Health & PlacePub Date : 2026-01-01Epub Date: 2025-12-18DOI: 10.1016/j.healthplace.2025.103593
Guibo Sun , Yao Du , Tim Schwanen
{"title":"Gendered impacts of public transport on social isolation and loneliness among older adults: Evidence from a natural experiment in Hong Kong","authors":"Guibo Sun , Yao Du , Tim Schwanen","doi":"10.1016/j.healthplace.2025.103593","DOIUrl":"10.1016/j.healthplace.2025.103593","url":null,"abstract":"<div><div>A well-designed public transport system has the potential to support social participation and alleviate social isolation and loneliness among older adults. However, limited research has explored whether such benefits differ between older men and women. Using a natural experiment involving a new metro line in Hong Kong, our cohort study (N = 449) of older people yields a surprising finding: contrary to previous studies suggesting that women are more likely than men to experience social isolation and loneliness, our analysis reveals that older men report higher levels of both. Despite this, the new metro line has not significantly reduced social isolation or loneliness among older men. In contrast, older women have actively engaged with the new metro line, especially for those with greater social participation at the baseline, leveraging it to strengthen their social networks and mitigate social isolation and loneliness. These findings suggest that public transport may not equally benefit all groups, underscoring the importance of considering gender differences, particularly the needs of older men, in transport planning to reduce social isolation and loneliness.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"97 ","pages":"Article 103593"},"PeriodicalIF":4.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790790","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 : 2026-01-01Epub Date: 2025-12-05DOI: 10.1016/j.healthplace.2025.103574
Katie Powell , Laura Fenton , Elizabeth McGill , Saima Nazir-Desforges , Mark Clowes , Abigail Kate Stevely , Cheryl McQuire , Paige M. Hulls , Zoe L. Clarke , Michael P. Daly , Matt Egan , Frank de Vocht
{"title":"A synthesis of explanations for spatial inequalities in gambling harm: integrating social and material dimensions of place","authors":"Katie Powell , Laura Fenton , Elizabeth McGill , Saima Nazir-Desforges , Mark Clowes , Abigail Kate Stevely , Cheryl McQuire , Paige M. Hulls , Zoe L. Clarke , Michael P. Daly , Matt Egan , Frank de Vocht","doi":"10.1016/j.healthplace.2025.103574","DOIUrl":"10.1016/j.healthplace.2025.103574","url":null,"abstract":"<div><div>Place matters for understanding patterns of gambling harm as shown by the spatial clustering of both ‘vulnerable’ people and gambling outlets. Harms are experienced at a community level (and never restricted to individuals) and are spread unequally across communities of place. Following the liberalisation of gambling laws in the UK in the 1990s, gambling outlets and advertising have proliferated in many economically disadvantaged places, with the gambling industries in some cases appearing to target these areas. Despite growing recognition of place-based inequalities in the harms caused by gambling, there have been limited efforts to understand gambling as a spatial practice that reflects and produces inequalities in health. This paper presents a synthesis of theories and explanations in the social science and public health literature about the unequal harms from gambling experienced by people in different places. We draw on a socio-material approach in our synthesis to show how different assemblages of gambling products, venues, marketing materials and collective histories form in different localities to influence different gambling practices with varying consequences for health. The synthesis foregrounds how different levels of power and influence in the production, regulation and experience of space across communities shape i) the meanings of gambling as a social practice and ii) the collective resources of communities to protect themselves from gambling harms. The analysis thus points to socio-material spaces as sites for interventions to reduce inequalities in harm.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"97 ","pages":"Article 103574"},"PeriodicalIF":4.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145685027","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 : 2026-01-01Epub Date: 2026-01-11DOI: 10.1016/j.healthplace.2025.103571
Rebecca Olive , Ronan Foley , Kate Moles
