ORCID Profile
0000-0002-9232-2749
Current Organisation
University of South Australia
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
Publisher: Oxford University Press
Date: 22-10-2020
DOI: 10.1093/OSO/9780190885304.003.0011
Abstract: This chapter reviews ways the concepts and tools of systems approaches can help understand how city environments affect health and identify the most effective policies. The authors discuss basic conceptual elements of systems thinking, review core systems modeling methods, and provide ex les of their applications in urban health. They conclude with a discussion of the challenges involved in using these approaches.
Publisher: Cambridge University Press (CUP)
Date: 13-12-2021
DOI: 10.1017/S1368980021004833
Abstract: To develop a simulation framework for assessing how combinations of taxes, nutrition warning labels and advertising levels could affect purchasing of ultra-processed foods (UPF) in Latin American countries and to understand whether policies reinforce or reduce pre-existing social disparities in UPF consumption. We developed an agent-based simulation model using international evidence regarding the effect of price, nutrition warning labels and advertising on UPF purchasing. We estimated policy effects in scenarios representing two stages of the ‘social transition’ in UPF purchasing: (1) a pre-transition scenario, where UPF purchasing is higher among high-income households, similar to patterns in Mexico and (2) a post-transition scenario where UPF purchasing is highest among low-income households, similar to patterns in Chile. A population of 1000 in idual agents with levels of age, income, educational attainment and UPF purchasing similar to adult women in Mexico. A 20 % tax would decrease purchasing by 24 % relative to baseline in both the pre- and post-transition scenarios, an effect that is similar in magnitude to that of a nutrition warning label policy. A 50 % advertising increase or decrease had a comparatively small effect. Nutrition warning labels were most effective among those with higher levels of educational attainment. Labelling reduced inequities in the pre-transition scenario (i.e. highest UPF purchasing among the highest socio-economic group) but widened inequities in the post-transition scenario. Effective policy levers are available to reduce UPF purchasing, but policymakers should anticipate that equity impacts will differ depending on existing social patterns in UPF purchasing.
Publisher: Informa UK Limited
Date: 15-03-2018
DOI: 10.1080/13607863.2018.1450832
Abstract: Daily transport may impact depression risk among older adults through several pathways including facilitating the ability to meet basic needs, enabling and promoting contact with other people and nature, and promoting physical activity (e.g. through active transportation such as walking or walking to public transit). Both daily transport and depression are influenced by the neighborhood environment. To provide insights into how transport interventions may affect depression in older adults, we developed a pilot agent-based model to explore the contribution of daily transport and neighborhood environment to older adults' depression in urban areas. The model includes about 18,500 older adults (i.e. agents) between the ages of 65 and 85 years old, living in a hypothetical city. The city has a grid space with a number of neighborhoods and locations. Key dynamic processes in the model include aging, daily transport use and feedbacks, and the development of depression. Key parameters were derived from US data sources. The model was validated using empirical studies. An intervention that combines a decrease in bus fares, shorter bus waiting times, and more bus lines and stations is most effective at reducing depression. Lower income groups are likely to be more sensitive to the public transit-oriented intervention. Preliminary results suggest that promoting public transit use may be a promising strategy to increase daily transport and decrease depression. Our results may have implications for transportation policies and interventions to prevent depression in older adults.
Publisher: Human Kinetics
Date: 10-2021
Abstract: Background : Many of the known solutions to the physical inactivity pandemic operate across sectors relevant to the United Nations Sustainable Development Goals (SDGs). Methods : The authors examined the contribution of physical activity promotion strategies toward achieving the SDGs through a conceptual linkage exercise, a scoping review, and an agent-based model. Results : Possible benefits of physical activity promotion were identified for 15 of the 17 SDGs, with more robust evidence supporting benefits for SDGs 3 (good health and well-being), 9 (industry, innovation, and infrastructure), 11 (sustainable cities and communities), 13 (climate action), and 16 (peace, justice, and strong institutions). Current evidence supports prioritizing at-scale physical activity-promoting transport and urban design strategies and community-based programs. Expected physical activity gains are greater for low-and middle-income countries. In high-income countries with high car dependency, physical activity promotion strategies may help reduce air pollution and traffic-related deaths, but shifts toward more active forms of travel and recreation, and climate change mitigation, may require complementary policies that disincentivize driving. Conclusions : The authors call for a synergistic approach to physical activity promotion and SDG achievement, involving multiple sectors beyond health around their goals and values, using physical activity promotion as a lever for a healthier planet.
