Health & Place最新文献

{"title":"‘Clean and safe’?: Swimming ethically in compromised times and polluted places","authors":"Kate Moles ,&nbsp;Rebecca Olive","doi":"10.1016/j.healthplace.2025.103457","DOIUrl":"10.1016/j.healthplace.2025.103457","url":null,"abstract":"<div><div>In this article we explore emergent and enduring tensions that exist in thinking about outdoor swimming and what these can tell us about the expectations swimmers have for the possibilities in the world today and the world becoming. We will explore and describe encounters that let us see the complexities between the desire for encounters with nature, and the desire to maintain ‘clean and safe’ swimming experiences. Thinking in dialogue with Clifton Evers (2019, 2021, 2023) work on ‘polluted leisure’ and Alexis Shotwell’s (2016) concerns ‘about the evocations of purity and cleanliness’ (p.2), we are interested in how swimming spaces create barriers of access to healthy encounters by limiting the vulnerability swimmers feel in relation to various risks. Like Shotwell, we aim to challenge the privilege afforded to some groups of people to ‘perceive things how they should be, rather than how they are’ (p.7). By exploring the politics of maintaining ‘safe and clean’ swimming spaces, we aim to engage with how ‘Purity politics arise not only in our response to potential physical contamination but are also an issue for our ethical and political situation in the world’ (p.6). Maintaining purity, safety and cleanliness for ourselves and our communities of practice is an impossible task, and one that ensures we remain complicit in ongoing social and environmental injustices as well as re-producing social and cultural hierarchies related to nature, wellbeing, place, and health.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"93 ","pages":"Article 103457"},"PeriodicalIF":3.8,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143823567","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 urban greenspace on time to major adverse cardiovascular events among women with breast cancer in the US: Insights from the Greater Milwaukee, WI Area","authors":"Jean C. Bikomeye ,&nbsp;Sergey Tarima ,&nbsp;Yuhong Zhou ,&nbsp;Jamila L. Kwarteng ,&nbsp;Andreas M. Beyer ,&nbsp;Tina W.F. Yen ,&nbsp;Aaron N. Winn ,&nbsp;Kirsten M.M. Beyer","doi":"10.1016/j.healthplace.2025.103460","DOIUrl":"10.1016/j.healthplace.2025.103460","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Cardiovascular (CV) disease (CVD) remains a significant concern among breast cancer (BC) survivors, particularly following potentially cardiotoxic treatments, such as anthracyclines and anti-HER2 drugs, which increase the risk of major adverse CV events (MACE). Social determinants of health (SDOH) and environmental factors influence health outcomes, including those related to CVD. Urban greenspace has been associated with CV and cancer-related health benefits, yet its specific impact on MACE among BC survivors remains unknown.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;This study aims to investigate the association between urban greenspace and time to first MACE incidence among individuals with BC after being treated with cardiotoxic therapies in the greater Milwaukee, WI area.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;A retrospective cohort study was conducted using electronic medical records from the Froedtert Health System, linked to the National Death Index. Cox proportional hazards regression models were used to assess the association between percent tree canopy cover and MACE-specific hazards, adjusting for sociodemographic, clinical, and neighborhood-level factors.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Among the 849 women included, 44.6 % experienced a MACE. Adjusted models indicated an 18 % reduction in MACE-specific hazard (HR: 0.82, 95 % CI: 0.70, 0.96) and a 20 % reduction in MACE-specific hazard (HR: 0.80, 95 % CI: 0.67, 0.97) for women in the second and third quartiles of percent tree canopy cover, respectively, compared to the women in the first (lowest) quartile. However, we did not observe a risk difference for women living in the fourth quartile of tree canopy. Racial/ethnic disparities in greenspace exposure and MACE incidence were evident, with Non-Hispanic Black (NHB) women having a lower proportion living in areas with the highest tree canopy cover and a higher MACE incidence (61.9 %) compared to Non-Hispanic White (NHW) women (41.6 %), who had the highest proportion residing in areas within the 4th quartile of tree canopy cover.