ORCID Profile
0000-0002-2056-9646
Current Organisation
University of Sydney School of Medical Sciences
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Publisher: BMJ
Date: 12-2018
DOI: 10.1136/BMJOPEN-2018-026954
Abstract: Deficiencies in childhood development is a major global issue and inequalities are large. The influence of environmental exposures on childhood development is currently insufficiently explored. This project will analyse the impact of various modifiable early life environmental exposures on different dimensions of childhood development. Born to be Wise will study a Canadian cohort of approximately 34 000 children who have completed an early development test at the age of 5. Land use regression models of air pollution and spatially defined noise models will be linked to geocoded data on early development to analyse any harmful effects of these exposures. The potentially beneficial effect on early development of early life exposure to natural environments, as measured by fine-grained remote sensing data and various land use indexes, will also be explored. The project will use data linkages and analyse overall and age-specific impact, including variability depending on cumulative exposure by assigning time-weighted exposure estimates and by studying subs les who have changed residence and exposure. Potentially moderating effects of natural environments on air pollution or noise exposures will be studied by mediation analyses. A matched case–control design will be applied to study moderating effects of natural environments on the association between low socioeconomic status and early development. The main statistical approach will be mixed effects models, applying a specific software to deal with multilevel random effects of nested data. Extensive confounding control will be achieved by including data on a range of detailed health and sociodemographic variables. The study protocol has been ethically approved by the Behavioural Research Ethics Board at the University of British Columbia. The findings will be published in peer-reviewed journals and presented at scholarly conferences. Through stakeholder engagement, the results will also reach policy and a broader audience.
Publisher: Elsevier BV
Date: 04-2019
DOI: 10.1016/J.ENVRES.2019.01.034
Abstract: In a rapidly urbanizing world, identifying evidence-based strategies to support healthy design is essential. Although urban living offers increased access to critical resources and can help to mitigate climate change, densely populated neighborhood environments are often higher in many of the physical and psychological stressors that are detrimental to health, and lower in the social capital that is beneficial to health. One component of urban form that can reduce these stressors and improve social capital is nature: greenspace, such as parks and street trees, and bluespace, such as rivers and oceans. In this project, we applied measures from a Natural Space Index previously developed for the Vancouver, Canada census metropolitan area to explore the relationship between distinct measures of natural space and prevalence of (1) major depressive disorder, (2) negative mental health, and (3) psychological distress. In addition, we examined direct associations between natural space exposure and neighborhood social capital, as measured via self-reported sense of community belonging (SoC), as well as the potential mental health benefits of natural space mediated via SoC. Using data from the population-based, cross-sectional 2012 Canadian Community Health Survey-Mental Health (weighted n = 1,930,048), we found no direct associations between any measure of natural space and mental health in models adjusted for 11 demographic, socioeconomic, household arrangement, health, and urban design variables. However, publicly accessible neighborhood nature was associated with increased odds of higher SoC. A 1% increase in the percentage of natural space (combined greenspace and bluespace) within 500 m had an odds ratio [95% confidence interval] of 1.05 [1.00, 1.10] for very strong vs. very weak SoC and 1.04 [1.01, 1.08] for somewhat strong vs. very weak SoC. In addition, higher levels of SoC were associated with improvements in all three mental health outcomes. Mediation tests indicated significant indirect effects of both publicly accessible neighborhood nature variables on reductions in psychological distress and reduced odds of negative mental health via increased sense of SoC. This suggests that natural space has the potential to address the pressing issue of social isolation and, in turn, poor mental health faced by residents of dense urban environments.
Publisher: MDPI AG
Date: 02-06-2021
Abstract: The COVID-19 pandemic has caused an increase in anxiety and depression levels across broad populations. While anyone can be infected by the virus, the presence of certain chronic diseases has been shown to exacerbate the severity of the infection. There is a likelihood that knowledge of this information may lead to negative psychological impacts among people with chronic illness. We hypothesized that the pandemic has resulted in increased levels of anxiety and depression symptoms among people with chronic illness. We recruited 540 participants from the ongoing Prospective Urban and Rural Epidemiology (PURE) study in British Columbia, Canada. Participants were asked to fill out an online survey that included the Hospital Anxiety Depression Scale (HADS) to assess anxiety and depression symptoms. We tested our hypothesis using bivariate and multivariable linear regression models. Out of 540 participants, 15% showed symptoms of anxiety and 17% reported symptoms of depression. We found no significant associations between having a pre-existing chronic illness and reporting higher levels of anxiety or depression symptoms during COVID-19. Our results do not support the hypothesis that having a chronic illness is associated with greater anxiety or depression symptoms during the COVID-19 pandemic. Our results were similar to one study but in contrast with other studies that found a positive association between the presence of chronic illness and developing anxiety or depression during this pandemic.
