A comparison of content from across contemporary Australian population health surveys.

OBJECTIVE: Associations between place and population health are of interest to researchers and policymakers. The objective of this paper is to explore, summarise and compare content across contemporary Australian geo-referenced population health survey data sets. METHODS: A search for recent (2015 or later) population health surveys from within Australia containing geographic information from participants was conducted. Survey response frames were analysed and categorised based on demographic, risk factor and disease-related characteristics. Analysis using interactive Sankey diagrams shows the extent of content overlap and differences between population health surveys in Australia. RESULTS: Thirteen Australian geo-referenced population health survey data sets were identified. Information captured across surveys was inconsistent as was the spatial granularity of respondent information. Health and demographic features most frequently captured were symptoms, signs and clinical findings from the International Statistical Classification of Diseases and Related Health Problems version 11, employment, housing, income, self-rated health and risk factors, including alcohol consumption, diet, medical treatments, physical activity and weight-related questions. Sankey diagrams were deployed online for use by public health researchers. CONCLUSIONS: Identifying the relationship between place and health in Australia is made more difficult by inconsistencies in information collected across surveys deployed in different regions in Australia. IMPLICATIONS FOR PUBLIC HEALTH: Public health research investigating place and health involves a vast and inconsistent patchwork of information within and across states, which may impact broad-scale research questions. The tools developed here assist public health researchers to identify surveys suitable for their research queries related to place and health.

Land surface and air temperature dynamics: The role of urban form and seasonality.

Due to the scarcity of air temperature (Ta) observations, urban heat studies often rely on satellite-derived Land Surface Temperature (LST) to characterise the near-surface thermal environment. However, there remains a lack of a quantitative understanding on how LST differs from Ta within urban areas and what are the controlling factors of their interaction. We use crowdsourced air temperature measurements in Sydney, Australia, combined with urban landscape data, Local Climate Zones (LCZ), high-resolution satellite imagery, and machine learning to explore the influence of urban form and fabric on the interaction between Ta and LST. Results show that LST and Ta have distinct spatiotemporal characteristics, and their relationship differs by season, ecological infrastructure, and building morphology. We found greater seasonal variability in LST compared to Ta, along with more pronounced intra-urban spatial variability in LST, particularly in warmer seasons. We also observed a greater temperature difference between LST and Ta in the built environment compared to the natural LCZs, especially during warm days. Natural LCZs (areas with mostly dense and scattered trees) showed stronger LST-Ta relationships compared to built areas. In particular, we observe that built areas with higher building density (where the heat vulnerability is likely more pronounced) show insignificant or negative relationships between LST- Ta in summer. Our results also indicate that surface cover, distance from the ocean, and seasonality significantly influence the distribution of hot and cold spots for LST and Ta. The spatial distribution for Ta hot spots does not always overlap with LST. We find that relying solely on LST as a direct proxy for the urban thermal environment is inappropriate, particularly in densely built-up areas and during warm seasons. These findings provide new perspectives on the relationship between surface and canopy temperatures and how these relate to urban form and fabric.

The impact of the COVID-19 pandemic on air pollution: A global assessment using machine learning techniques.

In response to the COVID-19 pandemic, most countries implemented public health ordinances that resulted in restricted mobility and a resultant change in air quality. This has provided an opportunity to quantify the extent to which carbon-based transport and industrial activity affect air quality. However, quantification of these complex effects has proven to be difficult, depending on the stringency of restrictions, country-specific emission source profiles, long-term trends and meteorological effects on atmospheric chemistry, emission levels and in-flow from nearby countries. In this study, confounding factors were disentangled for a direct comparison of pandemic-related reductions in absolute pollutions levels, globally. The non-linear relationships between atmospheric processes and daily ground-level NO 2 , PM10, PM2.5 and O 3 measurements were captured in city- and pollutant-specific XGBoost models for over 700 cities, adjusting for weather, seasonality and trends. City-level modelling allowed adaptation to the distinct topography, urban morphology, climate and atmospheric conditions for each city, individually, as the weather variables that were most predictive varied across cities. Pollution forecasts for 2020 in absence of a pandemic were generated based on weather and formed an ensemble for country-level pollution reductions. Findings were robust to modelling assumptions and consistent with various published case studies. NO 2 reduced most in China, Europe and India, following severe government restrictions as part of the initial lockdowns. Reductions were highly correlated with changes in mobility levels, especially trips to transit stations, workplaces, retail and recreation venues. Further, NO 2 did not fully revert to pre-pandemic levels in 2020. Ambient PM2.5 pollution, which has severe adverse health consequences, reduced most in China and India. Since positive health effects could be offset to some extent by prolonged exposure to indoor pollution, alternative transport initiatives could prove to be an important pathway towards better health outcomes in these countries. Increased O 3 levels during initial lockdowns have been documented widely. However, our analyses also found a subsequent reduction in O 3 for many countries below what was expected based on meteorological conditions during summer months (e.g., China, United Kingdom, France, Germany, Poland, Turkey). The effects in periods with high O 3 levels are especially important for the development of effective mitigation strategies to improve health outcomes.

