Ssm-Population Health最新文献

{"title":"Mapping war trauma: A machine learning approach to predict mental health impacts in Ukraine","authors":"Safiyeh Tayebi ,&nbsp;Ayse Sert Oti ,&nbsp;Hossein Fathollahian ,&nbsp;Ubydul Haque","doi":"10.1016/j.ssmph.2025.101879","DOIUrl":"10.1016/j.ssmph.2025.101879","url":null,"abstract":"<div><div>This paper presents a predictive modeling system based on the use of GeoAI to estimate mental health outcomes of wartime in Ukrainian cities, utilizing spatially linked data on the environment, infrastructure, and conflict. Six self-reported psychological outcomes, symptoms of post-traumatic stress disorder, or PSD, anxiety, depression, insomnia, loneliness, and sleep duration, were collected in surveys throughout the war and analyzed in the context of more than 30 spatial predictors: cold exposure, access to heating, power outages, housing insulation, and city-level frequency of drone, missile, artillery, and shelling attacks. Predictor datasets that are derived from incident tracking, World Health Organization, and humanitarian reporting systems, and environmental indicators derived from surveys, which are harmonized using a spatial data integration protocol. In realizing the GeoAI concept, we developed a machine learning pipeline utilizing Ordinary Least Squares, Lasso, Random Forest, Gradient Boosting, and Extreme Gradient Boosting. All models were trained and tested on spatially independent training and testing splits in order to preserve the generalization properties of the models. XG Boost is also shown to be effective, with R2 values often exceeding 0.74 and MAPE values typically less than 7.2 %. Feature importance analysis revealed that key drivers of being exposed to prolonged cold, inadequate insulation, and exposure to drones or artillery were found to be dominant drivers of psychological distress. This GeoAI framework combines the strength of geospatial analytics with artificial intelligence to give precise and high-resolution location-based forecasting of mental health burdens in conflict settings. The method offers a flexible tool for a proactive humanitarian response that can target mental health services spatially based on predictions of mental health vulnerability, in contrast to retrospective clinical information, for relief agencies and public health planners. This work is a step towards incorporating GeoAI in the field of crisis epidemiology, demonstrating the ability to use GeoAI in real-time, place-based mental health planning in war-affected areas.</div></div>","PeriodicalId":47780,"journal":{"name":"Ssm-Population Health","volume":"32 ","pages":"Article 101879"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Childhood IQ and adolescent health behavior","authors":"Hendrik Jürges ,&nbsp;Rasheda Khanam","doi":"10.1016/j.ssmph.2025.101887","DOIUrl":"10.1016/j.ssmph.2025.101887","url":null,"abstract":"<div><div>This study investigates whether cognitive ability in early childhood predicts adolescent health-related and risky behaviors, independent of schooling and socioeconomic background. Using longitudinal data from the Kindergarten cohort of the Longitudinal Study of Australian Children (LSAC), we link matrix reasoning scores from ages 6 to 10 to health behaviors at age 16/17. Behaviors include substance use, unsafe driving, nutrition, dental hygiene, and sleep. To reduce dimensionality and interpret behavioral patterns, we derive two composite indices via principal component analysis: a risk-taking index and a health habit index. We find that higher early-life IQ is consistently associated with lower risk-taking and better health habits in adolescence, even after adjusting for a comprehensive set of early life covariates including non-cognitive traits, parental health behaviors, family SES, and regional disadvantages. A Gelbach decomposition shows distinct patterns of confounding: for risk-taking, the attenuation of the IQ-health behavior association is primarily explained by parental health behavior and ethnocultural background; for health habits, socioeconomic disadvantage is more salient. Peer characteristics at age 14/15 explain a substantial share of the IQ-risk-taking relationship, suggesting social environments as potential pathways. Robustness checks using the Cinelli &amp; Hazlett sensitivity framework indicate that the IQ-health habits association is substantively and statistically robust to unobserved confounding. We interpret these findings as support for the hypothesis that early-life IQ may be an important upstream factor of health inequalities before educational differentiation occurs.