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1.
Lancet Glob Health ; 10(6): e882-e894, 2022 06.
Article in English | MEDLINE | ID: mdl-35561723

ABSTRACT

City planning policies influence urban lifestyles, health, and sustainability. We assessed policy frameworks for city planning for 25 cities across 19 lower-middle-income countries, upper-middle-income countries, and high-income countries to identify whether these policies supported the creation of healthy and sustainable cities. We systematically collected policy data for evidence-informed indicators related to integrated city planning, air pollution, destination accessibility, distribution of employment, demand management, design, density, distance to public transport, and transport infrastructure investment. Content analysis identified strengths, limitations, and gaps in policies, allowing us to draw comparisons between cities. We found that despite common policy rhetoric endorsing healthy and sustainable cities, there was a paucity of measurable policy targets in place to achieve these aspirations. Some policies were inconsistent with public health evidence, which sets up barriers to achieving healthy and sustainable urban environments. There is an urgent need to build capacity for health-enhancing city planning policy and governance, particularly in low-income and middle-income countries.


Subject(s)
City Planning , Urban Health , Cities , Health Policy , Humans , Transportation
2.
Lancet Glob Health ; 10(6): e907-e918, 2022 06.
Article in English | MEDLINE | ID: mdl-35561725

ABSTRACT

Benchmarking and monitoring of urban design and transport features is crucial to achieving local and international health and sustainability goals. However, most urban indicator frameworks use coarse spatial scales that either only allow between-city comparisons, or require expensive, technical, local spatial analyses for within-city comparisons. This study developed a reusable, open-source urban indicator computational framework using open data to enable consistent local and global comparative analyses. We show this framework by calculating spatial indicators-for 25 diverse cities in 19 countries-of urban design and transport features that support health and sustainability. We link these indicators to cities' policy contexts, and identify populations living above and below critical thresholds for physical activity through walking. Efforts to broaden participation in crowdsourcing data and to calculate globally consistent indicators are essential for planning evidence-informed urban interventions, monitoring policy effects, and learning lessons from peer cities to achieve health, equity, and sustainability goals.


Subject(s)
Global Health , Health Status , Cities , Humans , Software , Spatial Analysis
3.
Sci Rep ; 12(1): 3509, 2022 03 03.
Article in English | MEDLINE | ID: mdl-35241706

ABSTRACT

Out-of-hospital cardiac arrest (OHCA) is a worldwide health problem. The aim of the study is to utilize the territorial-wide OHCA data of Hong Kong in 2012-2015 to examine its spatiotemporal pattern and high-risk neighborhoods. Three techniques for spatiotemporal data mining (SaTScan's spatial scan statistic, Local Moran's I, and Getis Ord Gi*) were used to extract high-risk neighborhoods of OHCA occurrence and identify local clusters/hotspots. By capitalizing on the strengths of these methods, the results were then triangulated to reveal "truly" high-risk OHCA clusters. The final clusters for all ages and the elderly 65+ groups exhibited relatively similar patterns. All ages groups were mainly distributed in the urbanized neighborhoods throughout Kowloon. More diverse distribution primarily in less accessible areas was observed among the elderly group. All outcomes were further converted into an index for easy interpretation by the general public. Noticing the spatial mismatches between hospitals and ambulance depots (representing supplies) and high-risk neighborhoods (representing demands), this setback should be addressed along with public education and strategic ambulance deployment plan to shorten response time and improve OHCA survival rate. This study offers policymakers and EMS providers essential spatial evidence to assist with emergency healthcare planning and informed decision-making.