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;div&gt;Our findings suggest that urban tree canopy is associated with time to incident MACE among BC survivors receiving cardiotoxic treatments. These results underscore the importance of considering socioenvironmental factors in CardioOncology care and highlight the benefits of greenspace in mitigating CV complications among individuals with BC. Future research should delve into individual lifestyle and behavioral factors, environmental factors, and biological mechanisms that may underlie these associations. Additionally, longitudinal studies should be conducted to evaluate greenspace-based interventions for BC survivors, aiming to advance precision CardioOncology interventions. Observed racial/ethnic disparities in MACE incidence underscore the urgent need for equity-focused interventions addressing greenspace access and MACE-related disparities.&lt;","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"93 ","pages":"Article 103460"},"PeriodicalIF":3.8,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789463","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":"Patterns of intimate partner violence in Victoria, Australia: analysis using the National Ambulance Surveillance System","authors":"Shane Yin Choo ,&nbsp;James Wilson ,&nbsp;Naomi Beard ,&nbsp;Michael McGrath ,&nbsp;Dan I. Lubman ,&nbsp;Karen Smith ,&nbsp;Debbie Scott ,&nbsp;Rowan P. Ogeil","doi":"10.1016/j.healthplace.2025.103461","DOIUrl":"10.1016/j.healthplace.2025.103461","url":null,"abstract":"<div><div>Limited surveillance mechanisms have investigated the acute harms associated with intimate partner violence (IPV). This study used novel coded ambulance data to examine the socioeconomic and geographical remoteness distribution of IPV victim survivors attended to by paramedics in the context of acute alcohol and/or drug and mental health harms. Coded ambulance records involving IPV (N = 1484) from 2016 to 2018 were extracted from the Victorian arm of the National Ambulance Surveillance System. Regression models were used to examine sociodemographic characteristics associated with IPV-related ambulance attendances. These attendances were more likely to be associated with the most disadvantaged socioeconomic areas (incidence rate ratio (IRR) = 3.56, 95 % CI 2.71–4.67), and occur in outer regional and remote areas (IRR = 1.58, 95 % CI 1.07–2.35). Ambulance data offers unique potential to map and predict socioeconomic and geographical help-seeking in IPV victim survivors.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"93 ","pages":"Article 103461"},"PeriodicalIF":3.8,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring sex differences in the longitudinal association between streetlighting and transport walking","authors":"Tharindu Niwarthana Bandara ,&nbsp;Gavin Turrell ,&nbsp;Alysha De Livera ,&nbsp;Belen Zapata-Diomedi ,&nbsp;Lucy Gunn","doi":"10.1016/j.healthplace.2025.103442","DOIUrl":"10.1016/j.healthplace.2025.103442","url":null,"abstract":"<div><div>Regular physical activity, such as transport walking, is essential for health, yet many adults do not meet recommended physical activity levels. The built environment, particularly streetlighting, plays a critical role in promoting transport walking. However, existing evidence on the relationship between streetlighting and transport walking is largely cross-sectional, with limited longitudinal research exploring potential sex differences. This study aimed to assess the longitudinal association between objectively measured streetlight count and transport walking among mid-to-older-aged adults in Brisbane, Australia, and to explore whether this association varies by sex. Data were from the How Areas in Brisbane Influence HealTh and AcTivity (HABITAT) study, a multilevel cohort study with five waves over nine years (2007–2016). The analytical sample included participants who did not move during the study. Transport walking was self-reported and dichotomized into walkers and non-walkers. Streetlight counts within a 1 km road network buffer around participants’ homes were measured alongside transport walking. Generalized linear mixed-effects models were used, adjusting for sociodemographic factors, length of stay, neighbourhood preference, and built environment attributes. Higher streetlight counts were positively associated with transport walking (OR 1.002; 95% CI 1.001, 1.002), and the association remained significant after adjusting for residential density, street connectivity, and land-use mix. No significant sex differences were found. This study provides longitudinal evidence that well-lit environments promote transport walking among mid-to-older-aged adults. This finding can inform urban planning and public health policies aimed at encouraging transport walking to help reduce the risk of chronic disease.