SEARCH · PubMed Health

Results for “Built Environment”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 37 records · Page 2Linked to original sources

PubMed2004

Evaluation of the built environment at a children's convalescent hospital: development of the Pediatric Quality of Life Inventory parent and staff satisfaction measures for pediatric health care facilities.

In preparation for the design, construction, and postoccupancy evaluation of a new Children's Convalescent Hospital, focus groups were conducted and measurement instruments were developed to quantify and characterize parent and staff satisfaction with the built environment of the existing pediatric health care facility, a 30-year-old, 59-bed, long-term, skilled nursing facility dedicated to the care of medically fragile children with complex chronic conditions. The measurement instruments were designed in close collaboration with parents, staff, and senior management involved with the existing and planned facility. The objectives of the study were to develop pediatric measurement instruments that measured the following: (1) parent and staff satisfaction with the built environment of the existing pediatric health care facility, (2) parent satisfaction with the health care services provided to their child, and (3) staff satisfaction with their coworker relationships. The newly developed Pediatric Quality of Life Inventory scales demonstrated internal consistency reliability (average alpha = 0.92 parent report, 0.93 staff report) and initial construct validity. As anticipated, parents and staff were not satisfied with the existing facility, providing detailed qualitative and quantitative data input to the design of the planned facility and a baseline for postoccupancy evaluation of the new facility. Consistent with the a priori hypotheses, higher parent satisfaction with the built environment structure and aesthetics was associated with higher parent satisfaction with health care services (r =.54, p <.01; r =.59, p <.01, respectively). Higher staff satisfaction with the built environment structure and aesthetics was associated with higher coworker relationship satisfaction (r =.53; p <.001; r =.51; p <.01, respectively). The implications of the findings for the architectural design and evaluation of pediatric health care facilities are discussed.

Attitude of Health Personnel↗

PubMed2006

The impact of the built environment on children's school conduct grades: the role of diversity of use in a Hispanic neighborhood.

A population-based study examined the relationship between diversity of use of the built environment and teacher reports of children's grades. Diversity of use of the built environment (i.e., proportion of a block that is residential, institutional, commercial and vacant) was assessed for all 403 city blocks in East Little Havana, Miami-a Hispanic neighborhood. Cluster analysis identified three block-types, based on diversity of use: Residential, Mixed-Use, and Commercial. Cross-classified hierarchical linear modeling was used to examine the impact of diversity of use, school, gender, and year-in-school on academic and conduct grades for 2857 public school children who lived in these blocks. Contrary to popular belief, mixed-use blocks were associated with optimal outcomes. Specifically, follow-up analyses found that a youth living on a residential block had a 74% greater odds of being in the lowest 10% of conduct grades (conduct GPA <2.17) than a youth living on a mixed-use block. In fact, an analysis of the population attributable fraction suggests that if the risk associated with residential blocks could be reduced to the level of risk associated with mixed-use blocks, a 38% reduction in Conduct GPAs <2.17 could be achieved in the total population. These findings suggest that public policy targeting the built environment may be a mechanism for community-based interventions to enhance children's classroom conduct, and potentially related sequelae.

Achievement↗

PubMed2003

Sorting out the connections between the built environment and health: a conceptual framework for navigating pathways and planning healthy cities.

The overarching goal of this article is to make explicit the multiple pathways through which the built environment may potentially affect health and well-being. The loss of close collaboration between urban planning and public health professionals that characterized the post-World War II era has limited the design and implementation of effective interventions and policies that might translate into improved health for urban populations. First, we present a conceptual model that developed out of previous research called Social Determinants of Health and Environmental Health Promotion. Second, we review empirical research from both the urban planning and public health literature regarding the health effects of housing and housing interventions. And third, we wrestle with key challenges in conducting sound scientific research on connections between the built environment and health, namely: (1) the necessity of dealing with the possible health consequences of myriad public and private sector activities; (2) the lack of valid and reliable indicators of the built environment to monitor the health effects of urban planning and policy decisions, especially with regard to land use mix; and (3) the growth of the "megalopolis" or "super urban region" that requires analysis of health effects across state lines and in circumscribed areas within multiple states. We contend that to plan for healthy cities, we need to reinvigorate the historic link between urban planning and public health, and thereby conduct informed science to better guide effective public policy.