Subject(s)
Cardiopulmonary Resuscitation , Emergency Medical Services , Out-of-Hospital Cardiac Arrest , Aged , Ambulances , Cardiopulmonary Resuscitation/methods , Data Mining , Humans , Out-of-Hospital Cardiac Arrest/epidemiology , Out-of-Hospital Cardiac Arrest/therapy
4.
Geospat Health ; 17(s1)2022 02 14.
Article in English | MEDLINE | ID: mdl-35156358

ABSTRACT

The modern highly globalised economy is jeopardising human health as the increased mobility and interconnectedness has the potential to rapidly transmit pathogens across the globe. This was recently confirmed by the coronavirus disease 2019 outbreak, which quickly led to localised outbreaks in virtually every country. As the existing health systems were unprepared, the world has witnessed a critical shortage of life-supporting and health-sustaining resources. In the absence of effective non-pharmaceutical interventions to suppress the virus transmission, many governments imposed total or partial lockdowns, with devastating economic consequences. The case of Hong Kong in quickly suppressing the virus from spreading can thus be a lesson for all. In this study, open data sources of infected individuals are employed to compile maps of disease incidents at various geographic scales with the aim of better understanding the transmission dynamics and discern spatial variability. Our findings show that tracking human mobility patterns can improve awareness of spatiotemporal factors driving the risks of human exposure to viruses. Moreover, we have demonstrated that spatial tools can be successfully employed to explore connections between individuals and wider communities with the aim of informing adaptation of policies at different spatial scales and for different time periods. As was shown in the case of Hong Kong, disease control encompasses the interrelated tasks of reducing social interactions and encouraging adoption of protective behaviours.


Subject(s)
COVID-19 , Communicable Disease Control , Disease Outbreaks , Hong Kong/epidemiology , Humans , SARS-CoV-2
5.
Int J Health Geogr ; 20(1): 35, 2021 08 16.
Article in English | MEDLINE | ID: mdl-34399765

ABSTRACT

BACKGROUND: Urban parks are critical environmental resources in which adolescents engage in physical activity (PA). Evidence on the associations between park environmental characteristics and park-based PA in adolescents is mixed, particularly for high-density cities. Evidence is also lacking concerning the moderating role of neighbourhood socioeconomic status on the park-PA relationships. The current study aimed to examine the associations between park environmental characteristics and moderate-to-vigorous physical activity (MVPA) in parks among adolescents in Hong Kong and the moderating effect of neighbourhood income on these associations. METHODS: A cross-sectional study involving direct observations of adolescents was conducted in 32 randomly selected urban parks in Hong Kong. Park environmental characteristics were measured using the Community Park Audit Tool. Park-based MVPA among adolescents was measured using the System for Observation Play and Recreation in Communities. Neighbourhood income was extracted from the 2011 Hong Kong Population Census data on median household income. RESULTS: There was a significant positive association between the quality of amenities and park-based MVPA (metabolic equivalents per observation) in adolescents. However, the associations between the diversity of active facilities, greenness and adolescents' park-based MVPA were not significant. Neighbourhood income moderated the association between adolescents' park-based MVPA and park safety, where the relationship between park safety and park-based MVPA was significantly positive in low-income neighbourhoods but not significant in high-income neighbourhoods. An income-by-environment interaction was also observed concerning park aesthetics, with a negative relationship between park aesthetics and park-based MVPA in high-income neighbourhoods but not in low-income neighbourhoods. CONCLUSION: Our findings provide evidence regarding how park environment and neighbourhood income impact adolescents' park-based MVPA in Hong Kong. These findings can inform urban planning and policymakers who seek to improve urban park development in high-density cities.


Subject(s)
Parks, Recreational , Residence Characteristics , Adolescent , Cities , Cross-Sectional Studies , Environment Design , Exercise , Humans
6.
Sci Rep ; 11(1): 4699, 2021 02 25.
Article in English | MEDLINE | ID: mdl-33633273

ABSTRACT

COVID-19 reaffirms the vital role of superspreaders in a pandemic. We propose to broaden the research on superspreaders through integrating human mobility data and geographical factors to identify superspreading environment. Six types of popular public facilities were selected: bars, shopping centres, karaoke/cinemas, mega shopping malls, public libraries, and sports centres. A historical dataset on mobility was used to calculate the generalized activity space and space-time prism of individuals during a pre-pandemic period. Analysis of geographic interconnections of public facilities yielded locations by different classes of potential spatial risk. These risk surfaces were weighed and integrated into a "risk map of superspreading environment" (SE-risk map) at the city level. Overall, the proposed method can estimate empirical hot spots of superspreading environment with statistical accuracy. The SE-risk map of Hong Kong can pre-identify areas that overlap with the actual disease clusters of bar-related transmission. Our study presents first-of-its-kind research that combines data on facility location and human mobility to identify superspreading environment. The resultant SE-risk map steers the investigation away from pure human focus to include geographic environment, thereby enabling more differentiated non-pharmaceutical interventions and exit strategies to target some places more than others when complete city lockdown is not practicable.