{"title":"The blue Un/Commons: Tracing new directions in research on outdoor swimming, health and place","authors":"Rebecca Olive , Ronan Foley , Kate Moles","doi":"10.1016/j.healthplace.2025.103571","DOIUrl":"10.1016/j.healthplace.2025.103571","url":null,"abstract":"<div><div>This discussion provides an introduction to our special issue, The Blue Un/Commons: Tracing new directions in research on outdoor swimming, health and place. This introduction provides a rationale and overview of the social and research contexts the special issue is immersed in, including the growing multi-disciplinary literature on the established health and wellbeing swimming benefits of swimming. Our aim is to extend this ‘health and wellbeing’ focus and develop a new research agenda that reflects positive connections, while simultaneously considering critical dimensions of feminist, anticolonial, environmental, posthuman, and inclusionary research. The main sections examine the literature around four core themes; access, risk, the blue commons, and more-than-human water. Access is considered as both a material and affectual component that is shaped by varied permissions/allowances. Risk is considered in terms of relational immersions between bodies and waters that have personal, societal, environmental and cultural dimensions. The idea of a blue (un)commons is critically described in relation to key inclusions and exclusions, recognising wider existential threats around ownership and sustainability. The final theme considers the more-than-human water itself, in terms of nature and mood, cultural and practical knowledges and ecological allyship. The final section of the article identifies significant potential for research about outdoor swimming, health and wellbeing and specifically engages with the potential of future work on diverse swimming bodies, relational swimming spaces, swimming practices, cultures and knowledges, innovative methodological possibilities and swimming as a lifelong health-promoting practice. Uncovering new immersive connections with water promotes the idea of a blue spatial justice as a productive co-collaboration that supports not just human but also planetary wellbeing.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"97 ","pages":"Article 103571"},"PeriodicalIF":4.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145961074","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 : 2026-01-01Epub Date: 2026-01-13DOI: 10.1016/j.healthplace.2026.103610
Mariana Ramos Castro , Henrique Telo Alves , Carla Moreira , Thomas Astell-Burt , Marilyne Cancela , Filipa Guilherme , Ana Isabel Ribeiro
{"title":"Exposure to green, blue, and biodiverse spaces and their associations with loneliness in urban adults: Findings from the EPIPorto cohort","authors":"Mariana Ramos Castro , Henrique Telo Alves , Carla Moreira , Thomas Astell-Burt , Marilyne Cancela , Filipa Guilherme , Ana Isabel Ribeiro","doi":"10.1016/j.healthplace.2026.103610","DOIUrl":"10.1016/j.healthplace.2026.103610","url":null,"abstract":"<div><div>Emerging evidence suggests green space may reduce loneliness, while the role of blue space and biodiversity remains under-researched. This study examines associations between exposure to green, blue, and biodiverse spaces and loneliness in adults in Porto, Portugal and explores potential effect modifiers.</div><div>Loneliness was assessed in 2022 in 657 EPIPorto cohort participants using the UCLA Loneliness Scale (>32 indicating ‘high loneliness’). Vegetation and surface water were measured using Normalized Difference Vegetation Index (NDVI) and Modified Normalized Difference Water Index (MNDWI) within 100m, 300m, and 500m pedestrian buffers. Biodiversity was assessed using a species richness index. Cross-sectional associations between these variables and loneliness were estimated with linear regression (robust standard errors) and logistic regression. Additional models considered long-term trends of NDVI and MNDWI since baseline (1999). Effect modification of sex, marital status, cohabitation and age was assessed through multiplicative interactions. Models were adjusted for confounders, including markers of socioeconomic status.</div><div>Cross-sectionally, greater amounts of vegetation within 100m [β per one-unit increase = −1.555, 95 %CI (−3.090; −0.007)] and higher species richness within 300m and 500m [-0.514 (−1.027; −0.001) and −0.581 (−1.132; −0.031)] were associated with lower levels of loneliness, while blue space presence showed non-significant associations. Concerning long-term trends, the results lacked significance. Non-significant results were found for loneliness as a binary outcome and no effect modification was confirmed.</div><div>This study suggests that near home greenness and biodiversity may reduce levels of loneliness, while the association with blue spaces is inconsistent. This highlights the potential of urban greening and biodiversity to help mitigate loneliness.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"97 ","pages":"Article 103610"},"PeriodicalIF":4.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145967810","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 : 2026-01-01Epub Date: 2025-12-02DOI: 10.1016/j.healthplace.2025.103589
Katerina E.B. Beach , Dalton A. Norwood , Ricardo L. Dominguez , Eleazar Montalvan-Sanchez , Paul Delamater , Scott M. Williams , Douglas R. Morgan , Michael Emch
