Health & Place最新文献

{"title":"Places of end-of-life care and death in health policies of four countries (EOLinPLACE Project)","authors":"Sifra H. van de Beek ,&nbsp;Barbara Gomes ,&nbsp;Krista Eckels ,&nbsp;Sara Pinto ,&nbsp;Beatriz Sanguedo ,&nbsp;Dorothy A. Olet ,&nbsp;Elizabeth Namukwaya ,&nbsp;Joanna V. Brooks ,&nbsp;Emmanuelle Belanger ,&nbsp;Jenny T. van der Steen","doi":"10.1016/j.healthplace.2025.103534","DOIUrl":"10.1016/j.healthplace.2025.103534","url":null,"abstract":"<div><h3>Background</h3><div>Place of death and its concordance with patient preference is a key indicator for end-of-life care, studied cross-nationally and flagged as a priority by the OECD. However, it is unclear if and how ‘place’ is considered in health policy in relation to end-of-life care. This study aims to examine if and how health policies in different nations consider places of end-of-life care and death.</div></div><div><h3>Methods</h3><div>We conducted a comparative qualitative study across the US, the Netherlands, Portugal, and Uganda, of health policy documents following the READ (i.e., Ready materials, Extract data, Analyze data, Distill findings) systematic approach for document analysis in health policy research. Documents were analyzed using directed content analysis following Hsieh and Shannon (2005). Timelines for document publication were country-specific, based on local health policy developments relevant to end-of-life care in the last two decades. Backdates ranged from 2001 in Uganda to 2015 in the Netherlands; the most recent publication year was 2024 for all countries.</div></div><div><h3>Findings</h3><div>We identified 89 policy documents relevant to end-of-life care mentioning preferred or actual places of end-of-life care or death. The first topic was ‘<em>Narratives around places</em>’, where home was prioritized while inpatient facilities were most problematized. A second topic ‘<em>Policy measures acting on places</em>’ included: i) <em>Availability of services across places</em>, where the rural-urban divide, workforce shortages, waitlists and financial considerations challenged availability of end-of-life care across places; and ii) <em>Professional expertise vs. community empowerment</em>, which highlighted a key tension in the extent to which countries invest in professional expertise versus community empowerment.</div></div><div><h3>Conclusions</h3><div>While improving care at home is prioritized with evidence-based reasons to support it, our study shows that policymakers overlook the potential benefits of other care settings and flexible care solutions that promote continuity of care. This comparative analysis unveiled implications to improve end-of-life care across care settings.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"96 ","pages":"Article 103534"},"PeriodicalIF":4.1,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145254116","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":"Social drivers of type 2 diabetes in Mexico: A spatial multilevel approach to urbanization and unhealthy food expenditure","authors":"Aldo Daniel Jiménez-Ortega ,&nbsp;J. Mauricio Galeana-Pizaña ,&nbsp;Gustavo M. Cruz-Bello ,&nbsp;Juan Manuel Núñez","doi":"10.1016/j.healthplace.2025.103555","DOIUrl":"10.1016/j.healthplace.2025.103555","url":null,"abstract":"<div><div>Type 2 diabetes mellitus (T2DM) is growing worldwide, particularly in Latin American countries. The determinants of this pandemic are diverse and exhibit distinctive spatial variations. Moreover, there is often a mismatch between the scale of disease reporting units and the spatial resolution of disease determinants. This study examines the social drivers of T2DM mortality in Mexican municipalities for 2016 and 2022, focusing on variables related to urbanization and expenditure on unhealthy food. We applied general linear mixed-effects models with a spatial random component to account for state heterogeneity. We found that some urbanization-related variables were significantly associated with T2DM mortality in both years, such as urban land use area per 1000 inhabitants, access to basic housing services, and population employed in informal activities. The effect of unhealthy food access became significant only in 2022, coinciding with an increase in spatial dependence, suggesting a broader geographic diffusion of urban and dietary risk factors. The marginal and conditional R-squared values indicate high explanatory power in both models (marginal: 0.811 in 2016 and 0.808 in 2022; and conditional: 0.834 and 0.832, respectively), with most variance explained by the fixed effects. Notably, the mean mortality rate for T2DM increased by 26 % during the study period. This approach enhances our understanding of how structural and spatial factors interact to shape health outcomes, highlighting the need for targeted public health strategies in rapidly urbanizing regions and emphasizing the multifactorial impact of urban conditions and food environments on health, particularly in guiding dietary interventions to mitigate T2DM.