Outdoor public recreation spaces and social connectedness among adolescents.

BACKGROUND: Outdoor public recreation spaces are important settings for leisure and physical activity. Adolescents' use of these spaces may contribute to social connectedness via social interaction with peers and the community in these settings. However, research on this topic is limited. This exploratory study examined associations of frequency of visitation and physical activity in outdoor public recreation spaces with social connectedness among adolescents in Melbourne, Australia. METHODS: Adolescents self-reported their frequency of visitation to parks, trails, beach/lake, and sports facilities; frequency of physical activity in a park, local street or path, and their street; and social connectedness. Separate analyses were conducted for visitation (n = 349, 15.4 ± 1.6 years, 58% female) and physical activity (n = 441, 15.4 ± 1.6 years, 59% female) using multilevel linear regression models. RESULTS: No significant associations were observed for frequency of visitation to a park (B = 0.86, 95% CI = - 0.26, 1.99), trails (B = 0.41, 95% CI = - 0.61, 1.44), beach/lake (B = - 0.44, 95% CI = - 1.46, 0.57), or sports facilities (B = 0.64, 95% CI = - 0.43, 1.70), nor for frequency of physical activity in their street (B = - 0.07, 95% CI = - 0.46, 0.31), local street/path (B = - 0.05, 95% CI = - 0.43, 0.33) or in a park (B = 0.23, 95% CI = - 0.14, 0.60) with adolescents' social connectedness. CONCLUSIONS: The findings did not support the hypothesis that visiting and being active in outdoor public recreation spaces are associated with adolescents' social connectedness. Future research should consider the duration and context of outdoor public recreation space use (e.g., sports, socialising, relaxing alone) and whether different types and/or a combination of public spaces are more/less conducive to social connectedness.

Environmental Mismatch: Do Associations between the Built Environment and Physical Activity among Youth Depend on Concordance with Perceptions?

Without accurate awareness of features within the built environment, the availability of a supportive built environment alone may not be sufficient to influence physical activity levels. We examined the moderating effects of concordance/discordance between selected objective and perceived built environment features in the relationship between objective built environment features and physical activity. Cross-sectional data from 465 youth aged 12-20 years from 18 schools in Melbourne, Australia were used. The relationship between trails and physical activity differed by concordance/discordance. There were positive relationships among those with concordant perceptions, but no significant differences for those with discordant perceptions. At least for trails, environmental interventions designed to enhance physical activity may be less effective if efforts are not made to enhance individuals' awareness of their environment.

Built environment and physical activity among adolescents: the moderating effects of neighborhood safety and social support.

BACKGROUND: Increasing emphasis has been placed on improving physical activity levels through multilevel interventions. This study aims to examine moderating effects of neighborhood safety (crime and traffic) and social support (from parent and sibling/peer) for physical activity in the relationship between the built environment and moderate-to-vigorous physical activity (MVPA) outside school hours among adolescents in Melbourne. METHODS: Data were from the NEighbourhood Activity in Youth study conducted among adolescents in Melbourne, Australia (n = 358, 15.3 (SD = 1.5) years). MVPA outside school hours was assessed by accelerometer. Built environment features within 1 km and 2 km residential buffers including recreation facilities, park area, and walkability and its components were assessed using Geographic Information Systems. Neighborhood safety, social support for physical activity and sociodemographic information were self-reported by adolescents. Multilevel linear regression models were used to estimate associations. RESULTS: Support for physical activity from sibling/peer positively moderated the relationship between recreation facilities (1 km), residential density (2 km) and MVPA. Recreation facility (count within 2 km), walkability (1 km and 2 km) and residential density (1 km) had significant positive associations with MVPA outside school hours. CONCLUSION: The built environment appeared to have stronger facilitating effects on MVPA among adolescents who had favourable support for physical activity from their sibling or peer. Multilevel interventions that target the built environment and social factors are needed to promote MVPA outside school hours among adolescents.

Neighbourhood built environment and physical function among mid-to-older aged adults: A systematic review.

