Understanding causal relationships between the built and social environment, health and associated behaviours and risk factors

Introduction: Built environment interventions designed to reduce non-communicable diseases and health inequity, complement urban planning agendas focused on creating more ‘liveable’, compact, pedestrian-friendly, less automobile dependent and more socially inclusive cities.However, what constitutes a ‘liveable’ community is not well defined. Moreover, there appears to be a gap between the concept and delivery of ‘liveable’ communities. The recently funded NHMRC Centre of Research Excellence (CRE) in Healthy Liveable Communities established in early 2014, has defined ‘liveability’ from a social determinants of health perspective. Using purpose-designed multilevel longitudinal data sets, it addresses five themes that address key evidence-base gaps for building healthy and liveable communities. The CRE in Healthy Liveable Communities seeks to generate and exchange new knowledge about: 1) measurement of policy-relevant built environment features associated with leading non-communicable disease risk factors (physical activity, obesity) and health outcomes (cardiovascular disease, diabetes) and mental health; 2) causal relationships and thresholds for built environment interventions using data from longitudinal studies and natural experiments; 3) thresholds for built environment interventions; 4) economic benefits of built environment interventions designed to influence health and wellbeing outcomes; and 5) factors, tools, and interventions that facilitate the translation of research into policy and practice. This evidence is critical to inform future policy and practice in health, land use, and transport planning. Moreover, to ensure policy-relevance and facilitate research translation, the CRE in Healthy Liveable Communities builds upon ongoing, and has established new, multi-sector collaborations with national and state policy-makers and practitioners. The symposium will commence with a brief introduction to embed the research within an Australian health and urban planning context, as well as providing an overall outline of the CRE in Healthy Liveable Communities, its structure and team. Next, an overview of the five research themes will be presented. Following these presentations, the Discussant will consider the implications of the research and opportunities for translation and knowledge exchange. Theme 2 will establish whether and to what extent the neighbourhood environment (built and social) is causally related to physical and mental health and associated behaviours and risk factors. In particular, research conducted as part of this theme will use data from large-scale, longitudinal-multilevel studies (HABITAT, RESIDE, AusDiab) to examine relationships that meet causality criteria via statistical methods such as longitudinal mixed-effect and fixed-effect models, multilevel and structural equation models; analyse data on residential preferences to investigate confounding due to neighbourhood self-selection and to use measurement and analysis tools such as propensity score matching and ‘within-person’ change modelling to address confounding; analyse data about individual-level factors that might confound, mediate or modify relationships between the neighbourhood environment and health and well-being (e.g., psychosocial factors, knowledge, perceptions, attitudes, functional status), and; analyse data on both objective neighbourhood characteristics and residents’ perceptions of these objective features to more accurately assess the relative contribution of objective and perceptual factors to outcomes such as health and well-being, physical activity, active transport, obesity, and sedentary behaviour. At the completion of the Theme 2, we will have demonstrated and applied statistical methods appropriate for determining causality and generated evidence about causal relationships between the neighbourhood environment, health, and related outcomes. This will provide planners and policy makers with a more robust (valid and reliable) basis on which to design healthy communities.

Comments on: "The role of the social environment in psychiatric research: Outstanding challenges and future directions by Dana March, James Kirkbride, Wim Veling"

On 17 March 2009, we hosted a live discussion of fresh new ideas in the epidemiology of schizophrenia. Discussion leaders Dana March of Columbia University, James Kirkbride of the University of Cambridge, and Wim Veling of Parnassia Psychiatric Institute delivered a wide-ranging discussion of social factors such as migration, ethnicity, and urbanicity, but also asked how this research could benefit from genetic insights. Finally, they discussed possible biological mechanisms that might transduce social factors into psychosis

Measuring wellness through interdisciplinary community development: linking the physical, economic and social environment

The aim of this study is to answer the question: Is there evidence that the quality of life of residents in a community that has had community development intervention is different as compared to the quality of life of residents in a nearby community that did not have community development initiatives? This was done by administering community development initiatives in a local area and comparing it to a similar community that did not receive this intervention. The residents of these communities rated the quality of their lives and communities in two purposively selected suburbs in Perth, Western Australia using the Australian Unity Wellbeing Index to measure individual and neighbourhood well-being. The quality of life of residents in both communities is then compared to national averages for quality of life or well-being. Answering this question provides empirical evidence of variation between ratings of quality of life of residents in different communities and highlights the utility of the Wellbeing Index for the evaluation of interdisciplinary community development

Are perceptions of the physical and social environment associated with mothers' walking for leisure and for transport? A longitudinal study

Objective
The role local neighbourhood environments play in influencing purpose-specific walking behaviors has not been well-explored in prospective studies. This study aimed to cross-sectionally and prospectively examine whether local physical and social environments were associated with mothers' walking for leisure and for transport.

Methods
In 2004, 357 mothers from Melbourne, Australia, provided information on their local physical and social neighbourhood environments, and in 2004 and 2006 reported weekly time spent walking for leisure and for transport. Environmental predictors of high levels of walking and increases in walking were examined using log binomial regression.

Results
Public transport accessibility and trusting many people in the neighbourhood were predictive of increases in walking for leisure, while connectivity, pedestrian crossings, a local traffic speed were predictive of increases in transport-related walking. Satisfaction with local facilities was associated with increasing both types of walking, and the social environment was important for maintaining high levels of both leisure- and transport-related walking.

