Designing Healthier Built Environments

2018 ◽  
Author(s):  
Pedro Gullón ◽  
Gina S. Lovasi
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Type 2 Diabetes ◽  
Built Environment ◽  
Health Outcomes ◽  
Low Income ◽  
Built Environments ◽  
Street Connectivity ◽  
Research Challenges

The “built environment” is comprised of human-made structures and systems, and aspects include access to and attractiveness of walkable destinations (e.g., retail stores, parks) and community design features (e.g., street connectivity, sidewalk access). A variety of built environment characteristics can influence health outcomes and behaviors, including physical activity, obesity, type 2 diabetes, hypertension, and mental health, as well as sleep and use of tobacco and alcohol. This chapter discusses the large and complex accumulated research on the built environment as well as the methods used to study it, research challenges, policy implication, and how to bring together partnerships for policy change. This chapter also discusses the research conducted across populations (e.g., children, low-income individuals) and geographies (e.g., urban and rural geographies).

scholarly journals Association between mental health comorbidity and health outcomes in type 2 diabetes mellitus patients

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Inmaculada Guerrero Fernández de Alba ◽  
Antonio Gimeno-Miguel ◽  
Beatriz Poblador-Plou ◽  
Luis Andrés Gimeno-Feliu ◽  
Ignatios Ioakeim-Skoufa ◽  
...  
Keyword(s):  
Mental Health ◽  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Substance Use ◽  
Type 2 Diabetes Mellitus ◽  
Health Outcomes ◽  
Substance Use Disorder ◽  
Emergency Room Visit ◽  
Mental Health Problems

Abstract Type 2 diabetes mellitus (T2D) is often accompanied by chronic diseases, including mental health problems. We aimed at studying mental health comorbidity prevalence in T2D patients and its association with T2D outcomes through a retrospective, observational study of individuals of the EpiChron Cohort (Aragón, Spain) with prevalent T2D in 2011 (n = 63,365). Participants were categorized as having or not mental health comorbidity (i.e., depression, anxiety, schizophrenia, and/or substance use disorder). We performed logistic regression models, controlled for age, sex and comorbidities, to analyse the likelihood of 4-year mortality, 1-year all-cause hospitalization, T2D-hospitalization, and emergency room visit. Mental health comorbidity was observed in 19% of patients. Depression was the most frequent condition, especially in women (20.7% vs. 7.57%). Mortality risk was higher in patients with mental health comorbidity (odds ratio 1.24; 95% confidence interval 1.16–1.31), especially in those with substance use disorder (2.18; 1.84–2.57) and schizophrenia (1.82; 1.50–2.21). Mental health comorbidity also increased the likelihood of all-cause hospitalization (1.16; 1.10–1.23), T2D-hospitalization (1.51; 1.18–1.93) and emergency room visit (1.26; 1.21–1.32). These results suggest that T2D healthcare management should include specific strategies for the early detection and treatment of mental health problems to reduce its impact on health outcomes.

Walking: a matter of quantity and quality physical activity for type 2 diabetes management

2008 ◽  
Vol 33 (4) ◽  
pp. 797-801 ◽  
Author(s):  
Steven T. Johnson ◽  
Normand G. Boulé ◽  
Gordon J. Bell ◽  
Rhonda C. Bell
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Clinical Practice ◽  
Health Outcomes ◽  
Walking Speed ◽  
Diabetes Management ◽  
Health Benefit ◽  
Current Clinical Practice ◽  
Steps Per Day

Walking is often prescribed as a mode of physical activity for people with type 2 diabetes (T2D). We and others have found that although people with T2D may increase the amount that they walk (e.g., more steps per day), improvements in key health outcomes are rarely achieved. We agree that walking is an acceptable approach for people with T2D to meet current clinical practice guidelines, but consideration of both the total number of daily steps and the walking speed of a portion of those total daily steps are necessary to gain health benefit.

scholarly journals Experience of type 2 diabetes mellitus patients during COVID-19

2021 ◽  
Vol 8 (4) ◽  
pp. 2042
Author(s):  
Prathap Vasigar ◽  
Rajalakshmi Mahendran ◽  
Reenaa Mohan
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Chronic Diseases ◽  
Diabetes Patient ◽  
Stress Development ◽  
Patients With Diabetes

Lockdown during COVID-19 have impact in type 2 diabetes mellitus patients requiring medication and routine physical activity. The stress, development of complications of chronic diseases, locked in experience, fear of dying and loneliness in hospital. All these issues suggest that mental health of the diabetes patient is being affected enormously. In this report, we discussed the experience of three patients with diabetes mellitus and among them two acquired COVID-19 admitted to the COVID ward.