{"title":"Geographic dimensions of gastric cancer risk in western Honduras: A spatial ecological analysis","authors":"Katerina E.B. Beach , Dalton A. Norwood , Ricardo L. Dominguez , Eleazar Montalvan-Sanchez , Paul Delamater , Scott M. Williams , Douglas R. Morgan , Michael Emch","doi":"10.1016/j.healthplace.2025.103589","DOIUrl":"10.1016/j.healthplace.2025.103589","url":null,"abstract":"<div><div>Gastric cancer is fifth most common cancer globally, with a complex and multifactorial etiology, including human and bacterial genetics, health behaviors, and environmental exposures. Honduras has among the highest rates of gastric cancer in the western hemisphere, and previous research indicates that gastric cancer risk varies geographically at a sub-national scale. We analyzed characteristics of all 788 incident cases diagnosed in western Honduras between 2002 and 2015 for which residence information was available to assess geographic patterns of excess risk and population-level risk factors. We built hierarchal Bayesian Poisson models to implement spatial ecological analysis stratified by sex and gastric cancer sub-type (diffuse, intestinal, mixed/indeterminate) to explore sex and sub-type specific etiologies. We identified differential geospatial patterns of high observed relative risk (i.e., greater than 1.0) for across male/female and diffuse/intestinal strata. Unexplained variance was more spatially structured in models for males, but less so among females, suggesting that unobserved, spatially autocorrelated factors contributing to geographic risk patterns among males in this area. Additionally, ecological associations varied by sex/sub-type strata. Among males, risk of intestinal gastric cancer was elevated with an increase in the percentage of indigenous Maya/Chortí in the population, but this association was not detected in female strata. Our findings demonstrated substantial differences in geographic patterns of risk across sex and ancestry, which implicated that unobserved, sex-stratified factors, such as germline mutations and behaviors, play a role in shaping geographic patterns of cancer risk at the subnational level in western Honduras.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"97 ","pages":"Article 103589"},"PeriodicalIF":4.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145673305","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 : 2026-01-01Epub Date: 2025-12-01DOI: 10.1016/j.healthplace.2025.103575
Jessie L. Heneghan , Kavya Velmurugan , Colleen Weatherwax , Sarah M. Bartsch , Corby K. Martin , Tiffany M. Powell-Wiley , Nevin Cohen , Megan A. McCrory , Abigail Horn , Kevin L. Chin , Tej D. Shah , Katherine T. Fraser , Samuele A. Petruccelli , Alexis M. Dibbs , Sheryl A. Scannell , Kayla de la Haye , Bruce Y. Lee
{"title":"Adherence to the combined Mediterranean-dietary approaches to stop hypertension diet is shaped by neighborhood socio-economics and food environments","authors":"Jessie L. Heneghan , Kavya Velmurugan , Colleen Weatherwax , Sarah M. Bartsch , Corby K. Martin , Tiffany M. Powell-Wiley , Nevin Cohen , Megan A. McCrory , Abigail Horn , Kevin L. Chin , Tej D. Shah , Katherine T. Fraser , Samuele A. Petruccelli , Alexis M. Dibbs , Sheryl A. Scannell , Kayla de la Haye , Bruce Y. Lee","doi":"10.1016/j.healthplace.2025.103575","DOIUrl":"10.1016/j.healthplace.2025.103575","url":null,"abstract":"<div><h3>Introduction</h3><div>Over the years, different diets have been recommended often with little consideration to how feasible they may be to follow given a person's circumstances and surroundings (e.g., the food environment). Therefore, we sought to determine how difficult it would be for people to maintain the Mediterranean and Dietary Approaches to Stop Hypertension (MED-DASH) versus default to the Typical American diet (TAD) in three different income-level neighborhoods in Los Angeles, California.</div></div><div><h3>Methods</h3><div>We developed geospatially explicit ABMs of three neighborhoods in Los Angeles that had varied socioeconomics and food environments with varying income levels – one lower-income (Boyle Heights), one middle-income (Inglewood), and one higher-income (Santa Monica). We tested how well the virtual residents (represented by computational agents) could adhere to the MED-DASH compared to defaulting to TAD. To summarize outcomes of average dietary adherence levels among agents within each neighborhood, we used means and 95 % confidence intervals (CIs) for each diet scenario.</div></div><div><h3>Results</h3><div>Adherence to the MED-DASH diet was on average only 57.43 % (95 % CI: 55.67 %–59.19 %) in the lower-income neighborhood, 62.39 % (95 % CI: 60.59–64.19 %) in the middle-income neighborhood, and 68.02 % (95 % CI: 66.21–69.82 %) in the higher-income neighborhood. Decreasing by 50 % the average price of foods that comprise the MED-DASH diet increased adherence by 17.24 %, 10.36 %, and 1.88 % in the neighborhoods, respectively.</div></div><div><h3>Conclusions</h3><div>Dietary recommendations, especially precision nutrition approaches, should take into consideration the surrounding food environment and ways to make suggested diets more feasible.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"97 ","pages":"Article 103575"},"PeriodicalIF":4.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145656604","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 : 2026-01-01Epub Date: 2025-12-26DOI: 10.1016/j.healthplace.2025.103599
