Variations in land surface temperatures in small-scale urban areas in Vietnam during Covid-19 restrictions: Case studies from Da Nang, Hue and Vinh City.

Land surface temperature (LST) is an important variable in urban microclimate research. At the end of 2019, the emergence of Covid-19 pandemic has changed the world in a manner that forced many countries to impose restrictions in human activities. As a measure to prevent the expansion of Covid-19 infections, most of the major cities have entered a prolonged lockdown period and reduction in human activities between the early 2020 and the late 2021. These restrictions were strict in most of the cities in Southeast Asia, particularly in Vietnam. The present study investigated the variations in LST and NDVI observed in three rapidly growing urban areas, namely Da Nang, Hue and Vinh, in Vietnam using Landsat-8 imagery acquired between 2017 and 2022. There has been a slight reduction in LST in the study sites, particularly in Da Nang City, during the lockdown period but not as high as observed in recently conducted studies from big metropolitan cities, including in Vietnam. It is also observed that LST estimated from built-up areas and other impervious surfaces remained relatively stable during the study period which is similar to the results from recent studies.

Special Issue: Place, Space, and Mental Health.

Global megatrends, including climate change and urbanisation, are shaping and changing how we live in the future [...].

Clinical courses of 24,563 hospitalized COVID-19 patients during the first 12 months of the pandemic in the Central City of Iran.

This study was designed and implemented to analyze and establish documents related to the above cases in the first to third COVID-19 epidemic waves for the use of researchers and doctors during and after the epidemic. The current case series study was conducted on 24,563 thousand hospitalized COVID-19 patients by examining their clinical characteristics within a one-year period from the beginning of the pandemic on 02.22.2020 to 02.14.2021, which included the first to the third waves, based on gender and severity of COVID-19. The mean age of the participants was 56 ± 20.71, and 51.8% were male. Out of a total of 24,563 thousand hospitalized COVID-19 patients until February 2021, there were 2185 mortalities (9.8%) and 2559 cases of severe COVID-19 (13.1%). The median length of hospitalization from the time of admission to discharge or death in the hospital (IQR: 13-41) was estimated to be 21 days. The rate of hospital mortality was higher in severe (37.8%) than in non-severe (4.8%) cases of COVID-19, While the risk of severe cases increased significantly in the third (HR = 1.65, 95% CI: 1.46-1.87, P < 0.001) and early fourth waves (HR = 2.145, 95% CI: 1.7-2.71, P < 0.001). Also, the risk of contracting severe COVID-19 increased significantly in patients aged ≥ 65 years old (HR = 2.1, 95% CI 1.1.93-2.72, P < 0.001). As shown by the results, the rates of hospital mortality (9.3% vs. 8.5%) and severe cases of COVID-19 (13.6% vs. 12.5%) were higher among men than women (P < 0.01). In our study, the mortality rate and severity of COVID-19 were within the scope of global studies. Men experienced higher severity and mortality than women. The was a significantly higher prevalence of old age and underlying diseases in individuals with severe COVID-19. Our data also showed that patients with a previous history of COVID-19 had a more severe experience of COVID-19, while most of these patients were also significantly older and had an underlying disease.

Did the Covid-19 restrictions influence land surface temperatures in Southeast Asia? A study from Ho Chi Minh City, Vietnam.

There have been a prolonged lockdown period and reduction in human activities in most of the major cities in the world during the Covid-19 pandemic period between the early 2020 and the late 2021. Such a reduction in human activities was believed to have influenced pollution levels and land surface temperatures (LST) in urban areas. This paper describes the variations in LSTs before, during and after the Covid-19 lockdown in Ho Chi Minh City in southern Vietnam, which is the economic hub of the country. For this purpose, Landsat-8 OLI and TIRS images acquired between 2015 and 2022 were used. It is observed that there was a significant reduction of 1 to 1.8 °C in LST in open areas, excepting impervious surfaces and built-up areas, during the strict lockdown period in Ho Chi Minh City, and an increase in LST since then. The observed reduction in LST during the lockdown period in Ho Chi Minh City is in agreement with the reduction in greenhouses gases during the same period in recent studies. Human mobility and industrial activities have been restored in November 2021 in the study area which would explain the regain in LST in the post-lockdown period.

