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A Framework for Pediatric Health Care Providers to Promote Active Play in Nature for Children
Aim: Time outdoors and contact with nature are positively associated with a broad range of children’s health outcomes. Pediatricians are uniquely positioned to promote active play in nature (APN) but may face challenges to do so during well child visits. The objective of this study was to understand barriers to children’s APN, before and during the COVID-19 pandemic, and how health care providers could promote APN. Methods: Focus groups were conducted with 14 pediatric providers and interviews with 14 parents (7 in English, 7 in Spanish) of children ages 3 to 10 on public insurance. Dedoose was used for coding and content analysis. We contextualized this work within the WHO’s Commission on Social Determinants of Health conceptual framework. Results: Parents mentioned a range of material circumstances (time, finances, family circumstances, access to safe outdoor play spaces and age-appropriate activities) and behavioral/psychosocial factors (previous experiences in nature, safety, and weather concerns), many of which were exacerbated by the pandemic, that serve as barriers to children’s APN. Providers said they were motivated to talk to families about children’s APN but mentioned barriers to this conversation such as time, other pressing priorities for the visit, and lack of resources to give families. Conclusions: Many pre-pandemic barriers to APN were exacerbated by the COVID-19 pandemic. Well-child visits may be an effective setting to discuss the benefits of APN during and beyond the pandemic, and there is a need for contextually appropriate resources for pediatric providers and families.
Read moreAn Open‐Source Image Classifier for Characterizing Recreational Activities Across Landscapes
Environmental management increasingly relies on information about ecosystem services for decision-making. Compared with regulating and provisioning services, cultural ecosystem services (CES) are particularly challenging to characterize and measure at management-relevant spatial scales, which has hindered their consideration in practice. Social media are one source of spatially explicit data on where environments support various types of CES, including physical activity. As tools for automating social media content analysis with artificial intelligence (AI) become more commonplace, studies are promoting the potential for AI and social media to provide new insights into CES. Few studies, however, have evaluated what biases are inherent to this approach and whether it is truly reproducible. This study introduces and applies a novel and open-source convolutional neural network model that uses computer vision to recognize recreational activities in the content of photographs shared as social media. We train a model to recognize 12 common recreational activities to map one aspect of recreation in a national forest in Washington, USA, based on images uploaded to Flickr. The image classifier performs well, overall, but varies by activity type. The model, which is trained with data from one region, performs nearly as well in a novel region of the same national forest, suggesting that it is broadly applicable across similar public lands. By comparing the results from our CNN model with an on-site survey, we find that there are apparent biases in which activities visitors choose to photograph and post to social media. After considering potential issues with underlying data and models, we map activity diversity and find that natural features (such as rivers, lakes and higher elevations) and some built infrastructure (campgrounds, trails, roads) support a greater diversity of activities in this region. We make our model and training weights available in open-source software, to facilitate reproducibility and further model development by researchers who seek to understand recreational values at management-relevant scales—and more broadly provide an example of how to build, test and apply AI to understand recreation and other types of CESs.
Read moreBiodiversity and Infrastructure Interact to Drive Tourism to and Within Costa Rica
Costa Rica. Credit: Domenico Convertini, flickr Nature-based tourism has potential to sustain biodiversity and economic development, yet the degree to which biodiversity drives tourism patterns, especially relative to infrastructure, is poorly understood. Here, we examine relationships between different types of biodiversity and different types of tourism in Costa Rica to address three questions. First, what is the contribution of species richness in explaining patterns of tourism in protected areas and country-wide in Costa Rica? Second, how similar are the patterns for birdwatching tourism compared to those of overall tourism? Third, where in the country is biodiversity contributing more than other factors to birdwatching tourism and to overall tourism? We integrated environmental data and species occurrence records to build species distribution models for 66 species of amphibians, reptiles, and mammals, and for 699 bird species. We used built infrastructure variables (hotel density and distance to roads), protected area size, distance to protected areas, and distance to water as covariates to evaluate the relative importance of biodiversity in predicting birdwatching tourism (via eBird checklists) and overall tourism (via Flickr photographs) within Costa Rica. We found that while the role of infrastructure is larger than any other variable, it alone is not sufficient to explain birdwatching and tourism patterns. Including biodiversity adds predictive power and alters spatial patterns of predicted tourism. Our results suggest that investments in infrastructure must be paired with successful biodiversity conservation for tourism to generate the economic revenue that countries like Costa Rica derive from it, now and into the future.