Conclusion
The findings provide evidence of a longitudinal relationship between physical and social environments and walking behaviors amongst mothers. Enhancing satisfaction with local facilities and giving consideration to ‘walkability’, safety and public transport accessibility during environment planning processes may help mothers to increase walking.

Associations between the physical and social environment and depressive symptomology among Australian adolescents

Depression is a significant public health issue among Australian adolescents. A number of family, school and community level factors have been identified as important determinants of adolescent's health and well-being, including depression. This study examines associations between measures of the social and physical environment and adolescent mental health, specifically depressive symptomotology using data from the Healthy Neighbourhoods study, a large observational study carried out in 231 Australian schools stratified by socioeconomic quartiles and urban/non-urban geography, which focuses on adolescent health and well-being. Participants were 8256 year 6 and 8
students (48% male), aged 11-16 years (M = 11.6, SD = 0.8 years) from schools across Victoria,Queensland and Western Australia who completed a comprehensive on-line survey. Data collected included the Short Mood and Feeling Questionnaire (SMFQL a tool for assessing depressive symptomotology in adolescents. Results showed that the mean total depression score (possible range 0-26 with total scores;:: 8 used as the cutoff for depression symptomotology) was 6.4 (SD = 5.9), with scores for females (M = 6.8, SD = 6.3) higher than those for males (M = 5.9, SD = 5.5), and scores for year 8 students (M = 6.7,SD = 6.1) higher than those for year 6 students (M = 6.2, SD = 5.8) (p < .001). Greater access to sporting and play equipment, local parks, and more functional neighbourhoods for walking and jogging reduced the odds for depressive symptomotology (p < .05L while increased levels of abandoned homes, and higher levels of fighting within the neighbourhood, and fewer scout/guide clubs, local teams to play sport, and adults in the neighbourhood to talk with, as well as reduced neighbourhood safety increased the odds for depressive symptomotology (p < .05). These findings support the important role of physical and social environments in influencing adolescent health and well-being. Modifications to particular aspects of these environments at the community level may assist in providing adolescents some protection from depression.

vPELS : an eLearning social environment for VLSI design with content security using DRM

This paper provides a proposal for personal e-learning system (vPELS) architecture in the context of social network environment for VLSI Design. The main objective of vPELS is to develop individual skills on a specific subject, say, VLSI and share resources with peers. Our system architecture defines organization and management of personal learning environment that aids in creating, verifying and sharing learning artifacts and making money at the same time. We also focus on in our research one of the most interesting arenas in digital content or document management called Digital Right Management (DRAM) and its application to eLearning.

The neighborhood social environment and body mass index among youth : a mediation analysis

Background

This study aimed to examine associations between aspects of the neighborhood social environment and body mass index (BMI) in youth both cross-sectionally and prospectively; and whether this association was mediated by physical activity, screen-time and sedentary time.
Methods

Data were collected in 2004 and 2006 in high and low socio-economic areas of Melbourne, Australia. In 2004, 185 children aged 8-9 years (47% boys) and 359 children aged 13-15 years (45% boys) participated. Parents reported their perceptions of aspects of the social environment (i.e. social networks and social trust/cohesion), and physical activity (i.e. time spent outdoors by their children; and their younger children's walking and cycling trips) and screen-time (i.e. TV viewing, computer use). The older children self-reported their walking and cycling trips and their screen-time. All children wore an accelerometer to objectively assess outside-school hours moderate- to-vigorous physical activity and sedentary time. BMI was calculated from height and weight measured in 2004 and 2006. Multilevel linear regression analyses were conducted to examine associations between the social environment and BMI. Mediation analyses using the products of coefficient method were conducted to determine whether associations between the social environment and BMI were mediated by the time spent in a range of physical activity and sedentary behaviors.
Results

Cross-sectional and prospective regression analyses showed that a more positive social network and higher social trust/cohesion was related to lower BMI among children. There was no evidence that time spent in physical activity or sedentary behaviors mediated this relation, despite significant associations between social networks and screen-time and between screen-time and BMI.
Conclusions

The findings suggest that the neighborhood social environment may be important for preventing overweight and obesity in children. Further research investigating the mechanisms through which the neighborhood social environment exerts its effect on BMI is needed.

vPELS : An e-learning social environment for VLSI design with content security using DRM

This article provides a proposal for personal e-learning system (vPELS [where 'v' stands for VLSI: very large scale integrated circuit])) architecture in the context of social network environment for VLSI Design. The main objective of vPELS is to develop individual skills on a specific subject - say, VLSI - and share resources with peers. The authors' system architecture defines the organisation and management of the personal learning environment in such a way as to aid in creating, verifying and sharing learning artefacts and making money at the same time. The authors also focus in their research on one of the most interesting arenas in digital content or document management - Digital Rights Management (DRM) - and its application to e-learning.

Safety in numbers: Does perceived safety mediate associations between the neighborhood social environment and physical activity among women living in disadvantaged neighborhoods?

The aim of this study is to examine associations between the neighborhood social environment and leisure-time physical activity (LTPA)(1) and walking among women, and whether these associations are mediated by perceived personal safety.