The mental health of children and young people living in big cities in a revolving postpandemic world.

PURPOSE OF REVIEW: The world's population is increasingly urban, with most children and young people growing up and living in cities. Evidence suggests that urbanicity is linked to an increased risk for the development of mental health disorders. Rather than an accumulation of risk factors, urbanization is a complex process that profoundly structures living conditions. In this sense, it is timely to discuss what are the social and structural determinants of mental health of children and young people in such settings. RECENT FINDINGS: Three domains of determinants of mental health were selected for discussion: economics and living conditions, crime and violence, and urban layouts. For each, we debated realities faced by urban children and young people, providing an overview of recent evidence on implications for mental disorders and well being. We also discuss the potential impacts of the covid-19 pandemic on each domain, as well as recommendations for future action. SUMMARY: Structural factors are of major relevance for the mental health of children and young people living in cities. The agenda of mental health promotion and prevention must include whole-of-society interventions aimed at improving living conditions, including economic and social capital, violence prevention and urbanistic planning.

Association between urbanization and Internet addiction.

PURPOSE OF REVIEW: Understanding the association between urbanization and Internet addiction is essential to the design and implementation of Internet addiction prevention measures in urban areas. This epidemiological review explores the urbanization-Internet addiction association and its potential underlying factors. RECENT FINDINGS: Nine studies have reported that Internet addiction prevalence is higher in urban areas, but three studies have noted the opposite. Psychiatric disorders and stress are the most commonly mentioned factors underlying the association. The effects of urbanization on Internet availability, Internet cafes, online gaming, outdoor or interactive activities, and family regulation and monitoring have been suggested to lead to higher Internet addiction risk. The ongoing COVID-19 pandemic, obesity, sleep problems, and the migration of parents to urban areas in search of work have strengthened the effect of urbanization on Internet addiction. SUMMARY: Early assessment and treatment provided by mental health services are crucial for mitigating the effect of urbanization on Internet addiction risk. Cities should be designed to provide adequate space for physical and interactive activities. To promote outdoor activities, air pollution, traffic congestion, and crime should be controlled. Prospective face-to-face studies involving analysis of data on pollution, traffic, and Internet addiction could provide evidence to elucidate the urbanization- Internet addiction association.

Urbanization-Related Environmental Factors and Hemorrhagic Fever with Renal Syndrome: A Review Based on Studies Taken in China.

Hemorrhagic fever with renal syndrome (HFRS) is a rodent-borne disease that has threatened Chinese residents for nearly a century. Although comprehensive prevent and control measures were taken, the HFRS epidemic in China presents a rebounding trend in some areas. Urbanization is considered as an important influencing factor for the HFRS epidemic in recent years; however, the relevant research has not been systematically summarized. This review aims to summarize urbanization-related environmental factors and the HFRS epidemic in China and provide an overview of research perspectives. The literature review was conducted following the PRISMA protocol. Journal articles on the HFRS epidemic in both English and Chinese published before 30 June 2022 were identified from PubMed, Web of Science, and Chinese National Knowledge Infrastructure (CNKI). Inclusion criteria were defined as studies providing information on urbanization-related environmental factors and the HFRS epidemic. A total of 38 studies were included in the review. Changes brought by urbanization on population, economic development, land use, and vaccination program were found to be significantly correlated with the HFRS epidemic. By changing the ecological niche of humans-affecting the rodent population, its virus-carrying rate, and the contact opportunity and susceptibility of populations-urbanization poses a biphasic effect on the HFRS epidemic. Future studies require systematic research framework, comprehensive data sources, and effective methods and models.