Subject(s)
COVID-19/transmission , COVID-19/epidemiology , Communicable Disease Control , Environmental Microbiology , Hong Kong/epidemiology , Humans , Public Facilities , Restaurants , Risk Factors , SARS-CoV-2/isolation & purification , Sports and Recreational Facilities
7.
Int J Behav Nutr Phys Act ; 17(1): 73, 2020 06 09.
Article in English | MEDLINE | ID: mdl-32517790

ABSTRACT

BACKGROUND: Many studies have examined neighbourhood environmental correlates of older adults' physical activity (PA) but only a few focused on sedentary time (ST). Only a small proportion of these studies used objective measures of PA/ST, such as accelerometer-assessed PA/ST, and only a couple employed accelerometer cut-points appropriate for older adults. Furthermore, although older adults experience declines in physical function as they age, there is a dearth of information on the impact of the neighbourhood environment on PA/ST in individuals with different levels of physical function. METHODS: We used data from two extant cross-sectional studies conducted in Hong Kong (China) and Ghent (Belgium) (N = 829). Participants were recruited from pre-selected administrative units stratified by socio-economic status and walkability. Moderate-to-vigorous PA (MVPA) and ST were assessed for 7 days using accelerometers and cut-points developed for older adults. Objective neighbourhood environmental attributes within 400 m and 1 km buffers surrounding participants' homes were quantified using Geographic Information Systems data. Lower extremity physical function was objectively assessed. Socio-demographic information was collected via interviews. Total, direct and indirect (mediated) effects of environmental attributes on MVPA and ST were estimated using generalised additive mixed models and the joint-significant test. RESULTS: Commercial/civic destination density and number of parks within 1 km from home showed positive total and direct effects on MVPA, and public transport density showed negative total and direct effects on ST, which were consistent across cities and physical function levels. The total and direct effects of residential density on MVPA depended on physical function, and those of residential density on ST differed by city. A complex network of potential inconsistent pathways linking all environmental attributes to MVPA and ST in the whole sample or in subgroups of participants was revealed. DISCUSSION: Access to parks and commercial/civic destinations appear to support older adults' MVPA in different geographical and cultural contexts and irrespective of their physical function level. By supporting MVPA, these characteristics also contribute to a reduction in ST. The potential effects of public transport, recreational facilities and residential density are less straightforward and point at inconsistent effects that may depend on the geographical context and level of physical function.


Subject(s)
Exercise/physiology , Independent Living , Sedentary Behavior , Accelerometry , Belgium , China , Cities , Geographic Information Systems , Humans , Residence Characteristics , Walking
8.
Int J Health Geogr ; 19(1): 14, 2020 04 16.
Article in English | MEDLINE | ID: mdl-32299439