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"93 ","pages":"Article 103442"},"PeriodicalIF":3.8,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143768109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Newness, unfamiliarity, and cultural beliefs; social and behavioural barriers to COVID-19 vaccination among the Dumagat Remontado, an Indigenous population in the Philippines","authors":"Catherine J. Silvestre ,&nbsp;Bianca Joyce T. Sornillo ,&nbsp;Vivienne Endoma ,&nbsp;Thea Andrea Bravo ,&nbsp;Mila Aligato ,&nbsp;Maria Paz Demonteverde ,&nbsp;Lourdes Pambid ,&nbsp;Marianette T. Inobaya ,&nbsp;Johanna Beulah T. Sornillo ,&nbsp;Mark Donald C. Reñosa","doi":"10.1016/j.healthplace.2025.103444","DOIUrl":"10.1016/j.healthplace.2025.103444","url":null,"abstract":"<div><div>Indigenous Peoples faced unique challenges that contributed to vaccine hesitancy, including limited healthcare access, mistrust of medical institutions, and adherence to traditional practices. While vaccination played a critical role in improving public health, Indigenous communities often remained underserved and sceptical about its benefits, particularly in the context of COVID-19. Thus, this study aimed to explore the perceptions and experiences of the Dumagat Remontado, an Indigenous Peoples in the Philippines, on COVID-19 vaccination. Through their narratives, the study aimed to identify the factors that affect their intention to get vaccinated and uptake of the COVID-19 vaccine. A qualitative research design was employed, with in-depth interviews conducted with 18 respondents in Rizal, Philippines in January 2023 and the Framework Approach used for data analysis. Findings were presented within the World Health Organization's Behavioural and Social Drivers (BeSD) framework for vaccination. Key factors influencing vaccine intention included government policies, social norms, perceived disease severity, susceptibility, and vaccine benefits and risks. Health experts and vaccinated individuals were identified as the most favoured sources of vaccine information. Accessibility of services, healthcare worker demeanour, and information availability surfaced as practical issues which hindered vaccine uptake. The study underscored the importance of involving the Dumagat Remontado in conceptualising and implementing vaccination programmes, as well as utilising vaccine champions, real-life narratives, and the local language in information dissemination. These contributions emphasised the need for inclusive public health strategies to address vaccine hesitancy among Indigenous Peoples, ultimately promoting equitable access to healthcare and improving vaccination rates.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"93 ","pages":"Article 103444"},"PeriodicalIF":3.8,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143776924","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":"Rapid review on healthy ageing interventions that incorporate action on climate change and sustainability in cities and communities","authors":"Rebecca Patrick ,&nbsp;Sue Noy ,&nbsp;Molly McKew ,&nbsp;Siwon Lee ,&nbsp;Mikiko Kanda ,&nbsp;Sally J. Edwards ,&nbsp;Akeem Ali ,&nbsp;Kathryn Bowen","doi":"10.1016/j.healthplace.2025.103435","DOIUrl":"10.1016/j.healthplace.2025.103435","url":null,"abstract":"<div><h3>Objectives</h3><div>Intersecting global trends of population ageing and climate change have far-reaching implications for health and sustainability in cities and community contexts. Older adults are highly impacted by climate change, and yet reports of the implementation of the World Health Organizations’ Age-Friendly Cities and Communities (AFCC) approach rarely examine the impacts of climate change on older adults. There is limited research on climate change interventions that target older populations. This rapid scoping review characterizes existing evidence in this area, including climate and health-related interventions involving older populations around the world.</div></div><div><h3>Methods</h3><div>The PCC framework (Population, Context, Concept) guided the implementation of this rapid scoping review. Peer reviewed articles were sourced from Scopus (Elsevier), Greenfile, Academic Search Complete (EBSCO), Global Health (OVID) and Google Scholar. Grey literature was sourced from Google Scholar, Google and relevant international websites. Inclusion criteria were grey and academic publications in English, after the year 2000 and described an intervention. Screening was undertaken on Covidence software and critically appraised using MMAT and AACODS tools. The AFCC framework was used to guide analysis and interpretation.</div></div><div><h3>Results</h3><div>Twenty-five articles were included. The review found a paucity of literature describing age-friendly cities and community interventions that considered health-related impacts of climate change on older adults, issues for rural communities and those in developing nations. Climate change was rarely mentioned other than for context in the peer-reviewed literature, and the grey literature was similarly sparse. Peer-reviewed literature was top-down, focusing on disasters and older adults’ vulnerability, whilst the grey literature privileged older adult agency and potential contribution to addressing climate change. Successful interventions were programs that positioned older adults as active, empowered participants.