The presence of COVID-19 face masks in the largest hypersaline lagoon of South America is predicted by urbanization level.

The inadequate disposal of face masks has caused a widespread presence of COVID-19 litter in the environment. We monitored 10 beach arcs along approximately 15 km of the largest hypersaline lagoon of South America looking for face masks during the lockdown (2021) and in the "new normal" (2022) period. Our working hypothesis is that the probability of finding face masks increases with higher urbanization levels, which was estimated by the Human Modification Metric. Approximately 3 × 10-3 face masks m-2 were found on nine of 10 beaches (90 %) during the lockdown. However, this reduced to 1 × 10-4 face masks m-2 found in eight beaches (80 %) after the lockdown. The probability of finding a face mask was significantly higher as urbanization increased (z = 2.799; p = 0.005). This situation imposes the need for a better waste management and environmental education actions, targeting the reduction of direct littering on coastal ecosystem.

Impact of COVID lockdowns on spatio-temporal variability in land surface temperature and vegetation index.

In urban areas, industrial and human activities are the prime cause that exacerbates the heating effects, also called the urban heat island (UHI) effect. The land surface temperature (LST), normalized difference vegetation index (NDVI), and the proportion of vegetation (Pv) are indicators of measurement of the heating/urbanization effects. In the present work, we investigated the impact of the COVID-19 lockdown, i.e., restricted human activities. We used Landsat-8 OLI/TIRS (level 1) data to investigate spatial and temporal heterogeneity changes in these urbanization indicators during full and partial lockdown periods in 2020 and 2021, with 2019 as the base year. We have selected three cities in India's eastern coal mining belt, Bokaro, Dhanbad, and Ranchi, for the study. Results showed a significant decrease in LST values over all sites, with a maximum reduction over mining sites, i.e., Bokaro and Dhanbad. The LST value decreased by about 13-19% during the lockdown period. Vegetation indices (i.e., NDVI and Pv) showed a substantial increase of about 15% overall sites. With decreased LST values and increased NDVI values, these quantities' correlations became more negative during the lockdown period. More positive changes are noticed over mining sites than non/less mining sites. This indirectly indicates the reduction in the heat-absorbing particles in the environment and surface of these sites, a possible cause for the reduction in LST values substantially. Reduction in coal particles at the land and vegetation surface likely contributed to decreased LST and enhanced vegetation indices. To check the statistical significance of changes in the UHI indicators in the lockdown period, statistical tests (ANOVA and Tukey's test) are performed. Results indicate that most of the case changes have been significant. The study's finding suggests the lockdown's positive impact on the heating/UHI effects. It emphasizes the need for planned lockdowns as city mitigation strategies to overcome pollution and environmental issues.

Spatiotemporal Evolution of Carbon Emissions According to Major Function-Oriented Zones: A Case Study of Guangdong Province, China.

Studying the spatiotemporal evolution of carbon emissions from the perspective of major function-oriented zones (MFOZs) is crucial for making a carbon reduction policy. However, most previous research has ignored the spatial characteristics and MFOZ influence. Using statistical and spatial analysis tools, we explored the spatiotemporal characteristics of carbon emissions in Guangdong Province from 2001 to 2021. The following results were obtained: (1) Carbon emissions fluctuated from 2020 to 2021 because of COVID-19. (2) Over the last 20 years, the proportion of carbon emissions from urbanization development zones (UDZs) has gradually decreased, whereas those of the main agricultural production zones (MAPZs) and key ecological function zones (KEFZs) have increased. (3) Carbon emissions efficiency differed significantly among the three MFOZs. (4) Carbon emissions from coastal UDZs were increasingly apparent; however, the directional characteristics of MAPZ and KEFZ emissions were not remarkable. (5) Carbon transfer existed among the three kinds of MFOZs, resulting in the economy and carbon emissions being considerably misaligned across Guangdong Province. These results indicated that the MFOZ is noteworthy in revealing how carbon emissions evolved. Furthermore, spatiotemporal characteristics, especially spatial characteristics, can help formulate carbon reduction policies for realizing carbon peak and neutrality goals in Guangdong Province.