This systematic review included 23 quantitative studies that estimated associations between aspects of the neighbourhood built environment and physical function among adults aged ≥45 years. Findings were analysed according to nine aspects of the neighbourhood built environment: walkability, residential density, street connectivity, land use mix, public transport, pedestrian infrastructure, aesthetics, safety and traffic. Evidence was found for a positive association of pedestrian infrastructure and aesthetics with physical function, while weaker evidence was found for land use mix, and safety from crime and traffic. There was an insufficient number of studies for walkability, residential density, street connectivity and access to public transport.

Neighborhood Disadvantage and Physical Function: The Contributions of Neighborhood-Level Perceptions of Safety From Crime and Walking for Recreation.

BACKGROUND: Residents of more socioeconomically disadvantaged neighborhoods are more likely to report poorer physical function, although the reasons for this remain unknown. It is possible that neighborhood-level perceptions of safety from crime contribute to this relationship through its association with walking for recreation. METHODS: Data were obtained from the fourth wave (collected in 2013) of the HABITAT (How Areas in Brisbane Influence HealTh and AcTivity) multilevel longitudinal study of middle- to older-aged adults (46-74 y) residing in 200 neighborhoods in Brisbane, Australia. The data were analyzed separately for men (n = 2190) and women (n = 2977) using multilevel models. RESULTS: Residents of the most disadvantaged neighborhoods had poorer physical function, perceived their neighborhoods to be less safe from crime, and do less walking for recreation. These factors accounted for differences in physical function between disadvantaged and advantaged neighborhoods (24% for men and 25% for women). CONCLUSION: This study highlights the importance of contextual characteristics, through their associations with behaviors, that can have in explaining the relationship between neighborhood disadvantage and physical function. Interventions aimed at improving neighborhood safety integrated with supportive environments for physical activity may have positive impact on physical function among all socioeconomic groups.

Changes in waist circumference independent of weight: Implications for population level monitoring of obesity.

Population monitoring of obesity is most commonly conducted using body mass index (BMI). We test the hypothesis that because of increases in waist circumference (WC) independent of increases in weight, BMI alone detects an increasingly smaller proportion of the population with obesity. METHODS: Australian adults with measured height, weight, and WC were selected from three nationally representative cross-sectional surveys (1989, 1999-2000, 2011-12; n=8313, 5903 & 3904). Participants were defined as having obesity using classifications for an obese BMI (≥30kg·m-2) and substantially-increased-risk WC (≥88cm [women], ≥102cm [men]). Age-standardised prevalence of obesity according to BMI and/or WC, and the proportion of these detected by BMI and by WC were compared across surveys. FINDINGS: Between 1989 and 2011-12, weight and WC increased by 5.4kg and 10.7cm (women), and by 7.0kg and 7.3cm (men). For women and men, 63% and 38% of increases in WC were independent of increases in weight. Over this period, the prevalence of obesity according to BMI and/or WC increased by 25.3 percentage-points for women (18.9% to 44.3%) and 21.1 percentage-points for men (17.1% to 38.2%). The proportion of these detected by BMI decreased for women by 20 percentage-points (77% to 57%) with no change for men. The proportion of these detected by WC increased for women and men by 10 percentage-points (87% to 97%) and 6 percentage-points (85% to 91%) respectively. CONCLUSION: BMI alone is detecting a decreasing proportion of those considered obese by BMI and/or WC. Renewed discussion regarding how we monitor obesity at the population level is required.

Associations between physical activity and the neighbourhood social environment: baseline results from the HABITAT multilevel study.

Limitations have arisen when measuring associations between the neighbourhood social environment and physical activity, including same-source bias, and the reliability of aggregated neighbourhood-level social environment measures. This study examines cross-sectional associations between the neighbourhood social environment (perceptions of incivilities, crime, and social cohesion) and self-reported physical activity, while accounting for same-source bias and reliability of neighbourhood-level exposure measures, using data from a large population-based clustered sample. This investigation included 11,035 residents aged 40-65years from 200 neighbourhoods in Brisbane, Australia, in 2007. Respondents self-reported their physical activity and perceptions of the social environment (neighbourhood incivilities, crime and safety, and social cohesion). Models were adjusted for individual-level education, occupation, and household income, and neighbourhood disadvantage. Exposure measures were generated via split clusters and an empirical Bayes estimation procedure. Data were analysed in 2016 using multilevel multinomial logistic regression. Residents of neighbourhoods with the highest incivilities and crime, and lowest social cohesion were reference categories. Individuals were more likely to be in the higher physical activity categories if they were in neighbourhoods with the lowest incivilities and the lowest crime. No associations were found between social cohesion and physical activity. This study provides a basis from which to gain a clearer understanding of the relationship between the neighbourhood social environment and individual physical activity. Further work is required to explore the pathways between perceptions of the neighbourhood social environment and physical activity.

