The socio ecological model states that individual behaviors at work are shaped by the interactions between individual employees and their work environments. This study used citizen science to gain insights into which elements of the built, social, and organizational environment in an office and surrounding neighborhoods in two Swedish cities were perceived as barriers to or facilitators of healthy and sustainable behaviors at work. Participants in the eight-week Sustainable Office Intervention pilot study (SOFIA) (n = 33) were cluster-randomized into an experimental arm (sustainable lifestyle) or a control intervention arm (healthy lifestyle). They used the Our Voice Healthy Neighborhood Discovery Tool mobile app to document contextual elements at their workplaces. In total, 114 photos and text-based narratives were recorded, and four themes emerged: built environment, building design, office ergonomics, and food and beverages. Eighteen percent of the photos were linked to pro-environmental behaviors, all exclusively captured by the experimental arm. Twelve barriers and solutions for improving the workplace environment were identified during discussions with participants in both arms. The findings provide insights for designing or renovating office spaces and urban planning to promote healthier and more sustainable lifestyles for office workers.

Neighborhood socioeconomic marginalization and racial residential segregation are associated with differential health outcomes in adulthood and pregnancy, but the intergenerational effects of these exposures on early childhood growth are underexplored. Our objective was to investigate racial and ethnic differences in the association between neighborhood deprivation and early childhood growth trajectories, with modification by neighborhood racial concentration.

Poor health is a key reason for early exit from the labour market. Few studies have explored how the health of local populations is related to occupational differences in employment outcomes among older people. Our study used data for England and Wales from the ONS Longitudinal Study linked with 2001 Census measures of the health of the older working age population at local authority level. We included 128,710 people aged 40-64y in 2001 who were in paid work in the previous five years. We investigated the associations of both occupation and area level with two employment outcomes ten years later (in 2011): i) in paid work or not; ii) economic activity (employed (reference), unemployed, retired, sick/disabled, other). People in elementary occupations were more likely to not be in paid work in 2011 compared to those in managerial occupations (RRR 1·55 [95%CI 1·47,1·64]). Compared to the healthiest third of local authority areas, being resident in the unhealthiest third was associated with greater likelihood of not being in paid employment ten years later (RRR 1·25 [95% CI 1·18,1·33]). While area level health was associated with employment outcomes for all major occupation groups, the gap between the healthiest and unhealthiest areas was most marked for skilled trades; process, plant and machine operatives; and elementary occupations. Occupational differences for the economic activity outcome were most marked for the sick/disabled category. Policies to improve the health of local populations may support retention and reduce occupational inequalities in employment rates of older workers.

Worldwide, the number and proportion of people living in cities continue to grow. Building new districts creates opportunities for designing urban environments that promote the health of their residents from the get-go. In this study, we used the photovoice methodology to explore the perspectives of adolescents on health and well-being in a new urban development area in Munich, Germany. Eleven adolescents aged 13-19 years were recruited in the new residential development area of Freiham on the Southwestern outskirts of Munich. Participants were given ten days to take photographs in the study area, focusing on objects or sceneries they considered to be important for their health. We then conducted qualitative interviews related to these photographs. Interviews were transcribed verbatim and analyzed using thematic analysis. We identified eight recurring themes: emotional well-being, meeting peers, being physically active, growing as a person, safety, waste, development of the urban environment, aesthetics of the urban environment. Adolescents highlighted aspects of mental and social health when assessing the urban environment. Interacting with other young people was an important reason for our participants to visit public places. Public health professionals and urban planners should consider the specific needs of this age group when building new urban areas, and especially provide safe and clean public spaces that adolescents can use for recreation and social interactions.

Understanding the interplay between people's daily sleep and physical activity and how geographic environment influences them are important for developing healthy cities. However, such research has been limited. This study aims to explore the bidirectional and nonlinear relationship between daily sleep and physical activity, and further investigate the comprehensive influences of multi-dimensional geographic environment on these health behaviors. Based on the objective data on sleep and physical activity over seven consecutive days using wrist-based accelerometers in Beijing, China, we developed a series of models to analyze the mutual influences between people's daily sleep and physical activity, and employed the generalized additive model (GAM) to examine their potential nonlinear relationships and how geographic environment - including meteorological conditions, built environment, and social environment - influences them. The results show that sleep and physical activity exhibit notable bidirectional relationship. Moderate-to-vigorous physical activity (MVPA) is observed to improve sleep quality, but it decreases sleep duration. In contrast, total sleep time (TST) exhibits an inverted U-shaped pattern with both MVPA and total step counts, with the optimal sleep duration at 5 h. Furthermore, meteorological factors, built environment characteristics, and social environment have significant linear or nonlinear effects on people's daily sleep and physical activity. The outcomes of this study offer valuable insights for enhancing residents' health and developing healthy cities.