Catherine D. Brown , Alessandro Rigolon , Piper Zdrodowski , Amber L. Pearson
{"title":"A systematic review of green gentrification and mental health","authors":"Catherine D. Brown , Alessandro Rigolon , Piper Zdrodowski , Amber L. Pearson","doi":"10.1016/j.healthplace.2025.103599","DOIUrl":"10.1016/j.healthplace.2025.103599","url":null,"abstract":"<div><div>Urban development projects increasingly incorporate greening efforts in underserved communities to improve human health and promote biodiversity. Unfortunately, these efforts can create a paradox whereby target communities do not reap the benefits due to increased property values, and subsequent physical or social-cultural displacement. This process, green gentrification, may negatively affect residents’ mental health. Despite increased urban greening efforts, we currently lack a review evaluating the impacts of green gentrification on mental health. Thus, we systematically reviewed the existing green gentrification-mental health research. Through 16 articles, we identified pathways relating green gentrification exposures to mental health outcomes. For instance, as neighborhoods experience green gentrification, rising housing prices introduce new financial pressures and concerns surrounding housing availability and quality, which can introduce stress. Also, as living expenses increase, there is a change in demographics, which can diminish sense of community and feelings of belonging. Furthermore, the green space itself can serve as a space of exclusion as longtime residents experience barriers to use, which have negative implications for their mental health. Finally, when the new green space provides ecological remediation or restoration, longtime residents may experience anxiety due to fear of exposure to historic contaminants. Still, there were some benefits from the green space as it provides a location for relaxation, enhances neighborhood aesthetics, and even improves sense of community. Because of the popularity of urban greening as a public health solution, researchers could incorporate longitudinal designs and assess potential mediators to better assess the role of green gentrification in mental health.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"97 ","pages":"Article 103599"},"PeriodicalIF":4.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145840148","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 : 2026-01-01Epub Date: 2025-11-27DOI: 10.1016/j.healthplace.2025.103588
Chima Anyanwu , Kai Yang , Valerie Bonne , Amy E. Kalkbrenner , Constance Kostelac , Kirsten M.M. Beyer
{"title":"Geographic access to lung cancer screening and environmental lung cancer risk factors in the contiguous United States","authors":"Chima Anyanwu , Kai Yang , Valerie Bonne , Amy E. Kalkbrenner , Constance Kostelac , Kirsten M.M. Beyer","doi":"10.1016/j.healthplace.2025.103588","DOIUrl":"10.1016/j.healthplace.2025.103588","url":null,"abstract":"<div><h3>Objective</h3><div>Lung cancer is the leading cause of cancer mortality in the U.S., and worldwide. We examined the association between geographic access to lung cancer screening facilities (LCSF) and geographically distributed lung cancer risk factors – fine particulate matter (PM<sub>2.5</sub>) and indoor radon levels in the contiguous U.S.</div></div><div><h3>Methods</h3><div>We estimated geographic access to LCSF using facility information from the American College of Radiology, Lung Cancer Screening Registry and the enhanced two-step floating catchment area method. Census tract level PM<sub>2.5</sub> and county level radon data were obtained from the U.S. EPA. We examined whether PM<sub>2.5</sub> and radon predicted geographic access to LCSF using a linear mixed effects model with random intercepts for counties, adjusting for smoking prevalence and other factors, and testing for modification by urban-rural area.</div></div><div><h3>Results</h3><div>We found higher geographic access to LCSF in counties with moderate and high radon levels, and census tracts with higher levels of PM<sub>2.5</sub>, with significant modification by urban-rural areas.</div></div><div><h3>Discussion</h3><div>Our results suggest that accessibility to LCSF in the U.S. is generally aligned with environmental risk factors for lung cancer, with the exception of micropolitan areas or small cities, where higher PM<sub>2.5</sub> areas had lower screening access. It is worth considering how environmental risk factors may be incorporated into lung cancer screening programs.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"97 ","pages":"Article 103588"},"PeriodicalIF":4.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145618402","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 : 2026-01-01Epub Date: 2025-11-24DOI: 10.1016/j.healthplace.2025.103584
