Jenny Roe

Mitigating Stress and Supporting Health in Deprived Urban Communities: The Importance of Green Space and the Social Environment

Environment-health research has shown significant relationships between the quantity of green space in deprived urban neighbourhoods and people’s stress levels. The focus of this paper is the nature of access to green space (i.e., its quantity or use) necessary before any health benefit is found. It draws on a cross-sectional survey of 406 adults in four communities of high urban deprivation in Scotland, United Kingdom. Self-reported measures of stress and general health were primary outcomes; physical activity and social wellbeing were also measured. A comprehensive, objective measure of green space quantity around each participant’s home was also used, alongside self-report measures of use of local green space. Correlated Component Regression identified the optimal predictors for primary outcome variables in the different communities surveyed. Social isolation and place belonging were the strongest predictors of stress in three out of four communities sampled, and of poor general health in the fourth, least healthy, community. The amount of green space in the neighbourhood, and in particular access to a garden or allotment, were significant predictors of stress. Physical activity, frequency of visits to green space in winter months, and views from the home were predictors of general health. The findings have implications for public health and for planning of green infrastructure, gardens and public open space in urban environments.

Understanding Relationships between Health, Ethnicity, Place and the Role of Urban Green Space in Deprived Urban Communities

Very little is known about how differences in use and perceptions of urban green space impact on the general health of black and minority ethnic (BME) groups. BME groups in the UK suffer from poorer health and a wide range of environmental inequalities that include poorer access to urban green space and poorer quality of green space provision. This study used a household questionnaire (n = 523) to explore the relationship between general health and a range of individual, social and physical environmental predictors in deprived white British and BME groups living in ethnically diverse cities in England. Results from Chi-Squared Automatic Interaction Detection (CHAID) segmentation analyses identified three distinct general health segments in our sample ranging from “very good” health (people of Indian origin), to ”good” health (white British), and ”poor” health (people of African-Caribbean, Bangladeshi, Pakistani origin and other BME groups), labelled ”Mixed BME” in the analyses. Correlated Component Regression analyses explored predictors of general health for each group. Common predictors of general health across all groups were age, disability, and levels of physical activity. However, social and environmental predictors of general health-including use and perceptions of urban green space-varied among the three groups. For white British people, social characteristics of place (i.e., place belonging, levels of neighbourhood trust, loneliness) ranked most highly as predictors of general health, whilst the quality of, access to and the use of urban green space was a significant predictor of general health for the poorest health group only, i.e., in ”Mixed BME”. Results are discussed from the perspective of differences in use and perceptions of urban green space amongst ethnic groups. We conclude that health and recreation policy in the UK needs to give greater attention to the provision of local green space amongst poor BME communities since this can play an important role in helping address the health inequalities experienced by these groups.

The natural outdoors and health: assessing the value and potential contribution of secondary public data sets in the UK to current and future knowledge

UK policy interest in the health effects of the outdoors has grown rapidly in recent years. In parallel, the research communitys effort to strengthen the evidence base for the relationships between the outdoors and health has also increased. However, little has been done to explore quantitative secondary public data sets conducted by government departments and agencies to improve the evidence base on understanding such links. This paper aims to provide an overview of potentially valuable secondary public data sets and to assess their relevance for adding to the existing evidence base on the health effects of the natural outdoors. The search identified 41 data sets dealing with the outdoors/outdoor use, health or both. Review results indicated that, due to their large scale, extensive coverage, and continuous or longitudinal nature, knowledge included in secondary public data sets could be a valuable addition to the current evidence base and provide useful baseline information for future studies. This paper also identifies some aspects of secondary public data which could be improved, establishing a stronger knowledge base for the health effects of the natural outdoors.

Gaze and pupil changes during navigation in age-related macular degeneration

Background The central visual field is particularly affected in age-related macular degeneration (AMD), and this can impinge on a variety of functional tasks, including navigation, which can affect activities of daily living. It has been difficult to assess navigational function under standardised conditions. The aim of this study is to examine gaze function and pupil diameter during navigation in patients with AMD. Methods This study was designed as an observational case–control investigation. 34 patients with AMD and 23 controls were recruited. We simulated a walking journey using video projection and monitored patients using automated eye tracking. Visual acuity, fixation count, fixation duration and pupil diameter were recorded while subjective measurements included recorded voice comments. Results The pupil diameters were significantly greater in the AMD group compared with the control group in both easy and difficult segments of navigation (p=0.002). Fixation counts were significantly higher in the AMD group during difficult segments of navigation (p=0.001). The differences in both pupil diameter and fixation count correlated with subject visual acuity. Conclusions Fixation count is a marker of difficult navigational environments in patients with AMD. The combination of video projection and eye tracking to assess visual navigation function is a useful clinical tool and an adjunct to current investigation tools in AMD intervention studies providing objective clinical measures under standardised settings.