ABSTRACT

BACKGROUND: Population growth, population ageing, and urbanisation are major global demographic trends that call for an examination of the impact of urban densification on older adults' health-enhancing behaviours, such as walking. No studies have examined the pathways through which urban densification may affect older adults' walking. This information is key to evidence-based, health-oriented urban and transport planning. This study aimed to identify neighbourhood environment characteristics potentially responsible for the effects of neighbourhood densification on older adults' frequency and amount of transportation and recreation walking within and outside the neighbourhood. METHODS: The Active Lifestyle and the Environment in Chinese Seniors (ALECS) project collected self-reported data from 909 older adults (≥ 65 years) living in 128 physically and socially diverse neighbourhoods in Hong Kong (71% response rate). Walking was measured using the Neighbourhood Walking Questionnaire for Chinese Seniors. Objective residential density and other neighbourhood environmental attributes were assessed using Geographic Information Systems. Generalised additive mixed models examined the total effects of neighbourhood residential density on walking and the mediating role of other environmental attributes and car ownership. RESULTS: A complex network of potential pathways of positive and negative influences of neighbourhood residential density on different aspects of walking was revealed. While residential density was positively related to within-neighbourhood transportation and outside-neighbourhood recreation walking only, it exhibited positive and/or negative nonlinear indirect effects on all examined aspects of walking via recreation, public transport, food/retail and street intersection densities, and/or car ownership. CONCLUSIONS: High-density environments appear to support within-neighbourhood walking by providing access to food and retail outlets via well-connected street networks and discouraging car ownership. However, extreme density may lead to reductions in walking. Public transport density accompanying high-density areas may facilitate outside-neighbourhood walking but deter within-neighbourhood walking. The development of activity-friendly communities for ageing populations need to consider these opposing influences.


Subject(s)
Aging , Environment Design , Urban Health , Walking , Aged , Cross-Sectional Studies , Geographic Information Systems , Hong Kong , Humans , Independent Living , Residence Characteristics/statistics & numerical data , Surveys and Questionnaires , Transportation , Walking/statistics & numerical data
9.
Prev Med ; 129: 105874, 2019 12.
Article in English | MEDLINE | ID: mdl-31654731

ABSTRACT

The study aimed to examine associations of neighborhood built environments and proximity of food outlets (BE measures) with body weight status using pooled data from an international study (IPEN Adult). Objective BE measures were calculated using geographic information systems for 10,008 participants (4463 male, 45%) aged 16-66 years in 14 cities. Participants self-reported proximity to three types of food outlets. Outcomes were body mass index (BMI) and overweight/obesity status. Male and female weight status associations with BE measures were estimated by generalized additive mixed models. Proportion (95% CI) of overweight (BMI 25 to <30) ranged from 16.6% (13.1, 19.8) to 41.1% (37.3, 44.7), and obesity (BMI ≥ 30) from 2.9% (1.3, 4.4) to 31.3% (27.7, 34.7), with Hong Kong being the lowest and Cuernavaca, Mexico highest for both proportions. Results differed by sex. Greater street intersection density, public transport density and perceived proximity to restaurants (males) were associated with lower odds of overweight/obesity (BMI ≥ 25). Proximity to public transport stops (females) was associated with higher odds of overweight/obesity. Composite BE measures were more strongly related to BMI and overweight/obesity status than single variables among men but not women. One standard deviation improvement in the composite measures of BE was associated with small reductions of 0.1-0.5% in BMI but meaningful reductions of 2.5-5.3% in the odds of overweight/obesity. Effects were linear and generalizable across cities. Neighborhoods designed to support public transport, with food outlets within walking distance, may contribute to global obesity control.


Subject(s)
Body Mass Index , Built Environment , Food , Internationality , Obesity , Restaurants , Adolescent , Adult , Cities , Cross-Sectional Studies , Female , Geographic Information Systems/statistics & numerical data , Humans , Male , Middle Aged , Residence Characteristics , Sex Factors , Transportation/statistics & numerical data , Young Adult
10.
Article in English | MEDLINE | ID: mdl-30857372

ABSTRACT

With an ageing world population, preservation of older adults' health and quality of life (QoL) is paramount. Due to lower levels of physical functionality, older adults are particularly susceptible to local environment influences, especially those living alone and lacking family support. Using generalised additive mixed models, we examined associations and confounder-adjusted associations between objectively-measured neighbourhood attributes and QoL domains in 909 Hong Kong Chinese elderly community dwellers. Most examined neighbourhood attributes were not associated with QoL in the whole sample. Neighbourhood residential and entertainment density was curvilinearly and/or linearly related to specific QoL domains. Number of parks was negatively associated with social QoL and having well-treed parks with higher levels of social QoL. Older adults living alone in neighbourhoods with poor access to destinations and few activities in parks showed lower environmental and/or social QoL than their counterparts. Neighbourhood built environment characteristics do not seem to impact Hong Kong older adults' physical and psychological QoL. Medium-to-high density, well-ordered neighbourhoods with optimal mixes of well-treed public open spaces and services meeting their daily needs may significantly contribute to social and environmental QoL in this population and appear particularly important to those living alone.