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"96 ","pages":"Article 103555"},"PeriodicalIF":4.1,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240709","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":"From sanitation to safety: Investigating the link between water, sanitation and hygiene and intimate partner violence in Nepal","authors":"Karan Babbar ,&nbsp;Supriya Garikipati","doi":"10.1016/j.healthplace.2025.103556","DOIUrl":"10.1016/j.healthplace.2025.103556","url":null,"abstract":"<div><div>Intimate Partner Violence (IPV) disproportionately affects women globally. While the link between Water, Sanitation, and Hygiene (WASH) and IPV is recognized, the underlying mechanisms require further exploration. This study investigates the mediating role of Menstrual Health and Hygiene (MHH) practices and the moderating role of Partner Controlling Behaviors in the WASH-IPV relationship in Nepal. Drawing on Sen's Capability Approach and Social Control Theory, we hypothesize that access to WASH facilities, by improving MHH practices, is negatively associated with IPV. We propose that this relationship is moderated by Partner Controlling Behaviors. Using Nepal Demographic Health Survey data of 5178 women and girls, we employed Structural Equation Modelling. Our findings reveal that access to WASH facilities was positively associated with better MHH outcomes, which were significantly negatively associated with IPV. The indirect effect of WASH on IPV via MHH was statistically significant, supporting MHH's mediating role. The interaction between Partner Controlling Behavior and MHH outcomes significantly predicts IPV, highlighting the moderating influence of gender norms. The protective effect of improved MHH practices is weakened where Partner Controlling Behavior are more prevalent. These findings underscore the importance of addressing both resource availability (enhancing capabilities) and harmful gender norms (enacted through controlling behaviors) to mitigate IPV. We advocate for a comprehensive approach that includes enhanced WASH access, improved MHH practices, and interventions targeting harmful gender norms and controlling behaviors within relationships.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"96 ","pages":"Article 103556"},"PeriodicalIF":4.1,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234783","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":"To go or not to go: The challenges of UK public toilet provision","authors":"Jo-Anne Bichard,&nbsp;Gail Ramster","doi":"10.1016/j.healthplace.2025.103545","DOIUrl":"10.1016/j.healthplace.2025.103545","url":null,"abstract":"<div><div>The United Kingdom's public toilet provision currently faces many challenges. This paper sets out some of the key barriers to providing inclusive toilet provision. We suggest that one of the key challenges provision faces is the taboo of the public toilet and that this contributes to a lack of recognition in the essentials of provision. However, we argue that the taboo around public toilets also affects future funding, not only of the provision itself but extends to research of the provision and it's social and economic necessity. Such research would generate evidence on the importance of public toilets for everyone's successful urban living, but especially from a public health perspective that affects everyone.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"96 ","pages":"Article 103545"},"PeriodicalIF":4.1,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145160091","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":"Inequalities in road traffic noise exposure levels in greenspaces in Greater London","authors":"Kathryn Adams ,&nbsp;Calvin Jephcote ,&nbsp;Benjamin Fenech ,&nbsp;Anna Hansell ,&nbsp;Tess Osborne ,&nbsp;John Gulliver","doi":"10.1016/j.healthplace.2025.103536","DOIUrl":"10.1016/j.healthplace.2025.103536","url":null,"abstract":"<div><div>Exposure to road traffic noise in residential settings has been associated with detrimental effects on health including annoyance, sleep disturbance, cardiometabolic outcomes, and mental health. Conversely, exposure to natural sounds improves cognitive performance and aids in stress recovery in humans. Environmental exposure studies have shown that the distribution of noise exposures is often not equitable across cities, but evidence related to noise in UK greenspaces remains limited. This study provides an analysis of noise variability and inequalities in noise levels for greenspaces in Greater London related to