scholarly journals Influence of social determinants, diabetes knowledge, health behaviors, and glycemic control in type 2 diabetes: An analysis from real-world evidence

2020 ◽  
Author(s):  
Rubén Silva-Tinoco ◽  
Teresa Cuatecontzi-Xochitiotzi ◽  
Viridiana De la Torre-Saldaña ◽  
Enrique León-García ◽  
Javier Serna-Alvarado ◽  
...  
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Primary Care ◽  
Glycemic Control ◽  
Mexico City ◽  
Low Income ◽  
Self Care ◽  
Diabetes Knowledge ◽  
Care Behavior

Abstract Background Although important achievements have been done in type 2 diabetes mellitus (T2D) treatment and glycemic control, new strategies may take advantage of non-pharmacological approaches and of other potential determinants of health (e.g., socioeconomic status, education, diabetes knowledge, physical activity, and self-care behavior). However, the relationships between these factors are not totally clear and have not been studied in the context of large urban settings. This study aimed to explore the relationship between these determinants of glycemic control (GC) in a low-income urban population from Mexico City, focused in exploring potential the mediation of self-care behaviors in the association between diabetes knowledge and GC.Methods A multicenter cross-sectional study was conducted in patients with type 2 diabetes (T2D) from 28 primary care outpatient centers located in Mexico City. Using multivariable-adjusted models, we determined the associations between diabetes knowledge, self-care behaviors, and GC. The mediation analyses to determine the pathways on glycemic control were done using linear regression models, where the significance of indirect effects was calculated with bootstrapping.Results The population (N=513) had a mean age of 53.8 years (standard deviation: 11.3 yrs.), and 65.9% were women. Both socioeconomic status and level of education were directly associated with diabetes knowledge. Using multivariable-adjusted linear models, we found that diabetes knowledge was associated with GC (β: -0.102, 95% Confidence Interval [95% CI] -0.189, -0.014). Diabetes knowledge was also independently associated with self-care behavior (for physical activity: β: 0.181, 95% CI 0.088, 0.273), and self-care behavior was associated with GC (for physical activity: β: -0.112, 95% CI -0.194, -0.029). The association between diabetes knowledge and GC was not observed after adjustment for self-care behaviors, especially physical activity (β: -0.084, 95% CI -0.182, 0.014, p-value: 0.062). Finally, the mediation models showed that the effect of diabetes knowledge on GC was 17% independently mediated by physical activity (p-value: 0.049). Conclusions Socioeconomic and educational gradients influence diabetes knowledge among primary care patients with type 2 diabetes. Self-care activities, particularly physical activity, mediated the effect of diabetes knowledge on GC. Our results indicate that diabetes knowledge should be reinforced in low-income T2D patients, with an emphasis on the benefits physical activity has on improving GC.

scholarly journals Determinants of Glycemic Control among Urban Patients with Type 2 Diabetes: A mediation analysis from real-world evidence

2020 ◽  
Author(s):  
Rubén Silva-Tinoco ◽  
Teresa Cuatecontzi-Xochitiotzi ◽  
Viridiana De la Torre-Saldaña ◽  
Enrique León-García ◽  
Javier Serna-Alvarado ◽  
...  
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Low Income ◽  
Self Care ◽  
P Value ◽  
Diabetes Knowledge ◽  
Linear Regression Models ◽  
Care Behavior

Abstract Aims To explore the determinants of glycemic control (GC) among patients with type 2 diabetes (PwD) to provide insight into the pathways of the effect of diabetes knowledge on GC.Methods A multicenter cross-sectional study was conducted in PwD from 28 primary outpatient centers located in Mexico City. Using the multivariable-adjusted models, we determined the associations between diabetes knowledge, self-care behaviors, and glycemic control. The mediation analyses used linear regression models, where the significance of indirect effects was calculated with bootstrapping.Results The population (N=513) had a mean age of 53.8 years (standard deviation: 11.3 yrs.), and 65.9% were women. Using multivariable-adjusted linear models, we found that diabetes knowledge was associated with glycemic control (β: -0.102, 95% Confidence Interval [95% CI] -0.189, -0.014). Diabetes knowledge was also independently associated with self-care behavior (for physical activity: β: 0.181, 95% CI 0.088, 0.273), and self-care behavior was associated with glycemic control (for physical activity: β: -0.112, 95% CI -0.194, -0.029).The association between diabetes knowledge and glycemic control was lost after adjustment for self-care behaviors, especially physical activity (β: -0.084, 95% CI -0.182, 0.014, p -value: 0.062). Finally, the mediation models showed that the effect of diabetes knowledge on glycemic control was 17% independently mediated by physical activity ( p -value: 0.049).Conclusions Self-care activities, particularly physical activity, mediated the effect of diabetes knowledge on glycemic control. Our results indicate that diabetes knowledge should be reinforced in low-income PwD, with an emphasis on the benefits physical activity has on improving GC.