</div></div><div><h3>Conclusions</h3><div>Climate change justice and resilience should be incorporated explicitly into the AFCC framework. Greater information exchange between Global North and Global South and inclusion of diverse perspectives (i.e., Indigenous knowledge, people with disabilities and/or experiencing homelessness) will enhance policy efforts. Similarly, recognition of the broader impacts of climate change on the fundamental pre-requisites for health across the lifespan such as food, water and energy security are required. Older adults should be seen as a valuable resource integral to the design and implementation of innovative interventions with climate resilience, healthy ageing focus.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"93 ","pages":"Article 103435"},"PeriodicalIF":3.8,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143747107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coping with maternity care in rural areas: A holistic approach using Bourdieusian concepts of capital and fields","authors":"Silja Mets-Oja ,&nbsp;Kadi Lubi ,&nbsp;Anu Toots","doi":"10.1016/j.healthplace.2025.103445","DOIUrl":"10.1016/j.healthplace.2025.103445","url":null,"abstract":"<div><div>Efficiency-oriented healthcare reforms have led to the closure of obstetric units in several European countries, particularly affecting rural areas that are experiencing depopulation and a decreased birthrate. Using Bourdieu’s field theory, this qualitative study aimed to explore how women’s economic, cultural, and social capital affects their coping at different stages of maternity. The study was based on 20 semi-structured interviews with women in rural Estonian areas where obstetric units have been closed or face imminent closure because of the low number of deliveries. The findings suggest that the utilisation and interplay of these types of capital are shaped by the geographical context, digital opportunities, and the framework of biomedicalization. From pregnancy through childbirth to the postpartum stage, the importance of economic capital increased because the women were obliged to plan their travel to doctors and hospitals more carefully. The women’s cultural and social capital, in the form of information retrieved from the Internet and the availability of family support, was closely associated with their travel decisions. Structural limitations and poor collaboration between healthcare providers and social services hindered capital interplay across fields, especially during the postpartum period. This focus on rural women’s lived experiences of coping with maternity care complements previous quantitative studies that have highlighted the health risks associated with the closure of obstetric units in rural hospitals. Our findings suggest that the effect is not overwhelmingly negative, although we observed greater risk for some individuals and varying capabilities in coping with maternity care challenges.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"93 ","pages":"Article 103445"},"PeriodicalIF":3.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143739561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A potential environmental paradox in India: Associations between air pollution precautions and sedentary behaviour among children and youth","authors":"Sapneet Sandhu ,&nbsp;Jamin Patel ,&nbsp;Anuradha Khadilkar ,&nbsp;Jasmin Bhawra ,&nbsp;Tarun Reddy Katapally","doi":"10.1016/j.healthplace.2025.103440","DOIUrl":"10.1016/j.healthplace.2025.103440","url":null,"abstract":"<div><div>The negative impact of ambient air pollution on movement behaviours in the global south is a significant concern. Yet, evidence about this complex relationship is limited. This study assessed how precautions taken to prevent ambient air pollution exposure are associated with sedentary behaviour among children and youth in India. Participants aged 5–17 years (N = 986) from 41 schools in 28 urban and rural areas across India completed online surveys to provide information on movement behaviours, including precautions taken to avoid exposure to air pollution, perception of built environment, and sedentary behaviour. Multivariate gamma regression models were developed, adjusting for sociodemographic variables with sedentary behaviour as the primary criterion variable. Apart from an overall sample model, six segregated models were built to understand age, gender, and geographical variations. Children and youth who reported taking precautions to prevent ambient air pollution exposure were associated with significantly higher daily minutes of sedentary behaviour in both the overall sample (β = 0.085, 95 % CI = 0.001, 0.169) and the 13 to 17 age group (β = 0.110, 95 % CI = 0.007, 0.227). However, being able to access outdoor physical activity facilities before or after school was associated with lower sedentary behaviour in the following models: overall, rural, 5 to 12 and 13 to 17 age groups, and boys and girls. To our knowledge, this is the first study to depict a potential paradoxical relationship between precautions taken to avoid exposure to ambient air pollution and higher sedentary behaviour among children and youth in India i.e., a health-preserving behaviour is perpetuating another chronic disease risk factor.