City Planning↗

PubMed2002

Mental health and the built environment: cross-sectional survey of individual and contextual risk factors for depression.

BACKGROUND: Little is known about the effects of the physical environment on individual health. AIMS: The present study tested the hypothesis that the prevalence of depression is associated with independently rated measures of the built environment, after adjusting for individuals' socio-economic status and the internal characteristics of their dwellings. METHOD: Cross-sectional survey of 1887 individuals aged 16 years and over in two electoral wards in north London. Depression was ascertained using the Center for Epidemiologic Studies Depression scale (CES-D). The built environment was rated independently, using a validated measure. RESULTS: After adjusting for socio-economic status, floor of residence and structural housing problems, statistically significant associations were found between the prevalence of depression and living in housing areas characterised by properties with predominantly deck access (odds ratio=1.28, 95% CI 1.03-1.58; P=0.02) and of recent (post-1969) construction (odds ratio=1.43, 95% CI 1.06-1.91; P=0.02). CONCLUSIONS: The prevalence of depression was associated with independently rated features of the built environment, independent of individuals' socio-economic status and internal characteristics of dwellings.

Adolescent↗

PubMedDate not supplied

Incorporating a built environment module into an accelerated second-degree community health nursing course.

Environmental quality is a leading indicator of population health. Environmental health content has been integrated into the curriculum of an Accelerated Bachelor of Science in Nursing program for second-degree students through development of an environmental health nursing module for the final-semester community health nursing course. The module was developed through collaboration between two professional schools at Duke University (the School of Nursing and the Nicholas School of the Environment and Earth Sciences). It focused on the role of the built environment in community health and featured a mix of teaching strategies, including five components: (1) classroom lecture with associated readings, (2) two rounds of online small-group student discussions, (3) assessment of the built environment in local neighborhoods by student teams, (4) team presentation of the neighborhood assessments, and (5) individual student papers synthesizing the conclusions from all team presentations. The goal of the module was to provide nursing students with an organizing framework for integrating environmental health into clinical practice and an innovative tool for understanding community-level components of public health.

Community Health Nursing↗

PubMed2005

Patient-centred improvements in health-care built environments: perspectives and design indicators.

OBJECTIVE: To explore patients' perceptions of health-care built environments, to assess how they perceived health-care built facilities and designs. To develop a set of patient-centred indicators by which to appraise future health-care designs. DESIGN: Qualitative and quantitative methodologies, including futures group conferencing, autophotographic study, novice-expert exchanges and a questionnaire survey of a representative sample of past patients. SETTING AND PARTICIPANTS: The research was carried out at Salford Royal Hospitals NHS Trust (SRHT), Greater Manchester, UK, selected for the study because of planned comprehensive redevelopment based on the new NHS vision for hospital care and service delivery for the 21st century. Participants included 35 patients who took part in an autophotographic study, eight focus groups engaged in futures conferencing, a sample of past inpatients from the previous 12 months that returned 785 completed postal questionnaires. RESULTS: The futures group provided suggestions for radical improvements which were categorized into transport issues; accessibility and mobility; ground and landscape designs; social and public spaces; homeliness and assurance; cultural diversity; safety and security; personal space and access to outside. Patients' autophotographic study centred on: the quality of the ward design, human interactions, the state and quality of personal space, and facilities for recreation and leisure. The novices' suggestions were organized into categories of elemental factors representing patient-friendly designs. Experts from the architectural and surveying professions and staff at SRHT in turn considered these categories and respective subsets of factors. They agreed with the novices in terms of the headings but differed in prioritizing the elemental factors. The questionnaire survey of past patients provided opinions about ward designs that varied according to where they stayed, single room, bay ward or long open ward. The main concerns were limitation of private space around the bed area, supportive of privacy and dignity, ward noise and other disturbances. CONCLUSIONS: Patients perceived sustainable health-care environments to be supportive of their health and recovery. The design indicators developed from their perspectives and from their considerations for improvements to the health-care built environment were based on their visions of the role of the health-care facilities. These were homely environments that supported normal lifestyle and family functioning and designs that were supportive of accessibility and travel movements through transitional spaces.

