Built environment and elderly population health: a comprehensive literature review

Global population aging over recent years has been linked to poorer health outcomes and higher healthcare expenditure. Policies focusing on healthy aging are currently being developed but a complete understanding of health determinants is needed to guide these efforts. The built environment and other external factors have been added to the International Classification of Functioning as important determinants of health and disability. Although the relationship between the built environment and health has been widely examined in working age adults, research focusing on elderly people is relatively recent. In this review, we provide a comprehensive synthesis of the evidence on the built environment and health in the elderly.

Obesity and diabetes, the built environment, and the ‘local’ food economy in the United States, 2007

Obesity and diabetes are increasingly attributed to environmental factors, however, little attention has been paid to the influence of the ‘local’ food economy. This paper examines the association of measures relating to the built environment and ‘local’ agriculture with U.S. county-level prevalence of obesity and diabetes. Key indicators of the ‘local’ food economy include the density of farmers’ markets and the presence of farms with direct sales. This paper employs a robust regression estimator to account for non-normality of the data and to accommodate outliers. Overall, the built environment is associated with the prevalence of obesity and diabetes and a strong local’ food economy may play an important role in prevention. Results imply considerable scope for community-level interventions.

Objective assessment of the built environment and its relationship to physical activity and obesity

The role of physical activity in the promotion of individual and population health has been well documented in research and policy publications. Significant research activities have produced compelling evidence for the support of the positive association between physical activity and improved health. Despite the knowledge about these public health benefits of physical activity, over half of US adults do not engage in physical activity at levels consistent with public health recommendations. Just as physical inactivity is of significant public health concern in the US, the prevalence of obesity (and its attendant co-morbidities) is also increasing among US adults.^ Research suggests racial and ethnic disparities relevant to physical inactivity and obesity in the US. Various studies have shown more favorable outcomes among non-Hispanic whites when compared to other minority groups as far as physical activity and obesity are concerned. The health disparity issue is especially important because Mexican-Americans who are the fastest growing segment of the US population are disproportionately affected by physical inactivity and obesity by a significant margin (when compared to non-Hispanic whites), so addressing the physical inactivity and obesity issues in this group is of significant public health concern. ^ Although the evidence for health benefits of physical activity is substantial, various research questions remain on the potential motivators for engaging in physical activity. One area of emerging interest is the potential role that the built environment may play in facilitating or inhibiting physical activity.^ In this study, based on an ongoing research project of the Department of Epidemiology at the University of Texas M. D. Anderson Cancer Center, we examined the built environment, measured objectively through the use of geographical information systems (GIS), and its association with physical activity and obesity among a cohort of Mexican- Americans living in Harris County, Texas. The overall study hypothesis was that residing in dense and highly connected neighborhoods with mixed land-use is associated with residents’ increased participation in physical activity and lowered prevalence of obesity. We completed the following specific aims: (1) to generate a land-use profile of the study area and create a “walkability index” measure for each block group within the study area; (2) to compare the level of engagement in physical activity between study participants that reside in high walkability index block groups and those from low walkability block groups; (3) to compare the prevalence of obesity between study participants that reside in high walkability index block groups and those from low walkability block groups. ^ We successfully created the walkability index as a form of objective measure of the built environment for portions of Harris County, Texas. We used a variety of spatial and non-spatial dataset to generate the so called walkability index. We are not aware of previous scholastic work of this kind (construction of walkability index) in the Houston area. Our findings from the assessment of relationships among walkability index, physical activity and obesity suggest the following, that: (1) that attempts to convert people to being walkers through health promotion activities may be much easier in high-walkability neighborhoods, and very hard in low-walkability neighborhoods. Therefore, health promotion activities to get people to be active may require supportive environment, walkable in this case, and may not succeed otherwise; and (2) Overall, among individuals with less education, those in the high walkability index areas may be less obese (extreme) than those in the low walkability area. To the extent that this association can be substantiated, we – public health practitioners, urban designers, and policy experts – we may need to start thinking about ways to “retrofit” existing urban forms to conform to more walkable neighborhoods. Also, in this population especially, there may be the need to focus special attention on those with lower educational attainment.^

The Relationship of Built Environment and Weather with Bike Share –Evidence from the Pronto Bike Share System in Seattle

Thesis (Master's)--University of Washington, 2016-06

Transforming Health: Emerging technology, the built environment and health behaviors

Thesis (Master's)--University of Washington, 2016-06

Human Mobility, Exposure to the Built Environment, and Health

Thesis (Ph.D.)--University of Washington, 2016-06

Coupling 3D visualisation to qualitative assessment of built environment designs

Geographical information systems (GIS) coupled to 3D visualisation technology is an emerging tool for urban planning and landscape design applications. The utility of 3D GIS for realistically visualising the built environment and proposed development scenarios is much advocated in the literature. Planners assess the merits of proposed changes using visual impact assessment (VIA). We have used Arcview GIS and visualisation software: called PolyTRIM from the University of Toronto, Centre for Landscape Research (CLR) to create a 3D scene for the entrance to a University campus. The paper investigates the thesis that to facilitate VIA in planning and design requires not only visualisation, but also a structured evaluation technique (Delphi) to arbitrate the decision-making process. (C) 2001 Elsevier Science B.V. All rights reserved.