Territorial differences in the spread of COVID-19 in European regions and US counties.

This article explores the territorial differences in the onset and spread of COVID-19 and the excess mortality associated with the pandemic, with a focus on European regions and US counties. Both in Europe and in the US, the pandemic arrived earlier and recorded higher Rt values in urban regions than in intermediate and rural ones. A similar gap is also found in the data on excess mortality. In the weeks during the first phase of the pandemic, urban regions in EU countries experienced excess mortality of up to 68 pp more than rural ones. We show that, during the initial days of the pandemic, territorial differences in Rt by the degree of urbanisation can be largely explained by the level of internal, inbound and outbound mobility. The differences in the spread of COVID-19 by rural-urban typology and the role of mobility are less clear during the second wave. This could be linked to the fact that the infection is widespread across territories, to changes in mobility patterns during the summer period as well as to the different containment measures which reverse the link between mobility and Rt.

A Study on the Spatial-Temporal Evolution and Driving Factors of Non-Grain Production in China's Major Grain-Producing Provinces.

Food self-sufficiency in a large country with 1.4 billion people is very important for the Chinese government, especially in the context of COVID-19 and the Russian-Ukrainian conflict. The objective of this paper is to explore the spatial-temporal evolution and driving factors of non-grain production in thirteen major grain-producing provinces in China, which account for more than 75% of China's grain production, using 2011-2020 prefecture-level statistics. In the present study, the research methodology included GIS spatial analysis, hot spot analysis, and spatial Durbin model (SDM). The findings of this study are as follows: (1) The regions with a higher level of non-grain production were mainly concentrated in the central and western regions of Inner Mongolia, the middle and lower reaches of Yangtze River and Sichuan, while the regions with a low level of non-grain production were mainly distributed in the Northeast Plain. The regions with a higher proportion of grain production to the national total grain production were concentrated in the Northeast Plain, the North China Plain, and the Middle and Lower Yangtze River Plain of China. The hot spot regions with changes in non-grain production levels were mainly distributed in the Sichuan region and Alashan League City in Inner Mongolia, and the cold spot regions were mainly distributed in Hebei, Shandong, Henan, and other regions. (2) An analysis of the SDM indicated that the average air temperature among the natural environment factors, the ratio of the sum of gross secondary and tertiary industries to GDP, the ratio of gross primary industry to the GDP of economic development level, the urbanization rate of social development, and the difference in disposable income per capita between urban and rural residents of the urban-rural gap showed positive spatial spillover effects. The grain yield per unit of grain crop sown area of grain production resource endowment, the total population of social development, and the area sown to grain crops per capita of grain production resource endowment all showed negative spatial spillover effects. The research results of this paper can provide a reference for the country to carry out the governance of non-grain production and provide a reference for China's food security guarantee.

Spatial-Temporal Characteristics and Driving Factors of the Eco-Efficiency of Tourist Hotels in China.