Anne Sebert Kuhlmann, Kenan Li, Maire MacMaster, Sydney Gellner, Adam Gilmore, Enbal Shacham
{"title":"Availability, accessibility, and functionality of public restrooms in the City of St. Louis, Missouri","authors":"Anne Sebert Kuhlmann, Kenan Li, Maire MacMaster, Sydney Gellner, Adam Gilmore, Enbal Shacham","doi":"10.1016/j.healthplace.2025.103584","DOIUrl":"10.1016/j.healthplace.2025.103584","url":null,"abstract":"<div><h3>Background</h3><div>Individuals experiencing homelessness face daily challenges of sanitation and hygiene. These challenges are exacerbated during menstruation.</div></div><div><h3>Aim</h3><div>We sought to assess the location, accessibility, and functionality of public restrooms in the City of St. Louis.</div></div><div><h3>Methods</h3><div>We compiled and mapped a list of public restrooms based on local government websites. Then, using an audit tool based on previous research and UNICEF guidelines, we audited them for accessibility, functionality, cleanliness, and infrastructure that facilitates menstrual hygiene. We also determined the service area for each public restroom by mapping a 0.5-, 1- and 2-mile travel distance along the road network around each restroom location.</div></div><div><h3>Results</h3><div>In total, we visited 31 unique locations and audited 53 restrooms. Four locations were completely boarded up and could not be audited. Only 15 % of the City's total area is within one-half mile of a public restroom, and 67 % is within 2 miles from the closest public restroom. Nearly all the audited restrooms had functional toilets and locks/latches on the door or stall for privacy. Only 10 of the restrooms had period products available, and less than half had disposable bins available within reach of the toilet.</div></div><div><h3>Conclusion</h3><div>Availability of public restrooms is a key concern in St. Louis – limited both by physical availability and hours of operation. When restrooms are available, however, they tend to be physically accessible and functional, while infrastructure to help maintain menstrual hygiene is more limited. Local government needs to invest in increasing the availability of public restrooms for those in need.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"97 ","pages":"Article 103584"},"PeriodicalIF":4.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145580306","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":"Visualising the impacts of COVID-19 on health service delivery during the height of the pandemic in Papua New Guinea; a photovoice study","authors":"Jamee Newland , Agnes Kupul Mek , Ruthy Neo-Boli , Nalisa Neuendorf , Lisa Vallely , Anna Maalsen , Angela Kelly-Hanku","doi":"10.1016/j.healthplace.2025.103601","DOIUrl":"10.1016/j.healthplace.2025.103601","url":null,"abstract":"<div><div>In Papua New Guinea (PNG), like other countries, health service access, engagement and the provision of primary health and public health infectious disease care changed dramatically during the height of the COVID-19 pandemic. To understand this disruption a photovoice study was conducted with community members (n = 12), clients of health services (n = 10) and healthcare workers (n = 5) and in six provinces in PNG during the third and largest wave of COVID-19 in country. The key findings from this study highlight how COVID-19 fear, and absence and avoidance of health facilities during COVID-19 directly influenced how healthcare was accessed and provided during COVID-19 in PNG. Spatiality, specifically the distance to service, to each other, and to treatment and care were directly influenced by health facility changes, service provision reconfigurations, and fear of COVID-19. This fear and these changes were presented through stark, but symbolic, images of health facilities empty and devoid of clients and healthcare workers. People struggled to get to health facilities due to a lack of transport, and when they could entry was restricted by locked gates and doors, and movement across health facility spaces was controlled by security. This article follows the varying, but mostly similar, experience of healthcare works and clients with respect to health setting spatiality and its important influence in providing or accessing care during COVID-19 – providing important lessons for the management of health facilities for future health emergencies and pandemics.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"97 ","pages":"Article 103601"},"PeriodicalIF":4.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145976862","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}