Health & PlacePub Date : 2025-05-01DOI: 10.1016/j.healthplace.2025.103465
Mohammad Javad Koohsari , Koichiro Oka , Tomoki Nakaya , Emily Talen , Andrew T. Kaczynski
{"title":"Revisiting public open space and physical activity: What we know, what we still don't, and emerging issues—A decade later","authors":"Mohammad Javad Koohsari , Koichiro Oka , Tomoki Nakaya , Emily Talen , Andrew T. Kaczynski","doi":"10.1016/j.healthplace.2025.103465","DOIUrl":"10.1016/j.healthplace.2025.103465","url":null,"abstract":"<div><div>Public open spaces provide settings for physical activity, but research on their role continues to develop. A decade ago, a paper published by Koohsari et al. (2015) in <em>Health & Place</em> identified key conceptual and methodological challenges in public open spaces and physical activity research. Since its publication, the paper has been widely cited, with over 340 citations and a field-weighted citation impact of 10.70 (Scopus). The current interdisciplinary commentary revisits the original study, evaluates progress over the past decade, and discusses emerging issues. While some conceptual and methodological gaps have been addressed, challenges remain. Emerging issues such as intensifying climate change, pandemics, and technological shifts continue to shape how public open spaces influence physical activity. Further interdisciplinary studies among urban designnce, parks and recreation, geography, public health, and other relevant fields are needed to address these challenges.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"94 ","pages":"Article 103465"},"PeriodicalIF":3.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143895040","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":"Neighborhood socioeconomic disadvantage and travel time to diabetes prevention programs in Maryland","authors":"Portia Buchongo , Jie Chen , Quynh Nguyen , Kellee White-Whilby , Dushanka Kleinman , Luisa Franzini","doi":"10.1016/j.healthplace.2025.103470","DOIUrl":"10.1016/j.healthplace.2025.103470","url":null,"abstract":"<div><h3>Background</h3><div>Transportation issues are a significant barrier for accessing the National Diabetes Prevention Program (NDPP), which remains an effective intervention to prevent type 2 diabetes. Although the link between neighborhood socioeconomic disadvantage and access to health care resources has been widely studied, its impact on travel time and access to NDPP has been underexplored.</div></div><div><h3>Methods</h3><div>Medicaid and private claims data for 2019 from the Maryland Medical Care Data Base were linked to 2019 Social Deprivation Index (SDI) data to measure neighborhood socioeconomic disadvantage. Google Distance Matrix Application Programming Interface key for Google Maps Platform was used to generate travel time estimates for enrollees diagnosed with prediabetes. Then adjusted generalized linear regression models using SDI quintiles and the interaction of SDI quintile and race and ethnicity were fitted to predict driving and public transit travel time to the nearest NDPP.</div></div><div><h3>Findings</h3><div>Enrollees living in neighborhoods with the highest SDI scores (most disadvantaged) had significantly shorter driving and public transit travel time to the nearest NDPP compared to enrollees living in neighborhoods with the lowest SDI scores (least disadvantaged). We found differences in the magnitude of shorter travel times across racial and ethnic groups and transportation mode.</div></div><div><h3>Conclusion</h3><div>Our findings fill a major gap in the literature on neighborhood socioeconomic disadvantage and travel time to NDPP. Findings highlight the role state policies may have had in expanding access to NDPP. More research is needed to examine strategies to address racial and ethnic disparities, and transportation needs to improve access to in-person NDPP.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"94 ","pages":"Article 103470"},"PeriodicalIF":3.8,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143891530","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}
Health & PlacePub Date : 2025-04-30DOI: 10.1016/j.healthplace.2025.103462
Yuru Huang , Tom RP. Bishop , Jean Adams , Steven Cummins , Matthew Keeble , Chiara Rinaldi , Annie Schiff , Thomas Burgoine
