All posts by pearcej1

Food environments around schools: what historical data might reveal about current obesity patterns

Life course, environments & health

We know that factors throughout life influence our health and well-being in older age. Childhood poverty, early life education, difficult life events and many other factors have been shown to be strongly related to subsequent health outcomes. Yet almost all of this work has focused on our individual circumstances, and there have been few attempts to consider whether a wider set of factors – such as those at the community or neighbourhood level – affect our health over the life course. This is perhaps a surprise given the evidence that features of our local environment – such as air pollution, green space, and high numbers of retailers selling fast food, alcohol or cigarettes – are often associated with current health status. If these factors are causally related to health then there may be a number of policy opportunities (e.g. see our recent post on alcohol retail licensing). Continue reading Food environments around schools: what historical data might reveal about current obesity patterns

Watch CRESH seminar on YouTube: Why is urban health so unequal?

Why is urban health so unequal?

CRESH member Prof Jamie Pearce recently contributed to an event jointly organised by the  Global Environment and Society Academy (GESA) and the Global Health Academy to deliver a public seminar series exploring the complex relationships between environment and health.  The seminar series marks The Year of  Environment and Health and will examine key issues such as urbanisation, population growth, extreme weather, pollution and  ecosystem services through the lens of global environmental change. You can watch the public lecture here:

 

Can we develop a ‘life course’ of place to understand spatial inequalities in health?

There has been a great deal of recent interest amongst social scientists and public health researchers on the multitude of social, economic and cultural factors that operate across the life course to affect our health.  Life course perspectives have helped us to appreciate that socioeconomic status and health in older age are not independent of social and economic inequalities earlier in life.  Two related pathways are possible. First, social and economic factors accumulate over our lives and this accrual is associated with health later in life. Second, negative socioeconomic exposures early in life influence our social trajectory, in turn affecting health; in other words the playing field in early life is uneven and this helps to establish subsequent health inequalities.

Given that life course perspectives have been so useful it is perhaps surprising that those of us with interests in ‘place’ or the ‘environment’ and health have rarely taken a life course perspective. Place-based factors early in life as well as cumulative exposure to the environment over the life course may well be important for subsequent health. Yet this assertion has rarely been tested despite the possibilities that these approaches offer for enhancing our understanding of health-environment relations. Longitudinal studies of health and the environment have almost exclusively focused on area-level social disadvantage (e.g. using historical census data) and the cumulative effects on health of living in a low income area.

Of course many aspects of the environment have been implicated in explaining health outcomes so why is it that there have been so few studies examining the health implications of a broad set of environmental characteristics over the life course? The likely answer to this question is that we have been put off by the difficultly of the task!  It is rare that neighbourhood-level historical information for multiple points in time (e.g. green spaces, local infrastructure, housing quality etc.) is readily available. Even when geographical information is obtainable it is often in an inconvenient form (e.g. a paper map or buried in an archive) or incompatible with social and health information on individuals over the life courses.

Current work at CRESH is exploring the feasibility of developing a ‘life course of places’. We are examining whether we can develop a heuristic for measuring a range of ‘health-related’ neighbourhood measures across the Lothian region of Scotland at various time points over the past 80 years.  We are considering the suitability of a range of available data sources including past censuses, historical maps, aerial photography and historical land use information. Of course the environmental characteristics will have a plausible link to health and may include local green space, population and housing density, street connectivity, local destinations, air pollution, availability of services, public space and transport links.  We are developing the measures with a view to combining the data with cohort information relating to individuals born in the Lothian region.

If we are successful in our work, then this study promises to provide some new perspectives on understanding the role of place in explaining health outcomes in later life. Watch this space to follow our progress….

 Jamie Pearce, February 2013

ESRC-Scottish Government/ Forestry Commission Scotland Studentship

ESRC-Scottish Government/ Forestry Commission Scotland Studentship – NOW AVAILABLE!

Designing and managing forests for health

Applications are sought from suitably qualified candidates for a joint ESRC-Scottish Government PhD three-year (‘+3’) studentship. The project entitled ‘Designing and ManagingForests for Health’ has been developed in collaboration with the Forestry Commission Scotland and seeks to examine the links between forestry and community health across Scotland.

The successful candidate will be based in the Centre for Research on Environment, Society and Health (CRESH) in the School of GeoSciences, University of Edinburgh. They will also be active members of the university’s OPENspace Research Centre and the Human Geography Research Group.

www.cresh.org.uk

www.openspace.eca.ac.uk

www.ed.ac.uk/schools-departments/geosciences/research/human-geography/overview

Applications will be particularly welcome from candidates with a social science / environmental background (e.g. geography, landscape architecture, sociology, environmental science), and quantitative methods will be emphasised in project and training plans. Applicants must have a Masters degree or equivalent in an appropriate field. A working knowledge in GIS would be advantageous.

Start Date: Available from January 2013

Applicants should submit the following documentation through the University of Edinburgh online system:

– A recent CV

– A cover letter explaining their interest in the project.

