Built environment and health: a systematic review of studies in Germany

Schulz, Maike; Romppel, Matthias; Grande, Gesine

doi:10.1093/pubmed/fdw141

Cited by 56 publications

(57 citation statements)

References 52 publications

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“…Numerous epidemiological studies have investigated associations between greenspace exposure and obesity and body mass index (BMI) in different populations, but the results have been heterogeneous. Six prior reviews synthesized epidemiological studies on this topic, 15–20 although none performed a meta‐analysis. Three of the previous reviews focused on multiple features of the built environment, and greenspace was only considered as one of them 15,17,19 .…”

Section: Introductionmentioning

confidence: 99%

“…Six prior reviews synthesized epidemiological studies on this topic, 15–20 although none performed a meta‐analysis. Three of the previous reviews focused on multiple features of the built environment, and greenspace was only considered as one of them 15,17,19 . Two reviews 16,18 focused on associations between greenspace exposure and human health endpoints, including obesity.…”

Section: Introductionmentioning

confidence: 99%

“…The summarized findings of these recent reviews were inconsistent. For example, James et al 16 concluded a lower risk of obesity associated with more greenspace, whereas Schulz et al 15 reported no association. Further, these reviews included articles published before 2016 and so could not incorporate several more recent high‐quality articles on this topic 9,10,28–48 …”

Section: Introductionmentioning

confidence: 99%

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Greenspace with overweight and obesity: A systematic review and meta‐analysis of epidemiological studies up to 2020

et al. 2020

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Several reviews have been conducted to assess the association between greenspace and overweight or obesity, but the conclusions were inconsistent. However, an updated comprehensive review and meta-analysis is warranted, because several high-quality papers have been published more recently. The objectives of this study are to systematically and quantitatively assess the evidence for a link between greenspace with overweight/obesity and to make specific recommendations for further research. We searched three English language databases, four Chinese language databases and the reference lists of previously published reviews for epidemiological studies on greenspace and overweight/obesity published before January 2020. We developed inclusion criteria, screened the literature and extracted key data from selected papers. We assessed methodological quality and risk of bias, and we graded the credibility of the pooled evidence. We also performed sensitivity analyses. Fifty-seven records met our inclusion criteria and were included in the study. Most studies were cross-sectional designs (81%) and were from developed nations (88%). More than half (55%) of the included studies found beneficial associations between greenspace and overweight/obesity in overall or subpopulations. Our meta-analytical results showed that greater normalized difference vegetation index was associated with lower odds of overweight/obesity in a statistically significant fashion (odds ratio [OR]: 0.88; 95% CI: 0.84, 0.91) but not residential proximity to greenspace (OR: 0.99; 95% CI: 0.99, 1.00), proportion of greenspace (OR: 0.96; 95% CI: 0.85, 1.08) or number of parks in an area (OR: 0.99; 95% CI: 0.97, 1.01). However, we detected high between-study heterogeneity in two of the four meta-analyses, which reduced the credibility of the pooled evidence. Current evidence indicates that there might be an association between greater access to greenspace and lower odds of overweight/obesity. However, additional high-quality studies are needed to more definitively assess the evidence for a causal association.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Greenspace with overweight and obesity: A systematic review and meta‐analysis of epidemiological studies up to 2020

et al. 2020

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“…Country-specific literature reviews on the association between built environment and different health outcomes are scarce. 32 Generating and sharing local evidence (e.g., via literature reviews) with stakeholders, practitioners, and decision-makers is identified as one of several vital approaches needed for the development and implementation of land use and transportation policies for a health-supportive environment within the Canadian context. 33 Thus, the aim of our study was to undertake a scoping review to synthesize and map evidence from quantitative studies that have investigated the built environment and its associations with modifiable health conditions, self-reported health, quality of life, and injuries in the Canadian adult population.…”

Section: Introductionmentioning

confidence: 99%

A scoping review on the relations between urban form and health: a focus on Canadian quantitative evidence