Publisher: Springer Science and Business Media LLC
Date: 13-01-2022
DOI: 10.1186/S12889-021-12438-5
Abstract: By 2050, the global population of adults 60 + will reach 2.1 billion, surging fastest in low- and middle-income countries (LMIC). In response, the World Health Organization (WHO) has developed indicators of age-friendly urban environments, but these criteria have been challenging to apply in rural areas and LMIC. This study fills this gap by adapting the WHO indicators to such settings and assessing variation in their availability by community-level urbanness and country-level income. We used data from the Prospective Urban and Rural Epidemiology (PURE) study’s environmental-assessment tools, which integrated systematic social observation and ecometrics to reliably capture community-level environmental features associated with cardiovascular-disease risk factors. The results of a scoping review guided selection of 18 in idual indicators across six distinct domains, with data available for 496 communities in 20 countries, including 382 communities (77%) in LMIC. Finally, we used both factor analysis of mixed data (FAMD) and multitrait-multimethod (MTMM) approaches to describe relationships between indicators and domains, as well as detailing the extent to which these relationships held true within groups defined by urbanness and income. Together, the results of the FAMD and MTMM approaches indicated substantial variation in the relationship of in idual indicators to each other and to broader domains, arguing against the development of an overall score and extending prior evidence demonstrating the need to adapt the WHO framework to the local context. Communities in high-income countries generally ranked higher across the set of indicators, but regular connections to neighbouring towns via bus (95%) and train access (76%) were most common in low-income countries. The greatest amount of variation by urbanness was seen in the number of streetscape-greenery elements (33 such elements in rural areas vs. 55 in urban), presence of traffic lights (18% vs. 67%), and home-internet availability (25% vs. 54%). This study indicates the extent to which environmental supports for healthy ageing may be less readily available to older adults residing in rural areas and LMIC and augments calls to tailor WHO’s existing indicators to a broader range of communities in order to achieve a critical aspect of distributional equity in an ageing world.
Publisher: Elsevier BV
Date: 06-2023
Publisher: Elsevier BV
Date: 06-2020
Publisher: Informa UK Limited
Date: 04-08-2023
Publisher: Elsevier BV
Date: 11-2017
DOI: 10.1016/J.ENVRES.2017.08.033
Abstract: Natural spaces can provide psychological benefits to in iduals, but population-level epidemiologic studies have produced conflicting results. Refining current exposure-assessment methods is necessary to advance our understanding of population health and to guide the design of health-promoting urban forms. The aim of this study was to develop a comprehensive Natural Space Index that robustly models potential exposure based on the presence, form, accessibility, and quality of multiple forms of greenspace (e.g., parks and street trees) and bluespace (e.g., oceans and lakes). The index was developed for greater Vancouver, Canada. Greenness presence was derived from remote sensing (NDVI/EVI) forms were extracted from municipal and private databases and accessibility was based on restrictions such as private ownership. Quality appraisals were conducted for 200 randomly s led parks using the Public Open Space Desktop Appraisal Tool (POSDAT). Integrating these measures in GIS, exposure was assessed for 60,242 postal codes using 100- to 1,600-m buffers based on hypothesized pathways to mental health. A single index was then derived using principal component analysis (PCA). Comparing NDVI with alternate approaches for assessing natural space resulted in widely ergent results, with quintile rankings shifting for 22-88% of postal codes, depending on the measure. Overall park quality was fairly low (mean of 15 on a scale of 0-45), with no significant difference seen by neighborhood-level household income. The final PCA identified three main sets of variables, with the first two components explaining 68% of the total variance. The first component was dominated by the percentages of public and private greenspace and bluespace and public greenspace within 250m, while the second component was driven by lack of access to bluespace within 1 km. Many current approaches to modeling natural space may misclassify exposures and have limited specificity. The Natural Space Index represents a novel approach at a regional scale with application to urban planning and policy-making.
Publisher: Elsevier BV
Date: 09-2015
DOI: 10.1016/J.APPET.2015.05.011
Abstract: Adequate fruit and vegetable consumption has been linked to reductions in all-cause mortality, stroke, and cancer. Unfortunately, less than half of Canadians aged 65+ meet the standard international guideline for adequate consumption (≥5 servings per day). Among older adults, social isolation and low social support are barriers to proper nutrition, but the effects of specific types of social support on adequate fruit and vegetable consumption are unknown. This study sought to test hypotheses regarding direct and indirect pathways through which tangible and emotional/informational social support may facilitate adequate fruit and vegetable consumption among older adults. Analyzing 2008-2009 Canadian Community Health Survey - Healthy Aging component data (n = 14,221), logistic regression models were developed to examine associations between tangible and emotional/informational social support, eating behaviors (eating alone and preparing one's own meals), and meeting the recommended guideline of consuming ≥5 servings of fruit and vegetables per day. In pooled models, emotional/informational support was positively associated with adequate fruit and vegetable consumption (OR = 1.16 95% CI = 1.07, 1.27). Among men, neither social support form was directly or indirectly associated with adequate consumption among women, adequate consumption was negatively associated with tangible support but positively associated with higher emotional/informational support. Both of these associations were mediated by not usually cooking one's own meals. Programs and policies that seek to foster social support for older adults as a means of ensuring proper nutrition should consider the nuanced mechanisms through which different social support forms may operate for men and women.
Publisher: Routledge
Date: 25-07-2023
Location: Canada
No related grants have been discovered for Emily Rugel.