for low-income residents. (2) Inadequate infrastructure and environmental risks in informal settlements lead to a higher disease burden and an overflow of demand into better-equipped districts, which overwhelms public health centers across the city. (3) This structural mismatch fuels widespread reliance on informal and unregulated care practices. This study positions Douala as a microcosm of broader public health challenges in rapidly urbanizing African cities. It highlights the need for integrated urban planning and health system reforms that address spatial inequalities, strengthen public health infrastructure, and prioritize equity—key principles for achieving the third Sustainable Development Goal (ensuring good health and well-being for all residents) in sub-Saharan Africa. Full article

This study aimed to longitudinally analyze changes in body mass index (BMI) among Korean middle and high school students before and after the COVID-19 pandemic. Data were obtained from the national-level Physical Activity Promotion System (PAPS), collected between 2018 and 2024. A total of 171,705 adolescents aged 13 to 18 were included in the analysis (86,542 males and 85,163 females), with a mean age of 15.2 years (SD = 1.68). Time-series analysis and two-way analysis of variance (ANOVA) were conducted to examine differences in BMI by year, sex, region (capital vs. non-capital), and urban–rural classification. The results indicated a significant increase in BMI during the pandemic period (2020–2022), peaking in 2022, followed by a gradual decline thereafter. Notably, male students and those living in rural or non-capital areas consistently exhibited higher BMI levels, suggesting structural disparities in access to physical activity opportunities and health resources. This study employed the Socio-Ecological Model and the Health Equity Framework as theoretical lenses to interpret BMI changes not merely as individual behavioral outcomes but as consequences shaped by environmental and policy-level determinants. The findings underscore the need for equity-based interventions in physical education and health policy to mitigate adolescent health inequalities during future public health crises. Full article

Per- and polyfluoroalkyl substances (PFASs), commonly known as “forever chemicals”, are synthetic compounds with highly stable carbon–fluorine bonds, making them resistant to environmental degradation. These chemicals accumulate in ecosystems and water supplies, posing significant risks to human health, including cancer, immune system dysfunction, and neurological disorders. However, the mental health impacts of PFAS exposure remain underexplored, particularly in marginalized communities. This review examines the emerging evidence linking PFAS exposure to mental health issues such as anxiety, depression, and cognitive decline, with a focus on communities of color who face heightened vulnerability due to environmental and social health disparities. The review highlights the persistence of PFASs in the environment, common exposure pathways, and the disproportionate effects on populations living near contaminated sites. Despite some regulatory progress, U.S. regulations on PFASs are limited, especially compared to international standards. The review calls for stronger policy frameworks and emphasizes the need for environmental justice, health equity, and public awareness. By connecting environmental health, social justice, and mental well-being, the review aims to guide future research and policy reforms to mitigate the mental health consequences of PFAS exposure in vulnerable populations. Full article

Despite spending a substantial proportion of their time indoors, the mental health effects of indoor air pollution on children and adolescents remain inadequately explored. This study aimed to elucidate the spatiotemporal variations and sociodemographic inequalities in exposure to multiple indoor pollutants and to assess their potential associations with depressive symptoms among school-aged children in Beijing. Using real-time portable monitors, concentrations of fine particulate matter (PM_2.5), coarse particulate matter (PM₁₀), carbon dioxide (CO₂), formaldehyde (HCHO), total volatile organic compounds (TVOC), temperature, and humidity in classrooms and bedrooms were measured during both weekdays and weekends. Moreover, substantial spatiotemporal heterogeneity was observed. It was found that concentrations of PM_2.5, PM₁₀, and TVOC peaked in classrooms during weekday daytime, while CO₂ levels were highest in bedrooms on weekend nights. Exposure levels were notably higher among children whose mothers had lower educational attainment and those living in recently renovated homes, indicating marked socio-demographic disparities. In multivariable logistic regression models, indoor exposure to CO₂ and TVOC was significantly associated with increased odds of depressive symptoms. These findings highlight the critical need to improve indoor air quality through enhanced ventilation and the mitigation of emissions from indoor sources, particularly within school and residential settings. The results offer valuable empirical evidence to guide the development of targeted environmental interventions and public health policies designed to support and enhance the psychological well-being of children. Full article