Health and the Built Environment, Sources of Information

The Institute of Public Health in Ireland (IPH) has produced a series of reviews which look at the health impacts of identified subject areas. Four reviews have been produced in the areas of employment, transport, the built environment and education. All reviews may be found at http://www.publichealth.ie/ireland/hiaresources. This resource supplements the ‘Health Impacts of Built Environment’ report. It highlights a number of organisations whose work considers issues relevant to the relationship between health and built environment.

Energy policy and standard for built environment in China

Trends in China's energy future will have considerable consequences for both China and the global environment. Though China's carbon emissions are low on a per capita basis, China is already ranked the world's second largest producer of carbon, behind only America. China's buildings sector currently accounts for 23% of China's total energy use and is projected to increase to one-third by 2010. Energy policy plays an important role in China's sustainable development. The purpose of this study is to provide a broad overview of energy efficiency issues in the built environment in China. This paper, firstly briefly, reviews the key national policies related to the built environment and demonstrates the government's environmental concern. Secondly, the authors introduce recent energy policies in the built environment. Energy efficiency and renewable energy in the built environment, which are the key issues of the national energy policy, have been reviewed. Discussion of the implementation of energy policy has been carried out.

Sustainability in the built environment

This introductory chapter sets the scene for the book, providing an overview of sustainability in the built environment. With a bias towards buildings and the urban environment, it illustrates the range of issues that impinge upon global carbon reduction and the mechanisms available to help bring about change. Climate change, and its impact on built environment, is briefly introduced and sustainability in the built environment and associated factors are described. The specific topics relating to sustainable design and management of the built environment, including policy and assessment, planning, energy, water and waste, technology, supply and demand, occupants’ behaviour and management have been highlighted. This chapter emphasises the importance of a systemic approach in delivering a sustainable built environment.

The assessment of change in rural landscape and the analysis of the driving forces. Proposal of a spatial model for the rural built environment

The presented study carried out an analysis on rural landscape changes. In particular the study focuses on the understanding of driving forces acting on the rural built environment using a statistical spatial model implemented through GIS techniques. It is well known that the study of landscape changes is essential for a conscious decision making in land planning. From a bibliography review results a general lack of studies dealing with the modeling of rural built environment and hence a theoretical modelling approach for such purpose is needed. The advancement in technology and modernity in building construction and agriculture have gradually changed the rural built environment. In addition, the phenomenon of urbanization of a determined the construction of new volumes that occurred beside abandoned or derelict rural buildings. Consequently there are two types of transformation dynamics affecting mainly the rural built environment that can be observed: the conversion of rural buildings and the increasing of building numbers. It is the specific aim of the presented study to propose a methodology for the development of a spatial model that allows the identification of driving forces that acted on the behaviours of the building allocation. In fact one of the most concerning dynamic nowadays is related to an irrational expansion of buildings sprawl across landscape. The proposed methodology is composed by some conceptual steps that cover different aspects related to the development of a spatial model: the selection of a response variable that better describe the phenomenon under study, the identification of possible driving forces, the sampling methodology concerning the collection of data, the most suitable algorithm to be adopted in relation to statistical theory and method used, the calibration process and evaluation of the model. A different combination of factors in various parts of the territory generated favourable or less favourable conditions for the building allocation and the existence of buildings represents the evidence of such optimum. Conversely the absence of buildings expresses a combination of agents which is not suitable for building allocation. Presence or absence of buildings can be adopted as indicators of such driving conditions, since they represent the expression of the action of driving forces in the land suitability sorting process. The existence of correlation between site selection and hypothetical driving forces, evaluated by means of modeling techniques, provides an evidence of which driving forces are involved in the allocation dynamic and an insight on their level of influence into the process. GIS software by means of spatial analysis tools allows to associate the concept of presence and absence with point futures generating a point process. Presence or absence of buildings at some site locations represent the expression of these driving factors interaction. In case of presences, points represent locations of real existing buildings, conversely absences represent locations were buildings are not existent and so they are generated by a stochastic mechanism. Possible driving forces are selected and the existence of a causal relationship with building allocations is assessed through a spatial model. The adoption of empirical statistical models provides a mechanism for the explanatory variable analysis and for the identification of key driving variables behind the site selection process for new building allocation. The model developed by following the methodology is applied to a case study to test the validity of the methodology. In particular the study area for the testing of the methodology is represented by the New District of Imola characterized by a prevailing agricultural production vocation and were transformation dynamic intensively occurred. The development of the model involved the identification of predictive variables (related to geomorphologic, socio-economic, structural and infrastructural systems of landscape) capable of representing the driving forces responsible for landscape changes.. The calibration of the model is carried out referring to spatial data regarding the periurban and rural area of the study area within the 1975-2005 time period by means of Generalised linear model. The resulting output from the model fit is continuous grid surface where cells assume values ranged from 0 to 1 of probability of building occurrences along the rural and periurban area of the study area. Hence the response variable assesses the changes in the rural built environment occurred in such time interval and is correlated to the selected explanatory variables by means of a generalized linear model using logistic regression. Comparing the probability map obtained from the model to the actual rural building distribution in 2005, the interpretation capability of the model can be evaluated. The proposed model can be also applied to the interpretation of trends which occurred in other study areas, and also referring to different time intervals, depending on the availability of data. The use of suitable data in terms of time, information, and spatial resolution and the costs related to data acquisition, pre-processing, and survey are among the most critical aspects of model implementation. Future in-depth studies can focus on using the proposed model to predict short/medium-range future scenarios for the rural built environment distribution in the study area. In order to predict future scenarios it is necessary to assume that the driving forces do not change and that their levels of influence within the model are not far from those assessed for the time interval used for the calibration.