The evaluation of place-keeping: unrealised potential

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Restorative Environments and Promoting Physical Activity Among Older People

This chapter provides an overview of what is known about restorative environments (REs) for older adults. The chapter begins by setting out what constitutes an RE and considering these attributes in relation to the needs of older people. Next, it considers the processes of psychological restoration and how this intersects with physical activity, and the relationship between mood and mobility. Then, it sets out what is known in this research area in relation to, first, healthy older adults and, second, those experiencing cognitive impairment and dementia by RE setting (e.g. the neighbourhood and street context). We conclude with reflections on the potential of restorative environments to promote mobility and psychological well-being in older people.

Seasonal Differences in Light Exposure and the Associations With Health and Well-Being in Older Adults: An Exploratory Study

Objective: This article reports summer verses winter seasonal variations across a suite of blue light, illuminance levels and health and well-being indicators. Background: The quality of lighting in care homes has been assessed previously, yet seasonal comparisons and the associations with sleep quality are limited. This exploratory study investigates light exposure in two seasons to determine the changes over time and the associations with health and well-being. Methods: In a repeated measures design, 16 older people (aged 72–99 years) living in a care home had their personal light exposure and sleep/wake patterns monitored for 4 days. Cognitive ability, mental well-being, daytime physical activity, and visual function were assessed. Mean light levels at preset times across the day, duration in light exposure over 1,000 lux, and sleep parameters were computed. Statistical investigations included correlations exploring associations and paired means tests to detect the changes between seasons. Results: The mean morning illuminance level in summer was 466 lux and 65 lux in winter. Duration in bright light over 1,000 lux was 46 min in summer and 3 min in winter. Light measures were significantly higher in summer. There was no statistical difference in sleep quality parameters between seasons, but there were significant difference in daytime physical activity level (i.e., this was higher in summer). Conclusion: The findings indicate low level of light exposures experienced in both seasons, with exposure levels being particularly low in winter. This provides new insights into the limited amount of light older people receive independent of season and the possible impacts on sleep and daytime physical activity level.

Coping with Stress in Deprived Urban Neighborhoods: What Is the Role of Green Space According to Life Stage?

This study follows previous research showing how green space quantity and contact with nature (via access to gardens/allotments) helps mitigate stress in people living in deprived urban environments (Ward Thompson et al., 2016). However, little is known about how these environments aid stress mitigation nor how stress levels vary in a population experiencing higher than average stress. This study used Latent Class Analysis (LCA) to, first, identify latent health clusters in the same population (n = 406) and, second, to relate health cluster membership to variables of interest, including four hypothetical stress coping scenarios. Results showed a three-cluster model best fit the data, with membership to health clusters differentiated by age, perceived stress, general health, and subjective well-being. The clusters were labeled by the primary health outcome (i.e., perceived stress) and age group (1) Low-stress Youth characterized by ages 16–24; (2) Low-stress Seniors characterized by ages 65+ and (3) High-stress Mid-Age characterized by ages 25–44. Next, LCA identified that health membership was significantly related to four hypothetical stress coping scenarios set in peoples current residential context: “staying at home” and three scenarios set outwith the home, “seeking peace and quiet,” “going for a walk” or “seeking company.” Stress coping in Low stress Youth is characterized by “seeking company” and “going for a walk”; stress coping in Low-stress Seniors and High stress Mid-Age is characterized by “staying at home.” Finally, LCA identified significant relationships between health cluster membership and a range of demographic, other individual and environmental variables including access to, use of and perceptions of local green space. Our study found that the opportunities in the immediate neighborhood for stress reduction vary by age. Stress coping in youth is likely supported by being social and keeping physically active outdoors, including local green space visits. By contrast, local green space appears not to support stress regulation in young-middle aged and older adults, who choose to stay at home. We conclude that it is important to understand the complexities of stress management and the opportunities offered by local green space for stress mitigation by age and other demographic variables, such as gender.