McCormack

Cabaj

Orpana

et al. 2019

Health Promot Chronic Dis Prev Can

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Introduction Despite the accumulating Canadian evidence regarding the relations between urban form and health behaviours, less is known about the associations between urban form and health conditions. Our study aim was to undertake a scoping review to synthesize evidence from quantitative studies that have investigated the relationship between built environment and chronic health conditions, self-reported health and qual¬ity of life, and injuries in the Canadian adult population. Methods From January to March 2017, we searched 13 databases to identify peer-reviewed quantitative studies from all years that estimated associations between the objectively-measured built environment and health conditions in Canadian adults. Studies under¬taken within urban settings only were included. Relevant studies were catalogued and synthesized in relation to their reported study and sample design, and health outcome and built environment features. Results Fifty-five articles met the inclusion criteria, 52 of which were published after 2008. Most single province studies were undertaken in Ontario (n = 22), Quebec (n = 12), and Alberta (n = 7). Associations between the built environment features and 11 broad health outcomes emerged from the review, including injury (n = 19), weight status (n = 19), cardiovascular disease (n = 5), depression/anxiety (n = 5), diabetes (n = 5), mortality (n = 4), self-rated health (n = 2), chronic conditions (n = 2), metabolic condi¬tions (n = 2), quality of life (n = 1), and cancer (n = 1). Consistent evidence for asso¬ciations between aggregate built environment indicators (e.g., walkability) and diabetes and weight and between connectivity and route features (e.g., transportation route, trails, pathways, sidewalks, street pattern, intersections, route characteristics) and injury were found. Evidence for greenspace, parks and recreation features impacting multiple health outcomes was also found. Conclusion Within the Canadian context, the built environment is associated with a range of chronic health conditions and injury in adults, but the evidence to date has limi¬tations. More research on the built environment and health incorporating rigorous study designs are needed to provide stronger causal evidence to inform policy and practice.

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“…Evidence demonstrating associations between the neighborhood environment and chronic disease [26,27], well-being [28], and physical activity [29,30] exists, yet few studies have investigated the relations between the neighborhood built environment and fitness [31][32][33][34][35]. For example, Hoehner et al [31] found positive associations between objectively-measured neighborhood intersection density, vegetation coverage, and count of private exercise facilities and objectively-measured CRF.…”

Section: Introductionmentioning

confidence: 99%

Active and Fit Communities. Associations between Neighborhood Walkability and Health-Related Fitness in Adults

McCormack

Frehlich

Blackstaffe

et al. 2020

IJERPH

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There are many health benefits of regular physical activity and improving physical fitness levels can reduce the risk of chronic disease. Accumulating evidence suggests the neighborhood built environment is important for supporting physical activity; however, few studies have investigated the contribution of the neighborhood built environment to fitness levels. We examined the associations between objectively-determined and self-reported neighborhood walkability and overall and specific components of perceived health-related fitness (cardiorespiratory, muscular strength, and flexibility) in a random sample of 592 adults from two areas of Calgary (Canada). Participants provided complete data to an online questionnaire capturing perceived cardiorespiratory fitness (CRF), muscular strength (MST), flexibility, moderate-to-vigorous intensity physical activity (MVPA), resistance training, and sociodemographic characteristics. The questionnaire also captured participant’s perceptions of their neighborhood’s walkability (Physical Activity Neighborhood Environment Scale; PANES) and the physical activity supportiveness of neighborhood parks (Park Perceptions Index; PPI). Objectively-measured neighborhood walkability was estimated using Walk Score®. The average (SD) age of participants was 46.6 (14.8) years and 67.2% were female. Participants, on average, participated in at least 30-minutes of MVPA on 3.4 (2.1) days/week and undertook resistance training 2.0 (1.8) days/week. Adjusting for covariates, Walk Score® was not associated with any fitness outcomes. Adjusting for covariates, the PANES index was positively associated (p < 0.05) with CRF, MST, flexibility, and overall fitness and the PPI was positively associated (p < 0.05) with all fitness outcomes except MST. Our findings provide novel preliminary evidence suggesting the neighborhood built environment may be important for supporting higher health-related fitness levels in adults.

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Built environment and health: a systematic review of studies in Germany

Abstract: Future research should investigate relationships using a sound theoretical basis and research designs that better account for the complex relationship between the built environment and health.

Cited by 56 publications

References 52 publications

Greenspace with overweight and obesity: A systematic review and meta‐analysis of epidemiological studies up to 2020

Greenspace with overweight and obesity: A systematic review and meta‐analysis of epidemiological studies up to 2020

A scoping review on the relations between urban form and health: a focus on Canadian quantitative evidence

Active and Fit Communities. Associations between Neighborhood Walkability and Health-Related Fitness in Adults

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