Zoning and the built environment: A public health analysis of zoning in Austin, Texas

The built environment is part of the physical environment made by people and for people. Because the built environment is such a ubiquitous component of the environment, it acts as an important pathway in determining health outcomes. Zoning, a type of urban planning policy, is one of the most important mechanisms connecting the built environment to public health. This policy analysis research paper explores how zoning regulations in Austin, Texas promote or prohibit the development of a healthy built environment. A systematic literature review was obtained from Active Living Research, which contained literature published about the relationships between the built environment, physical activity, and health. The results of these studies identified the following four components of the built environment that were associated to health: access to recreational facilities, sprawl and residential density, land use mix, and sidewalks and their walkability. A hierarchy analysis was then performed to demonstrate the association between these aspects of the built environment and health outcomes such as obesity, cardiovascular disease, and general health. Once these associations had been established, the components of the built environment were adapted into the evaluation criteria used to conduct a public health analysis of Austin's zoning ordinance. A total of eighty-eight regulations were identified to be related to these components and their varying associations to human health. Eight regulations were projected to have a negative association to health, three would have both a positive and negative association simultaneously, and nine were indeterminable with the information obtained through the literature review. The remaining sixty-eight regulations were projected to be associated in a beneficial manner to human health. Therefore, it was concluded that Austin's zoning ordinance would have an overwhelmingly positive impact on the public's health based on identified associations between the built environment and health outcomes.^

The relationship between physical activity and perceived built environment factors among adult Mexican Americans living in Brownsville, Texas

Background. Physical Activity (PA) is a central part in the fight to reduce obesity rates that are higher in Mexican Americans in the United States than any other ethnic groups. More than half of all Americans do not meet the daily PA recommendations and 48% of Mexican Americans do not exercise. The built environment is believed to affect participation in physical activity. The influence of the built environmental on physical activity levels in low-income Mexican Americans living along the Texas-Mexico border has not been investigated. ^ Purpose. The purpose of this secondary data analysis was trifold: (1) to determine the levels of self-reported PA in adults living in Brownsville, Texas; (2) to characterize the perceptions of this population regarding the built environment; and (3) to determine the association between self-reported PA and the built environment in Mexican Americans living in Brownsville, Texas. ^ Methods. 400 participants from the Tu Salud ¡Sí Cuenta! (TSSC) community-wide campaign were included in this secondary data analysis. Percentages for level of physical activity and the built environment were calculated using SPSS. Perceptions of the built environment were assessed by 14 items. Logistic regression analysis was used to assess the relationship between physical activity and built environment. All models were adjusted for age, gender, and level of education. ^ Results. The majority of men (41.97%) and women (59%), combined (56.7%)did not meet the 2008 PA Guidelines for Americans. We analyzed 14 built environment variables to characterize participants’ perceptions of the built environment. We conducted odds ratio (OR) to find if those who met PA levels associated the built environment such as neighborhood shops ([OR:1.806], CI:1.074,3.038 ]) bus stops ([OR:1.436], CI:.806,2.558) unattended stray dogs ([OR: 1.806], CI:1. 074,3.038), sidewalk access ([OR: .858],CI:.437,1.686), access to free parks ([OR:.549],CI:.335,.900) heavy traffic in neighborhood ([OR:.802], CI:.501,1.285), crime rate ([OR:.779], CI:.494,1.228) ranked the highest by mean score. The association between physical activity and the perceived built environment factors for Mexican Americans participating in the TSSCStudy were weakly associated. ^ Conclusions. This study provides evidence that PA levels are low in this Mexican American population. The built environment factors assessed in this study characterized the need for further studies of the variables that are seen as important to the Mexican American population. Lastly, the association of PA levels to the built environment was weak overall and further studies are recommended of the built environment.^