scholarly journals Public open spaces and physical activity: disparities of resources in Florianópolis

2019 ◽  
Vol 53 ◽  
pp. 112
Author(s):  
Sofia Wolker Manta ◽  
Rodrigo Siqueira Reis ◽  
Tânia Rosane Bertoldo Benedetti ◽  
Cassiano Ricardo Rech
Keyword(s):  
Physical Activity ◽  
Low Income ◽  
High Income ◽  
Sociodemographic Characteristics ◽  
Open Spaces ◽  
High Quality ◽  
Census Tracts ◽  
Physical Activity Facilities ◽  
Public Open Spaces

ABSTRACT OBJECTIVE: To analyze the association between sociodemographic characteristics of census tracts and the presence/quality of public open spaces and physical activity facilities. METHODS: A cross-sectional study was conducted in 643 census tracts in Florianópolis, Brazil, the presence and quality of public open spaces and physical activity facilities were objectively analyzed and the data by census tracts using Geographic Information Systems was treated. Outcomes were analyzed considering the census tracts as having: ≥ 1 public open spaces; ≥ 1 public open spaces with high quality; ≥ 2 physical activity facilities and high-quality physical activity facilities. Sociodemographic characteristics were the independent variables. Logistic regression analysis was performed. RESULTS: Census tracts with a medium-income (OR = 1.8; 95%CI 1.1–3.0) and high-income (OR = 2.4; 95%CI 1.4–4.0), in those with medium (OR = 1.7; 95%CI 1.0–2.7) and high residential density (OR = 2.0; 95%CI 1,2–3.3), and with higher proportions of older adults (OR = 3.3; 95%CI 1.9–5.7) had a higher proportion of public open spaces. Census tracts with higher proportions of children/adolescents (OR = 0.3; 95%CI 0.2–0.6) and non-white residents (OR= 0.6; 95%CI 0.3–0.9) were less likely to contain public open spaces. The tracts with medium (OR = 4.0; 95%CI 1.4–11.3) and high-income (OR = 3.6; 95%CI 1.2–10.2) were more likely to contain public open spaces with ≥ 2 structures for physical activity, compared with those with low-income. We observed the inverse in sectors with a high proportion of non-white residents (OR = 0.3; 95%CI 0.1–0.9). CONCLUSIONS: Census tracts with higher proportions of children or adolescents, non-white individuals and those in the low-income strata had lower odds of containing public open spaces and physical activity facilities.

Observational physical activity in public open spaces: environmental determinants of physical activity intensity levels in Iran

2019 ◽  
Vol 27 (3) ◽  
pp. 131-139
Author(s):  
Zeinab Aliyas ◽  
Keyvan Jafari
Keyword(s):  
Physical Activity ◽  
Age Groups ◽  
Activity Levels ◽  
User Characteristics ◽  
Physical Activity Intensity ◽  
Environmental Determinants ◽  
Open Spaces ◽  
Activity Intensity ◽  
Public Open Spaces

Public open spaces play an important role in promoting physical activity (PA). This study aimed to describe user characteristics of public open spaces (POSs) given the type of location and levels of PA. The study also evaluated the relationship between the environmental determinants of POSs and PA intensity. The study used observational data to measure environmental determinants and obtain information on users and their activity levels in the POSs of Darab in Iran. Out of 13,342 individuals observed, the proportion of men was slightly higher than that of women. More than half of the users observed in the community parks performed vigorous activities. Children and teenagers were found more often than other age groups doing vigorous activities. Most of the observed users performed vigorous activities in the evening and sedentary activities during weekends. Seniors were more sedentary than the other groups. Greater size, and better facilities and aesthetics of POSs increased the odds of being more active. However, a higher number of incivilities was associated with a greater chance of walking and lower odds of performing vigorous activities. As the quality of POSs contributes to PA levels, stakeholders should consider the quality of such spaces to improve retrofitting and designing POSs to maximize activity levels.

Physical Activity Clusters and Income Inequality in Brazilian Adults

2020 ◽  
Vol 17 (9) ◽  
pp. 859-866
Author(s):  
Sofia Wolker Manta ◽  
Kelly Samara da Silva ◽  
Giovani Firpo Del Duca ◽  
Luís Eduardo A. Malheiros ◽  
Margarethe Thaisi Garro Knebel ◽  
...  
Keyword(s):  
Physical Activity ◽  
Marital Status ◽  
Low Income ◽  
Leisure Activities ◽  
Income Group ◽  
High Income ◽  
Sociodemographic Characteristics ◽  
High Income Group ◽  
Income Inequalities ◽  
Household Activities

