Health & Place最新文献

{"title":"Modeling time-varying spatial accessibility to healthcare: A system dynamic approach","authors":"Liang Mao","doi":"10.1016/j.healthplace.2025.103416","DOIUrl":"10.1016/j.healthplace.2025.103416","url":null,"abstract":"<div><div>Spatial accessibility to healthcare is essential for policymakers to identify health disparities and develop targeted interventions. Current modeling approaches poorly capture temporal dynamics of contributing factors, and few have represented dynamic interactions among these factors. Further, validating current models is hindered by data limitations and methodological challenges. To fill these gaps, I propose a new modeling approach that produces time-varying and empirically validated measures of healthcare accessibility. Specifically, I develop a system dynamic model to represent interplay between population demand and healthcare supply over time. The model simultaneously estimated people's potential accessibility to healthcare and their utilization over time and space, then validated these estimates with actual hospitalization data. To illustrate the model's practical use, a working prototype was constructed to estimate and validate healthcare accessibility by day and by ZIP code in Florida, USA, during a disease outbreak in 2022-23. The results indicate that system dynamic modeling offers a robust framework for monitoring healthcare accessibility fluctuations across regions and time periods, thereby guiding the development of timely and targeted interventions to reduce disparities.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"91 ","pages":"Article 103416"},"PeriodicalIF":3.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018810","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":"Geographical variation in the long-arm of childhood","authors":"Emily C. Dore","doi":"10.1016/j.healthplace.2025.103417","DOIUrl":"10.1016/j.healthplace.2025.103417","url":null,"abstract":"<div><div>Scholars have documented the lasting impact of childhood socioeconomic status (SES) on health, but few studies have considered how state contexts in childhood shape health trajectories based on childhood SES across the life course. The current project uses data from the Panel Study of Income Dynamics, 2009–2021 (N = 18,227 person-year observations of adults aged 18–41) to build on these studies by 1) examining state variation in the relationship between childhood SES and adult self-rated health, and 2) assessing the contributions of childhood state-level economic context in moderating this relationship. Logistic regression models first confirmed the expected relationship between childhood SES and adult self-rated health that parallels other literature (OR = 1.79, 95% CI 1.46, 2.19). Of the 37 states included in the analysis, there was a statistically significant difference in reporting poor health between low and high-childhood SES groups in 14 states. The interaction between childhood SES and state-level income inequality (OR = .01, 95% CI -9.77, −.62), suggests that exposure to higher levels of income inequality in childhood was more harmful for the health of individuals from higher SES backgrounds. The interaction between childhood SES and unemployment rates (OR = 1.13, 95% CI 1.03, 1.24), suggests that exposure to higher unemployment rates in childhood was more harmful for the health of individuals from lower SES backgrounds. This study finds important state-variation in the relationship between childhood SES and adult health and identifies income inequality and unemployment rates as factors in these differences.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"91 ","pages":"Article 103417"},"PeriodicalIF":3.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043880","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 multi-constraint Monte Carlo Simulation approach to downscaling cancer data","authors":"Lingbo Liu ,&nbsp;Lauren Cowan ,&nbsp;Fahui Wang ,&nbsp;Tracy Onega","doi":"10.1016/j.healthplace.2024.103411","DOIUrl":"10.1016/j.healthplace.2024.103411","url":null,"abstract":"<div><div>This study employs an innovative multi-constraint Monte Carlo simulation method to estimate suppressed county-level cancer counts for population subgroups and extend the downscaling from county to ZIP Code Tabulation Areas (ZCTA) in the U.S. Given the known cancer counts at a higher geographic level and larger demographic groups at the same geographic level as constraints, this method uses the population structure as probability in the Monte Carlo simulation process to estimate suppressed data entries. It not only ensures consistency across various data levels but also accounts for demographic structure that drives varying cancer risks. The 2016–2020 cancer incidence data from the Utah Cancer Registry is used to validate our approach. The method yields results with high precision and consistency across the full urban-rural continuum, and significantly outperforms several machine-learning models such as Random Forest and Extreme Gradient Boosting.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"91 ","pages":"Article 103411"},"PeriodicalIF":3.