{"title":"Understanding the socio-spatial distribution of “dark retail” in England: Development of a unique retail location dataset","authors":"Yuru Huang , Tom RP. Bishop , Jean Adams , Steven Cummins , Matthew Keeble , Chiara Rinaldi , Annie Schiff , Thomas Burgoine","doi":"10.1016/j.healthplace.2025.103462","DOIUrl":"10.1016/j.healthplace.2025.103462","url":null,"abstract":"<div><div>Online food delivery services (OFDS) are an increasingly popular way of accessing both ready-to-consume foods and groceries. Such foods are sometimes delivered from facilities not open to the public - so called ‘dark retail’. However, there is a lack of data on ‘dark retail’, which limits understanding of their location, prevalence and growth. We identified different types of dark kitchens (i.e., “virtual brands”, “ghost kitchens”) and dark grocery stores (i.e., “large dark grocers”, “small/independent dark grocers”). Using data on 113,370 unique online food outlets from three major food delivery platforms (<em>Uber Eats, JustEat, and Deliveroo</em>) in England, we created a database of dark retail locations and analysed their socio-spatial distribution. Dark retail accounted for 14 % of all online food outlets, with the majority being virtual brands. Overall, dark retail is more likely to be located in more deprived areas. The extent of dark retail observed highlights the importance of incorporating them into existing regulatory frameworks. Our database and findings provide insights into the socio-spatial distribution of dark retail, which could inform future research and policy development in this area.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"94 ","pages":"Article 103462"},"PeriodicalIF":3.8,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143891532","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}
Health & PlacePub Date : 2025-04-30DOI: 10.1016/j.healthplace.2025.103477
Wenbo Guo , Tim Schwanen , Christian Brand , Yanwei Chai
{"title":"The associations of real-time and perceived air pollution exposure with episode-level subjective wellbeing: a case study of a suburban community in Beijing","authors":"Wenbo Guo , Tim Schwanen , Christian Brand , Yanwei Chai","doi":"10.1016/j.healthplace.2025.103477","DOIUrl":"10.1016/j.healthplace.2025.103477","url":null,"abstract":"<div><h3>Background</h3><div>The dynamics of everyday life and mobility patterns are often neglected in studies examining the association between air pollution and subjective wellbeing (SWB). We investigated the association between air pollution exposure, both by ambient and perceived measurement, and subjective wellbeing for individuals’ activity episodes and trips in Beijing.</div></div><div><h3>Methods</h3><div>Data on 1688 activities and 573 trips were obtained from the activity-travel diary survey in the Meiheyuan residential community, Beijing, from November 2017 to January 2018. Real-time exposure to ambient air pollution (AAP) in the form of fine particulate matter (PM<sub>2.5</sub>) was collected using portable air pollution sensors, and perceived air pollution (PAP) and SWB at the episode level were acquired through activity-travel diaries. Multi-level structural equation modelling (ML-SEM) was used to investigate the associations between air pollution and SWB separately for daily activity episodes and trips.</div></div><div><h3>Results</h3><div>PAP is not only directly associated with SWB at both activity and trip episodes but also mediates between AAP and SWB for activities. A time-lagged effect of AAP on SWB is observed for trips, where AAP of the preceding episode is directly linked to SWB at the current episode. Location plays a fundamental role in shaping individuals’ AAP, PAP and SWB at activity episodes. The effects of start time, location, activity type and duration are primarily mediated by location and location-PAP. life circumstances shape their exposure to and perceptions of air pollution, as well as their SWB during activity and trip episodes.</div></div><div><h3>Conclusion</h3><div>People's perception of air pollution bears a more pronounced relationship with their satisfaction with individual activities and trips compared to the objective measurements of ambient PM<sub>2.5</sub> exposure. It also highlights that ambient PM<sub>2.5</sub> exposure during the preceding activity episode has a time-lagged effect on satisfaction with the current trip episode.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"94 ","pages":"Article 103477"},"PeriodicalIF":3.8,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143891594","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}
Health & PlacePub Date : 2025-04-30DOI: 10.1016/j.healthplace.2025.103475
Jason Wong , Emma Zang
