CRESH

Category: Physical Environment

  • CRESH research on children and the outdoors mentioned in House of Lords debate

    Research by Rich Mitchell was mentioned in a House of Lords debate on 16 May. The debate centred on the contribution of outdoor activities to the United Kingdom economy and to the health and well-being of the population. The research cited was completed  in 2009. Rich Mitchell and Rebecca Shaw followed a group of children (average age 13) undertaking an outdoor education scheme; the John Muir Award. The children completed questionnaires before, during and then 18 months after, their Award experience. The study showed massive inequalities in experience of outdoor environments. Children living in the poorest circumstances were over 6 times more likely to have had no prior experience of wild places than their more affluent peers. The study showed that participation in the Award increased aspirations for visiting the outdoors, particularly among the most deprived children, but it did not affect actual visiting behaviour.
    You can find out more about the John Muir Award here
    There is a summary of the research here
    The full report is here

  • Green space, physical activity and health in New Zealand

    A new piece of CRESH research has been published online in the journal Public Health this week.  The paper “The role of physical activity in the relationship between urban green space and health” can be downloaded here.  We looked at the health of over 8000 individuals who were interviewed for the New Zealand Health Survey in 2006 and 2007 and asked whether they were likely to be healthier if they lived in greener neighbourhoods.  We found that residents of greener neighbourhoods did indeed have better cardiovascular and mental health, independently of their individual risk factors (e.g., sex, age, socioeconomic status).  Green space might benefit health because it provides greater opportunities for physical activity, and we were able to test this hypothesis because the New Zealand Health Survey included information about how physically active each individual respondent typically was.  We found that although physical activity was higher in greener neighbourhoods it did not fully explain the green space and health relationship.  Therefore, other pathways between green space and health (e.g., social contacts, attention restoration) are likely to be equally/more important.

    Author: Liz Richardson

  • 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.

     

     

  • CRESH Symposium on Physical Activity and the Environment. November 19th

    One day symposium – Physical Activity and the Environment

    School of Geosciences, Drummond Street, University of Edinburgh

    19th November 10.00 – 16.30

    Evidence exists to suggest that physical activity is important for health and that low levels of physical activity are of increasing concern. The global importance of this was highlighted in a recent collection of papers in The Lancet quantifying the public health importance of physical activity. The local environment can provide opportunities for promoting or hindering engagement in physical activity and recent research in this field has sought to understand, if and how, features of the local environment shape individual health related behaviours, and in turn, area level health inequalities.

    This workshop will bring together academics, public health professionals and policy makers to discuss emerging research and interventions in this area. Speakers from both academia and public policy will present current research and interventions and a group discussion will consider the future for work in this area.

    9.30        Coffee and registration

    10.00     Welcome

    10:15     Prof Nanette Mutrie, Sport, Physical Education & Health Sciences, University of Edinburgh

    10.45     Ian Findlay, Chief Officer, Paths for all

    11.15     Coffee

    11.45     Dr Niamh Shortt, CRESH, University of Edinburgh

    12:30     Lunch

    13.30     Sharon Allison, Physical Activity and Health Alliance Coordinator, NHS Health Scotland

    14.00     Prof Andy Jones, Centre for Diet and Activity Research (CEDAR), University of East Anglia

    14.30     Coffee

    15.00     Where next for research and policy on physical activity and the environment (Group discussion facilitated by Prof Richard Mitchell and Prod Jamie Pearce)

    16.30     Wine reception

     

    Places are limited and will be allocated on a first come first served basis.  Please register your interest by Friday November 2nd by contacting Fiona Hartree on 0131 651 4348 or email Fiona.Hartree@ed.ac.uk

  • 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). .

  • Regular physical activity in natural environments halves risk of poor mental health

    Regular exercise in a natural environment may cut the risk of suffering from poor mental health by half, according to a new study published by CRESH today.

    Rich Mitchell studied the use of natural and non-natural environments for physical activity, like walking, running and cycling. He found regular use of natural environments such as forests and parks seemed to protect against mental ill-health, whilst use of non-natural environments like a gym, did not.

    Previous experimental studies have shown that exercise in natural environments has a positive effect on biomarkers and self-reports of stress, on mood and reported levels of fatigue. This new study was designed to look at whether such effects can be detected in the general population in every day settings.