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075708","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":"Neighbourhood social cohesion, loneliness and multimorbidity: Evidence from a UK longitudinal panel study","authors":"Laurence Rowley-Abel ,&nbsp;Chunyu Zheng ,&nbsp;Kimberly More ,&nbsp;Eleojo Abubakar ,&nbsp;Chris Dibben ,&nbsp;Jamie R. Pearce ,&nbsp;Alan Marshall","doi":"10.1016/j.healthplace.2025.103414","DOIUrl":"10.1016/j.healthplace.2025.103414","url":null,"abstract":"<div><div>In the context of population ageing, multimorbidity is an increasingly prevalent public health issue that has a substantial impact on both individuals and healthcare systems. Alongside the literature looking at risk factors at the individual level, there is a growing body of research examining the role of neighbourhoods in the development of multimorbidity. However, most of this work has focused on physical features of place such as air pollution and green space, while social features of place have been largely overlooked. In this study, we therefore explored neighbourhood cohesion as a social neighbourhood characteristic that could influence multimorbidity risk. Additionally, we analysed how loneliness may help to explain any relationship between neighbourhood cohesion and multimorbidity, given the emergence of loneliness as an important risk factor for multimorbidity in individual-level studies. Using Understanding Society, a UK household longitudinal panel study of approximately 40,000 households, we conducted both multilevel cross-sectional and longitudinal analyses to model these relationships. We found that there is a substantial association between greater neighbourhood cohesion and lower multimorbidity risk (odds ratio (OR) for second most cohesive quintile versus least cohesive quintile = 0.75, p &lt; .01), even after controlling for a wide range of socio-economic factors, health behaviours and physical features of place. This cross-sectional result was confirmed by longitudinal analysis of individuals with no health conditions at baseline who moved between neighbourhoods over a nine-year follow-up period. Movers who experienced a decrease in cohesion had greater odds of becoming multimorbid compared to movers who did not experience a decrease in cohesion (OR = 1.68, p = .057). Controlling for loneliness substantially attenuates the odds ratios for neighbourhood cohesion, and in a mediation analysis we found a significant indirect effect of neighbourhood cohesion on multimorbidity risk acting through loneliness, suggesting it is a plausible mechanism through which the social environment influences the development of multiple long-term health conditions.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"91 ","pages":"Article 103414"},"PeriodicalIF":3.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018814","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 the association between neighborhood disadvantage and cannabis retail density: A multi-measure analysis","authors":"Lindsay Kephart ,&nbsp;Vaughan W. Rees ,&nbsp;S.V. Subramanian ,&nbsp;Daniel P. Giovenco","doi":"10.1016/j.healthplace.2024.103396","DOIUrl":"10.1016/j.healthplace.2024.103396","url":null,"abstract":"<div><h3>Introduction</h3><div>There is growing interest in the relationship between neighborhood disadvantage and increased cannabis retail density, driven by evidence suggesting higher density is associated with increased cannabis use. Yet little is known on how this relationship varies across different measures of cannabis retail density. This study explores how measures of neighborhood advantage and disadvantage relate to four cannabis retail density measures in the US.</div></div><div><h3>Methods</h3><div>Data on licensed recreational cannabis retailers (n = 5586) were obtained from 18 state agency websites, geocoded, and spatially joined to 3369 census tracts to calculate four retail density measures: count per tract, cannabis retailers per 1000 population, per square mile, and per 10 miles of roadway. Multilevel regression models assessed the association between three Index of Concentration at the Extremes (ICE) measures—capturing tract concentration of racial and economic advantage/disadvantage—and the four cannabis retail density measures.</div></div><div><h3>Results</h3><div>Census tracts with the highest concentrations of economic and racialized/economic disadvantage exhibited greater odds of increased cannabis retail density across all measures, compared to tracts with the highest concentration of advantage. Tracts with the greatest concentration of racialized populations did not show a higher count or density per population but did exhibit higher density per square mile and per roadway.</div></div><div><h3>Conclusion</h3><div>On average, cannabis retail density is higher in neighborhoods with the greatest structural disadvantage. Researchers, public health agencies, and policymakers should use multiple measures of cannabis retailer density in surveillance and evaluation efforts to identify policy strategies that would most effectively reduce the clustering of cannabis retailers in areas primarily occupied by low-income or racialized populations.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"91 ","pages":"Article 103396"},"PeriodicalIF":3.