Subject(s)
Environment Design , Quality of Life , Residence Characteristics/statistics & numerical data , Aged , Aged, 80 and over , Cross-Sectional Studies , Female , Hong Kong , Humans , Male
11.
Sci Total Environ ; 670: 696-703, 2019 Jun 20.
Article in English | MEDLINE | ID: mdl-30909046

ABSTRACT

Rapid urbanization has significantly increased air pollution especially in urban regions with high traffic volumes. Existing methods for estimating traffic-related air pollution (TRAP) and TRAP-related health impacts are based on two-dimensional modelling. This paper describes a point-based methodology to monitor vertical pollutant concentrations in typical street canyons of Hong Kong. It explains the conceptual design, monitoring strategy and selection criteria for a limited number of receptor locations in street canyons to undertake field measurements for both outdoor exposure and indoor infiltration. It also expounds on the limitations and complications associated with field instrumentation and retention of participating home units. The empirical results were applied on the building infiltration efficiencies assessment. It is concluded that the cost-effective field methodology developed in this paper expects to strike a balance between exposure error and limited data locations. These findings will have important implications in future monitoring design of vertical TRAP exposure to support health studies.

12.
Article in English | MEDLINE | ID: mdl-30813303

ABSTRACT

The focus of this study is on examining sufficiency and quality of play space in a densely populated city from the spatial perspective. The study employed a three-stage multilevel mixed-method design using spatial analysis, user questionnaire, and site surveys. Provision of play space was assessed based on location, user perception, and proximity to residential areas and roads. The spatial distribution of play space was mapped and examined by applying GIS-based multicriteria analysis. Without considering play space provided by private housing estates, the study found a mismatch between children population and location of play space. The study also identified stair, slope, and sidewalk conditions as key issues of accessibility to selected playgrounds, even in districts with sufficient play space. Kowloon has limited play space of which a high percentage is inferior in terms of safety and pollution standards. Spatial analysis can help inform optimal locations for play space. Future studies should be based on more well-rounded and complete data to advise urban planning. Additionally, policy makers should focus more on quality standards of play space (i.e., openness, absence of pollution, attraction, safety, etc.) when planning as opposed to simply meeting the minimum area per person quota for open space.


Subject(s)
City Planning/statistics & numerical data , Parks, Recreational/statistics & numerical data , Play and Playthings , Residence Characteristics/statistics & numerical data , Cities , Hong Kong , Population Density
13.
Sci Total Environ ; 646: 618-624, 2019 Jan 01.
Article in English | MEDLINE | ID: mdl-30059922

ABSTRACT

BACKGROUND: City is becoming warmer, especially in the process of urbanization and climate change. However, it is largely unknown whether this warming urban climate may modify the short-term effects of air pollution. OBJECTIVES: To test whether warmer urban climates intensify the acute mortality effects of air pollution on pneumonia in Hong Kong. METHODS: Participants who died of pneumonia from a prospective Chinese elderly cohort between 1998 and 2011 were selected as cases. Urban climatic (UC) classes of cases were determined by an established Urban Climatic Map according to their residential addresses. UC classes were first dichotomized into cool and warm climates and case-crossover analysis was used to estimate the short-term association of pneumonia mortality with air pollution. We further classified UC classes into climate quartiles and used case-only analysis to test the trend of urban climate modification on the short-term association of pneumonia mortality with air pollution. RESULTS: Among 66,820 elders (≥65 years), 2208 pneumonia deaths (cases) were identified during the 11-14 years of follow-up. The effects of air pollution for cases residing in the warm climate were statistically significant (p < 0.05) higher than those living in the cool climate. There was an increasing linear trend of urban climate modification on the association of pneumonia mortality with NO2 (nitrogen dioxide) (p for trend = 0.035). Compared to climate Quartile 1 (the lowest), deaths resided in climate Quartile 2, 3, and 4 (the highest) were associated with an additional percent change of 9.07% (0.52%, 17.62%), 12.89% (4.34%, 21.43%), and 8.45% (-0.10%, 17.00%), respectively. CONCLUSIONS: Warmer urban climate worsened the acute mortality effects of pneumonia associated with air pollutants in Hong Kong. Our findings suggest that warmer urban climate introduced by climate change and urbanization may increase the risks of air pollution-related pneumonia.