</div></div>","PeriodicalId":47780,"journal":{"name":"Ssm-Population Health","volume":"32 ","pages":"Article 101887"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145614559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Policing as a social determinant of health in three decades of public health research: A systematic review","authors":"Denise Herd","doi":"10.1016/j.ssmph.2025.101801","DOIUrl":"10.1016/j.ssmph.2025.101801","url":null,"abstract":"<div><h3>Background</h3><div>This study explores how policing and police violence are analyzed in critical theoretical frameworks used in public health research literature such as the Social Determinants of Health (SDOH) in the United States.</div></div><div><h3>Methods</h3><div>We reviewed articles published from 1990 to 2021 that studied U.S. populations and/or those residing at the U.S. southern border and appeared in public health journals to analyze the relationship between policing and the SDOH. After searching key academic databases and screening the results, 25 articles met the criteria for inclusion in the review.</div></div><div><h3>Results</h3><div>The key themes identified in the papers include ecosocial theory and stress; research that characterizes police violence as a form of racism; the role of policing in enforcing harsh immigration policies; research that focuses on how police harassment and fear limit access to health care resources; and research that uses the SDOH to predict police fatalities.</div></div><div><h3>Conclusions</h3><div>The studies reviewed provide persuasive evidence that policing has significant and harmful effects on health and critical social determinants of health. However, none of the research focused on determinants of health such as the social gradient, unemployment or neighborhood features like food or transportation. The impact of policing on other critical determinants such as work, social support, and social inclusion were only described in studies of criminalized populations such as street sex workers and injection drug users. Other limitations include the lack of research confirming hypothesized biological or social pathways showing the links between police behavior and adverse health outcomes.</div></div>","PeriodicalId":47780,"journal":{"name":"Ssm-Population Health","volume":"32 ","pages":"Article 101801"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145097106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The use of solitary confinement and in-custody mortality in North Carolina State Prisons, 2021–2023","authors":"Katherine LeMasters ,&nbsp;Sara N. Levintow ,&nbsp;Jennifer Lao ,&nbsp;Erin McCauley ,&nbsp;Craig Waleed ,&nbsp;Zaire Cullins ,&nbsp;M. Forrest Behne ,&nbsp;Lauren Brinkley-Rubinstein","doi":"10.1016/j.ssmph.2025.101865","DOIUrl":"10.1016/j.ssmph.2025.101865","url":null,"abstract":"<div><h3>Purpose</h3><div>Solitary confinement is associated with increased mortality post-release. Little is known about its use following recent reforms and COVID-19 challenges, and its association with in-custody deaths. We investigated patterns of and associations between solitary confinement and mortality in North Carolina (NC) state prisons.</div></div><div><h3>Methods</h3><div>Using weekly housing data from Disability Rights NC, we created a retrospective cohort of those newly incarcerated in NC prisons between 2021 and 2023. We calculated the weekly proportion of individuals experiencing solitary confinement for 2+ weeks by type (e.g., administrative purposes). We calculated all-cause mortality rates stratified by those who did and did not experience solitary confinement.</div></div><div><h3>Results</h3><div>Nearly one-quarter of 41,525 individuals in NC state prisons experienced solitary confinement. By the end of follow-up, over 6.0 % of individuals were in solitary confinement per week, and there were 43 in-custody deaths. Those who never experienced solitary confinement had an all-cause mortality rate of 1.96 per 100,000 person-weeks (95 % CI: 1.32, 2.82), and those who experienced solitary confinement had an all-cause mortality rate of 4.23 per 100,000 person-weeks (95 % CI: 2.31, 7.09).</div></div><div><h3>Conclusions</h3><div>Solitary confinement is common in NC prisons and is associated with elevated death rates in custody. There is an urgent need to document the types and duration of solitary stays to ultimately end this punitive practice.</div></div>","PeriodicalId":47780,"journal":{"name":"Ssm-Population Health","volume":"32 ","pages":"Article 101865"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145220897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of sidewalk availability in gentrification: A longitudinal study of U.S. neighborhoods and racial/ethnic composition","authors":"Najma Abdi ,&nbsp;Adam Szpiro ,&nbsp;Stephen J. Mooney ,&nbsp;Quynh Nguyen ,&nbsp;Jana A. Hirsch ,&nbsp;Brian E. Saelens","doi":"10.1016/j.ssmph.2025.101868","DOIUrl":"10.1016/j.ssmph.2025.101868","url":null,"abstract":"<div><h3>Introduction</h3><div>Gentrification may displace lower-income populations, particularly in neighborhoods where the majority of residents identify as Black, Indigenous, and/or People of Color (BIPOC). While the health impacts of gentrification and displacement have been explored, little is known about how pedestrian infrastructure (e.g. sidewalks) may be associated with gentrification. This study assesses whether sidewalk availability is associated with gentrification and changes in BIPOC population, with attention to differences between urban and suburban/small-town contexts where patterns of demographic change may diverge, including potential change in BIPOC population by context.