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822962","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":"Who goes foraging in Bristol, UK and why? A qualitative investigation into wild food acquisition and food justice","authors":"Ruth Sharman","doi":"10.1016/j.healthplace.2024.103397","DOIUrl":"10.1016/j.healthplace.2024.103397","url":null,"abstract":"<div><div>In recent years, foraging for wild foods has grown in popularity in cities. Globally, urban foragers are diverse; motivations span contribution to the food basket, healthier living, and accessing urban nature. Research to date highlights ease of access across socio-demographic groups. There is little empirical evidence in the UK on how social identity intersects with the practices and meanings of foraging: who forages, what motivates them, and how are questions of equity understood? This paper takes a case study from Bristol (UK) to explore how foragers describe their motivations, their own and others social identities, and challenges of equitable access.</div><div>Data were generated from fieldwork with a foraging group and qualitative walking interviews (n = 15) in foraging locations. Qualitative thematic analysis identified three key themes; social identity, motivation and food justice.</div><div>Foraging in Bristol was framed as a lifestyle pursuit by the largely (self-identified) middle-class participants. Reported motivations centre on improving health through ‘nature cure’, exercising individual agency in food provision, and environmentalism. The rationales for foraging suggest subtle class distinctions in relation to food choices, and participants identify knowledge and experiential limitations, and sociocultural factors, as contributing to others' lack of access.</div><div>Findings contribute to the literature on urban foraging in the context of food justice. In one UK city, foraging was not primarily understood as a subsistence activity, but as a component of a particular lifestyle orientation. To improve equity of access to the subsistence benefits of foraging, better understanding of the social meanings attributed to foraging are needed.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"91 ","pages":"Article 103397"},"PeriodicalIF":3.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911192","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":"“Sometimes I just wanna be outside”: A qualitative analysis of experiences with accessing community greenspace among people living with chronic mobility disability","authors":"Lauren F. Murphy ,&nbsp;Denise C. Fyffe ,&nbsp;Rachel Byrne ,&nbsp;Brittany Maronna ,&nbsp;Amanda L. Botticello","doi":"10.1016/j.healthplace.2024.103399","DOIUrl":"10.1016/j.healthplace.2024.103399","url":null,"abstract":"<div><div>Exposure to nature is associated with better mental health in the general population, but prior evidence suggests that people living with severe, chronic mobility impairment from paralysis due to spinal cord injury (SCI) may not experience similar benefits. Since many people living with SCI use wheelchairs and other medical devices for mobility, further exploration of how people living with mobility disability experience greenspace is needed to achieve equity in access to all public places. We assessed experiences with accessing greenspace reported in a sample of people living with chronic SCI and the meanings they ascribe to these experiences for their health and quality of life. A thematic content analysis of the qualitative interview data from a mixed-methods study of community activity patterns among adults with SCI was conducted. Three major themes emerged: important accessibility features, strategies used to enable access, and psychosocial consequences of greenspace accessibility. These results suggest that people living with chronic mobility impairment have unmet needs for outdoor recreation that can be addressed through urban planning approaches that prioritize input from people with lived disability experience and universal design for creating equitable greenspace access, as well as ongoing policy work that aims to expand access to assistive technology needed for outdoor community activities.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"91 ","pages":"Article 103399"},"PeriodicalIF":3.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873689","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":"Energy poverty and health inequalities in Barcelona: A cross-sectional trends study in the context of COVID-19, energy crisis and climate change, 2016–2021","authors":"Karen Naes Aaserud ,&nbsp;Marc Marí-Dell’Olmo ,&nbsp;Laia Palència ,&nbsp;Juli Carrere ,&nbsp;María José López ,&nbsp;Laura Oliveras","doi":"10.1016/j.healthplace.2024.103401","DOIUrl":"10.1016/j.healthplace.2024.103401","url":null,"abstract":"<div><div>The aim of this study was to analyse the time trends in Barcelona before and during the adverse context of COVID-19, energy crisis, and climate change in 1) the energy poverty (EP) prevalence; 2) the association between EP and health and 3) the impact of EP on health, according to the axes of inequality (sex, age, social class, and country of birth). We conducted a cross-sectional trends study using data from the 2016 and 2021 Barcelona Health Survey. This study clearly recognizes that EP continues to be an important public health problem in the context of Barcelona. The results show that EP did increase somewhat, though not as sharply as hypothesized in the current adverse context. Neither did it have <em>as</em> large consequences on the effects of EP on health as we expected to see. However, it demonstrates that there is still a strong association between EP and poor health, particularly in vulnerable groups such as people born in LMI countries and manual workers, who experienced an increase in the impact of EP on poor health outcomes, which suggests increasing health inequalities.