Focus Groups↗

PubMed2005

Examining the relationships among built environment, physical activity, and body mass index in El Paso, TX.

OBJECTIVE: The current study examined the relationships among built environment, physical activity, and body mass index (BMI) in a primarily Hispanic border community in El Paso, TX. METHODS: Data from a 2001 community-wide health survey were matched to environmental data using geocoding techniques in ARC VIEW software. A total of 996 adults were surveyed by phone and 452 were successfully geocoded. RESULTS: The sample was 71% female, 79% Hispanic, 42 +/- 17 years old, moderately acculturated, and had socioeconomic status (SES) levels of semi-skilled workers. Increasing BMI was related to less moderate intensity physical activity (P = 0.05), higher SES (P = 0.0003), worse overall health (P = 0.0004), and living in areas with greater land-use mix (less residential; P = 0.03). The relationship between overall health and BMI was in part mediated by higher numbers of barriers to physical activity in those with poor health, which lead to a decrease in moderate physical activity. These variables explained 20% of the variance in BMI. CONCLUSIONS: This is one of the first studies to find a positive relationship between land-use mix and BMI in a predominantly Hispanic, low-income community. The positive association between BMI and land-use mix may be due to the inclusion of individual SES as a controlling variable in the analyses, suggesting that SES may have a differential effect on how the built environment influences BMI in low- to moderate-income minority communities.

Age Distribution↗

PubMed2005

Obesity and the built environment.

Biological, psychological, behavioral, and social factors are unable to fully explain or curtail the obesity epidemic. In this article we review research on the influence of the built environment on obesity. Studies were evaluated with regard to their methods of assessing the environment and obesity, as well as to their effects. Methods used to investigate the relationships between the built environment and obesity were found to be dissimilar across studies and varied from indirect to direct. Levels of assessment between and within studies varied from entire counties down to the individual level. Despite this, obesity was linked with area of residence, resources, television, walkability, land use, sprawl, and level of deprivation, showing promise for research utilizing more consistent assessment methods. Recommendations were made to use more direct methods of assessing the environment, which would include specific targeting of institutions thought to vary widely in relation to area characteristics and have a more influential effect on obesity-related behaviors. Interventions should be developed from the individual to the neighborhood level, specifically focusing on the effects of eliminating barriers and making neighborhood level improvements that would facilitate the elimination of obesogenic environments.

City Planning↗

PubMed2001

Light in the built environment: potential role of circadian disruption in endocrine disruption and breast cancer.

Life in industrialized societies is primarily life inside buildings. Illumination from electric lighting in the built environment is quite different from solar radiation in intensity, spectral content, and timing during the 24-hour daily period. Humans evolved over millions of years with the day-night pattern of solar radiation as the primary circadian cue. This pattern maintained a 24-hour rhythm of melatonin release, as well as a host of other physiological rhythms including the sleep-wake cycle. Electric lighting in the built environment is generally more than sufficient for visual performance, but may be inappropriate for the maintenance of normal neuroendocrine rhythms in humans; e.g., insufficient during the day and too much at night. Lighting standards and engineering stress visual performance, whereas circadian function is not currently emphasized. The molecular biological research on the circadian clock and on mechanisms of phototransduction makes it clear that light for vision and light for circadian function are not identical systems. In particular, if electric lighting as currently employed contributes to 'circadian disruption' it may be an important cause of 'endocrine disruption' and thereby contribute to a high risk of breast cancer in industrialized societies.