Read moreCoding Manual for a Study With the Girl Scouts of Western Washington on the Importance of (Not Just Visual) Interaction With Nature
Linked vs. Non-Linked Nature Description: Coding Example #1 This technical report provides our coding manual – our systematic method to code the qualitative narrative data – from a study of Girl Scouts’ meaningful nature experiences. Other authors on this study (but not on this coding manual) include Joshua J. Lawler, Pooja S. Tandon, Gregory N. Bratman, Sara P. Perrins, and Frances Boyens. Our research question was whether children’s nature interactions that are embodied (vs. only visual) would be associated with eudemonic wellbeing. Using the interaction pattern approach detailed in this coding manual, we coded written narratives from 127 Girl Scouts (8-11 years old) about a recent meaningful nature experience, and, through a novel questionnaire, assessed Presence, a eudemonic state of wellbeing. A total of 372 interactions patterns were coded from the Girl Scouts’ written narratives. Participants who enacted embodied interactions with nature (e.g., “making snowman,” “wrapping arms around tree,” “talking to chickens”) experienced a greater sense of Presence than participants whose interactions relied solely on vision (e.g., “seeing snow,” “seeing moss,” “watching pileated woodpecker”). This technical report provides open access to our core intellectual qualitative work on this project, and can be used by others seeking to employ an interaction pattern approach, or more generally seeking to characterize people’s interactions with nature.
Read moreDevelopment and Validation of an Attitudes Towards Spending Time in Nature Scale
Figure 1. Pictorial representation of methodology steps Time spent in nature (TSN) is related to improved health and well-being; however, many adults spend little time in nature. Interventions based on health behavior theories may be effective at increasing TSN. Attitudes toward a behavior have been shown to be a strong predictor of both intention and behaviors, but valid and reliable measures regarding these attitudes are lacking. The study aim was to develop a valid and reliable attitude toward TSN scale. This scale was developed using a sequential procedure: domain identification and item generation, content validity, question pretesting, survey administration, item reduction, factors extraction, dimensionality, reliability, and validity. The investigative team generated 49 unique items. Content validity and pretesting reduced the item set to 21. A countrywide sample of 2109 adults (50.3% male, median age = 58.1; 38.8% non-White) completed an online survey. Using split-half measures, principal components analysis indicated a three-factor solution: positive attitudes, negative attitudes, and concerns about being in nature. The factor structure was upheld in confirmatory factor analyses with strong internal consistency (α = 0.92 positive attitudes; 0.84 negative attitudes; 0.84 concerns). The scales were strongly related to intentions and TSN with large effect sizes. The study resulted in a reliable and valid three-factor attitudes toward spending time in nature scale that could be used to develop interventions to increase TSN.
Read moreDevelopment and Validation of Self-Efficacy and Intention Measures for Spending Time in Nature
Figure 1. Pictorial representation of methodology steps Purpose The purpose of this study was to develop and evaluate the reliability and validity of self-efficacy and intentions measures for time spent in nature (TSN). TSN is related to improvement in psychological well-being and health, yet most American adults spend very little time in such settings. Theory-based interventions have been effective in increasing physical activity, a related behavior, and may be one mechanism to increase TSN. Self-efficacy and intentions have been shown to be strong predictors of health behaviors and are used across several theories. However, scales to measure these factors have not yet been developed and are needed to facilitate effective interventions. Methods TSN self-efficacy and intentions scales were developed using a sequential nine-step procedure: identification of the domain and item generation; content validity; pre-testing of questions; sampling and survey administration; item reduction; extraction of factors; tests of dimensionality; tests of reliability; and tests of validity. The 14-member multidisciplinary, researcher and practitioner investigative team generated 50 unique items for self-efficacy and 24 unique items for intentions. After subjecting items to content validity and pre-testing, item sets were reduced to 21 assessing self-efficacy and nine assessing intentions. A nationwide sample of 2109 adult participants (49.7% female, Mean Age = 58.1; 59.8% White, 18.4% Hispanic, 13.3% Black) answered these items via an on-line survey. Results Using split-half measures, principal components analysis indicated a one-factor solution for both scales. The factor structure was upheld in confirmatory factor analyses and had high internal consistency (α = .93 self-efficacy; .91 intentions). The scales were moderately correlated with each other (r = .56, p < .001) and were strongly related to TSN with large effect sizes (eta2 > .20). Conclusions The study resulted in reliable and valid self-efficacy (14 items) and intentions (8 items) scales that can be used to develop future theory-based interventions to increase TSN and thereby improve population health.