{"title":"Regional disparities in cognitive life expectancy: The role of birth and current residence in the United States","authors":"Jason Wong , Emma Zang","doi":"10.1016/j.healthplace.2025.103475","DOIUrl":"10.1016/j.healthplace.2025.103475","url":null,"abstract":"<div><div>Regional disparities in cognitive impairment are well-documented, but the combined impact of birth and current residence remains unclear. Prior studies examine geographic patterns, yet none estimate years spent in different cognitive states—key for understanding long-term health and policy implications. Using data from the 1998–2020 Health and Retirement Study (105,491 observations from 19,213 individuals), we employ a Bayesian multistate life table approach to estimate cognitively healthy and impaired life expectancies at age 50 across different combinations of birth and current regions. Our findings show that birth region plays a stronger role in cognitive impairment risk than current residence. At age 50, Southern-born individuals, regardless of where they live later, have fewer years without cognitive impairment (Men: 20.5–21.5; Women: 24.8–25.4) and more years with dementia (Men: 2.3–2.5; Women: 3.0–3.1) than those born elsewhere. Those both born and living in the South have the shortest cognitively healthy life expectancy. Regional differences based on current residence alone are minimal and only evident when considered alongside birthplace. Beyond the Southern birth disadvantage, we also identify a Western birth disadvantage, particularly in life expectancy with dementia and, for women, a higher percentage of life spent with cognitive impairment but not dementia. This suggests that Western-born individuals, especially women, may experience prolonged cognitive decline even if they avoid full-blown dementia. These findings provide new evidence of the lasting impact of early-life geographic exposures on cognitive impairment risk, underscoring that growing up in certain regions, particularly the South and, in some respects, the West, can shape cognitive health trajectories decades later.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"94 ","pages":"Article 103475"},"PeriodicalIF":3.8,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143891531","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}
Health & PlacePub Date : 2025-04-30DOI: 10.1016/j.healthplace.2025.103476
Valdés-Giraldo Paulina , Munera-Moreno Viviana , Ordóñez-Monak Ivonne Andrea , Arroyave Ivan , Trujillo Natalia
{"title":"Echoes of Inequity: Charting Colombia's stroke mortality shifts and socioeconomic and spatial disparities over two decades","authors":"Valdés-Giraldo Paulina , Munera-Moreno Viviana , Ordóñez-Monak Ivonne Andrea , Arroyave Ivan , Trujillo Natalia","doi":"10.1016/j.healthplace.2025.103476","DOIUrl":"10.1016/j.healthplace.2025.103476","url":null,"abstract":"<div><h3>Background</h3><div>Stroke remains a significant public health challenge globally and in Colombia, influenced by socioeconomic and demographic factors. Despite declining mortality rates, inequities persist. This study explores trends in stroke mortality in Colombia (1999–2017), focusing on inequalities by age, sex, and educational attainment.</div></div><div><h3>Method</h3><div>A descriptive longitudinal retrospective study was conducted using mortality data from the National Administrative Department of Statistics. Standardized Mortality Rates (SMRs) were calculated, adjusting for age and sex. Poisson regression models and the Relative Index of Inequality (RII) assessed inequalities. Geographic analyses examined spatial mortality patterns using Geographic Information Systems.</div></div><div><h3>Results</h3><div>Between 1999 and 2017, 262,350 stroke deaths occurred, predominantly in older adults and individuals with lower educational attainment. Stroke mortality declined over time but remained higher among men (66.01/100,000) compared to women (65.74/100,000). Mortality rates were highest in individuals with primary education and lowest in those with tertiary education. Geographic analysis revealed higher mortality in more economically developed regions, suggesting potential underreporting in less developed areas. The RII highlighted pronounced inequalities, especially among women and younger age groups.</div></div><div><h3>Conclusions</h3><div>While stroke mortality in Colombia has decreased, marked inequities persist, particularly by educational level and geographic region. Addressing these inequalities requires targeted public health policies to enhance healthcare access and promote equity.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"94 ","pages":"Article 103476"},"PeriodicalIF":3.8,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143891595","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}
Health & PlacePub Date : 2025-04-27DOI: 10.1016/j.healthplace.2025.103474
Padideh Lovan , Beck Graefe , Andrew Porter , José Szapocznik , Frank J. Penedo , Sarah E. Messiah , Guillermo Prado