Publisher: Elsevier BV
Date: 10-2023
Publisher: Springer Science and Business Media LLC
Date: 07-09-2015
Publisher: Elsevier BV
Date: 08-2021
Publisher: Elsevier BV
Date: 09-2019
DOI: 10.1016/J.HEALTHPLACE.2019.05.018
Abstract: A systematic review was conducted, following PRISMA guidelines, to examine the application of finite mixture models (FMMs) in the study of neighbourhoods and health. Two reviewers screened 814-studies identified through database searches and citation tracking. Data were extracted from 19-studies that met the inclusion criteria, and a risk of bias analysis undertaken. Data were synthesised narratively, with a focus on methodological issues idiosyncratic to FMMs. Motivated by a desire to account for neighbourhood heterogeneity, studies sought to identify meaningful neighbourhood-level typologies that explained the distributional nature of health outcomes. Neighbourhood-centred applications of FMMs were promising but there remains scope for advancement. Research-based recommendations are outlined to strengthen prospective neighbourhood-centred studies applying FMMs.
Publisher: Wiley
Date: 16-11-2021
DOI: 10.1002/AJCP.12566
Abstract: An updated zoning policy eliminating all alcohol outlets (liquor stores) in residential districts was implemented to reduce high rates of violent crime in Baltimore City. Diverse stakeholders were engaged in group model building (GMB) activities to develop causal loop diagrams (CLDs) that elucidate the impact of the new zoning policy on crime, and more broadly, the potentially unintended social and environmental consequences of the policy. Three distinct groups, community advocates, city officials/academics, and community residents, participated in three separate GMB sessions. Three CLDs, one from each stakeholder group, were created to depict the possible outcomes of the zoning policy. Our findings offer insight into potential unintended consequences of removing liquor stores from residential areas that may undermine the policy. Community members described the need for additional supports related to mental health and substance use, opportunities for investment in the community, access to other goods and services, and community‐police relations to ensure the policy achieved its intended goal of reducing violent crime. Our findings highlight the importance of timely engagement of local stakeholders to understand how complex neighborhood dynamics and contextual factors could impact the effectiveness of a zoning policy change.
Publisher: BMJ
Date: 06-2020
DOI: 10.1136/BMJOPEN-2019-036534
Abstract: We study the obesity transition by socioeconomic status (SES), gender and age within the Colombian urban population at the country, regional and department levels. The study is informed by cross-sectional data from the 2005 and 2010 ENSIN survey. We used these data to develop a system dynamics model that simulates the dynamics of obesity by body mass index (BMI) categories, gender and SES at the country, regional and department levels from 2005 to 2030. The s le size of the 2005 ENSIN comprised 8515 children younger than 5 years, 32 009 children and adolescents aged 5–17 years and 48 056 adults aged 18–64 years. In 2010, the corresponding numbers were 11 368, 32 524 and 64 425, respectively. The obesity prevalence ratio and prevalence rates for each BMI category. The results show, at the country level, transitions from overweight to obesity were projected to increase sharply among lower SES adults, particularly among women, suggesting that these groups will undergo an obesity transition by 2030. The model projections also indicate that the regions of Colombia are in different stages of the obesity transition. In the case of women, five out of the six regions were expected to undergo an obesity transition by SES over time. For men, only one region was expected to undergo an obesity transition. However, at the department level, trends in the burden of obesity varied. We evidence that the Colombian population could be experiencing an obesity transition where the increase in the GDP could be related to shifts in the burden of obesity from higher to lower SES, especially in women. These patterns support the need for policy planning that considers SES and gender, at the national and subnational levels, as important determinants of overweight and obesity among adults in Colombia.