Neighborhood disadvantage, individual-level socioeconomic position and physical function: A cross-sectional multilevel analysis.

INTRODUCTION: Understanding associations between physical function and neighborhood disadvantage may provide insights into which interventions might best contribute to reducing socioeconomic inequalities in health. This study examines associations between neighborhood-disadvantage, individual-level socioeconomic position (SEP) and physical function from a multilevel perspective. METHODS: Data were obtained from the HABITAT multilevel longitudinal (2007-13) study of middle-aged adults, using data from the fourth wave (2013). This investigation included 6004 residents (age 46-71years) of 535 neighborhoods in Brisbane, Australia. Physical function was measured using the PF-10 (0-100), with higher scores indicating better function. The data were analyzed using multilevel linear regression and were extended to test for cross-level interactions by including interaction terms for different combinations of SEP (education, occupation, household income) and neighborhood disadvantage on physical function. RESULTS: Residents of the most disadvantaged neighborhoods reported significantly lower physical function (men: ß -11.36 95% CI -13.74, -8.99; women: ß -11.41 95% CI -13.60, -9.22). These associations remained after adjustment for individual-level SEP. Individuals with no post-school education, those permanently unable to work, and members of the lowest household income had significantly poorer physical function. Cross-level interactions suggested that the relationship between household income and physical function is different across levels of neighborhood disadvantage for men; and for education and occupation for women. CONCLUSION: Living in a disadvantaged neighborhood was negatively associated with physical function after adjustment for individual-level SEP. These results may assist in the development of policy-relevant targeted interventions to delay the rate of physical function decline at a community-level.

Bisphenol A and the risk of cardiometabolic disorders: a systematic review with meta-analysis of the epidemiological evidence.

Bisphenol A (BPA) is suspected to be associated with several chronic metabolic diseases. The aim of the present study was to review the epidemiological literature on the relation between BPA exposure and the risk of cardiometabolic disorders. PubMed and Embase databases were searched up to August 2014 by two independent investigators using standardized subject terms. We included observational studies (cohort, case-control and cross-sectional studies) carried out in children or adults, measuring urinary BPA (uBPA), including at least 100 participants and published in English. The health outcomes of interest were diabetes, hyperglycemia, measures of anthropometry, cardiovascular disease (CVD) and hypertension. Data were extracted and meta-analyzed when feasible, using a random-effects model. Thirty-three studies with sample size ranging from 239 to 4811 met the inclusion criteria, including five with a prospective design. Twelve studies reported on diabetes or hyperglycemia, 16 on anthropometry, 6 on CVD and 3 on hypertension. Evidence for a positive association between uBPA concentrations and diabetes, overweight, obesity, elevated waist circumference (WC), CVD and hypertension was found in 7/8, 2/7, 6/7, 5/5, 4/5 and 2/3 of the cross-sectional studies, respectively. We were able to conduct outcome-specific meta-analyses including 12 studies. When comparing the highest vs. the lowest uBPA concentrations, the pooled ORs were 1.47 (95% CI: 1.21-1.80) for diabetes, 1.21 (95% CI: 0.98-1.50) for overweight, 1.67 (95% CI: 1.41-1.98) for obesity, 1.48 (95% CI: 1.25-1.76) for elevated WC, and 1.41 (95% CI: 1.12-1.79) for hypertension. Moreover, among the five prospective studies, 3 reported significant findings, relating BPA exposure to incident diabetes, incident coronary artery disease, and weight gain. To conclude, there is evidence from the large body of cross-sectional studies that individuals with higher uBPA concentrations are more likely to suffer from diabetes, general/abdominal obesity and hypertension than those with lower uBPA concentrations. Given the potential importance for public health, prospective cohort studies with proper adjustment for dietary characteristics and identification of critical windows of exposure are urgently needed to further improve knowledge about potential causal links between BPA exposure and the development of chronic disease.