    Data from the Scottish Health Survey 2008, described the different environments in which 1890 respondents were physically active, including woodlands, parks, swimming pools, the gym, the streets and the home. The data also showed how often respondents used each environment and how physically active they were overall. Rich looked at the association between use of each environment and the risk of poor mental health as measured by the General Health Questionnaire. Only activity in natural environments was associated with a lower risk of poor mental health.

    Rich said “I wasn’t surprised by the findings that exercise in natural environments is good for your mental health, but I was surprised by just how much better it is for your mental health to exercise in a green place like a forest, than in other places like the gym.”

     “Woodlands and parks seemed to have the greatest effect, so the message to doctors, planners and policy makers is that these places need protecting and promoting.

     “The results suggest that making the decision to exercise in a natural environment just once a week could be enough to gain a benefit. Any additional use may have a bigger effect.”

    The study, published online by Social Science & Medicine, revealed that local pavements or streets was the environment most commonly used regularly for physical activity, followed by home/garden. Around 50 per cent of the sampled group reported using any natural environment at least once in the last month.

    Rich did not know the type, duration or intensity of activity conducted in each environment and noted that this was a weakness in the study, but is also an area that could be looked at in more detail in future.

    You can see Rich talking about the study here: http://itunes.gla.ac.uk/web/news/video/RichardMitchell.mp4 

    You can read the full study here http://dx.doi.org/10.1016/j.socscimed.2012.04.012 (access required). If you don’t have access and want to read it, please email Rich at Richard.Mitchell@glasgow.ac.uk and ask for a copy.

    The research was funded by the Scottish Government’s Rural and Environmental Science and Analytical Services division (RESAS).

  • More green space equals less stress (as measured by cortisol)

    A project team which includes Rich Mitchell has just published a study showing that cortisol circulation (a marker of stress) is more favourable in areas with greater amounts of green space. The team was led by Catharine Ward Thompson, at OpenSpace research centre. The study is the first to show effects of green space on biomarkers of stress in everyday (i.e. non-experimental) settings. It’s published in Landscape and Urban Planning and you may be able to read it here . The study is part of the wider GreenHealth project, in which CRESH plays a large part. It was funded by the by the Scottish Government’s Rural and Environment Science and Analytical Services (RESAS) Division. For those without access to the journal, here’s the abstract:

    Green space has been associated with a wide range of health benefits, including stress reduction, but much pertinent evidence has relied on self-reported health indicators or experiments in artificially controlled environmental conditions. Little research has been reported using ecologically valid objective measures with participants in their everyday, residential settings. This paper describes the results of an exploratory study (n = 25) to establish whether salivary cortisol can act as a biomarker for variation in stress levels which may be associated with varying levels of exposure to green spaces, and whether recruitment and adherence to the required, unsupervised, salivary cortisol sampling protocol within the domestic setting could be achieved in a highly deprived urban population. Self-reported measures of stress and general wellbeing were also captured, allowing exploration of relationships between cortisol, wellbeing and exposure to green space close to home. Results indicate significant relationships between self-reported stress (P < 0.01), diurnal patterns of cortisol secretion (P < 0.05), and quantity of green space in the living environment. Regression analysis indicates percentage of green space in the living environment is a significant (P < 0.05) and independent predictor of the circadian cortisol cycle, in addition to self-reported physical activity (P < 0.02). Results also show that compliance with the study protocol was good. We conclude that salivary cortisol measurement offers considerable potential for exploring relationships between wellbeing and green space and discuss how this ecologically valid methodology can be developed to confirm and extend findings in deprived city areas to illuminate why provision of green space close to home might enhance health.

  • CRESH at the EUPHA conference on Public Health and Nature

    Rich Mitchell is giving a keynote address at a pre-meeting of the European Public Health Association in Copenhagen on the 9th November. Rich will be talking about Public Health’s new found interest in natural environments, the demand for high quality evidence and the relationships between experimental and observational studies. More details on the meeting can be found here.