At present, COVID-19 is seriously affecting the economic development of the hotel industry, and at the same time, the world is vigorously calling for "carbon emission mitigation". Under these two factors, tourist hotels are in urgent need of effective tools to balance economic and social contributions with ecological and environmental impacts. Therefore, this paper takes Chinese tourist hotels as the research object and constructs a research framework for Chinese tourist hotels by constructing a Super-SBM Non-Oriented model. We measured the economic efficiency and eco-efficiency of Chinese tourist hotels from 2000 to 2019; explored spatial-temporal evolution patterns of their income, carbon emissions, eco-efficiency, and economic efficiency through spatial hotspot analysis and center of gravity analysis; and identified the spatial agglomeration characteristics of such hotels through the econometric panel Tobit model to identify the different driving factors inside and outside the tourist hotel system. The following results were obtained: (1) the eco-efficiency of China's tourist hotels is higher than the economic efficiency, which is in line with the overall Kuznets curve theory, but the income and carbon emissions have not yet been decoupled; (2) most of China's tourist hotels are crudely developed with much room for improving the economic efficiency, and most of the provincial and regional tourist hotels are at a low-income level, but the carbon emissions are still on the increase; and (3) income, labor, carbon emissions, waste emissions, and water consumption are the internal drivers of China's tourist hotels, while industrial structure, urbanization rate, energy efficiency, and information technology are the external drivers of China's tourist hotels. The research results provide a clear path for the reduction in carbon emissions and the improvement of the eco-efficiency of Chinese tourist hotels. Under the backdrop of global climate change and the post-COVID-19 era, the research framework and conclusions provide references for countries with new economies similar to China and countries that need to quickly restore the hotel industry.

Spatiotemporal Characteristics and Influencing Factors of Tourism-Urbanization-Technology-Ecological Environment on the Yunnan-Guizhou-Sichuan Region: An Uncoordinated Coupling Perspective.

The tourism, urbanization, technology, and the ecological environment both promote and restrict each other. Coordinating the relationship between the four is of great significance to the realization of high-quality sustainable regional development. Taking the Yunnan-Guizhou-Sichuan region as an example, this paper constructs an uncoordinated coupling model for the tourism-urbanization-technology-ecological environment system. Using exploratory spatial analysis and geographic information systems, this paper reveals the temporal and spatial evolution law affecting the uncoordinated coupling relationship between tourism, urbanization, technology and the ecological environment in the Yunnan-Guizhou-Sichuan region from 2010 to 2020, before establishing a panel Tobit model that is used to explore the factors affecting the four systems. The research shows the following: (1) The level of comprehensive development for tourism, urbanization, technology, and the ecological environment in Yunnan, Guizhou, and Sichuan has increased rapidly. Of all these, the tourism industry was the most affected by COVID-19 in 2020, while the level of urbanization, technology, and ecological environment developments in the three provinces has become similar over time. (2) Uncoordinated development between cities is a prominent problem; while the uncoordinated coupling spatial agglomeration in various regions is relatively stable, the proportion of cities with no significant agglomeration form amounts to more than 70%, with mostly low-low (L-L) and high-high (H-H) agglomeration types. (3) The degree to which uncoordinated coupling exists among the four systems in the Yunnan-Guizhou-Sichuan region is affected by many factors. Only eco-environmental pressure has a significant positive correlation with the degree of uncoordinated coupling, while the tourism scale, economic urbanization, eco-environmental response, and investment in technology have a significant negative correlation. These results provide a theoretical basis and practical references for strengthening the government's macro-control and promoting collaborative regional development.

Evaluation of urban green space per capita with new remote sensing and geographic information system techniques and the importance of urban green space during the COVID-19 pandemic.