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"93 ","pages":"Article 103440"},"PeriodicalIF":3.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143739562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coal to swole: A survey of anabolic steroid use and muscularity concerns in coalfield areas of Wales","authors":"Christopher W.N. Saville ,&nbsp;Ieuan Cranswick ,&nbsp;David Tod ,&nbsp;Dean Acreman ,&nbsp;Lee Hogan ,&nbsp;Daniel Rhys Thomas","doi":"10.1016/j.healthplace.2025.103456","DOIUrl":"10.1016/j.healthplace.2025.103456","url":null,"abstract":"<div><h3>Background</h3><div>Growing male anabolic steroid use is often framed as symptomatic of a post-industrial masculinity crisis, but little quantitative evidence exists for this account. We examine whether steroid use is associated with geographic exposure to industrial decline, namely historical coal mining, and whether any association is mediated by masculine norms.</div></div><div><h3>Methods</h3><div>We fielded a quota-sampled survey of 18–49 year-old men in Wales (N = 1425). Data were geo-linked to the extent of historic coal mining locally to respondents. Generalised linear mixed models were fitted to test our hypotheses.</div></div><div><h3>Results</h3><div>Steroid use (odds ratio = 1.99, 1.10–3.60), but not body image (B = 1.06, −2.02-4.13), was positively associated with mining extent. However, this was not mediated by conformity to masculine norms.</div></div><div><h3>Discussion</h3><div>While use of steroids is more common in former mining areas, this is not due to more prevalent body image issues nor mediated by masculine norms. Thus, accounts of a post-industrial ‘thwarted masculinity’ do not fit the data. Steroid use in post-industrial areas is an issue for public health and these communities may benefit from targeted interventions to reduce risk of harms.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"93 ","pages":"Article 103456"},"PeriodicalIF":3.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143739560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence pathways of noise exposure on people's negative emotions and health across different activity contexts: A neural network-based double machine learning approach","authors":"Daming Lu ,&nbsp;Mei-Po Kwan","doi":"10.1016/j.healthplace.2025.103455","DOIUrl":"10.1016/j.healthplace.2025.103455","url":null,"abstract":"<div><div>Noise is a major global environmental issue that raises concerns about both mental and physical health. However, few studies have investigated the mediating role of emotions in the pathways linking noise exposure to health outcomes. Additionally, many studies have overlooked the varying effects of noise across different activity contexts. Most importantly, previous research has predominantly relied on correlational analysis, offering limited evidence of causality. In this study, we utilize real-time data from an environmental health survey of 800 residents in Hong Kong collected between 2021 and 2023 and apply a neural network-based Double Machine Learning model to estimate the pathways through which noise influences emotional states and health outcomes. Our findings reveal that (1) noise during travel significantly heightens real-time annoyance, while noise at home primarily increases real-time stress; (2) annoyance strongly contributes to headaches, whereas stress predominantly leads to insomnia and fatigue; and (3) noise at home directly triggers insomnia and fatigue, whereas noise during travel not only directly causes insomnia and headache but also indirectly exacerbates insomnia, fatigue, and headache through heightened annoyance. In contrast, noise in the workplace and outdoors has a limited impact on insomnia, fatigue, and headaches. This study provides valuable insights into the pathways through which noise influences negative emotional states and, subsequently, health outcomes, offering a methodological framework for unraveling the \"black box\" of environmental health relationships.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"93 ","pages":"Article 103455"},"PeriodicalIF":3.8,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143734503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}