ADDRESSING GLOBAL DISPARITIES IN BLOOD PRESSURE CONTROL: PERSPECTIVES OF THE INTERNATIONAL SOCIETY OF HYPERTENSION

Raised blood pressure is the leading cause of preventable death in the world. Yet, its global prevalence is increasing, and it remains poorly detected, treated, and controlled in both high and low resource settings. From the perspective of members of the International Society of Hypertension based in all regions, we reflect on the past, present, and future of hypertension care, highlighting key challenges and opportunities, which are often region-specific. We report that most countries failed to show sufficient improvements in blood pressure control rates over the past three decades, with greater improvements mainly seen in some high-income countries, also reflected in substantial reductions in the burden of cardiovascular disease and deaths. Globally there are significant inequities and disparities based on resources, sociodemographic environment, and race with subsequent disproportionate hypertension- related outcomes. Additional unique challenges in specific regions include conflict, wars, migration, unemployment, rapid urbanisation, extremely limited funding, pollution, COVID-19-related restrictions and inequalities, obesity and excessive salt and alcohol intake. Immediate action is needed to address suboptimal hypertension care and related disparities on a global scale. We propose a Global Hypertension Care Taskforce including multiple stakeholders and societies to identify and implement actions in reducing inequities, addressing social, commercial and environmental determinants, and strengthening health systems implement a welldesigned customised quality of care improvement framework.

Estonian population and regional development during the last 30 years—back to the small town?

This article reviews the socioeconomic factors that have shaped Estonia's regional population development during the last 30 years. In the 1990s, primary and secondary industries declined and massive urbanization started, depopulating rural and old industrial areas while suburban sprawl developed around the capital Tallinn. Urban growth accelerated in the 2000s, and the 2008 global financial crisis prompted migration from the peripheries. Since 2015, Estonia's population has been growing thanks to returning emigrants and new immigrants. Recent years have witnessed the spread effect and spatial oscillation boosted by COVID-19 and the Ukrainian war. Additionally, a growing number of people live temporarily in multiple places, including remote rural localities.

Emergent rural-urban relations in Covid-19 disturbances: Multi-locality affecting sustainability of rural change

The recent Covid-19 pandemic highlighted rural-urban interactions, in particular the fact that cities are dependent on the accessibility of non-metropolitan and rural spaces and vice versa. This article seeks to understand how these interactions contributed to emergent relational spaces of rurality during the Covid-19 crisis. The article analyses politicised mobilities between localities and rural-urban linkages that are tied to the sustainability of rural change. The study focuses on two countries: Estonia and Finland, exploring thematic narratives on second-home practices and related politics during the outbreak of the Covid-19 crisis. The explored regions were the South Savo region in Finland and the island of Saaremaa and northern coastal villages in Estonia. The analysis indicates ways in which the mobility restrictions and disturbances triggered by the Covid-19 pandemic attributed certain demands and hopes to rural areas and led the shift in rural-urban interactions. The article contributes to the understanding of co-existences between im/mobilities and multi-local living and sustainability in rural change.

From city to sea: Spatiotemporal dynamics of floating macrolitter in the Tiber River

Rivers are undoubtedly the main pathway of waste dispersed in the environment that from land reaches oceans and seas increasing the amount of marine litter. Major cities are a great source of riverine litter as large urbanization can originate pressure on the integrated waste management resulting in litter entering the rivers. Within this study, we aim to investigate the dynamic of floating riverine macrolitter (items >2.5 cm) in the city of Rome before it reaches the sea by assessing the composition, amount, and seasonal trends of litter transported from the urban centre to the main river mouth of Tiber River. Visual surveys for a whole year (March 2021–February 2022) were conducted from two bridges, Scienza Bridge (in the city) and Scafa Bridge (at the main river mouth) and followed JRC/RIMMEL protocol for riverine litter monitoring. Overall, similar litter composition was observed from the city centre to the mouth with a prevalence of plastic material, mainly related to fragmentation process (i.e. plastic pieces) and single use items, mainly in food and beverage sectors. An extrapolated annual loading of 4 × 105 items/year was estimated at the main mouth of Tiber River. The litter flux seems to be influenced by the seasonal variability and hydrometeorological parameters. The frequency of size classes decreases with increasing size in both sites, and more than half of the recorded items were below 10 cm. Specific categories belonging to "other plastics” have been reported related to anti-Covid-19 behaviour such as face masks and beverage sector, e.g. bottle lids and rings. The main colour of plastics was white, suggesting weathering process of floating riverine litter. This study contributes to increasing knowledge of the origin, composition and spatiotemporal dynamics of riverine floating litter from the city and entering the sea. © 2022 Elsevier B.V.