Read moreHope, Health, and the Climate Crisis
Hope has been viewed since ancient times as a bedrock of human thriving, and contemporary evidence suggests that hope is a determinant of health. However, the climate crisis, in addition to its many direct and indirect threats to human health, erodes hope in many people. This article describes medical aspects of hope and hopelessness, including clinical definitions, measurement methods, and treatments. It then touches on literary and philosophical perspectives on hope, from both ancient and modern sources, emphasizing the centrality of hope to human thriving. Finally, it applies these clinical and cultural perspectives to the climate crisis, arguing that health professionals should propel hope in themselves, their patients, and the broader society, and drawing on clinical insights to propose concrete ways of doing so.
Read moreIn Moral Relationship with Nature: Development and Interaction
One of the overarching problems of the world today is that too many people see themselves as dominating other groups of people, and dominating nature. That is a root problem. And thus part of a core solution builds from Kohlberg’s commitment to a universal moral orientation, though extended to include not only all people but the more-than-human world: animals, trees, plants, species, ecosystems, and the land itself. In this article, Peter Kahn makes a case for this form of ethical extensionism, and then present psychological evidence for it in both children and adults, including studies with inner-city Black youth and their parents. Then he builds on Piaget’s, Kohlberg’s, and Turiel’s emphasis that interaction with the physical and social world is a critical mechanism for development. His corollary is this: that to reverse the incredibly fast human-caused destruction of nature—the wellsprings of human existence—we need to deepen and extend people’s interactions with nature, and with its relatively wild forms, even in urban environments. Toward this end, Dr. Kahn discusses his current body of research and framework for urban design based on what are referred to as interaction patterns.
Read moreInequitable Changes to Time Spent in Urban Nature During COVID-19: A Case Study of Seattle, WA with Asian, Black, Latino, and White Residents
Figure 1. Change to average frequency of urban nature interaction among each racial/ethnic group The COVID-19 pandemic has impacted everyone in urban areas. Some of these impacts in the United States have negatively affected People of Color more than their White counterparts. Using Seattle, Washington as a case study, we investigated whether inequitable effects appear in residents’ interactions with urban nature (such as urban green space). Using a 48-question instrument, 300 residents were surveyed, equally divided across four racial/ethnic groups: Asian, Black and African American, Latino/a/x, and White. Results showed that during the span of about 6 months after the onset of the pandemic, Black and Latino residents experienced a significant loss of time in urban nature, while Asian and White residents did not. The implications of these findings, including inequities in the potential buffering effects of urban nature against COVID-19 and the future of urban nature conservation, are discussed. Multiple variables were tested for association with the changes to time spent in urban nature, including themes of exclusion from urban nature spaces found throughout the existing literature. Findings show that decreases in time spent in urban nature among Black and Latino residents may be associated with their feeling as though they did not belong in urban nature. We provide recommendations based on these findings for how government agencies can promote more equitable access to urban nature during the pandemic and beyond. The results of this study have implications that extend beyond the US and are relevant to the international scholarly literature of inequities and urban nature interaction during the COVID-19 pandemic.