Adult↗

PubMed2001

Measuring the built environment: validity of a site survey instrument for use in urban settings.

There are few reliable measures of place with which to study the effects of socio-economic context on health. We report on the development and inter-rater reliability of a 27-item observer-rated built environment site survey checklist (BESSC). Across eleven 'housing areas' (defined as areas of homogeneity in housing form) and two raters, kappa coefficients were > or =0.5 for fifteen categorical items, and intra-class correlation coefficients exceeded 0.6 for a further three continuous measures. Ratings on several BESSC items were associated to a statistically significant degree with the prevalence of depression and residents' dissatisfaction with 'their area as a place to live'. BESSC items may prove to be valuable descriptors of the urban built environment in future studies.

Cohort Studies↗

PubMed2003

Mortality risk associated with leaving home: recognizing the relevance of the built environment.

OBJECTIVES: I analyzed traffic fatalities and homicides related to leaving home for routine activities, and considered connections between these fatalities and the built environment. METHODS: I analyzed city, county, state, and federal data for traffic fatalities and homicides by strangers for 15 metropolitan areas, and classified deaths as occurring in the central city, in inner suburbs, or in outer suburbs (exurbs). RESULTS: Traffic fatality rates were highest in exurban areas. Combined traffic fatality and homicide-by-stranger rates were higher in some or all outer counties than in central cities or inner suburbs in all of the metropolitan areas studied. CONCLUSIONS: Traffic fatalities are largely unrecognized as a danger to be factored into residential location decisions. Land use controls that deter sprawl along narrow exurban roads can reduce the mortality risks associated with leaving home.

Accidents, Traffic↗

PubMed2006

The Irvine-Minnesota inventory to measure built environments: reliability tests.

BACKGROUND: Inter-rater reliability is an important element of environmental audit tools. This paper presents results of reliability tests of the Irvine-Minnesota Inventory, an extensive audit tool aimed at measuring a broad range of built environment features that may be linked to active living. METHODS: Inter-rater reliability was measured by percentage agreement between observers. Reliability was tested on a broad range of sites in both California and Minnesota. RESULTS: For the variables that remained in the inventory, in tests conducted at the University of California-Irvine, 76.8% of the variables had >80% agreement among the three raters. In tests conducted at the University of Minnesota, 99.2% of the variables had >80% agreement among the two raters. CONCLUSIONS: Reliability was high for most items. The inventory was modified to eliminate items with low reliability. Differences in the use of the inventory and the goals of the research led to generally higher reliability in Minnesota. Those differences, limitations, and directions for future research are discussed.

California↗

PubMed2006

A unilateral NMR magnet for sub-structure analysis in the built environment: the Surface GARField.

A new, portable NMR magnet with a tailored magnetic field profile and a complementary radio frequency sensor have been designed and constructed for the purpose of probing in situ the sub-surface porosity of cement based materials in the built environment. The magnet is a one sided device akin to a large NMR-MOUSE with the additional design specification of planes of constant field strength /B0/ parallel to the surface. There is a strong gradient G in the field strength perpendicular to these planes. As with earlier GARField magnets, the ratio G//:B0/ is a system constant although the method of achieving this condition is substantially different. The new magnet as constructed is able to detect signals 50mm (1H NMR at 3.2 MHz) away from the surface of the magnet and can profile the surface layers of large samples to a depth of 35-40 mm by moving the magnet, and hence the resonant plane of the polarising field, relative to the sample surface. The matching radio frequency excitation/detector coil has been designed to complement the static magnetic field such that the polarising B0 and sensing B1 fields are, in principal, everywhere orthogonal. Preliminary spatially resolved measurements are presented of cement based materials, including two-dimensional T1-T2 relaxation correlation spectra.

Construction Materials↗

PubMed2005

The role of the built environment in the disablement process.