– A completed Equal Opportunities Monitoring form (available here for download)

The deadline for submission is 17th December 2012. Interviews will take place during January 2013.

Applicants may discuss the project with any member of the supervisory team: Professor Jamie Pearce (jamie.pearce@ed.ac.uk), Professor Catharine Ward Thompson (c.ward-thompson@ed.ac.uk) or Dr Niamh Shortt (niamh.shortt@ed.ac.uk).

Outline of Research

The international evidence suggests that exposure to ‘green’ environments (including forests) is associated with health benefits, including lower mortality rates, blood pressure and obesity levels as well as better self-perceived health. Further, previous studies suggest that the availability of green space may reduce health inequalities. Three key mechanisms have been implicated in explaining the green space and health associations. First, green space provides opportunities for physical activity (PA), and increased PA levels are associated with reduced risks of physical and mental illnesses.  Second, green space facilitates social contacts, for example through providing opportunities to meet others or participate in group activities. Third, exposure (physical and visual contact) to green space can promote recovery from attention fatigue and stress, and stress has been implicated in the aetiology of common chronic physical and mental illnesses.

Despite the volume of conceptual and empirical work on green space and health, important gaps in the knowledge base remain.  In particular, it is unclear whether different types of green environments (e.g. parkland, coastal areas and woodland) have differential effects on health. This research gap has left policy makers bereft of insights into which greening interventions are likely to result in the maximum benefits for health and well-being, and address health inequalities. The focus of this study is on forestry and population-level health. The aims of the research are to: (1) evaluate the literature considering the relationships between forestry (and other forms of green spaces) and health; (2) develop a health related forest classification for Scotland to inform a spatial strategy for the health-centred management of woodlands; (3) examine links between forestry and community health across Scotland; (4) develop a ranked profile of communities with ‘good’ or ‘bad’ forestry-related health outcomes with a view to developing a needs appraisal; (5) contribute to the knowledge base supporting a spatial strategy regarding the range and level of wellbeing benefits that can be expected from forestry.

Working in close collaboration with the Forestry Commission, this project will provide new insights into the relationship between forestry and health in Scotland. It will also deliver new GIS products to compliment the ongoing work in the Commission’s GIS system (SIFT). The project also supports the Commission and the Scottish Government work priorities including the Scottish Forest Strategy (particularly Key Theme 5 ‘Access and Health’) and numerous Scottish Government priorities (e.g. four national outcomes: tackling inequalities; securing longer and healthier lives; delivering sustainable places and valuing our natural environment).

CRESH Seminar 6th Nov: Air Pollution Kills! So What? Air Quality Engineering to Improve Public Health

CRESH Seminar Announcement

Air Pollution Kills! So What? Air Quality Engineering to Improve Public Health

Julian Marshall

Department of Civil Engineering

University of Minnesota

When? 11-12pm Tues 6th November

Where? Hutton Room (3.18), Institute of Geography, Drummond St, Edinburgh

Abstract
The World Health Organization estimates that urban air pollution is one of the top 15 causes of death globally (one of the top 10 causes in high-income countries), responsible for ~ 1.7% of deaths annual (high-income countries, 2.1%). How can we reduce those health effects? This presentation will discuss three investigations into that question. (1) Urban form describes the physical layout of an urban area – for example, city shape, population density, and “patchiness” of urban growth. We have found that air pollution is related to urban form, for cities in the US and internationally, raising the question of whether urban planning can help cities meet air quality goals. (2) In low-income countries, indoor air can be especially polluted, owing to combustion of solid fuels for heating and cooking. In a rural village in Karnataka, India, we conducted a randomized control trial of a higher-efficiency stove, to test whether the stove improves indoor air pollution, health effects, and climate-relevant emissions. (3) Prior research emphasizes the health benefits of active travel (walking, biking). Can urban planning increase active travel without worsening exposure to air pollution? We explore spatial patterns in risks from those two factors (physical inactivity; and exposure to air pollution). A constant theme through these topics is environmental justice: which groups have higher exposures to air pollution, and how exposure correlates with demographic attributes such as race and income.

 

 

16th Emerging New Researchers in the Geographies of Health & Impairment (ENRGHI) conference

ENRGHI 2012

The 16th Emerging New Researchers in the Geographies of Health & Impairment (ENRGHI) conference took place in London at the beginning of September, jointly organised by University College London and Queen Mary’s University College London.

ENRGHI is a conference run for and by post graduate and early career researchers and provides an innovative and supportive forum for presenting and sharing ideas.  The conference consisted of two days of posters and presentations, as well as opportunities for networking, socialising and a careers Q&A session.

CRESH PhD student Anna Kenyon presented on the socio-spatial distribution of environments that are likely to support walking throughout urban Scotland, concluding that there is little evidence of inequality in the distribution of good walking environments in relation to area deprivation.