{"title":"Neighborhood matters: An exploration of neighborhood-level disadvantage and cancer preventive behaviors in Hispanic youth with unhealthy weight","authors":"Padideh Lovan , Beck Graefe , Andrew Porter , José Szapocznik , Frank J. Penedo , Sarah E. Messiah , Guillermo Prado","doi":"10.1016/j.healthplace.2025.103474","DOIUrl":"10.1016/j.healthplace.2025.103474","url":null,"abstract":"<div><h3>Objectives</h3><div>The present study aimed to assess the associations between the youth's cancer preventive behaviors (CPB) (i.e., healthy dietary intake and physical activity), parent stress, parent socio-demographic characteristics (i.e., education, household income, and marital status), and neighborhood influences measured by the Area Deprivation Index (ADI) in a sample of Hispanic families who have youth with unhealthy weight. Additionally, we examined whether parent stress mediated the relationship between ADI and youth CPB.</div></div><div><h3>Methods</h3><div>Baseline data from 280 Hispanic youth (M<sub>age</sub> = 13.01 ± 0.83; 52.1 % females; M<sub>Body Mass Index (BMI) Percentile</sub> = 94.55 ± 4.15) and their parents (M<sub>age</sub> = 41.87 ± 6.49; 88.2 % females) who enrolled in an RCT were used. Self-reported data on youth dietary intake and physical activity, parent stress, and parent socio-demographic characteristics were collected. Neighborhood impact was examined using ADI, a validated measure to classify neighborhood disadvantage (e.g., housing quality and neighborhood income) using data from the US Census Bureau. Structural Equation Modeling was used (CPB as a latent variable) to evaluate the study model.</div></div><div><h3>Results</h3><div>Our findings indicated significant associations between ADI and youth CPB (<em>b</em> = −0.17, <em>p</em> = .019), and parent stress (<em>b</em> = 0.23, <em>p</em> = .001). However, parent stress did not mediate the relationship between youth ADI and CPB.</div></div><div><h3>Conclusion</h3><div>Youth living in disadvantaged neighborhoods report less engagement in cancer preventive behaviors including poorer food intake quality and less physical activity, which may increase their risk of cancer. Future research should evaluate neighborhood resources to encourage physical activity and healthy eating.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"93 ","pages":"Article 103474"},"PeriodicalIF":3.8,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143876790","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}
Health & PlacePub Date : 2025-04-26DOI: 10.1016/j.healthplace.2025.103473
Tehreem Mustansar , Erik J. Timmermans , Ana Inês Silva , Esmée M. Bijnens , Wouter Lefebvre , Nelly D. Saenen , Charlotte Vanpoucke , Tim S. Nawrot , Ilonca Vaartjes
{"title":"Socioeconomic inequalities and ambient air pollution exposure in school-aged children living in an affluent society: an analysis on individual and aggregated data in Belgium","authors":"Tehreem Mustansar , Erik J. Timmermans , Ana Inês Silva , Esmée M. Bijnens , Wouter Lefebvre , Nelly D. Saenen , Charlotte Vanpoucke , Tim S. Nawrot , Ilonca Vaartjes","doi":"10.1016/j.healthplace.2025.103473","DOIUrl":"10.1016/j.healthplace.2025.103473","url":null,"abstract":"<div><h3>Background</h3><div>Individuals with lower socioeconomic status (SES) are at a higher risk of being exposed to adverse environmental factors. Children are more vulnerable to the harmful effects of air pollutants. Therefore, this study examined socioeconomic inequalities in air pollution exposure among children in Flanders, Belgium.</div></div><div><h3>Methods</h3><div>Data were used from 298 children (age range: 9–12 years), and from their parents who participated in the COGNition and Air pollution in Children study. Socioeconomic status was measured using highest parental education at the individual level and median income at the neighborhood (aggregated) level. Annual average outdoor concentrations of particulate matter with diameters <2.5 μm (PM<sub>2.5</sub>) and <10.0 μm (PM<sub>10</sub>), nitrogen dioxide (NO<sub>2</sub>), and black carbon (BC) in μg/m<sup>3</sup> were estimated at the residential address. Mixed regression models were applied to examine the associations.