Background: Income is an important determinant of physical activity (PA) when analyzed in its different domains. Sociodemographic characteristics such as sex, age, education, and marital status reveal distinct population profiles when PA domains are analyzed in isolation. This study aimed to describe clusters of PA in domains within income inequalities and to investigate the associated sociodemographic characteristics of Brazilian adults. Methods: A secondary analysis of the National Health Survey was performed (N = 50,176). PA, sociodemographic characteristics, and family income were investigated. Low- (n = 9504) and high-income adults (n = 6330) were analyzed. Two-step cluster and Rao–Scott chi-square tests were employed. Results: High-income adults accumulated 1.06 times more PA in leisure time compared with low-income adults. Of the 3 clusters observed, the inactive cluster was more prevalent (low-income group: 65.9%; 95% confidence interval [CI], 64.1–67.5; high-income group: 84.5%; 95% CI, 82.9–86.0). Work/leisure activities (21.2%; 95% CI, 19.8–22.8) and commuting/household activities (12.9%; 95% CI, 11.8–14.1) characterized low-income adults. Work/household activities (10.9%; 95% CI, 9.6–12.3) and commuting/leisure activities (4.6%, 95% CI, 3.9–5.4) characterized high-income adults. Sex (P < .001), age (P < .001), and marital status (P = .0023) were associated with low-income clusters. Conclusion: PA clustering differs within income inequalities. PA in leisure differentiates the opportunities in low- and high-income groups, but it is representative of a very small portion of the wealth.

scholarly journals The effect of physical activity on mortality and cardiovascular disease in 130 000 people from 17 high-income, middle-income, and low-income countries: the PURE study

The Lancet ◽  
2017 ◽  
Vol 390 (10113) ◽  
pp. 2643-2654 ◽  
Author(s):  
Scott A Lear ◽  
Weihong Hu ◽  
Sumathy Rangarajan ◽  
Danijela Gasevic ◽  
Darryl Leong ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cardiovascular Disease ◽  
Low Income ◽  
High Income ◽  
Low Income Countries ◽  
Middle Income

Abstract MP38: Local Population Income, Geographic Space and Interactions Predict Increased Presence of Physical Activity Facilities in New York City Metropolitan Area Census Tracts, 1990-2010

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
David M Wutchiett ◽  
Tanya K Kaufman ◽  
Daniel M Sheehan ◽  
Kathryn M Neckerman ◽  
Andrew G Rundle ◽  
...  
Keyword(s):  
Physical Activity ◽  
New York ◽  
New York City ◽  
Cross Validation ◽  
Local Population ◽  
Median Income ◽  
Census Tracts ◽  
Interaction Terms ◽  
Physical Activity Facility ◽  
Physical Activity Facilities

Introduction: Physical activity is associated with improved health and is supported, in part, by the presence of facilities that provide space and equipment to pursue a variety of physical activities. We assessed the hypothesis that socio-geographic characteristics predict increased local availability of commercial physical activity facilities over time. Longitudinal examination of physical activity facility distribution can inform our response to current disparities in access to public and private physical activity venues. Methods: We used data from the National Establishment Time-Series (NETS), a longitudinal database of U.S. businesses, focusing on 4528 census tracts (23 counties) in the New York City metropolitan area and on decennial intervals for which population data were also available through the Census or American Community Survey (1990, 2000, 2010). Commercial physical activity facilities (e.g., gyms, tennis courts, martial arts studios) were defined based on Standard Industrial Classification (SIC) codes and name searches. Facility counts were aggregated to 2010 census tract boundaries and linked to local population characteristics. Comparisons across decennial intervals were used to define increasing count of physical activity facilities and shifting population demographics. Associations were evaluated using lasso logistic regression to estimate relationships with predictor variables and their interactions with model shrinkage and variable subset selection through 10-fold cross-validation for minimization of test set model deviance. Results: Census tracts with at least one physical activity facility increased over time (1990=1172, 2000=2295, 2010=2365). Greater tract-level median income, larger land area, and higher previous total physical activity facilities at start of decade were positively associated with greater odds for local increase in physical activity facilities (OR=1.27 per SD median income; OR=1.30 per SD land area; OR=1.14 per SD lagged facility count). Inclusion of two-way interaction terms increased R2 estimates from 0.30 to 0.33, suggesting explanation of an additional 3% of the variation in facility count increase. Subset selection through lasso to minimize cross-validation error resulted in retention of 11 of 21 possible two-way predictor interactions. The association between 10-year increase in median income with increased physical activity facility count was stronger in geographically larger census tracts (interaction OR=1.05); similarly, a stronger relationship was found for 10-year population count increase with physical facility count increase in larger census tracts (interaction OR=1.05). Conclusion: Local population, geographic, and business environment characteristics are associated with change in physical activity facilities. Inclusion of interaction terms improved prediction.