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"91 ","pages":"Article 103401"},"PeriodicalIF":3.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142904577","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":"Demographic inequities and cumulative environmental burdens within communities near superfund sites on Long Island, New York","authors":"Fintan A. Mooney ,&nbsp;Jill R. Kelly ,&nbsp;Joshua L. Warren ,&nbsp;Nicole C. Deziel","doi":"10.1016/j.healthplace.2024.103409","DOIUrl":"10.1016/j.healthplace.2024.103409","url":null,"abstract":"<div><div>Nassau and Suffolk Counties of Long Island, New York are densely populated and contain 34 federally-designated and 449 state-designated Superfund sites, potentially exposing communities to toxic releases. We conducted a distributive justice analysis assessing proximity to Superfund sites, community socio-demographics, and other environmental burdens. Socio-demographic and environmental variables for 665 census tracts were obtained from the United States Census and Environmental Protection Agency's Environmental Justice Screening and Mapping Tool. Hierarchical Bayesian spatial Poisson regression models evaluated the relationship between socio-demographic and environmental variables and counts of Superfund sites per census tract. Analyses were further stratified by county and site type (Federal versus State). A 10% increase in low-income residents was associated with a 47% increase in Superfund sites (Risk Ratio [RR]: 1.47; 95% credible interval (CI): 1.20–1.81). A 10% increase in Hispanic/Latino residents was associated with a 20% increase (RR: 1.20; 95%CI: 1.02–1.42). Higher PM_2.5 concentrations (RR:1.64, 95% CI: 1.09–2.48), higher toxic air releases (RR: 1.27, 95%CI: 1.03–1.61), and greater proximity to underground gas storage tanks (RR: 1.27, 95%CI: 1.09–1.48) were associated with increases in Superfund counts. Stratified analyses revealed that low-income residents are concentrated near state not federal Superfund sites. County stratification found that only Suffolk County residents near Superfund sites have increased lead exposure potential, and Black residents in Suffolk (not Nassau) were more likely to live near Superfund sites. We observed localized distributive inequities in community demographics near Superfund sites on Long Island, and communities near Superfund sites are more likely to experience other environmental burdens.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"91 ","pages":"Article 103409"},"PeriodicalIF":3.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142974049","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 association between neighborhood built environment and mental health among older adults in Hangzhou, China","authors":"Xinyu Kong ,&nbsp;Haoying Han ,&nbsp;Fangting Chi ,&nbsp;Mengyao Zhan","doi":"10.1016/j.healthplace.2025.103415","DOIUrl":"10.1016/j.healthplace.2025.103415","url":null,"abstract":"<div><div>In the context of population ageing, the age-friendliness of neighborhood built environment (NBE) is increasingly recognized as essential for enabling ageing in place. However, while much research has focused on the impact of NBE on the physical health of older adults, its relationship with mental health (MH) remains underexplored, especially the pathways through which NBE indicators influence MH. This study measured NBE using ten indicators across three categories: daily travel (including barrier-free travel, elevator, rest seat, diversion of pedestrian and vehicle, road surface and public toilet), healthcare services (including public canteen and elderly care), and social participation (including outdoor fitness space and indoor activity space). It examined the association between NBE and MH among 1405 older adults in Hangzhou, China, utilizing structural equation models to explore potential pathways. The findings revealed a significant and robust direct association between outdoor fitness spaces and MH of older adults. Additionally, physical health significantly mediated the association between road surface and MH, while social interaction played a crucial mediating role between public toilets, public canteens, elderly care, indoor activity spaces, and MH. Although the durations and types of leisure activities did not independently mediate the NBE-MH relationship, leisure durations effectively mediated it through both physical health and social interaction, whereas leisure types mediated it through social interaction. This study empirically supported the compensatory process and enabling process proposed by the ecological theory of aging, offering valuable empirical evidence to inform policies aimed at enhancing NBE to promote MH among older adults.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"91 ","pages":"Article 103415"},"PeriodicalIF":3.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143026155","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}