Subject(s)
Air Pollution/statistics & numerical data , Environmental Exposure/statistics & numerical data , Pneumonia/mortality , Aged , Air Pollutants/analysis , Cities , Hong Kong/epidemiology , Humans , Mortality , Prospective Studies
14.
Environ Int ; 117: 99-106, 2018 08.
Article in English | MEDLINE | ID: mdl-29730535

ABSTRACT

BACKGROUND: Several studies have reported associations between long term exposure to air pollutants and cause-specific mortality. However, since the concentrations of air pollutants in Asia are much higher compared to those reported in North American and European cohort studies, cohort studies on long term effects of air pollutants in Asia are needed for disease burden assessment and to inform policy. OBJECTIVES: To assess the effects of long-term exposure to particulate matter with aerodynamic diameter < 2.5 µm (PM2.5), black carbon (BC) and nitrogen dioxide (NO2) on cause-specific mortality in an elderly cohort in Hong Kong. METHODS: In a cohort of 66,820 participants who were older than or equal to 65 years old in Hong Kong from 1998 to 2011, air pollutant concentrations were estimated by land use regression and assigned to the residential addresses of all participants at baseline and for each year during a 11 year follow up period. Hazard ratios (HRs) of cause-specific mortality (including all natural cause, cardiovascular and respiratory mortality) associated with air pollutants were estimated with Cox models, including a number of personal and area-level socioeconomic, demographic, and lifestyle factors. RESULTS: The median concentration of PM2.5 during the baseline period was 42.2 µg/m3 with an IQR of 5.5 µg/m3, 12.1 (9.6) µg/m3 for BC and 104 (25.6) µg/m3 for NO2. For PM2.5, adjusted HR per IQR increase and per 10 µg/m3 for natural cause mortality was 1.03 (95%CI: 1.01, 1.06) and 1.06 (95%CI: 1.02, 1.11) respectively. The corresponding HR were 1.06 (95%CI: 1.02, 1.10) and 1.01 (95%CI: 0.96, 1.06) for cardiovascular disease and respiratory disease mortality, respectively. For BC, the HR of an interquartile range increase for all natural cause mortality was 1.03 (95%CI: 1.00, 1.05). The corresponding HR was 1.07 (95%CI: 1.03, 1.11) and 0.99 (95%CI: 0.94, 1.04) for cardiovascular disease and respiratory disease mortality. For NO2, almost all HRs were approximately 1.0, except for IHD (ischemic heart disease) mortality. CONCLUSION: Long-term exposure to ambient PM2.5 and BC was associated with an elevated risk of cardiovascular mortality. Despite far higher air pollution exposure concentrations, HRs per unit increase in PM2.5 were similar to those from recent comparable studies in North America.


Subject(s)
Air Pollution , Cardiovascular Diseases/mortality , Environmental Exposure , Respiratory Tract Diseases/mortality , Aged , Cohort Studies , Environmental Exposure/analysis , Environmental Exposure/statistics & numerical data , Hong Kong/epidemiology , Humans
15.
Article in English | MEDLINE | ID: mdl-29518956

ABSTRACT

Compact cities and their urban forms have implications on sustainable city development because of high density urban settlement, increased accessibility, and a balanced land use mix. This paper uses quantitative means of understanding urban morphological characteristics with reference to the differing qualities of the urban form (i.e., street patterns, building volumes, land uses and greenery). The results, based on 89 neighborhood communities of Hong Kong, show varying degrees of regional differences in the urban built form supported by numerical statistics and graphical illustrations. This paper offers empirical evidence on some morphological characteristics that can be estimated objectively using modern geospatial technologies and applied universally to inform urban planning. However, more studies linking these quantifiable measures of the physical form with sustainable urban living are needed to account for human comfort in the totality of environmental, social, and economic responsibilities.