scholarly journals Influence of the built environment of Nanjing’s Urban Community on the leisure physical activity of the elderly: an empirical study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Zhi-jian Wu ◽  
Yanliqing Song ◽  
Hou-lei Wang ◽  
Fan Zhang ◽  
Fang-hui Li ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Built Environment ◽  
Low Income ◽  
Leisure Time Physical Activity ◽  
The Elderly ◽  
Linear Regression Method ◽  
Street Connectivity ◽  
Recreational Physical Activity ◽  
The Impact

Abstract Background Urbanization and aging are global phenomena that offer unique challenges in different countries. A supportive environment plays an important role in addressing the issues of health behavioral change and health promotion (e.g., prevent chronic illnesses, promote mental health) among older adults. With the development of the socio-ecological theoretical model, studies on the impact of supportive environments on physical activity have become popular in the public health field in the EU and US. Meanwhile, very few Chinese studies have examined the relationship between built environment features and older adults’ physical activity at the ecological level. The purpose of the study is to investigate how the factors part of the built environment of Nanjing’s communities also influence leisure time physical activity among the elderly. Methods Using a socio-ecological model as a theoretical framework, we conducted a cross-sectional study of 399 elderly people from 19 communities in Nanjing, China, using a one-on-one questionnaire to collect data, including participants’ perceived built environment and self-reported physical activity. A multivariate linear regression method was used to analyze the factors influencing their recreational physical activity. Results This study found that compared to older people with low average monthly income, the recreational physical activity of the elderly with average monthly incomes between 1001 and 2000 ¥ (β = 23.31, p < 0.001) and 2001 ¥ or more (β = 21.15, p < 0.001) are significantly higher. After controlling for individual covariates, street connectivity (β = 7.34, p = 0.030) and street pavement slope (β = − 7.72, p = 0.020), we found that two out of ten built environment factors indicators influence their physical activity. The importance of each influencing factor ranked from highest to lowest are monthly average income, street pavement slope, and street connectivity. Other factors were not significantly related to recreational physical activity by the elderly. Conclusions Older adults with a high income were more likely to participate in recreational physical activity than those with a low income. In order to positively impact physical activity in older adults and ultimately improve health, policymakers and urban planners need to ensure that street connectivity and street pavement slope are factored into the design and development of the urban environment.

Self-Reported Physical Activity in Medically Underserved Adults With Type 2 Diabetes in Clinical and Community Settings

2015 ◽  
Vol 12 (7) ◽  
pp. 968-975 ◽  
Author(s):  
John Cooper ◽  
Barbara Stetson ◽  
Jason Bonner ◽  
Sean Spille ◽  
Sathya Krishnasamy ◽  
...  
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Low Income ◽  
Short Form ◽  
International Comparisons ◽  
Self Care ◽  
Community Dwelling ◽  
Self Report ◽  
Clinical Settings

Background:This study assessed physical activity (PA) in community dwelling adults with Type 2 diabetes, using multiple instruments reflecting internationally normed PA and diabetes-specific self-care behaviors.Methods:Two hundred and fifty-three Black (44.8%) and White (55.2%) Americans [mean age = 57.93; 39.5% male] recruited at low-income clinic and community health settings. Participants completed validated PA self-report measures developed for international comparisons (International Physical Activity Questionnaire Short Form), characterization of diabetes self-care (Summary of Diabetes Self-Care Activities Measure; SDSCA) and exercise-related domains including provider recommendations and PA behaviors and barriers (Personal Diabetes Questionnaire; PDQ).Results:Self-reported PA and PA correlates differed by instrument. BMI was negatively correlated with PA level assessed by the PDQ in both genders, and assessed with SDSCA activity items in females. PA levels were low, comparable to previous research with community and diabetes samples. Pain was the most frequently reported barrier; females reported more frequent PA barriers overall.Conclusions:When using self-report PA measures for PA evaluation of adults with diabetes in clinical settings, it is critical to consider population and setting in selecting appropriate tools. PA barriers may be an important consideration when interpreting PA levels and developing interventions. Recommendations for incorporating these measures in clinical and research settings are discussed.

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