</div></div><div><h3>Results</h3><div>Children from parents with a low education level were exposed to significantly higher levels of PM<sub>2.5</sub>, PM<sub>10</sub>, and BC compared to children from parents with a high education level. However, the associations were not significant when tested using regression models. Children who lived in areas with a lower median neighborhood income were exposed to significantly higher levels of air pollution; an interquartile range (IQR; €4505.00) decrease in income was associated with an increase in exposure to PM<sub>2.5</sub> of 0.198 μg/m<sup>3</sup>, PM<sub>10</sub> of 0.406 μg/m<sup>3</sup>, NO<sub>2</sub> of 0.740 μg/m<sup>3</sup>, and BC of 0.063 μg/m<sup>3</sup>. Children of parents with a low/high education level had a higher exposure to PM<sub>2.5</sub>, PM<sub>10</sub>, NO<sub>2,</sub> and BC when living in a low income neighborhood. Exposure to all air pollutants was the highest for low parental education level and low neighborhood income. <strong>Conclusions</strong>: Low neighborhood income was significantly associated with higher levels of air pollution, while parental education level was not significantly associated. Children from parents with a low education and low income were exposed to the highest levels of air pollution.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"93 ","pages":"Article 103473"},"PeriodicalIF":3.8,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143876958","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}
Health & PlacePub Date : 2025-04-25DOI: 10.1016/j.healthplace.2025.103471
Antonio Zumelzu , Marta Moya Fierro , Marie Geraldine Herrmann-Lunecke
{"title":"Mental wellbeing and aging in place: The role of the built environment in promoting healthy aging","authors":"Antonio Zumelzu , Marta Moya Fierro , Marie Geraldine Herrmann-Lunecke","doi":"10.1016/j.healthplace.2025.103471","DOIUrl":"10.1016/j.healthplace.2025.103471","url":null,"abstract":"<div><div>We analyze the built environment and its impacts on senior citizens’ mental wellbeing. Through \"Go-Along\" method, 50 walking interviews were made to analyze the emotional experiences of elderly individuals in relation to the built environment. Results indicate that a highly walkable environment with local shops can generate a greater connection with the community, increasing individual tranquility and trust in public space. Natural elements like well-maintained gardens, consistent trees on sidewalks, varied tree leaf colors, and lush grass on streets positively influence seniors' mental wellbeing. These findings are crucial for urban design, offering valuable guidance to create inclusive environments that support healthy aging.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"93 ","pages":"Article 103471"},"PeriodicalIF":3.8,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143874294","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}
Health & PlacePub Date : 2025-04-25DOI: 10.1016/j.healthplace.2025.103468
Zhuolin Tao, Rui Zhang, Cheng Liu, Qianyu Zhong
{"title":"On the Modifiable Areal Unit Problem (MAUP) in healthcare accessibility measurement via the two-step floating catchment area (2SFCA) method","authors":"Zhuolin Tao, Rui Zhang, Cheng Liu, Qianyu Zhong","doi":"10.1016/j.healthplace.2025.103468","DOIUrl":"10.1016/j.healthplace.2025.103468","url":null,"abstract":"<div><div>The widely used two-step floating catchment area (2SFCA) method for healthcare accessibility measurement might be biased due to the Modifiable Areal Unit Problem (MAUP), which remains unknown. This study calculates and compares healthcare accessibility via the Gaussian-based 2SFCA method at various spatial scales to identify the scale effects. We also compare various spatial aggregation approaches at the township scale to examine the zoning effects, including geometric centroids, population centroids, government residences and a hybrid population-weighted average travel time approach. Taking Lhasa city as the study area, the grid-based travel time estimation method is adopted to reflect the influence of the physical environment. The results reveal significant scale effects in the application of the 2SFCA method. Using population centroids to represent the spatial distribution of population within townships can yield more accurate accessibility results, while the accessibility measured based on geometric centroids might be considerably biased. The population-weighted average travel time approach, which aggregates grid-scale travel times to the township scale, also ensures high accuracy of accessibility measurement. The population-weighted average travel time approach and the population centroid approach are more effective in mitigating potential scale effects on accessibility results with limited population data. These findings are valuable for researchers to apply accessibility methods properly and support reliable policy implications based on accessibility results.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"93 ","pages":"Article 103468"},"PeriodicalIF":3.8,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143869686","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}