residential addresses. Noise levels from major and minor roads were modelled across 2,532 greenspaces for the daytime and evening period in accordance with the European Commission Common Framework for Noise Assessment (CNOSSOS-EU) methods from Environment Noise Directive 2002/49/EC and the inverse square law of sound attenuation. Using modelled road traffic noise estimates, we found that 28 % of greenspaces exceeded equivalent World Health Organization noise guideline levels during daytime and evening periods. Greenspaces in Central London were more likely to have noise levels that exceeded the WHO noise guidelines. Distance-based proximity analyses showed that for populations in Central London, greenspace areas nearest to residential addresses were more likely to feature high noise levels. As distance travelled from residential locations increased, the distribution of high greenspace noise levels became more dispersed. However, no inequality gradient was observed between different deprivation groups, except for the least deprived communities’, who experienced noise levels that were 2 dB lower within greenspace areas within a 5 km radius.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"96 ","pages":"Article 103536"},"PeriodicalIF":4.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145152210","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":"Evaluating the protective effect of public open space on social connectedness: evidence from a natural experiment cohort study in three Canadian cities","authors":"Meridith Sones ,&nbsp;Daniel Fuller ,&nbsp;Yan Kestens ,&nbsp;Benoit Thierry ,&nbsp;Meghan Winters","doi":"10.1016/j.healthplace.2025.103541","DOIUrl":"10.1016/j.healthplace.2025.103541","url":null,"abstract":"<div><div>Community design has the potential to address urban isolation and loneliness at a population level, but limited research on the causal effects of the built environment constrains evidence-based action in cities. This study examined the effect of public open space on changes in social connectedness among adults (n = 665) during the COVID-19 pandemic, using geospatial data from OpenStreetMap and health survey data from three cities (Montréal, Saskatoon, and Vancouver). Treating the pandemic as a natural experiment, we used multilevel models to analyze whether public open space exposure (defined as the ratio of land area within 500m of home) modified changes in community belonging, loneliness, and neighbouring from 2018 to 2020/2021. First, we found little evidence of changes in social connectedness in our cohort overall and within subgroups. On average, loneliness increased slightly, and belonging and neighbouring remained stable. Second, we found that higher public open space exposure (≥10 % neighbourhood land area) had a modest protective effect on community belonging only (0.14, 95 % CI = 0.01 to 0.27). These findings add to a limited but growing evidence base on the role of the built environment in shaping social connectedness, while highlighting challenges involved in examining causal impacts. As cities invest in public open space to support policy goals around sustainability and livability, evaluating co-benefits for social connectedness are critical opportunities for strengthening the evidence on built environment solutions to social isolation and loneliness.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"96 ","pages":"Article 103541"},"PeriodicalIF":4.1,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145120408","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":"A comparison of HIV pre-exposure prophylaxis accessibility by public transit- and drive-time in Dallas-Fort Worth, Texas, 2024","authors":"Hui Luan ,&nbsp;Yusuf Ransome ,&nbsp;Tamara Taggart ,&nbsp;Jeremy Chow ,&nbsp;Noah Mancuso ,&nbsp;Miranda Grant ,&nbsp;Philip Huang ,&nbsp;Patrick Sullivan","doi":"10.1016/j.healthplace.2025.103550","DOIUrl":"10.1016/j.healthplace.2025.103550","url":null,"abstract":"","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"96 ","pages":"Article 103550"},"PeriodicalIF":4.1,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145120409","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 walkability and subsequent health and well-being in urban and rural Japan: An outcome-wide longitudinal study","authors":"Kenjiro Kawaguchi ,&nbsp;Atsushi Nakagomi ,&nbsp;Yu-Ru Chen ,&nbsp;Katsunori Kondo ,&nbsp;Masamichi Hanazato","doi":"10.1016/j.healthplace.2025.103549","DOIUrl":"10.1016/j.healthplace.2025.103549","url":null,"abstract":"<div><h3>Background</h3><div>Walkability notably affects the health of older adults; however, its relationship with various outcomes in different geographical contexts remains unclear. Considering urban–rural differences, this study examined associations between neighborhood walkability and the health and well-being of older adults in Japan.