While many studies focus on urban areas, it's vital to understand health-related behaviours in rural communities. This paper aims to explore the factors that influence dietary habits and physical activity from the perspective of men and women of different ethnic groups living in a hard-to-reach rural area in Ecuador. We conducted 5 focus groups with 37 participants (26 women) from diverse cultural and ethnic backgrounds in marginalized communities in Esmeraldas. The thematic analysis showed environment and culture shape dietary habits and physical activity, influenced by taste preferences, economic factors, and societal norms, with gender roles and beauty standards playing significant roles.

The targeted marketing of unhealthy food and beverages to vulnerable populations, particularly children and adolescents in lower-income communities, is pervasive and coincides with increased non-communicable disease (NCD) rates. This study examined the extent of food and beverage advertising surrounding schools in three townships in Cape Town, South Africa: Gugulethu, Nyanga, and Kensington.

Few studies have explored variability of associations between greenspace and cardiovascular (CVD) mortality according to demographic or neighborhood contextual factors. We estimated overall and sex-stratified associations between greenspace and CVD mortality rates in Philadelphia, PA, and quantified effect modification of the sex-stratified associations by neighborhood violent crime rates. Sex- and age-stratified census tract CVD mortality rates (years 2008-2015) were linked with proportion tree canopy cover, grass/shrub cover, and total vegetation cover, and proportion of adult residents reporting access to a park. We used multivariable negative binomial models to estimate overall and sex-stratified associations between neighborhood greenspace and CVD mortality rates, and quantified effect modification by tract-level rates of violent crime. Higher proportion tree canopy cover and higher proportion adults reporting access to parks were associated with modestly lower rates of CVD mortality, with more pronounced estimates in males than females. In tracts with higher rates of crime, higher tree canopy coverage and perceived park access were associated with lower CVD mortality rates. We did not observe strong evidence of sex-based differences in interaction between neighborhood crime rates and greenspace. Results from this study reveal variability of associations between greenspace and CVD mortality rates according to sex categories, and according to neighborhood social environments. There is a need for further research exploring the extent to which differences in perceived safety explain gender-based differences in associations between greenspace and cardiovascular outcomes.

The link between the built environment and physical activity (PA) has received substantial research attention in health geography and public health studies. Limited research efforts have been spent to investigate if the link would be different for people with or without obesity, and prior studies often overlook potential nonlinear associations. Knowledge of such potential differences will be essential for developing tailor-made urban planning or spatial policies to promote physical activities and health for different population groups. This study aims to address this research gap by exploring the nonlinear relationships between the built environment and PA engagement for people with normal weight, overweight, and obesity. Data are derived from a two-day household activity-travel diary survey conducted in 2018 in Shanghai, China. Using gradient boosting decision tree models, this study found distinct influences of the built environment on total PA duration and active PA for different weight status groups. Residents with obesity tend to have a shorter total PA duration and a lower rate of participating in active PA. By comparing the model results, it shows that the impact of the built environment on active PA is larger than that on the total PA duration for all three weight groups, and this increase is more pronounced for the obesity group. Population density, public transit, and land use mix are the three key built environment variables that exert nonlinear effects on PA engagement across all weight groups, with variations in trend and threshold values between groups. This research presents new insights into the relationship between the built environment and physical activities, which are relevant for promoting physical activities among people with different weight statuses.