Read moreMaking Healthy Places: Designing and Building for Well-Being, Equity, and Sustainability
In Making Healthy Places, Second Edition: Designing and Building for Well-Being, Equity, and Sustainability, planning and public health experts Nisha D. Botchwey, Andrew L. Dannenberg, and Howard Frumkin bring together scholars and practitioners from across the globe in fields ranging from public health, planning, and urban design, to sustainability, social work, and public policy. This updated and expanded edition explains how to design and build places that are beneficial to the physical, mental, and emotional health of humans, while also considering the health of the planet. This edition expands the treatment of some topics that received less attention a decade ago, such as the relationship of the built environment to equity and health disparities, climate change, resilience, new technology developments, and the evolving impacts of the COVID-19 pandemic. Drawing on the latest research, Making Healthy Places, Second Edition imparts a wealth of practical information on the role of the built environment in advancing major societal goals, such as health and well-being, equity, sustainability, and resilience. This update of a classic is a must-read for students and practicing professionals in public health, planning, architecture, civil engineering, transportation, and related fields.
Read moreMechanisms Underlying Childhood Exposure to Blue Spaces and Adult Subjective Well-Being: An 18-Country Analysis
Figure 1. Conceptual model linking childhood exposure to blue spaces to adult subjective well-being with serial-parallel mediation through intrinsic motivation and recent visits to blue and green spaces (solid lines = indirect paths, dotted lines = direct paths). Contact with natural environments is associated with good health and well-being. Although childhood nature experiences may be important in the development of an individual’s relationship with nature and subsequent well-being, previous studies have tended to focus on ‘nature’ in general, and the mechanisms by which childhood experiences influence well-being in adulthood remain insufficiently studied. Drawing on cross-sectional survey data from an 18-country sample (N = 15,743) the current work extended previous research by examining: a) blue spaces (coasts, rivers, lakes, etc.) in particular; b) associations between adults’ recalled childhood exposure to blue spaces, frequency of recent visits to green and blues spaces, and adult subjective well-being; c) the role of childhood exposure to blue spaces on intrinsic motivations to spend time in nature; and d) the consistency of these relationships across different countries. Tests of a model where childhood exposure to blue spaces was linked to adult subjective well-being serially through intrinsic motivation and then recent blue and green space visits exhibited a good fit, a pattern largely consistent across all 18 countries. However, an alternative model where recent visits predicted intrinsic motivation also demonstrated good fit, indicating that these processes may be iterative. Building familiarity with and confidence in and around blue spaces in childhood may stimulate a joy of, and greater propensity to spend recreational time in, nature in adulthood, with positive consequences for adult subjective well-being.
Read moreMore Green, Less Lonely? A Longitudinal Cohort Study
Figure 1. Association between green space within 1600 m and cumulative incidence of loneliness in all participants, and among those living alone at baseline and follow-up Both models were fully adjusted, including age group, sex, children, cohabitation status, percentage green space within 1600 m, highest educational qualifications, annual household income, % of last 12 months spent unemployed, disability or limiting long-term health condition, area-level socio-economic circumstances. Background Urban greening may reduce loneliness by offering opportunities for solace, social reconnection and supporting processes such as stress relief. We (i) assessed associations between residential green space and cumulative incidence of, and relief from, loneliness over 4 years; and (ii) explored contingencies by age, sex, disability and cohabitation status. Methods Multilevel logistic regressions of change in loneliness status in 8049 city-dwellers between 2013 (baseline) and 2017 (follow-up) in the Household, Income and Labour Dynamics in Australia study. Associations with objectively measured discrete green-space buffers (e.g. parks) (<400, <800 and <1600 m) were adjusted for age, sex, disability, cohabitation status, children and socio-economic variables. Results were translated into absolute risk reductions in loneliness per 10% increase in urban greening. Results The absolute risk of loneliness rose from 15.9% to 16.9% over the 4 years; however, a 10% increase in urban greening within 1.6 km was associated with lower cumulative incident loneliness [odds ratio (OR) = 0.927, 95% confidence interval (CI) = 