The Role of Economic Stress, Health Concerns, and Institutional Trust in Supporting Public Protests against COVID-19 Lockdown Measures in Denmark.

During the current COVID-19 pandemic, most governments around the world have adopted strict COVID-19 lockdown measures. In Denmark, mainly from January to March 2021, an anonymous protest group called Men in Black organized demonstrations against the Danish COVID-19 lockdown measures in the three major cities in Denmark. Based on an online survey that we carried out in March 2021 in the Danish population aged 16 years and above (n = 2692), we analyze the individual-level factors behind supporting these demonstrations. Based on ordered logit regressions, the results show that being Muslim and being self-employed (business owner) was positively related to supporting the demonstrations, and that age and living in a city municipality was negatively related to supporting the demonstrations. Based on structural equation modeling (SEM), the results showed that the municipal COVID-19 incidence rate mediates the effect of living in a city municipality, that institutional trust mediates the effect of being Muslim, and that COVID-19 health concerns and institutional trust mediate the effect of age. Overall, economic stress among business owners, health concerns, and institutional trust were found to be the main predictors of supporting the demonstrations against the COVID-19 lockdown measures in Denmark.

SPATIAL CLUSTERING PHENOMENA OF COVID-19 CASES IN SELANGOR: A HOTSPOT ANALYSIS AND ORDINARY LEAST SQUARES METHOD

An increase in number of Coronavirus disease 2019 (COVID-19) cases will lead to more cluster discovery in Malaysia. Furthermore, with the increasing population, city growth, workplace income needs, high-risk groups, and other relevant factors can contribute to the formation of the new clusters. The cluster distribution of the disease could be seen by mapping and spatial analysis to understand their spatial phenomena of the disease dynamics. The purpose of the study is to analyse the spatial distribution of COVID-19 cluster cases in Selangor for year 2020. Two objectives of the study are i) to determine the hotspot location of the COVID- 19 cluster, and ii)to examine the spatial distribution of the factors affecting the COVID-19 cluster. The data processing was conducted using hotspot analysis and ordinary least squares (OLS) in ArcGIS Pro and Microsoft Excel to explore the local disease phenomena. TheCOVID-19 cases was most prevalent in the Petaling district, followed by Hulu Langat and Klang. The virus had the least impact in Sabak Bernam, Hulu Selangor, Kuala Selangor, Sepang, Kuala Langat, and Gombak. Three environmental factors of population density, the effects of urbanisation, and workplace cases were influential variables at the local clusters. These findings could help the local agencies to facilitate and control the spread mode of the virus in a spatial human environment.

Socioeconomic differences in COVID-19 infection, hospitalisation and mortality in urban areas in a region in the South of Europe.

BACKGROUND: To analyse differences in confirmed cases, hospitalisations and deaths due to COVID-19 related to census section socioeconomic variables.  METHODS: Ecological study in the 12 largest municipalities in Andalusia (Spain) during the first three epidemic waves of the COVID-19 (02/26/20-03/31/21), covering 2,246 census sections (unit of analysis) and 3,027,000 inhabitants. Incidence was calculated, standardised by age and sex, for infection, hospitalisation and deaths based on average gross income per household (AGI) for the census tracts in each urban area. Association studied using a Poisson Bayesian regression model with random effects for spatial smoothing. RESULTS: There were 140,743 cases of COVID-19, of which 12,585 were hospitalised and 2,255 died. 95.2% of cases were attributed to the second and third waves, which were jointly analysed. We observed a protective effect of income for infection in 3/12 cities. Almeria had the largest protective effect (smoothed relative risk (SRR) = 0.84 (0.75-0.94 CI 95%). This relationship reappeared with greater magnitude in 10/12 cities for hospitalisation, lowest risk in Algeciras SRR = 0.41 (0.29-0.56). The pattern was repeated for deaths in all urban areas and reached statistical significance in 8 cities. Lowest risk in Dos Hermanas SRR = 0.35 (0.15-0.81). CONCLUSIONS: Income inequalities by geographical area were found in the incidence of COVID-19. The strengths of the association increased when analysing the severe outcomes of hospitalisations and, above all, deaths.