Online food delivery platforms are an emerging but poorly understood aspect of food retail environments. We collected data via web scraping methods from the two leading online food delivery platforms in Victoria, Australia, identifying 11,154 food outlets from Menulog, and 12,939 from Uber Eats (with 21,733 unique outlets available across both platforms). Outlets were classified according to their healthiness using a tool developed with Australian dietitians and public health nutritionists, and assigned a food environment score. Area level (suburb/neighbourhood) socioeconomic disadvantage was determined using the Socio-Economic Indexes for Areas Index of Relative Socio-economic Disadvantage, and relative remoteness was determined using both the Accessibility/Remoteness Index of Australia and the Modified Monash Model. Across both food delivery platforms, approximately 15% of food outlets were classified as "unhealthy", 82% were classified as "less healthy", and 3% were classified as "healthy". More food outlets were available in areas of socioeconomic advantage, and in metropolitan areas. Food environment scores indicated that unhealthy outlets were significantly more available in areas with higher socioeconomic disadvantage and greater relative remoteness. Disparities in the healthiness of food outlets available through online food delivery platforms may have a negative influence on the purchasing and dietary behaviours of residents in these areas, thereby widening diet related health inequalities. Further research is required to understand the potential influence of online food delivery platforms on inequities in population diets and health.

Researchers and policymakers have used a four-pillar framework- condition, consistency, context, and cost-to describe the characteristics of housing that are important for health equity. We propose adding a fifth pillar: care and connection. Housing for care and connection refers to the housing design, institutional policies, and housing programs that strengthen social connections, caregiving relationships, access to resources, and a sense of self in community. Attending to these needs in housing is especially important for people who are in transition in and out of homelessness, living in poverty, are very young or very old, or living with a disability or activity limitation.

This article explores aquatic engagements - particularly the practice of therapeutic sea bathing - in Goa, a coastal state in India. Goa accommodates a number of natural water bodies and residents engage with them in various ways, including by participating in sea bathing and swimming activities. This article uses the practice of sea bathing as a departure point to examine embodied aquatic engagements among women in Goa. It situates these practices within broader constraints imposed by structural and material restrictions while simultaneously showing how these embodied aquatic engagements create an inclusive space that offers new ways of thinking about well-being. The article argues that multiple framings of sea bathing provide a lens through which to understand the diverse domains that constitute well-being in India. In doing so, this article provides novel insights on the relationship between blue spaces and well-being.

Mental health continues to be a growing crisis for children, adolescents, and young adults. Yet, increasing trends in subgroups are not uniform, and key differences exist across geographic, racial, and age groups. Few studies examine structural factors like economic and racial inequality, important upstream structural inequities that impact mental health. This study examines the association between individual drivers and structural factors like neighborhood privilege and youth mental health (i.e., depression, schizophrenia, suicide ideation, anxiety) and associated racial and ethnic disparities. Data on mental health were obtained from psychiatric emergency department (ED) visits for the state of North Carolina from 2012 to 2021 for residents under age 24. Multilevel logistic regressions were employed to examine trends and drivers of psychiatric ED visits compared to non-psychiatric ED visits. Results show an increase in psychiatric ED visits from 2012 to 2021 across all races and ethnicities. Although white youth represent the majority of psychiatric ED visits, increasing trends among minorities, including Black and Hispanic youth, were notable, particularly for severe mental health conditions like schizophrenia and suicide-related outcomes and for urban neighborhoods with greater segregation. Findings underscore the need for policies addressing economic and racial inequalities at the neighborhood level to mitigate youth mental health disparities.

This study investigated (i) the social and political factors driving risk averse decision making for children's physically active play in schools, and (ii) the policies shaping these decisions in Victoria, Australia. A theory-informed multi-method case study design combined policy document mapping, semi-structured interviews, and photo elicitation with 30 education policy actors. Data were analysed using reflexive thematic analysis. Findings showed the policy landscape was heavily skewed towards managing risk and safety (84%; n = 42), with fewer, mostly optional, policies for promoting physical activity, and a lack of policy to promote or protect play. Thematic findings indicated an intersecting range of factors in this setting (including occupational health and safety, knowledge and skill gaps, parent factors, children's physical capabilities, an undervaluing of play) can deter schools from providing an environment that enables children's freely chosen, physically active play. Multi-faceted, systems-based approaches that go beyond interventions aimed at individual behaviour change are needed.

The nutrition transition underway in South Asia is likely mediated by changes to the food environment. Yet, few studies have been conducted in rural areas of South Asia to describe how the food environment has changed.