Publisher: BMJ
Date: 03-2023
DOI: 10.1136/BMJOPEN-2022-066875
Abstract: Food systems can shape dietary behaviour and obesity outcomes in complex ways. Qualitative systems mapping using causal loop diagrams (CLDs) can depict how people understand the complex dynamics, inter-relationships and feedback characteristic of food systems in ways that can support policy planning and action. To date, there has been no attempt to review this literature. The objectives of this review are to scope the extent and nature of studies using qualitative systems mapping to facilitate the development of CLDs by stakeholders to understand food environments, including settings and populations represented, key findings and the methodological processes employed. It also seeks to identify gaps in knowledge and implications for policy and practice. This protocol describes a scoping review guided by the Joanna Briggs Institute manual, the framework by Khalil and colleagues and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist reporting guidelines. A search strategy was iteratively developed with two academic librarians and the research team. This strategy will be used to search six databases, including Ovid MEDLINE, Embase, EmCare, Web of Science, Scopus and ProQuest Central. Identified citations will be screened by two independent reviewers first, by title and abstract, and then full-text articles to identify papers eligible for inclusion. The reference lists of included studies and relevant systematic reviews will be searched to identify other papers eligible for inclusion. Two reviewers will extract information from all included studies and summarise the findings descriptively and numerically. The scoping review will provide an overview of how CLDs developed by stakeholders have been elicited to understand food environments, diet and obesity, the insights gained and how the CLDs have been used. It will also highlight gaps in knowledge and implications for policy and practice. The review will be disseminated through publication in an academic journal and conference presentations.
Publisher: Springer Science and Business Media LLC
Date: 11-07-2018
DOI: 10.1007/S10488-018-0887-5
Abstract: We conducted a systematic review of studies employing complex systems approaches (i.e., agent based and system dynamics models) to understand drivers of mental health and inform mental health policy. We extracted key data (e.g., purpose, design, data) for each study and provide a narrative synthesis of insights generated across studies. The studies investigated drivers and policy intervention strategies across a ersity of mental health outcomes. Based on these studies and the extant literature, we propose a typology of mental health research and policy areas that may benefit from complex systems approaches.
Publisher: Springer Science and Business Media LLC
Date: 03-05-2012
Abstract: A systematic review of qualitative studies was undertaken to understand the barriers to physical activity experienced by adolescents who were overweight or obese. From a search of electronic databases and ‘grey’ literature, published between 1950 and 2009, 15 studies met the inclusion criteria. Bronfenbrenner’s model of human development provided an ecological lens for identifying and synthesising barriers to physical activity. Two reviewers appraised study quality. Miles and Huberman’s cross-case analysis was integrated with thematic networking to synthesize the in idual, interpersonal and environmental level barriers for boys and girls of different ethnicities and socioeconomic status, across school settings and generalised context. Thirty-five barriers were identified, 13 of which occurred in physical activity situations in the school setting, 18 were not linked to a specific setting, and the remainder were common across both contexts. The fact that these barriers emerged from studies that focused on topics such as victimisation and mental health is particularly poignant and reflects the potentially pervasive influence of adolescent’s excessive weight not only in relation to physical activity situations but other aspects of their lives. Furthermore, socioeconomic status and ethnicity was poorly considered, with only one study linking these participant characteristics to quotations and discussing the potential implications. At present, there are few qualitative studies with sufficiently thick description or interpretive validity that provide insight into this vulnerable group of adolescents, and give them a voice to influence policy and practice.