0.862 to 0.996; absolute risk reduction = 0.66%]. Stronger association was observed for people living alone (OR = 0.828, 95% CI = 0.725 to 0.944). In comparison to people with <10% green space, the ORs for cumulative incident loneliness were 0.833 (95% CI = 0.695 to 0.997), 0.790 (95% CI = 0.624 to 1.000) and 0.736 (95% CI = 0.549 to 0.986) for 10–20%, 20–30% and >30% green space, respectively. Compared with the <10% green-space reference group with 13.78% incident loneliness over 4 years and conservatively assuming no impact on incident loneliness, associations translated into absolute risk reductions of 1.70%, 2.26% and 2.72% within populations with 10–20%, 20–30% and >30% green space, respectively. These associations were stronger again for people living alone, with 10–20% (OR = 0.608, 95% CI = 0.448 to 0.826), 20–30% (OR = 0.649, 95% CI = 0.436 to 0.966) and >30% (OR = 0.480, 95% CI = 0.278 to 0.829) green space within 1600 m. No age, sex or disability-related contingencies, associations with green space within 400 or 800 m or relief from loneliness reported at baseline were observed. Conclusions A lower cumulative incidence of loneliness was observed among people with more green space within 1600 m of home, especially for people living alone. Potential biopsychosocial mechanisms warrant investigation.
Read moreNature and Health: Perspectives and Pathways
As many scholars have noted, research and publications on the benefits of nature experience have grown substantially over recent years. Progress has been made on empirical fronts based on perspectives from psychology, epidemiology, sociology, exposure science, urban design, and other disciplines. Studies have revealed ways in which health outcomes differ by population characteristics (e.g., socioeconomic status), individual differences (e.g., states of baseline mental health), and interactions with different types of nature (e.g., street trees vs. large parks vs. deserts) (Barnes et al., 2019; Mitchell & Popham, 2008; Mitchell, Richardson, & Shortt, 2015; Olvera-Alvarez, Browning, Neophytou, & Bratman, 2021; Tester-Jones et al., 2020; Wheeler et al., 2015; Yin, Bratman, Browning, Spengler, & Olvera-Alvarez, 2022). Together, the evidence also illustrates the importance of accounting for different ways of “operationalizing nature” (e.g., Normalized Difference Vegetation Index [NDVI]), and methods of measuring exposure (e.g., subjective vs. objective), as well as the granularity in assessments of frequency and duration (Ekkel & de Vries, 2017; Shanahan et al., 2016).
Read morePark Access and Mental Health Among Parents and Children During the COVID-19 Pandemic
Table 2. Parent and child physical activity and mental health outcomes Background Time spent outdoors and in nature has been associated with numerous benefits to health and well-being. We examined relationships between park access and mental health for children and parents during the COVID-19 pandemic. We also explored associations between park access and co-participation of parent and child in time outdoors, and child and parent physical activity. Methods We used data from 1,000 respondents to a nationally representative U.S. survey of parent–child dyads during October–November 2020. Park access was defined as an affirmative response to: “do you have a park that you can safely walk to within 10 min of your home?” Child mental health was operationalized as the Strengths and Difficulties Questionnaire (SDQ) total difficulties score. The Patient Health Questionnaire-4 (PHQ-4) total score assessed parent mental health and the International Physical Activity Questionnaire (IPAQ) assessed parent physical activity. Child physical activity and co-participation in outdoor activity were reported as number of days in the prior week. Linear regression was used to examine relationships between park access and health outcomes in models adjusted for child and parent characteristics and COVID-19 impact. Results Our sample included 500 parents of children ages 6–10 years, and 500 parent–child dyads of children ages 11–17 years. Park access was associated with a lower SDQ total score among children (β: -1.26, 95% CI: -2.25, -0.27) and a lower PHQ-4 total score among parents (β: -0.89, 95% CI: -1.39, -0.40). In models stratified by child age, these associations were observed for SDQ scores among adolescents ages 11–17 and for PHQ-4 scores among parents of children ages 6–10 years. Park access was also associated with 0.50 more days/week of co-participation in outdoor time (95% CI: 0.16, 0.84), and higher levels of parent physical activity (β: 1009 MET-min/week, 95% CI: 301, 1717), but not child physical activity (β: 0.31 days/week, 95% CI: -0.03, 0.66). Conclusions Park access was associated with better mental health among children and parents, and more parent physical activity and parent–child co-participation in outdoor activity during the COVID-19 pandemic. Access to nearby parks may be an important resource to promote health and well-being, for both individuals and families.