A recently conducted study by the Centers for Disease Control and Prevention encouraged access to urban green space for the public over the prevalence of COVID-19 in that exposure to urban green space can positively affect the physical and mental health, including the reduction rate of heart disease, obesity, stress, stroke, and depression. COVID-19 has foregrounded the inadequacy of green space in populated cities. It has also highlighted the extant inequities so as to unequal access to urban green space both quantitatively and qualitatively. In this regard, it seems that one of the problems related to Malatya is the uncoordinated distribution of green space in different parts of the city. Therefore, knowing the quantity and quality of these spaces in each region can play an effective role in urban planning. The aim of the present study has been to evaluate urban green space per capita and to investigate its distribution based on the population of the districts of Battalgazi county in Malatya city through developing an integrated methodology (remote sensing and geographic information system). Accordingly, in Google Earth Engine by images of Sentinel-1 and PlanetScope satellites, it was calculated different indexes (NDVI, EVI, PSSR, GNDVI, and NDWI). The data set was prepared and then by combining different data, classification was performed according to support vector machine algorithm. From the landscaping maps obtained, the map was selected with the highest accuracy (overall accuracy: 94.43; and kappa coefficient: 90.5). Finally, by the obtained last map, the distribution of urban green space per capita and their functions in Battalgazi county and its districts were evaluated. The results of the study showed that the existing urban green spaces in the Battalgazi/Malatya were not distributed evenly on the basis of the districts. The per capita of urban green space is twenty-four regions which is more than 9m2 and in twenty-three ones is less than 9m2. The recommendation of this study was that Türkiye city planners and landscape designers should replan and redesign the quality and equal distribution of urban green spaces, especially during and following COVID-19 pandemic. Additionally, drawing on the Google Earth Engine cloud system, which has revolutionized GIS and remote sensing, is recommended to be used in land use land cover modeling. It is straightforward to access information and analyze them quickly in Google Earth Engine. The published codes in this study makes it possible to conduct further relevant studies.

Monitoring Spatiotemporal Distribution of the GDP of Major Cities in China during the COVID-19 Pandemic.

Monitoring the fine spatiotemporal distribution of urban GDP is a critical research topic for assessing the impact of the COVID-19 outbreak on economic and social growth. Based on nighttime light (NTL) images and urban land use data, this study constructs a GDP machine learning and linear estimation model. Based on the linear model with better effect, the monthly GDP of 34 cities in China is estimated and the GDP spatialization is realized, and finally the GDP spatiotemporal correction is processed. This study analyzes the fine spatiotemporal distribution of GDP, reveals the spatiotemporal change trend of GDP in China's major cities during the current COVID-19 pandemic, and explores the differences in the economic impact of the COVID-19 pandemic on China's major cities. The result shows: (1) There is a significant linear association between the total value of NTL and the GDP of subindustries, with R2 models generated by the total value of NTL and the GDP of secondary and tertiary industries being 0.83 and 0.93. (2) The impact of the COVID-19 pandemic on the GDP of cities with varied degrees of development and industrial structures obviously varies across time and space. The GDP of economically developed cities such as Beijing and Shanghai are more affected by COVID-19, while the GDP of less developed cities such as Xining and Lanzhou are less affected by COVID-19. The GDP of China's major cities fell significantly in February. As the COVID-19 outbreak was gradually brought under control in March, different cities achieved different levels of GDP recovery. This study establishes a fine spatial and temporal distribution estimation model of urban GDP by industry; it accurately monitors and assesses the spatial and temporal distribution characteristics of urban GDP during the COVID-19 pandemic, reveals the impact mechanism of the COVID-19 pandemic on the economic development of major Chinese cities. Moreover, economically developed cities should pay more attention to the spread of the COVID-19 pandemic. It should do well in pandemic prevention and control in airports and stations with large traffic flow. At the same time, after the COVID-19 pandemic is brought under control, they should speed up the resumption of work and production to achieve economic recovery. This study provides scientific references for COVID-19 pandemic prevention and control measures, as well as for the formulation of urban economic development policies.

Impact of urbanisation and environmental factors on spatial distribution of COVID-19 cases during the early phase of epidemic in Singapore.

Geographical weighted regression (GWR) can be used to explore the COVID-19 transmission pattern between cases. This study aimed to explore the influence from environmental and urbanisation factors, and the spatial relationship between epidemiologically-linked, unlinked and imported cases during the early phase of the epidemic in Singapore. Spatial relationships were evaluated with GWR modelling. Community COVID-19 cases with residential location reported from 21st January 2020 till 17th March 2020 were considered for analyses. Temperature, relative humidity, population density and urbanisation are the variables used as exploratory variables for analysis. ArcGIS was used to process the data and perform geospatial analyses. During the early phase of COVID-19 epidemic in Singapore, significant but weak correlation of temperature with COVID-19 incidence (significance 0.5-1.5) was observed in several sub-zones of Singapore. Correlations between humidity and incidence could not be established. Across sub-zones, high residential population density and high levels of urbanisation were associated with COVID-19 incidence. The incidence of COVID-19 case types (linked, unlinked and imported) within sub-zones varied differently, especially those in the western and north-eastern regions of Singapore. Areas with both high residential population density and high levels of urbanisation are potential risk factors for COVID-19 transmission. These findings provide further insights for directing appropriate resources to enhance infection prevention and control strategies to contain COVID-19 transmission.