Publisher: Elsevier BV
Date: 11-2019
Publisher: Springer Science and Business Media LLC
Date: 28-04-2023
Publisher: Springer Science and Business Media LLC
Date: 27-03-2019
DOI: 10.1007/S00127-019-01701-1
Abstract: To: (1) explore how multi-level factors impact the longitudinal prevalence of depression and alcohol misuse among urban older adults (≥ 65 years), and (2) simulate the impact of alcohol taxation policies and targeted interventions that increase social connectedness among excessive drinkers, socially isolated and depressed older adults both alone and in combination. An agent-based model was developed to explore the temporal co-evolution of depression and alcohol misuse prevalence among older adults nested in a spatial network. The model was based on Los Angeles and calibrated longitudinally using data from the Multi-Ethnic Study of Atherosclerosis. Interventions with a social component targeting depressed and socially isolated older adults appeared more effective in curbing depression prevalence than those focused on excessive drinkers. Targeting had similar impacts on alcohol misuse, though the effects were marginal compared to those on depression. Alcohol taxation alone had little impact on either depression or alcohol misuse trajectories. Interventions that improve social connectedness may reduce the prevalence of depression among older adults. Targeting considerations could play an important role in determining the success of such efforts.
Publisher: Elsevier BV
Date: 2021
Publisher: BMJ
Date: 13-06-2020
Abstract: Daily transport is associated with mental health. A free bus policy (FBP) may be effective in promoting the use of public transit in older adults and be associated with reductions in depressive symptoms. We developed an agent-based model and grounded it using empirical data from England to examine the impact of an FBP on public transit use and depression among older adults. We also used the model to explore whether the impact of the FBP bus use and depression is modified by the type of income segregation or by simultaneous efforts to improve attitudes towards the bus, to reduce waiting times or to increase the cost of driving via parking fees or fuel price. Our model suggests that improving attitudes towards the bus (eg, c aigns that promote bus use) could enhance the effect of the FBP, especially for those in proximity to public transit. Reducing wait times could also significantly magnify FPB impacts, especially in those who live in proximity to public transit. Contrary to expectation, neither fuel costs nor parking fees significantly enhanced the impact of the FBP. The impact of improving attitudes towards the bus and increasing bus frequency was more pronounced in the lower-income groups in an income segregation scenario in which destination and public transit are denser in the city centre. Our results suggest that the beneficial mental health effects of an FBP for older adults can be magnified when combined with initiatives that reduce bus waiting times and increased spatial access to transit.
Publisher: MDPI AG
Date: 09-02-2017
Publisher: Springer Science and Business Media LLC
Date: 10-05-2023
DOI: 10.1038/S41598-023-33641-X
Abstract: The SALURBAL (Urban Health in Latin America) Project is an interdisciplinary multinational network aimed at generating and disseminating actionable evidence on the drivers of health in cities of Latin America. We conducted a temporal multilayer network analysis where we measured cohesion over time using network structural properties and assessed ersity within and between different project activities according to participant attributes. Between 2017 and 2020 the SALURBAL network comprised 395 participants across 26 countries, 23 disciplines, and 181 institutions. While the cohesion of the SALURBAL network fluctuated over time, overall, an increase was observed from the first to the last time point of our analysis (clustering coefficient increased [0.83–0.91] and shortest path decreased [1.70–1.68]). SALURBAL also exhibited balanced overall ersity within project activities (0.5–0.6) by designing activities for different purposes such as capacity building, team-building, research, and dissemination. The network’s growth was facilitated by the creation of new erse collaborations across a range of activities over time, while maintaining the ersity of existing collaborations (0.69–0.75 between activity ersity depending on the attribute). The SALURBAL experience can serve as an ex le for multinational research projects aiming to build cohesive networks while leveraging heterogeneity in countries, disciplines, career stage, and across sectors.