Improving life after stroke needs global efforts to implement evidence-based physical activity pathways

2019 ◽  
Vol 14 (5) ◽  
pp. 457-459 ◽  
Author(s):  
Frederike van Wijck ◽  
Julie Bernhardt ◽  
Sandra A Billinger ◽  
Marie-Louise Bird ◽  
Janice Eng ◽  
...  
Keyword(s):  
Physical Activity ◽  
Low Income ◽  
Best Practice ◽  
Recurrent Stroke ◽  
Cost Effective ◽  
Preliminary Evidence ◽  
Low Income Countries ◽  
Active Lifestyle ◽  
High Quality ◽  
The World

There is an urgent need to improve life after stroke across the world—especially in low-income countries—through methods that are effective, equitable and sustainable. This paper highlights physical activity (PA) as a prime candidate for implementation. PA reduces modifiable risk factors for first and recurrent stroke and improves function and activity during rehabilitation and following discharge. Preliminary evidence also indicates PA is cost-effective. This compelling evidence urgently needs to be translated into seamless pathways to enable stroke survivors across the world to engage in a more active lifestyle. Although more quality research is needed—particularly on how to optimize uptake and maintenance of PA—this should not delay implementation of high-quality evidence already available. This paper shares examples of best practice service models from low-, middle-, and high-income countries around the world. The authors call for a concerted effort to implement high-quality PA services to improve life after stroke for all.

scholarly journals Implementing Technology That Disrupts Health Systems but not Quality of Care: The Pocket Colposcope in Lima, Peru

2020 ◽  
Vol 6 (Supplement_1) ◽  
pp. 34-34
Author(s):  
Marlee Krieger ◽  
Nimmi Ramanujam ◽  
Mary Elizabeth Dotson Libby
Keyword(s):  
Quality Of Care ◽  
Low Income ◽  
Value Chain ◽  
Ease Of Use ◽  
Patient Acceptance ◽  
Disruptive Technology ◽  
Global Value Chain ◽  
High Quality ◽  
Iron Triangle

PURPOSE Innovative devices are often targeted at increasing access, improving quality, or reducing costs—the three axes of the infamous Iron Triangle of Health Care, which are notoriously difficult to simultaneously optimize. The main aim of this study was to demonstrate that disruptive technologies, if high quality and appropriately implemented, can result in improved access, cost, and quality of care, overcoming the conventional constraints of the Iron Triangle framework. METHODS Our team conducted a global value chain analysis of the Pocket Colposcope in Lima, Peru, and developed surveys and conducted in-depth interviews to evaluate Pocket Colposcope stakeholders. All surveys were developed with consultations from the Duke Evidence Lab and had institutional review board approval. RESULTS The global value chain identified 5 leverage points: regulatory approval, task shifting, collaboration, telemedicine, and patient acceptance. We also identified stakeholders and processes that affect the degree to which the Pocket Colposcope is successfully implemented. Of women surveyed, 39.4% answered that they had previously wanted a cervical cancer screening test, but had been unable to receive one as a result of some barrier. The most common responses were distance to clinics (31.0%), participants could not leave work (27.6%), and patients were afraid of receiving a cancer diagnosis (20.7%). All 4 midwives who participated in the focus group identified the portability of the Pocket Colposcope as the device’s most appealing feature. Providers identified the quality of the image, cost to patient, and ease of use as the 3 most important aspects of the Pocket Colposcope. CONCLUSION The Pocket Colposcope provides an opportunity to make high-quality diagnostic technology more accessible at a cheaper price for more people. Often, disruptive technology in low-income settings is expected to increase access at the cost of reducing quality. In the case of the Pocket Colposcope, the disruptive technology is significantly cheaper than existing technology, but quality is still high enough to succeed.

scholarly journals Urban Moveability and physical activity in children: longitudinal results from the IDEFICS and I.Family cohort

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Christoph Buck ◽  
◽  
Gabriele Eiben ◽  
Fabio Lauria ◽  
Kenn Konstabel ◽  
...  
Keyword(s):  
Physical Activity ◽  
Built Environment ◽  
Children And Adolescents ◽  
Protective Factor ◽  
Transition Phase ◽  
Residential Density ◽  
Street Connectivity ◽  
Open Spaces ◽  
Positive Effects ◽  
Public Open Spaces