Subject(s)
City Planning , Sustainable Development , Cities , Hong Kong , Residence Characteristics
16.
BMJ Open ; 8(3): e020480, 2018 03 25.
Article in English | MEDLINE | ID: mdl-29581207

ABSTRACT

OBJECTIVES: This study aimed to examine the associations between objectively assessed neighbourhood environmental attributes and depressive symptoms in Hong Kong Chinese older adults and the moderating effects of neighbourhood environmental attributes on the associations between living arrangements and depressive symptoms. DESIGN: Cross-sectional observational study. SETTING: Hong Kong. PARTICIPANTS: 909 Hong Kong Chinese community dwellers aged 65+ years residing in preselected areas stratified by walkability and socioeconomic status. EXPOSURE AND OUTCOME MEASURES: Attributes of participants' neighbourhood environment were objectively assessed using geographic information systems and environmental audits. Depressive symptoms were measured using the Geriatric Depression Scale. RESULTS: Overall, pedestrian infrastructure (OR=1.025; P=0.008), connectivity (OR=1.039; P=0.002) and prevalence of public transport stops (OR=1.056; P=0.012) were positively associated with the odds of reporting depressive symptoms. Older adults living alone were at higher risk of reporting any depressive symptoms than those living with others (OR=1.497; P=0.039). This association was moderated by neighbourhood crowdedness, perceptible pollution, access to destinations and presence of people. Residing in neighbourhoods with lower levels of these attributes was associated with increased deleterious effects of living alone. Living in neighbourhoods with lower public transport density also increased the deleterious effects of living alone on the number of depressive symptoms. Those living alone and residing in neighbourhoods with higher levels of connectivity tended to report more depressive symptoms than their counterparts. CONCLUSIONS: The level of access to destinations and social networks across Hong Kong may be sufficiently high to reduce the risk of depressive symptoms in older adults. Yet, exposure to extreme levels of public transport density and associated traffic volumes may increase the risk of depressive symptoms. The provision of good access to a variety of destinations, public transport and public open spaces for socialising in the neighbourhood may help reduce the risk of depressive symptoms in older adults who live alone.


Subject(s)
Depressive Disorder/etiology , Environment Design , Residence Characteristics/statistics & numerical data , Aged , Aged, 80 and over , Cross-Sectional Studies , Female , Hong Kong , Humans , Male , Odds Ratio , Urban Population/statistics & numerical data
17.
Environ Int ; 113: 100-108, 2018 04.
Article in English | MEDLINE | ID: mdl-29421398

ABSTRACT

BACKGROUND: Epidemiological studies typically use subjects' residential address to estimate individuals' air pollution exposure. However, in reality this exposure is rarely static as people move from home to work/study locations and commute during the day. Integrating mobility and time-activity data may reduce errors and biases, thereby improving estimates of health risks. OBJECTIVES: To incorporate land use regression with movement and building infiltration data to estimate time-weighted air pollution exposures stratified by age, sex, and employment status for population subgroups in Hong Kong. METHODS: A large population-representative survey (N = 89,385) was used to characterize travel behavior, and derive time-activity pattern for each subject. Infiltration factors calculated from indoor/outdoor monitoring campaigns were used to estimate micro-environmental concentrations. We evaluated dynamic and static (residential location-only) exposures in a staged modeling approach to quantify effects of each component. RESULTS: Higher levels of exposures were found for working adults and students due to increased mobility. Compared to subjects aged 65 or older, exposures to PM2.5, BC, and NO2 were 13%, 39% and 14% higher, respectively for subjects aged below 18, and 3%, 18% and 11% higher, respectively for working adults. Exposures of females were approximately 4% lower than those of males. Dynamic exposures were around 20% lower than ambient exposures at residential addresses. CONCLUSIONS: The incorporation of infiltration and mobility increased heterogeneity in population exposure and allowed identification of highly exposed groups. The use of ambient concentrations may lead to exposure misclassification which introduces bias, resulting in lower effect estimates than 'true' exposures.