</div></div><div><h3>Methods</h3><div>Utilizing the Logitudinal Tract Database and U.S. national sidewalk availability, we conducted a longitudinal observational study of 26,498 gentrifiable census tracts limited to urban/suburban/smal town areas across the US in 2010–2020. Sidewalk availability was defined as the proportion of Google Street images within a given census tract that have at least one sidewalk. We used logistic regression to examine the association between sidewalk availability and gentrification and linear regression to assess changes in BIPOC residential composition between 2010 and 2020 in gentrified neighborhoods. Sensitivity and supplementary analysis was conducted for a stratified models by BIPOC thresholds (40 %, 50 %, 60 %) and urban/suburban outcomes.</div></div><div><h3>Results</h3><div>Sidewalk availability was significantly associated with higher odds of gentrification in all tracts (OR: 1.119; 95 % CI: 1.032–1.212; p = 0.0065) and in BIPOC-majority tracts (OR: 1.216; 95 % CI: 1.088–1.359; p &lt; 0.001). In gentrified neighborhoods, sidewalk availability was associated with a reduction in the percentage of BIPOC residents (−0.016 per 0.1-unit; 95 % CI: −0.027, −0.006; p &lt; 0.002) and a significant decline in the absolute number of BIPOC individuals (−81.2; 95 % CI: −114.78, −47.69; p &lt; 0.001). Supplementary analyses indicated divergence by context: in urban gentrified tracts, each 0.1-unit higher sidewalk availability was associated with −0.020 percentage points in BIPOC share (95 % CI –126.5, −57.2; p &lt; 0.001) and −91.86 BIPOC residents (95 % CI −126.51, −57.22; p &lt; 0.001); in suburban/small-town gentrified tracts, it was associated with +0.036 percentage points (95 % CI: 0.001, 0.071; p = 0.042) and +165 BIPOC residents (95 % CI 45.1, 285.8; p = 0.007).</div></div><div><h3>Conclusion</h3><div>Our results demonstrate a consistent relationship between sidewalk availability and gentrification, although different associations with BIPOC population change by context, contributing to the ongoing discourse on gentrification, urban development, and neighborhood change.</div></div>","PeriodicalId":47780,"journal":{"name":"Ssm-Population Health","volume":"32 ","pages":"Article 101868"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145220898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of a large-scale participatory learning and action programme in women's groups on knowledge and behaviour related to pregnancy and childcare: a cluster-randomized controlled trial in Bihar, India","authors":"Lisa Bogler ,&nbsp;Abhijeet Kumar ,&nbsp;S.V. Subramanian ,&nbsp;Sebastian Vollmer","doi":"10.1016/j.ssmph.2025.101880","DOIUrl":"10.1016/j.ssmph.2025.101880","url":null,"abstract":"<div><h3>Background</h3><div>Participatory learning and action (PLA) programmes are promoted as effective community-based intervention to improve maternal and child health. Evidence on their impact on knowledge and behaviour related to pregnancy and childcare is limited and mixed. Between 2015 and 2016, state-supported agencies implemented a large-scale PLA intervention in women's self-help groups in rural Bihar, India, with meetings facilitated by trained agency staff. We assessed the impact of this intervention using a cluster-randomized controlled trial.</div></div><div><h3>Methods</h3><div>In one implementation district, 68 village clusters were randomly assigned to receive the intervention or not. With survey data from 1612 women who were pregnant before the intervention, we evaluate programme impact on (a) beliefs about practices of feeding newborns, (b) knowledge about malaria, (c) childcare practices, (d) quantity and quality of antenatal care, and (e) attitude towards antenatal care and pregnancy. We estimate intention-to-treat effects in linear regression models using endline data and in a difference-in-differences model.</div></div><div><h3>Findings</h3><div>With no robust statistical significance across 50 outcomes, we find no evidence that the PLA intervention in Bihar had an impact on beliefs, attitudes, knowledge, behaviour related to pregnancy or childcare, or quality of antenatal care received. Less than one percent of the sample reported to have attended at least one PLA meeting.