Antimicrobial resistance (AMR) is considered a global healthcare emergency in the 21st century. Although the evolution of microorganisms through Darwinian mechanisms and antibiotic misuse are established drivers, the structural socioeconomic factors of AMR remain insufficiently explored. This review takes on an analytical perspective, drawing upon a wide spectrum of evidence to examine the extent to which socioeconomic factors contribute to the global proliferation of AMR, with an emphasis on low- and middle-income countries (LMICs). The analytical review at hand was carried out through a search for relevant articles and reviews on PubMed, Google Scholar, the Centers for Disease Control and Prevention, and the World Health Organization database using combinations of the keywords “antimicrobial resistance,” “socioeconomic factors,” “low- and middle-income countries,” “surveillance,” “healthcare access,” and “agriculture.” Preference was given to systematic reviews, high-impact primary studies, and policy documents published in peer-reviewed journals or by reputable global health organizations. Our analysis identifies a complex interplay of systemic vulnerabilities that accelerate AMR in resource-limited settings. A lack of regulatory frameworks regarding non-prescription antibiotic use enables the proliferation of multi-drug-resistant microorganisms. Low sewer connectivity facilitates the environmental dissemination of resistance genes. Proper antibiotic selection is hindered by subpar healthcare systems and limited diagnostic capabilities to deliver appropriate treatment. Additionally, gender disparities, forced migration, and climate-driven zoonotic transmission compound the burden. During the COVID-19 pandemic, antimicrobial misuse surged, further amplifying resistance trends. AMR is not solely a biological phenomenon, but a manifestation of global inequity. Mitigation requires a transformation of policy directed toward a “One Health” strategy that incorporates socioeconomic, environmental, and health system reforms. Strengthening surveillance, investing in infrastructure, regulating pharmaceutical practices, and promoting health equity are essential to curb the rising tide of resistance. Full article

The National Institute on Minority Health and Health Disparities Research Framework (NIMHD-RF) provides a multidimensional structure to examine health disparities across domains and levels of influence. While influential, its current Behavioral Domain centers on observable behaviors and underrepresents key psychological factors and determinants that shape health outcomes among minoritized populations. This gap limits the framework’s capacity to account for complex factors such as internalized stigma, identity-related stress, and cultural processes that significantly contribute to mental health disparities. In this viewpoint, we propose an adaptation of the Behavioral Domain into a Psychological/Behavioral Domain to better reflect the interconnected psychological, biological, sociocultural, and environmental factors influencing health. The revised domain incorporates psychological vulnerabilities, coping strategies, and identity-based stressors across all levels of influence, from individual to societal, and acknowledges macro-level processes such as structural stigma and inequitable policies. This reframing emphasizes that behaviors are shaped by psychological experiences and systemic inequities, not merely individual choice. By explicitly integrating psychological factors and determinants, the framework becomes more robust in guiding culturally responsive, equity-driven research and interventions. This adaptation aims to enhance the framework’s utility in mental health disparities research and to support efforts to achieve health equity for historically underserved populations. Full article

The Roma population is one of Europe’s largest ethnic minorities, often living in inadequate living conditions, worse than those of the majority population. They frequently lack access to essential services, even in high-income countries. This lack of basic services—particularly in combination with proximity to (stray) animals and human and solid waste—significantly increases environmental health risks, and leads to a higher rate of endoparasitic infections. Our study sheds light on the living conditions and health situation in Roma communities in Slovakia, focusing on the prevalence of intestinal endoparasitic infections across various settlement localisations. It highlights disparities and challenges in access to safe drinking water, sanitation, and hygiene (WASH) and other potentially disease-exposing factors among these marginalised populations. This study combines a comprehensive review of living conditions as per national data provided through the Atlas of Roma communities with an analysis of empirical data on parasitological infection rates in humans, animals, and the environment in settlements, applying descriptive statistical methods. It is the first study in Europe to provide detailed insights into how living conditions vary and cause health risks across Roma settlements, ranging from those integrated within villages (inside, urban), to those isolated on the outskirts (edge, sub-urban) or outside villages (natural/rural). Our study shows clear disparities in access to services, and in health outcomes, based on where people live. Our findings underscore the fact that (i) place—geographical centrality in particular—in an already challenged population group plays a major role in health inequalities and disease exposure, as well as (ii) the urgent need for more current and comprehensive data. Our study highlights persistent disparities in living conditions within high-income countries and stresses the need for greater attention and more sensitive targeted health-promoting approaches with marginalised communities in Europe that take into consideration any and all of the humans, ecology, and animals affected (=One Health). Full article

Air pollution is a growing environmental and public health concern, particularly in urban areas where vehicular emissions, industrial activities, and public events contribute to deteriorating air quality. This study examines air pollution concentrations in two districts of Cusco, Peru, using an interdisciplinary approach that integrates environmental monitoring and social risk perception analysis. Air quality measurements revealed elevated levels of PM2.5 and NO₂, with 40–60% of data falling within “Moderate” or “Unhealthy for sensitive groups” categories according to international standards. Notably, major cultural events such as Inti Raymi were associated with a threefold increase in pollutant concentrations, highlighting their impact on urban air quality. Simultaneously, surveys and interviews assessed public perception, revealing a varied understanding of pollution risks and a general concern for health impacts, especially in more polluted and densely populated areas. However, trust in scientists remains limited, which poses challenges for the implementation of evidence-based environmental strategies. This study highlights significant environmental inequality within the city, with central districts facing greater pollution burdens than peripheral zones. These findings underscore the need for holistic air quality management strategies that combine scientific assessments with community engagement. Strengthening trust between scientists and local populations is essential to develop inclusive and effective interventions that align with both technical and social priorities, particularly in rapidly urbanizing contexts such as Cusco. Full article