Dynamics of influenza-like illness under urbanization procedure and COVID-19 pandemic in the subcenter of Beijing during 2013-2021.

Influenza-like illness (ILI) varies in intensity year by year, generally keeping a stable pattern except for great changes of its epidemic pattern. Of the most impacting factors, urbanization has been suggested as shaping the intensity of influenza epidemics. Besides, growing evidence indicates the nonpharmaceutical interventions (NPIs) to severe acute respiratory syndrome coronavirus 2 offer great advantages in controlling infectious diseases. The present study aimed to evaluate the impact of urbanization and NPIs on the dynamic of ILI in Tongzhou, Beijing, during January 2013 to March 2021. ILI epidemiological surveillance data in Tongzhou district were obtained from Beijing Influenza Surveillance Network and separated into three periods of urbanization and four intervals of coronavirus disease 2019 pandemic. Standardized average incidence rates of ILI in each separate stages were calculated and compared by using Wilson method and time series model of seasonal ARIMA. Influenza seasonal outbreaks showed similar epidemic size and intensity before urbanization during 2013-2016. Increased ILI activity was found during the process of Tongzhou's urbanization during 2017-2019, with the rate difference of 2.48 (95% confidence interva [CI]: 2.44, 2.52) and the rate ratio of 1.75 (95% CI: 1.74, 1.76) of ILI incidence between preurbanization and urbanization periods. ILI activity abruptly decreased from the beginning of 2020 and kept at the bottom level almost in every epidemic interval. The top decrease in ILI activity by NPIs was shown in 5-14 years group in 2020-2021 influenza season, as 92.2% (95% CI: 78.3%, 95.2%). The results indicated that both urbanization and NPIs interrupted the epidemic pattern of ILI. We should pay more attention to public health when facing increasing population density, human contact, population mobility, and migration in the process of urbanization. NPIs and influenza vaccination should be implemented as necessary measures to protect people from common infectious diseases like ILI.

Bending the Curve in Cardiovascular Disease Mortality: Bethesda + 40 and Beyond.

More than 40 years after the 1978 Bethesda Conference on the Declining Mortality from Coronary Heart Disease provided the scientific community with a blueprint for systematic analysis to understand declining rates of coronary heart disease, there are indications the decline has ended or even reversed despite advances in our knowledge about the condition and treatment. Recent data show a more complex situation, with mortality rates for overall cardiovascular disease, including coronary heart disease and stroke, decelerating, whereas those for heart failure are increasing. To mark the 40th anniversary of the Bethesda Conference, the National Heart, Lung, and Blood Institute and the American Heart Association cosponsored the "Bending the Curve in Cardiovascular Disease Mortality: Bethesda + 40" symposium. The objective was to examine the immediate and long-term outcomes of the 1978 conference and understand the current environment. Symposium themes included trends and future projections in cardiovascular disease (in the United States and internationally), the evolving obesity and diabetes epidemics, and harnessing emerging and innovative opportunities to preserve and promote cardiovascular health and prevent cardiovascular disease. In addition, participant-led discussion explored the challenges and barriers in promoting cardiovascular health across the lifespan and established a potential framework for observational research and interventions that would begin in early childhood (or ideally in utero). This report summarizes the relevant research, policy, and practice opportunities discussed at the symposium.