The Disablement Process model explicates the transition from health conditions to disability and specifically emphasizes the role of intervening factors that speed up or slow down the pathway between pathology and disability. We used hierarchical Poisson regression analyses with data on older adults from central North Carolina to examine the role of the built environment as a modifying factor in the pathway between lower extremity functional limitations and activities of daily living. We found that, despite declining physical function, older adults report greater independence in instrumental activities when they live in environments with more land-use diversity. Independence in self-care activities is modified by housing density, in part through the effect of substandard and inadequate housing.

Activities of Daily Living↗

PubMed2004

Simulated impairment of contrast sensitivity: performance and gaze behavior during locomotion through a built environment.

PURPOSE: An experimental study investigated the effects of simulated impairment of contrast sensitivity (CS) on performance and eye gaze patterns during locomotion through a library. METHOD: Normally sighted participants with simulated CS impairment (diffusive blur) walked two routes, one entailing limited change in direction (simple) and the other entailing several changes in direction (complex), while eye movements relative to the scene were recorded. Performance variables included walking speed in completing the route, pauses during travel, and collisions with objects on the route. For eye movements, dwell time and saccades were determined for each of three object classes: (1) objects on the route below eye level; (2) objects on the route extending above eye level; and (3) elsewhere-objects not on the route. RESULTS: Walking speed was significantly affected by CS level and by route; pauses and collisions were rare. Dwell times and saccades suggested limited attention directed to low-level objects, except for CS impairment on the complex route. In the complex route, saccades and dwell times in the object class "elsewhere" were also reduced. CONCLUSIONS: The results for the simple route suggest ballistic strategies: the participant appraises the scene and follows a more or less predetermined path. For the complex route, CS impairment appears to adversely affect information processing and locomotion. The results have implications for the design of built environments, especially with regard to the safety of visually impaired occupants during emergency scenarios.

Adult↗

PubMed2005

The asthma and obesity epidemics: the role played by the built environment--a public health perspective.

Obesity and asthma have reached epidemic proportions in the United States. The reasons for these epidemics are complex, and the solutions to address them are many. This article explores the epidemics, their causes and consequences, associations and relationships, an expansion of the definition of the environment, and current national initiatives that address the components of the built and social environments that promote obesity and precipitate asthma.

Asthma↗

PubMed2003

Designing for quality: hospitals look to the built environment to provide better patient care and outcomes.

With recent shifts in the marketplace, hospital boards and administrators are increasing their focus on building new facilities or renovating old ones. But rather than stick with models of the past, many of them are beginning to look at the built hospital environment as a way to promote healing, improve clinical outcomes, enhance patient safety, increase patient satisfaction, and reduce costs. At the same time, they also are finding that when changing the physical structure, they must change the internal culture of the organization as well.

Evidence-Based Medicine↗

PubMed2005

Built environment and behavior: spatial sampling using parcel data.

PURPOSE: The quality and economy of inferential research rely heavily on the sampling method. This paper addresses a methodological challenge in environment-behavior research: sampling respondents in relation to their built environmental characteristics. METHODS: A discussion of issues related to traditional neighborhood-based sampling serves to introduce a new spatial sampling strategy. Spatial sampling consists of defining conceptual population of interest, constructing spatial sample frame using parcel-level environmental data in GIS, examining the sample frame, determining the sampling design and size, and drawing the samples. An application of this method is illustrated using a recent study examining environmental correlates of walking and biking. RESULTS: Spatial sampling with parcel-level data ensures sufficient variations in and proper distributions of the environmental variables of interest, while controlling for the conditions of no interest. The use of the individual as unit of analysis offers an economic, generalizable, and easily interpretable approach to environment-behavior research, and discourages the potentially erroneous a priori definition of neighborhoods and aggregation problems. CONCLUSIONS: With its capacity to consider a broad range of detailed environmental variables, spatial sampling contributes to finding new or stronger environment-behavior associations and to the growing number of studies using the social ecologic model.

Bicycling↗