Travel time to health facilities is one of the most important factors in evaluating health disparity. Previous extensive research has primarily leveraged the driving time to the nearest health facility to gauge travel time. However, such ideal travel time (ITT) may not accurately represent real individual travel time to health services and is often underestimated. This study aims to systematically understand such gaps by comparing ITT to actual travel time (ATT) derived from smartphone-based human mobility data and further identifying how various population groups across regions are most likely to be affected. This study takes mental health as an example and compares ATT with ITT to mental health facilities. Results indicate that ITT and ATT demonstrate significant disparities between urban and rural areas. ITT is consistently underestimated across the contiguous US. We compare travel times among diverse sociodemographic groups across eight geographical regions. The findings suggest that different age groups have similar travel times to mental health facilities. However, racial groups exhibit varied travel times. Hispanics have a larger percentage of the population experiencing longer ATT than ITT. We also employed spatial and non-spatial regression models, such as Ordinary Least Squares, Spatial Lag Model, and Spatial Error Model, to quantify the correlation between travel times and socioeconomic status. The results revealed that the proportion of older adults and high school dropouts positively correlates with travel times in most regions. Areas with more non-Hispanics show positive correlations with both travel times. Overall, this study reveals pronounced discrepancies between ITT and ATT, underscoring the importance of using smartphone-derived ATT to measure health accessibility.

Researchers performed a hybrid inductive-deductive thematic analysis of 25 individual interviews to explore factors influencing healthcare utilization in rural Missouri. Data indicated that a desire for self-sufficiency, preference for natural interventions, and poor perception of rural healthcare quality may deter healthcare utilization. Influential subjective norms included respect for toughness and resilience, conservative approach to healthcare, view of the body as an instrument, and influence of faith and religion. Financial barriers and lack of accessible healthcare options were noted as key structural obstacles. Findings emphasize the importance of individual, cultural, and structural factors in shaping healthcare utilization in underserved communities.

The examination of hospice settings from the position of space and place is an emerging area of academic interest. Engaging with this perspective, this paper explores how topophilia and topophobia of the physical hospice setting coincides with and informs a broader love and fear of hospice care and UK hospice organisations. We report the findings of a qualitative study of 53 participants in the catchment population of a hospice in England. The coexistence of topophilia and topophobia of hospice is argued to have potential implications for equitable access to hospice care and may both facilitate and hinder efforts towards patient education and service improvement.

Two hours of travel time specified by the World Health Organization (WHO) to access quality health services is among the most important criteria for the Universal Health Coverage. However, locations of health facilities (HF) in many developing countries fail to realise this target due to a lack of appropriate models considering the local environment. This work used the central-place theory to explore locations of HF in Kishapu and their accessibility status based on two means of transport in the AccessMod tool: walking only and the combination of walking-and-motor devices. The results of the walking scenario indicated that the travel times to the health centres and hospitals exceeded 2 h, and a direct relationship existed between the facility level and the travel time spent to access it. The combined transport (walking and motorized) showed that dispensaries are easily accessible (14.5 min) compared to health centres (42.8 min) and hospitals (67.3 min). To address the challenge, we have developed a model revealing optimal sites with quick access for HF construction and improvement using Multi-Criteria-Evaluation and Analytical-Hierarchy Process methods weighting five criteria including distance from settlements (44% weight), roads (26% weight), existing health facilities (16% weight), rivers (9% weight) and railway (5% weight). A test of the model with both means of transport shows that at all places proposed to be optimal allow patitents to travel in less than 2 h, indicating that the proposed model can effectively and efficiently solve the challenge of allocating HF in society.

Despite the multifaceted and diverse challenges that refugees, migrants, and asylum-seekers experience when entering a new country, they remain notably underrepresented in the evaluation and understanding of the health and wellbeing impacts of outdoor health interventions. We addressed this knowledge gap by a mixed-methods evaluation (questionnaires, focus groups and photo elicitation activity) facilitated by a community researcher. Qualitative data (focus groups and photo elicitation activity) revealed that the participants saw the social component of outdoor activities as a critical factor in improving their wellbeing, an insight not captured by established quantitative wellbeing scales. Given the diverse backgrounds of refugee, migrant, and asylum-seeker populations, we underline the importance of a transdisciplinary, collaborative, and mixed-methods research approach.