Read moreStress Recovery from Virtual Exposure to a Brown (Desert) Environment Versus a Green Environment
Fig. 1. Experimental procedure. Note: Mean arterial pressure, pulse, and cortisol measures were collected 6 times during the experiment (i.e. Stage T0∼T5). Serum samples were collected at T0 and T5. TSST: Trier Social Stressor Test. The beneficial association between nature contact and human health is often explained with psycho-evolutionary frameworks such as stress reduction theory and the savanna hypothesis. However, evidence is limited on how natural environments that are not green affect stress. One example is the desert, which does not offer affordances for nourishment or safety in an evolutionary sense. In this study, we determine the effect of a virtual reality (VR) exposure to a desert vs. green environment among 95 healthy adult male residents of El Paso, Texas. The procedure consisted of an acute stressor followed by random assignment to a 10 min VR experience (desert, green space, or office [control condition]) and a 40 min resting period. Participants in the desert condition showed significant reductions in salivary cortisol compared to participants in the office. Participants in the desert condition showed decreases in mean arterial pressure compared to participants in the control condition. Collectively, these findings suggest that factors beyond those proposed by psycho-evolutionary frameworks such as lived experiences and familiarity with landscapes may play a role in the health benefits of nature exposure.
Read moreThe Relationship Between Natural Environments and Subjective Well-Being as Measured by Sentiment Expressed on Twitter
Fig. 1. (A) The spatial distribution of tweets in the sample. (B) Land cover in Seattle. (C) Tree canopy coverage in Seattle. (D) Parks in Seattle. Land-cover and tree-canopy data were taken from the 2016 National Land Cover Database (NLCD) (Dewitz, 2019). Polygons representing urban parks within Seattle were downloaded from Seattle GeoData portal (Seattle Parks, 2012). There is growing evidence that time spent in nature can affect well-being. Nonetheless, assessing this relationship can be difficult. We used 1,971,045 geolocated tweets sent by 81,140 users from Seattle, Washington, USA to advance our understanding of the relationship between subjective well-being and natural environments. Specifically, we quantified the relationships between sentiment (negative/neutral/positive) expressed in geolocated tweets and their surrounding environments, focusing on three environmental indicators: land-cover type, tree-canopy density, and urban parks. We allowed the relationships to vary according to the broader type of environment (i.e., land-use zoning). We estimated three random-intercept partial proportional odds models corresponding to the three environmental indicators while controlling for multiple covariates. Our results suggested that for a given land-use type, tweets sent from some natural land-cover types were less likely to be negative compared to tweets sent from the urban built land-cover type. For tweets sent in industrial zones, an increase in tree-canopy cover was associated with a lower probability of having negative sentiments and with a higher probability of having positive sentiments; but for tweets sent in commercial/mixed zones, the association was reversed. Also, urban parks were generally associated with a lower probability of having negative sentiments, but tweets sent from large natural parks in residential zones were less likely to be positive. Our results suggest that the relationship between subjective well-being and natural environments depends on where people are situated in the built environment and may be more complex than previously thought. The more nuanced understanding provided by analyzing geolocated social media has potential to inform urban planning and land management.