Modelling SARS-CoV-2 disease progression in Australia and New Zealand: an account of an agent-based approach to support public health decision-making.

OBJECTIVE: In 2020, we developed a public health decision-support model for mitigating the spread of SARS-CoV-2 infections in Australia and New Zealand. Having demonstrated its capacity to describe disease progression patterns during both countries' first waves of infections, we describe its utilisation in Victoria in underpinning the State Government's then 'RoadMap to Reopening'. METHODS: Key aspects of population demographics, disease, spatial and behavioural dynamics, as well as the mechanism, timing, and effect of non-pharmaceutical public health policies responses on the transmission of SARS-CoV-2 in both countries were represented in an agent-based model. We considered scenarios related to the imposition and removal of non-pharmaceutical interventions on the estimated progression of SARS-CoV-2 infections. RESULTS: Wave 1 results suggested elimination of community transmission of SARS-CoV-2 was possible in both countries given sustained public adherence to social restrictions beyond 60 days' duration. However, under scenarios of decaying adherence to restrictions, a second wave of infections (Wave 2) was predicted in Australia. In Victoria's second wave, we estimated in early September 2020 that a rolling 14-day average of <5 new cases per day was achievable on or around 26 October. Victoria recorded a 14-day rolling average of 4.6 cases per day on 25 October. CONCLUSIONS: Elimination of SARS-CoV-2 transmission represented in faithfully constructed agent-based models can be replicated in the real world. IMPLICATIONS FOR PUBLIC HEALTH: Agent-based public health policy models can be helpful to support decision-making in novel and complex unfolding public health crises.

A global analysis of urban design types and road transport injury: an image processing study.

BACKGROUND: Death and injury due to motor vehicle crashes is the world's fifth leading cause of mortality and morbidity. City and urban designs might play a role in mitigating the global burden of road transport injury to an extent that has not been captured by traditional safe system approaches. We aimed to determine the relationship between urban design and road trauma across the globe. METHODS: Applying a combined convolutional neural network and graph-based approach, 1692 cities capturing one third of the world's population were classified into types based on urban design characteristics represented in sample maps. Associations between identified city types, characteristics contained within sample maps, and the burden of road transport injury as measured by disability adjusted life-years were estimated through univariate and multivariate analyses, controlling for the influence of economic activity. FINDINGS: Between Mar 1, 2017, and Dec 24, 2018, nine global city types based on a final sample of 1632 cities were identified. Burden of road transport injury was an estimated two-times higher (risk ratio 2·05, 95% CI 1·84-2·27) for the poorest performing city type compared with the best performing city type, culminating in an estimated loss of 8·71 (8·08-9·25) million disability-adjusted life-years per year attributable to suboptimal urban design. City types that featured a greater proportion of railed public transport networks combined with dense road networks characterised by smaller blocks showed the lowest rates of road traffic injury. INTERPRETATION: This study highlights the important role that city and urban design plays in mitigating road transport injury burden at a global scale. It is recommended that road and transport safety efforts promote urban design that features characteristics inherent in identified high-performance city types including higher density road infrastructure and high rates of public transit. FUNDING: See acknowledgments.

Opportunities to reduce road traffic injury: new insights from the study of urban areas.

Over the past four decades considerable efforts have been taken to mitigate the growing burden of road injury. With increasing urbanisation along with global mobility that demands not only safe but equitable, efficient and clean (reduced carbon footprint) transport, the responses to dealing with the burgeoning road traffic injury in low- and middle-income countries has become increasingly complex. In this paper, we apply unique methods to identify important strategies that could be implemented to reduce road traffic injury in the Asia-Pacific region; a region comprising large middle-income countries (China and India) that are currently in the throes of rapid motorisation. Using a convolutional neural network approach, we clustered countries containing a total of 1632 cities from around the world into groups based on urban characteristics related to road and public transport infrastructure. We then analysed 20 countries (containing 689 cities) from the Asia-Pacific region and assessed the global burden of disease attributed to road traffic injury and these various urban characteristics. This study demonstrates the utility of employing image recognition methods to discover new insights that afford urban and transport planning opportunities to mitigate road traffic injury at a regional and global scale.