</div></div><div><h3>Methods</h3><div>Data were obtained from the Japan Gerontological Evaluation Study, a nationwide cohort study of Japanese adults aged ≥65 years, across three waves (2013, 2016, and 2019). This study included 27,354 participants in the survey-based sample and 40,111 participants in the long-term care insurance-based sample. Neighborhood walkability was assessed using a composite index derived from population density, distance to retail and park areas, and road density. Forty-two outcomes across seven domains were analyzed using multilevel regression models stratified by urbanicity. Bonferroni correction was applied (α = 0.0012).</div></div><div><h3>Results</h3><div>In urban settings, higher walkability was significantly associated with increased walking time. Conversely, in rural areas, higher walkability showed mixed results; it was significantly associated with increased participation in hobby/sports groups and outings, but also with increased risk of functional disability (level ≥2), increased sedentary behavior, and decreased norms of reciprocity. Walkability was not significantly associated with walking time.</div></div><div><h3>Conclusions</h3><div>Walkability can have different effects on health and well-being in urban and rural areas, highlighting the need for location-specific strategies. While urban efforts could focus on pedestrian infrastructure, effective rural strategies would likely involve an integrated approach that addresses transportation, social connectivity, and activity promotion.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"96 ","pages":"Article 103549"},"PeriodicalIF":4.1,"publicationDate":"2025-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108819","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":"A Walk across Europe: Development of a high-resolution walkability index","authors":"Nishit Patel ,&nbsp;Hoang-Ha Nguyen ,&nbsp;Jet van de Geest ,&nbsp;Alfred Wagtendonk ,&nbsp;Mohan J.S. Raju ,&nbsp;Payam Dadvand ,&nbsp;Kees de Hoogh ,&nbsp;Marta Cirach ,&nbsp;Mark Nieuwenhuijsen ,&nbsp;Thao Minh Lam ,&nbsp;Jeroen Lakerveld","doi":"10.1016/j.healthplace.2025.103544","DOIUrl":"10.1016/j.healthplace.2025.103544","url":null,"abstract":"<div><div>Physical inactivity significantly contributes to obesity and other non-communicable diseases, yet efforts to increase population-wide physical activity levels have met with limited success. The built environment plays a pivotal role in encouraging active behaviors like walking. Walkability indices, which aggregate various environmental features, provide a valuable tool for promoting healthy, walkable environments. However, a standardized, high-resolution walkability index for Europe has been lacking. This study addresses that gap by developing a standardized, high-resolution walkability index for the entire European region. Seven core components were selected to define walkability: walkable street length, intersection density, green spaces, slope, public transport access, land use mix, and 15 min walking isochrones. These were derived from harmonized, high-resolution datasets such as Sentinel-2, NASA’s elevation models, OpenStreetMap, and CORINE Land Cover. A 100 m <span><math><mo>×</mo></math></span> 100 m hierarchical grid system and advanced geospatial methods, like network buffers and distance decay, were used at scale to efficiently model real-world density and proximity effects. The resulting index was weighted by population and analyzed at different spatial levels using visual mapping, spatial clustering, and correlation analysis. Findings revealed a distinct urban-to-rural gradient, with high walkability scores concentrated in compact urban centers rich in street connectivity and land use diversity. The index highlighted cities like Barcelona, Berlin, Munich, Paris, and Warsaw as walkability leaders. This standardized, high-resolution walkability index serves as a practical tool for researchers, planners, and policymakers aiming to support active living and public health across diverse European contexts.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"96 ","pages":"Article 103544"},"PeriodicalIF":4.1,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145093201","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":"Health in place and place in health: 30 years of Health & Place","authors":"Michael J. Widener ,&nbsp;Valorie A. Crooks","doi":"10.1016/j.healthplace.2025.103537","DOIUrl":"10.1016/j.healthplace.2025.103537","url":null,"abstract":"","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"95 ","pages":"Article 103537"},"PeriodicalIF":4.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144983960","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}