</div></div><div><h3>Conclusion</h3><div>Our results do not discredit the effectiveness of PLA interventions in general. They highlight that PLA interventions delivered through existing women's self-help groups need to consider the particular challenges to participation faced by pregnant women.</div></div>","PeriodicalId":47780,"journal":{"name":"Ssm-Population Health","volume":"32 ","pages":"Article 101880"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145519883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Taxing for healthier beginnings: The impact of a major tobacco tax hike on birth weight in Mexico","authors":"Francisco Beltran-Silva ,&nbsp;Rodrigo Aranda","doi":"10.1016/j.ssmph.2025.101851","DOIUrl":"10.1016/j.ssmph.2025.101851","url":null,"abstract":"<div><div>Tobacco consumption during pregnancy poses significant risks to maternal and neonatal health. In 2011, Mexico implemented a large nationwide increase in tobacco excise taxes. Because the policy was applied uniformly across the country and detailed smoking data are limited, identifying causal effects is particularly challenging. Using comprehensive vital statistics records on all singleton live births in Mexico, we apply a regression discontinuity in time design to evaluate the short-term impact of a 250% increase in the excise tax on tobacco products on newborn health outcomes. Our findings provide evidence of moderate short-term increases in birth weight after the tax hike. Although the effects diminish over time and show sensitivity to model specification, they may indicate potential long-term public health benefits. This study provides new evidence on the effects of nationwide tobacco tax increases on birth outcomes in middle-income countries.</div></div>","PeriodicalId":47780,"journal":{"name":"Ssm-Population Health","volume":"32 ","pages":"Article 101851"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145049191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of family caregiving on depression outcome among older European adults","authors":"Sherry Shu-Yeu Hou ,&nbsp;Jee Won Park ,&nbsp;Arijit Nandi","doi":"10.1016/j.ssmph.2025.101857","DOIUrl":"10.1016/j.ssmph.2025.101857","url":null,"abstract":"<div><h3>Background</h3><div>Most caregiver health studies rely on observational data and traditional regression methods, which fail to account for time-varying confounding, limiting causal inference. This analysis uses inverse probability weighting (IPW) to appropriately account for time-varying confounding in caregiving-depression relationship.</div></div><div><h3>Methods</h3><div>Using seven waves (2004–2019) of the Survey of Health, Ageing and Retirement in Europe, we estimated the effect of caregiving on probable depression (having 4+ symptoms) comparing daily and some caregiving to no caregiving. We accounted for censoring and potential measured confounding by time-fixed covariates (gender, number of children, country, and education) and time-varying covariates (age, employment, marital status, income, physical limitations, psychiatric medication, receiving help, previous caregiving, and previous depression) using IPCW and IPTW. The product of the two weights was applied to a marginal structural model to obtain the causal estimand on the prevalence difference scale. Confidence intervals were derived from bootstrapping.</div></div><div><h3>Results</h3><div>Among 36 346 participants and 67 800 person-waves, compared to no caregiving in the last year, daily caregiving was associated with a 6.7 percentage point (95 % CI: 4.8 %, 8.6 %) increase in the prevalence of probable depression, after accounting for time-fixed and time-varying covariates. Some caregiving was not associated with probable depression (PD = 0.5, 95 % CI = −0.8 %, 1.8 %).</div></div><div><h3>Conclusions</h3><div>Our results support existing findings that high levels of caregiving may increase the prevalence of probable depression, while lower levels of caregiving do not. Accurate documentation of the relationship between caregiving and health outcomes is foundational in creating evidence-based policies to support healthy aging.