Read moreWhat Can We Do When the Smoke Rolls In? An Exploratory Qualitative Analysis of the Impacts of Rural Wildfire Smoke on Mental Health and Well-Being, and Opportunities for Adaptation
Figure 1. Suggested content, distribution location, medium, and messenger for a wildfire smoke and wellbeing toolkit Background Extreme, prolonged wildfire smoke (WFS) events are becoming increasingly frequent phenomena across the Western United States. Rural communities, dependent on contributions of nature to people’s quality of life, are particularly hard hit. While prior research has explored the physical health impacts of WFS exposure, little work has been done to assess WFS impacts on mental health and wellbeing, or potential adaptation solutions. Methods Using qualitative methods, we explore the mental health and wellbeing impacts experienced by community members in a rural Washington State community that has been particularly hard hit by WFS in recent years, as well as individual, family, and community adaptation solutions. We conducted focus groups with residents and key informant interviews with local health and social service providers. Results Participants identified a variety of negative mental health and wellbeing impacts of WFS events, including heightened anxiety, depression, isolation, and a lack of motivation, as well as physical health impacts (e.g., respiratory issues and lack of exercise). Both positive and negative economic and social impacts, as well as temporary or permanent relocation impacts, were also described. The impacts were not equitably distributed; differential experiences based on income level, outdoor occupations, age (child or elderly), preexisting health conditions, housing status, and social isolation were described as making some residents more vulnerable to WFS-induced physical and mental health and wellbeing challenges than others. Proposed solutions included stress reduction (e.g., meditation and relaxation lessons), increased distribution of air filters, development of community clean air spaces, enhancing community response capacity, hosting social gatherings, increasing education, expanding and coordination risk communications, and identifying opportunities for volunteering. Findings were incorporated into a pamphlet for community distribution. We present a template version herein for adaptation and use in other communities. Conclusions Wildfire smoke events present significant mental health and wellbeing impacts for rural communities. Community-led solutions that promote stress reduction, physical protection, and community cohesion have the opportunity to bolster resilience amid this growing public health crisis.
Read moreWhat Next? Expanding our View of City Planning and Global Health, and Implementing and Monitoring Evidence-Informed Policy
Figure 1. The pathways through which urban and transport planning decisions affect health This Series on urban design, transport, and health aimed to facilitate development of a global system of health-related policy and spatial indicators to assess achievements and deficiencies in urban and transport policies and features. This final paper in the Series summarises key findings, considers what to do next, and outlines urgent key actions. Our study of 25 cities in 19 countries found that, despite many well intentioned policies, few cities had measurable standards and policy targets to achieve healthy and sustainable cities. Available standards and targets were often insufficient to promote health and wellbeing, and health-supportive urban design and transport features were often inadequate or inequitably distributed. City planning decisions affect human and planetary health and amplify city vulnerabilities, as the COVID-19 pandemic has highlighted. Hence, we offer an expanded framework of pathways through which city planning affects health, incorporating 11 integrated urban system policies and 11 integrated urban and transport interventions addressing current and emerging issues. Our call to action recommends widespread uptake and further development of our methods and open-source tools to create upstream policy and spatial indicators to benchmark and track progress; unmask spatial inequities; inform interventions and investments; and accelerate transitions to net zero, healthy, and sustainable cities.
Read moreApplying Novel Visitation Models using Diverse Social Media to Understand Recreation Change after Wildfire and Site Closure
Figure 1. Location of study sites in the Columbia River Gorge, USA. The area burned in the Eagle Creek Fire is shown in red. Sites are numbered from west to east. Names and closure and reopening dates are in Table S1. The purple star on the reference map shows the location of the study area in the USA. The Columbia River forms the border between Washington (to the north) and Oregon (to the south) in this region. Natural disturbances such as wildfires are increasing in severity and frequency. Although the ecological impacts of disturbance are well documented, we have limited understanding of how disturbances and associated management responses influence recreation use patterns. This reflects, in part, difficulty in quantifying recreation use across different land ownerships with inconsistent, or non-existent, recreation monitoring practices. In this study, we use visitation models based on social media to examine how recreation use changed after a wildfire and site closures in a large, mixed-ownership landscape. We find that wildfire and associated closures resulted in visitation loss to the recreation system as a whole and little site-to-site displacement within the system in the two years following the wildfire. Our study highlights the importance, when considering how wildfire and management may alter recreation use patterns, of considering the many factors that influence substitution behavior, including the relative locations of visitor origins, disturbances, and substitute sites.
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