The talk sparked debate about which features of urban environments are the most important to include in measures of area walkability. This led to a wider discussion about the balance, when measuring environmental determinants of health behaviours, between the benefits of using a large study area, such as urban Scotland, and the inevitable technical constraints this places on the specificity of measures used.

Other delegates made presentations on a diverse range of topics and attendees voted for the presentation they thought was the best.  Topics of the winning presentations were: Women’s detention and mental health, Environmental and socio economic factors associated with leishmaniasis outbreaks in Saudi Arabia, and Inequalities in the provision of treatment for chronic kidney disease in the UK.

Dr. Maurzio Gibin (Birkbeck University of London) gave a plenary speech on geovisualisation techniques and presenting geographic data to non-expert audiences as well as ingenious methods of presenting geographic data.  Prof. Steve Cummins (Queen Mary University of London) presented on the benefits of using of natural experiments in geography.  Prizes for the best three delegate presentations were presented by Dr Jim Dunn, deputy editor of the Journal of Epidemiology and Community Health.

Postgraduates and postdoctoral researchers travelled from countries including Canada, France, Australia and the Netherlands as well as throughout the UK to attend the conference.

Details of the next ENRGHI conference as well as including photos of the event, posters and prizes from this year can be viewed on the ENRGHI website: http://enrghi2012.wordpress.com/

 

Anna Kenyon

October 2012

Stigma, environments and health inequalities: why should we be interested?

In recent years there has been a great deal of interest amongst health researchers in the role of social stigma in affecting health. Social stigma can be articulated as a majority view that works to spoil the identity of others on the basis of a discriminating characteristic such as race, gender or class. The social stigma associated with some minority groups has been shown to have health salience in terms of providing an obstacle to gaining access health care, housing provision, welfare, employment and other underlying factors affecting health. Groups that have been the subjects of research include disabled, homeless and itinerant populations and this body of work has revealed the multitude of interpersonal and institutional factors linking discrimination with health. Stigma has also been adopted as a deliberate strategy in health promotion initiatives, most notably in tobacco control with recent work beginning to question whether the denormalisation and stigmatisation of smoking (and the smoker) has reached its limit as a public health goal.

Given the long tradition of work on stigma and health, and the importance of stigma for establishing and perpetuating health inequalities, it is perhaps surprising that few researchers have considered the potential significance of place and the environment in establishing, perpetuating and mediating social stigma. In a recent commentary* on a Japanese paper on place-based discrimination published in the journal Social Science and Medicine, I argue that geographers (and others with interests in place, space and health) could productively consider the role of spatial stigma in affecting the health of local residents. Spatial stigma arises in places with notoriety in the public discourse, and that are constructed as ‘no-go zones’ or ‘sink estates’ that require constant policing.  Neighbourhoods such as Toxteth in Liverpool, South Central in Los Angeles or the French banlieues have for instance been prejudiced by deep-rooted geographical discrimination.  Key to the argument in the commentary is that there are a range of consequences for population health of residing in a highly stigmatised community. Yet very few empirical studies have tested the salience of spatial stigma in affecting population health.

So why should researchers with interests in the environment and spatial inequalities in health be concerned with place-based stigma? In the Social Science and Medicine commentary, I suggest that health might be compromised by spatial stigma through a series of (non-mutually exclusive) individualised and institutional pathways, which in turn can exacerbate geographical inequalities in health. These include:

1. Being ‘looked down on’ because of residing in a stigmatised community can detrimentally affect a number of life chances such as education and training opportunities, employment prospects and the prospects of developing interpersonal relationships. These factors have all been implicated in studies of health.

2. Stigma relating to particular places may act as ‘badge of dishonour’ that results in local residents taking actions such as concealing their address, avoiding receiving visitors or providing excuses to others for where they live. These feelings of shame can work to spoil, manipulate and mediate individual identities and social relations and affect health (e.g. health behaviours or mental health).

3. Place-based stigma affects the levels investment and disinvestment of public and private resources put into the local community. Progressive social policy is undermined by the lack of investment in the local infrastructure, housing and other services that provide the opportunities for healthy living.

4. Social networks, community social bonds and collective efficacy are affected by residents’ withdrawal from the public realm in response to the perceived threats associated with spatial stigma (e.g. crime). The breakdown of these community ties is detrimental to physical and mental health outcomes of local populations.

In short, there is plenty of evidence from the urban sociology and urban geography literature that through a variety of intersecting pathways place-based stigmatisation is harmful to the life chances of local residents. The population health consequences of place-based stigma are however less well established; understanding these pathways is an important challenge for researchers with an interest in the environment and health. This challenge is particularly important during a period of austerity with major reductions in state investment in a range of health related infrastructure. A likely consequence of this retrenchment is the heightened stigmatisation of many socially disadvantaged communities with potentially disastrous implications for public health and health inequalities.

Jamie Pearce, August 2012

jamie.pearce@ed.ac.uk

 *Library access required; if you are unable to get hold of the paper then I’d be please to email you a copy (jamie.pearce@ed.ac.uk). .