Abstract Background Physical activity (PA) is one of the major protective behaviours to prevent non-communicable diseases. Positive effects of the built environment on PA are well investigated, although evidence of this association is mostly based on cross-sectional studies. The present study aims to investigate the longitudinal effects of built environment characteristics in terms of a moveability index on PA of children in their transition phase to adolescence using data of the IDEFICS/I.Family cohort. Methods We used data on 3394 accelerometer measurements of 2488 children and adolescents aged 3 to 15 years old from survey centres of three countries, Germany, Italy, and Sweden, who participated in up to three surveys over 6 years. In network-dependent home neighbourhoods, a moveability index was calculated based on residential density, land use mix, street connectivity, availability of public transport and public open spaces such as green spaces and public playgrounds in order to quantify opportunities for PA of children and adolescents. Linear trajectories of light PA (LPA) and moderate-to-vigorous PA (MVPA) were estimated using linear mixed models accounting for repeated measurements nested within individuals. Least squares means were estimated to quantify differences in trajectories over age. Results LPA and MVPA declined annually with age by approximately 20 min/day and 2 min/day respectively. In girls, the moveability index showed a consistent significantly positive effect on MVPA ($$ \hat{\beta} $$β̂ = 2.14, 95% CI: (0.11; 4.16)) for all ages, while in boys the index significantly lessened the decline in LPA with age for each year. ($$ \hat{\beta} $$β̂ = 2.68, 95% CI: (0.46; 4.90)). Availability of public open spaces was more relevant for MVPA in girls and LPA in boys during childhood, whereas in adolescence, residential density and intersection density became more important. Conclusion Built environment characteristics are important determinants of PA and were found to have a supportive effect that ameliorates the decline in PA during the transition phase from childhood to adolescence. In childhood environmental support for leisure time PA through public open spaces was found to be the most protective factor whereas in adolescence the positive influence of street connectivity and residential density was most supportive of physical activity.

scholarly journals DISTANCE TO FITNESS ZONE, USE OF FACILITIES AND PHYSICAL ACTIVITY IN ADULTS

2018 ◽  
Vol 24 (2) ◽  
pp. 157-161 ◽  
Author(s):  
Alice Tatiane da Silva ◽  
Rogério César Fermino ◽  
Adalberto Aparecido dos Santos Lopes ◽  
Claudia Oliveira Alberico ◽  
Rodrigo Siqueira Reis
Keyword(s):  
Physical Activity ◽  
Length Of Stay ◽  
Cross Sectional Study ◽  
Day Length ◽  
Inverse Association ◽  
Active Commuting ◽  
Open Spaces ◽  
Cross Sectional ◽  
Physically Active

ABSTRACT Introduction: The characteristics of the built environment are important predictors of physically active behavior. In this regard, the presence, availability, access to and quality of public open spaces for physical activity close to home are positively associated with their use and higher levels of physical activity in the population. Objective: To analyze the association between distance from home to outdoor fitness zones with the use of these facilities and physical activity in adults from Curitiba, Brazil. Methods: Cross-sectional study conducted with 328 users of 20 outdoor fitness zones. Distance was calculated with the Geographic Information System (GIS) using the street network in ArcGIS 10.1 and classified in tertiles (≤854 meters; 855-1741 meters; ≥1742 meters). To assess the use of the facilities, three attributes were considered: weekly frequency (times/week), length of stay (minutes/day) and length of use (months). The leisure module of the International Physical Activity Questionnaire (IPAQ) assessed physical activity, and travel to the destination was classified as "passive" or "active". The association was tested using Poisson regression in STATA 12.0. Results: An inverse association was found between the upper tertile of distance from home to the outdoor fitness zones and active commuting (PR: 0.70; 95% CI: 0.51-0.97), and ≥31 min/day length of stay (PR: 0.49; 95% CI: 0.31-0.76). Conclusion: Reducing distances and increasing the number of facilities may increase physical activity through active commuting and length of stay at outdoor fitness zones.

Quantity and quality of public open spaces in Israel

2012 ◽  
Vol 165 (3) ◽  
pp. 177-187 ◽  
Author(s):  
Yodan Rofè ◽  
Gabriella Feierstein ◽  
Inbal Zarchin
Keyword(s):  
Open Spaces ◽  
Public Open Spaces

Neoliberal Reforms in Swedish Primary Health Care: For Whom and for What Purpose?

2008 ◽  
Vol 38 (4) ◽  
pp. 697-715 ◽  
Author(s):  
Göran Dahlgren
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Primary Health Care ◽  
Low Income ◽  
Health Sector ◽  
High Income ◽  
Public Hospitals ◽  
Primary Health ◽  
Access And Quality

The conservative government that came to power in Sweden in 2006 has initiated major market-oriented reforms in the health sector. Its first health care policy bill changed the health legislation to make it possible to sell/transfer public hospitals to commercial providers while maintaining public funding. Far-reaching market-oriented primary health care reforms are also initiated, for example in Stockholm County. They are typically presented as “free choice models” in which “the money follows the patient.” The actual and likely effects of these reforms in terms of access and quality of care are discussed in this article. One main finding is that existing social inequities in geographic access to care not only are reinforced but also become very difficult to change by democratic political decisions. Furthermore, dynamic market forces will gradually reduce the quality of care in low-income areas while both access and quality of care will be even better in high-income areas. Public funds are thus transferred from people living in low-income areas to people living in high-income areas, even though the need for good health services is much greater in the low-income areas. Certain policy options for reversing the inverse law of care are also presented.

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