</div></div>","PeriodicalId":47780,"journal":{"name":"Ssm-Population Health","volume":"32 ","pages":"Article 101857"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145011219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Labour market exits in a former out-of-home care population: A birth cohort-based sequence analysis","authors":"Lisa Bornscheuer ,&nbsp;Josephine Jackisch ,&nbsp;Karl Gauffin ,&nbsp;Ylva B. Almquist","doi":"10.1016/j.ssmph.2025.101885","DOIUrl":"10.1016/j.ssmph.2025.101885","url":null,"abstract":"<div><div>Ways of exiting the labour market both reflect previous health and socioeconomic disadvantage, and shape opportunities for healthy ageing. We apply sequence analysis on data from a 1953 Stockholm birth cohort to describe typical labour market exit routes between ages 55 and 68, both in the full sample and among the subgroup of individuals with childhood experience of out-of-home care for family reasons — a population with a high prevalence of childhood adversity. Information on income is used to further characterize these routes. Based on multinomial logistic regression analysis, we examine educational attainment and gender as predictors of exit routes, and as effect modifiers in the association between out-of-home care and exit routes. The normative transition from employment to pension was the most common type of exit in both samples. Individuals clustered into two non-normative routes in the full sample (health-related benefits; early mortality) and four non-normative routes in the care-experienced sample (health-related benefits with income from work; health-related benefits without income from work; unemployment; early mortality), largely reflecting a higher degree of financial disadvantage. We furthermore show that out-of-home care is associated with higher odds of following non-normative exit routes and that higher educational attainment might have the potential to mitigate this association. No consistent differences between men and women emerged in the analyses. Altogether, this study is the first to take a person-centred and prospective approach to describe the heterogeneity in early labour market exits in a high-risk population. Future research should further explore resilience factors in this context.</div></div>","PeriodicalId":47780,"journal":{"name":"Ssm-Population Health","volume":"32 ","pages":"Article 101885"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is objectively measured exposure to built and natural environment associated with population-level cardiovascular disease mortality in Great Britain?","authors":"Laura Macdonald ,&nbsp;Natalie Nicholls ,&nbsp;Fiona Caryl ,&nbsp;Jonathan R. Olsen ,&nbsp;Daniela Fecht ,&nbsp;Richard Mitchell","doi":"10.1016/j.ssmph.2025.101875","DOIUrl":"10.1016/j.ssmph.2025.101875","url":null,"abstract":"<div><h3>Background</h3><div>Cardiovascular disease (CVD) causes one-third of global mortality, with modifiable risk factors such as unhealthy diet, sedentary behaviour, tobacco/alcohol use contributing to 80 % of CVD deaths. The built environment (BE) can influence CVD risk indirectly by shaping health behaviours and directly through environmental exposures like air pollution. While research has established connections between isolated environmental features and CVD, this study addresses significant research gaps in understanding how multiple BE characteristics influence CVD mortality across socioeconomic contexts, aiming to inform neighbourhood design to reduce both CVD and inequalities.</div></div><div><h3>Methods</h3><div>We modelled, for small areas across GB, tree cover, air pollution, walkability, densities of health-detrimental amenities (‘bads’) (e.g. fast-food outlets) and health-promoting amenities (‘goods’) (e.g. gyms), and income deprivation. Generalised linear models were used to assess associations between small area features and (sex-stratified) age-standardised CVD mortality rates (i.e. ICD-10 codes I00–I99), controlling for deprivation, urban-rural, country, and local authority. Combined models (i.e. models mutually adjusted for all BE features) identified the unique contribution of each feature while accounting for those that ‘co-located’. Interaction analysis was performed to examine variations by income deprivation.</div></div><div><h3>Results</h3><div>A slight increase in CVD mortality risk was associated with greater ‘goods’ densities (female mortality ratio (MR):1.005 (CIs:1.003–1.007), p &lt; 0.001, male MR:1.005 (CIs:1.003–1.006), p &lt; 0.001), and higher air pollution (female MR:1.006 (CIs:1.003–1.009), p &lt; 0.001, male MR:1.008 (CIs:1.005–1.009), p &lt; 0.001). A slight decrease in CVD mortality was associated with higher walkability for females (MR:0.996 (CIs:0.992–0.999), p = 0.034) and tree cover for males (MR:0.999 (CIs:0.998–0.999), p = 0.007). Higher air pollution levels and ‘bads’ were associated with higher male CVD mortality in deprived areas.</div></div><div><h3>Conclusion</h3><div>Findings have clear policy implications, suggesting prioritisation of reductions in air pollution—particularly in deprived areas—while promoting walkability and tree cover to reduce health inequalities. Unexpected positive associations between ‘goods’ and mortality highlight that complex neighbourhood effects warrant further study.</div></div>","PeriodicalId":47780,"journal":{"name":"Ssm-Population Health","volume":"32 ","pages":"Article 101875"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145416902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}