Publisher: Annual Reviews
Date: 21-04-2011
DOI: 10.1146/ANNUREV.PUBLHEALTH.012809.103557
Abstract: This review examines environments in relation to cardiometabolic diseases in Indigenous populations in developed countries. Environmental factors are framed in terms of context (features of places) and composition (features of populations). Indigenous peoples are seen to have endured sociopolitical marginalization and material disadvantage spanning generations. Past adverse collective experiences, modified by culture, are reflected by current heterogeneity in environmental context and composition. As risk conditions, unfavorable contextual and compositional exposures influence the expression of cardiometabolic risk for in iduals. Minimal research has evaluated heterogeneity in risk conditions against heterogeneity in cardiometabolic diseases between or within Indigenous populations. Thus far, the features of populations, not of places themselves, have been implicated in relation to cardiometabolic diseases. Behavioral, psychosocial, and stress-axis pathways may explain the relationships between risk conditions and cardiometabolic diseases. Implications of environmental factors and their pathways as well as important research needs are discussed in relation to ecological prevention to reduce cardiometabolic diseases.
Publisher: Springer Science and Business Media LLC
Date: 21-11-2018
Publisher: Elsevier BV
Date: 04-2019
DOI: 10.1016/J.AMEPRE.2018.11.008
Abstract: Depression among older adults (aged 60 years or older) is a problem that could be exacerbated by global trends in urbanization and population aging. The study purpose was to assess whether urban, relative to rural, residence is associated with depression among older adults and whether associations differ in countries with developed versus developing economies. In 2017, the authors identified and extracted information from comparative studies of urban-rural depression prevalence among older adults. Studies were identified in PubMed, PsychINFO, and Web of Science and limited to English language articles published after 1985. Eighteen studies met inclusion criteria. Random effects meta-analysis was conducted to produce weighted pooled ORs estimating the association between urban-rural residence and depression for all study participants (N=31,598) and sub-analyses were conducted for developed (n=12,728) and developing (n=18,870) countries. Depression prevalence was significantly higher among urban residents in ten studies and significantly higher among rural residents in three studies (all three conducted in China). Associations between urban-rural residence and depression generally remained significant after adjusting for covariates. In developed countries, the odds of depression were significantly higher among urban than rural residents (pooled OR=1.44, 95% CI=1.10, 1.88). However, in developing countries, this association was not observed (pooled OR=0.91, 95% CI=0.46, 1.77). Converging trends of urbanization and population aging could increase the global burden of depression among older adults. The pathways through which urban-rural residence influences depression risk among older adults might differ by country context. Future research should focus on measuring variation in these contexts.
Publisher: Elsevier BV
Date: 07-2020
Publisher: American Public Health Association
Date: 07-2014
Publisher: Public Library of Science (PLoS)
Date: 26-10-2021
DOI: 10.1371/JOURNAL.PONE.0257528
Abstract: The built environment of cities is complex and influences social and environmental determinants of health. In this study we, 1) identified city profiles based on the built landscape and street design characteristics of cities in Latin America and 2) evaluated the associations of city profiles with social determinants of health and air pollution. Landscape and street design profiles of 370 cities were identified using finite mixture modeling. For landscape, we measured fragmentation, isolation, and shape. For street design, we measured street connectivity, street length, and directness. We fitted a two-level linear mixed model to assess the association of social and environmental determinants of health with the profiles. We identified four profiles for landscape and four for the street design domain. The most common landscape profile was the “proximate stones” characterized by moderate fragmentation, isolation and patch size, and irregular shape. The most common street design profile was the “semi-hyperbolic grid” characterized by moderate connectivity, street length, and directness. The “semi-hyperbolic grid”, “spiderweb” and “hyperbolic grid” profiles were positively associated with higher access to piped water and less overcrowding. The “semi-hyperbolic grid” and “spiderweb” profiles were associated with higher air pollution. The “proximate stones” and “proximate inkblots” profiles were associated with higher congestion. In conclusion, there is substantial heterogeneity in the urban landscape and street design profiles of Latin American cities. While we did not find a specific built environment profile that was consistently associated with lower air pollution and better social conditions, the different configurations of the built environments of cities should be considered when planning healthy and sustainable cities in Latin America.
No related grants have been discovered for Ivana Stankov.