Subject(s)
Air Pollutants/analysis , Environmental Exposure , Travel , Aged , Air Pollution , Environmental Exposure/analysis , Environmental Exposure/statistics & numerical data , Female , Hong Kong , Humans , Male , Middle Aged
19.
Int J Biometeorol ; 61(9): 1695-1698, 2017 Sep.
Article in English | MEDLINE | ID: mdl-28374106

ABSTRACT

It is becoming popular to use biometeorological indexes to study the effects of weather on human health. Most of the biometeorological indexes were developed decades ago and only applicable to certain locations because of different climate types. Merely using standard biometeorological indexes to replace typical weather factors in biometeorological studies of different locations may not be an ideal research direction. This research is aimed at assessing the difference of statistical power between using standard biometeorological indexes and typical weather factors on describing the effects of extreme weather conditions on daily ambulance demands in Hong Kong. Results showed that net effective temperature and apparent temperature did not perform better than typical weather factors in describing daily ambulance demands in this study. The maximum adj-R 2 improvement was only 0.08, whereas the maximum adj-R 2 deterioration was 0.07. In this study, biometeorological indexes did not perform better than typical weather factors, possibly due to the differences of built environments and lifestyles in different locations and eras. Regarding built environments, the original parameters for calculating the index values may not be applicable to Hong Kong as buildings in Hong Kong are extremely dense and most are equipped with air conditioners. Regarding lifestyles, the parameters, which were set decades ago, may be outdated and not suitable to modern lifestyles as using hand-held electrical fans on the street to help reduce heat stress are popular. Hence, it is ideal to have tailor-made updated location-specific biometeorological indexes to study the effects of weather on human health.


Subject(s)
Ambulances/statistics & numerical data , Weather , Adolescent , Adult , Aged , Child , Child, Preschool , Female , Hong Kong , Humans , Infant , Infant, Newborn , Male , Meteorology , Middle Aged , Young Adult
20.
Sci Total Environ ; 592: 306-315, 2017 Aug 15.
Article in English | MEDLINE | ID: mdl-28319717

ABSTRACT

Land use regression (LUR) is a common method of predicting spatial variability of air pollution to estimate exposure. Nitrogen dioxide (NO2), nitric oxide (NO), fine particulate matter (PM2.5), and black carbon (BC) concentrations were measured during two sampling campaigns (April-May and November-January) in Hong Kong (a prototypical high-density high-rise city). Along with 365 potential geospatial predictor variables, these concentrations were used to build two-dimensional land use regression (LUR) models for the territory. Summary statistics for combined measurements over both campaigns were: a) NO2 (Mean=106µg/m3, SD=38.5, N=95), b) NO (M=147µg/m3, SD=88.9, N=40), c) PM2.5 (M=35µg/m3, SD=6.3, N=64), and BC (M=10.6µg/m3, SD=5.3, N=76). Final LUR models had the following statistics: a) NO2 (R2=0.46, RMSE=28µg/m3) b) NO (R2=0.50, RMSE=62µg/m3), c) PM2.5 (R2=0.59; RMSE=4µg/m3), and d) BC (R2=0.50, RMSE=4µg/m3). Traditional LUR predictors such as road length, car park density, and land use types were included in most models. The NO2 prediction surface values were highest in Kowloon and the northern region of Hong Kong Island (downtown Hong Kong). NO showed a similar pattern in the built-up region. Both PM2.5 and BC predictions exhibited a northwest-southeast gradient, with higher concentrations in the north (close to mainland China). For BC, the port was also an area of elevated predicted concentrations. The results matched with existing literature on spatial variation in concentrations of air pollutants and in relation to important emission sources in Hong Kong. The success of these models suggests LUR is appropriate in high-density, high-rise cities.


Subject(s)
Air Pollution/analysis , Environmental Monitoring , Air Pollutants/analysis , Cities , Hong Kong , Models, Theoretical , Nitric Oxide/analysis , Nitrogen Dioxide/analysis , Particulate Matter , Regression Analysis , Soot/analysis
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