  • Mental health and the environment symposium: some thoughts

    The CRESH symposium on mental health and the environment was one of those (quite rare) conference days that worked incredibly well. I’m not sure what it was that made the day so interesting and exciting. Perhaps it was the unusual mix of academics, practitioners, policy makers and GPs in the audience, all of whom seemed keen and willing to engage and debate. Perhaps it was the variety of interesting presentations. Whatever the magic ingredients, I came away from the day inspired and full of thoughts. I’d like to share two of them

    1) There was much discussion during the day about the nature of ‘evidence’ for the influence of environment on health. There was a clear tension between the desire for evidence from ‘intervention / evaluation’ type studies, which hold the promise of identifying causal mechanisms and offer a higher standard of ‘proof’ about whether environment does or does not hold influence over health (especially if the studies are controlled in some way), and the bulk of existing evidence which stems from observational designs. It certainly feels like the balance of funding available for health research is shifting rapidly to favour study designs which are more experimental than observational. Colleagues of mine have recently had funding requests turned down because of their observational study design, and we have had papers rejected from leading medical journals specifically because of an observational design. This pressure is, rightly or wrongly, asking scientists to work further up the hierarchy of study designs. What concerns me is the extent to which we are ignoring the weakness of experimental / evaluation study designs, especially in a) the extent to which they have external validity (i.e. can we really learn anything about how the wider world works from the controlled and unusual situations that experimental studies either create or exploit) and b) the extent to which we are tempted to believe that what are often relatively short-term studies can really tell us much about how social and physical environments really influence population health and health inequalities. This is a topic to which we intend to return in the next CRESH event. What is the right balance between experimental and observational studies in a portfolio, or mixed economy, of evidence? Is it all over for observation?

    2) Critical thinking is essential to the progress of science. If we don’t ask how, and for whom, our results or conclusions might not hold, our work is weaker. If we don’t question how and why we think and research in the way we do, our approaches will not develop. In one area CRESH researches, the health effects of contact with green spaces or natural environments, we frequently encounter land managers, policy makers and planners who adhere to a general orthodoxy that ‘green space is good for you’. The value of critical science is that it makes us aware that not everyone feels comfortable walking in the woods or the park, and that some people even feel threatened by open spaces in the their neighbourhoods. There is plenty of evidence from qualitative and quantitative studies that this is true.

    One of the weaknesses of critical thinking in the field at the moment however is that the critique seems to stop at ‘not everyone benefits from green space’. My question is, what do we do with that knowledge? If we can understand how and for whom benefits are not realised, that could help adjust expectations about what green space can deliver, and also help us think through how benefits could be brought to a wider range of people. Perhaps the real value of critical approaches to thinking about environment and health is that they pose these questions.

    News about the next CRESH symposium will appear on the site soon. In the meantime, if any attendees want to post their thoughts on the mental health and environment day, please use the form below.

    This is a personal post, written by Rich Mitchell. It doesn’t represent the views of ‘CRESH’

  • Our green space work in the news

    Green spaces keep men healthy

    Jun 21, 2010

    Recent work by Dr Elizabeth Richardson and Prof Richard Mitchell attracted considerable media interest recently.

    Their study found that men who live in neighbourhoods with more green space are less likely to die from cardiovascular and respiratory diseases – conditions that account for almost half of all deaths in the UK. But it also found that these benefits of greener neighbourhoods do not extend to women. The results were a surprise because it had previously been widely assumed that green spaces are equally good for everyone, through offering opportunities for physical activity and social contacts for example. The reasons for the findings were unclear, but other literature tells us that women use green space less than men and don’t exercise as much there, particularly if they perceive the area to be unsafe or threatening. This could explain the findings.

    The study was the first to study green space and health relationships for the UK as a whole, as the researchers combined remotely sensed data and Ordnance Survey map data to quantify green space at a national level. Mortality statistics based on a population of almost 30 million adults were used, giving the results substantial significance. It should be stressed that as the study only considered mortality statistics it cannot be assumed that women’s health does not benefit from green space in other ways.

    The paper “Gender differences in relationships between urban green space and health in the United Kingdom” was funded by the Forestry Commission and originally published in the journal Social Science and Medicine, but has now received diverse coverage through outlets such as BBC Radio Scotland, the Daily Telegraph, and even The Sun, where the headline read “Park life is better for blokes’ hearts”.

    Links:

    Daily Mail: “Why living near a park is good for a man’s heart and lungs”

    Scotsman: “Women miss out on health benefit of green spaces, major study finds”

    Scottish Sun: “Park life is better for blokes’ hearts”