October 28 | 2019

The association between walkable neighbourhoods and physical activity across the lifespan. 

Colley RC, Christidis T, Michaud I, Tjepkema M, Ross NA. 

Health Rep. 2019 Sep 18;30(9):3-13. doi: 10.25318/82-003-x201900900001-eng




Walkability is positively associated with physical activity in adults. Walkability is more consistently associated with walking for transportation than recreational walking. The purpose of this study is to examine how the association between walkable neighbourhoods and physical activity varies by age and type of physical activity using a new Canadian walkability database.


The 2016 Canadian Active Living Environments (Can-ALE) database was attached to two cross-sectional health surveys: the Canadian Health Measures Survey (CHMS; 2009 to 2015) and the Canadian Community Health Survey (CCHS; 2015 to 2016). Physical activity was measured in the CHMS using the Actical accelerometer (n = 10,987; ages 3 to 79). Unorganized physical activity outside of school among children aged 3 to 11 was reported by parents in the CHMS (n = 4,030), and physical activity data by type (recreational, transportation-based, school-based, and household and occupational) was self-reported by respondents in the CCHS (n = 105,876; ages 12 and older).


Walkability was positively associated with accelerometer-measured moderate-to-vigorous physical activity in youth (p ⟨ 0.05), younger adults (p ⟨ 0.0001) and older adults (p ⟨ 0.05), while walkability was negatively associated with light physical activity in youth (ages 12 to 17) and older adults (ages 60 to 79) (p ⟨ 0.05). Walkability was positively associated with self-reported transportation-based physical activity in youth (p ⟨ 0.001) and adults of all ages (p ⟨ 0.0001). Walkability was negatively associated with parent-reported unorganized physical activity of children aged 5 to 11, and children living in the most walkable neighbourhoods accumulated 10 minutes of physical activity less-on average-than those living in the least walkable neighbourhoods.


The results of this study are consistent with previous studies indicating that walkability is more strongly associated with physical activity in adults than in children and that walkability is associated with transportation-based physical activity. Walkability is one of many built environment factors that may influence physical activity. More research is needed to identify and understand the built environment factors associated with physical activity in children and with recreational or leisure-time physical activity.

October 21 | 2019

Low concentrations of fine particle air pollution and mortality in the Canadian Community Health Survey cohort.

Christidis T, Erickson AC, Pappin AJ, Crouse DL, Pinault LL, Weichenthal SA, Brook JR, van Donkelaar A, Hystad P, Martin RV, Tjepkema M, Burnett RT, Brauer M.

Environ Health. 2019 Oct 10;18(1):84. doi: 10.1186/s12940-019-0518-y



Approximately 2.9 million deaths are attributed to ambient fine particle air pollution around the world each year (PM2.5). In general, cohort studies of mortality and outdoor PM2.5 concentrations have limited information on individuals exposed to low levels of PM2.5 as well as covariates such as smoking behaviours, alcohol consumption, and diet which may confound relationships with mortality. This study provides an updated and extended analysis of the Canadian Community Health Survey-Mortality cohort: a population-based cohort with detailed PM2.5 exposure data and information on a number of important individual-level behavioural risk factors. We also used this rich dataset to provide insight into the shape of the concentration-response curve for mortality at low levels of PM2.5.


Respondents to the Canadian Community Health Survey from 2000 to 2012 were linked by postal code history from 1981 to 2016 to high resolution PM2.5 exposure estimates, and mortality incidence to 2016. Cox proportional hazard models were used to estimate the relationship between non-accidental mortality and ambient PM2.5 concentrations (measured as a three-year average with a one-year lag) adjusted for socio-economic, behavioural, and time-varying contextual covariates.


In total, 50,700 deaths from non-accidental causes occurred in the cohort over the follow-up period. Annual average ambient PM2.5 concentrations were low (i.e. 5.9 μg/m3, s.d. 2.0) and each 10 μg/m3 increase in exposure was associated with an increase in non-accidental mortality (HR = 1.11; 95% CI 1.04-1.18). Adjustment for behavioural covariates did not materially change this relationship. We estimated a supra-linear concentration-response curve extending to concentrations below 2 μg/m3 using a shape constrained health impact function. Mortality risks associated with exposure to PM2.5 were increased for males, those under age 65, and non-immigrants. Hazard ratios for PM2.5 and mortality were attenuated when gaseous pollutants were included in models.


Outdoor PM2.5 concentrations were associated with non-accidental mortality and adjusting for individual-level behavioural covariates did not materially change this relationship. The concentration-response curve was supra-linear with increased mortality risks extending to low outdoor PM2.5 concentrations.


October 15 | 2019

Disproportionately higher exposure to urban heat in lower-income neighborhoods: a multi-city perspective.

T Chakraborty, A Hsu, D Manya and G Sheriff.

Environmental Research Letters, Volume 14, Number 10
Focus on Sustainable Cities: Urban Solutions Towards Desired Outcomes Published 30 September 2019 • © 2019 The Author(s). Published by IOP Publishing Ltd

DOI https://doi.org/10.1088/1748-9326/ab3b99


A growing literature documents the effects of heat stress on premature mortality and other adverse health outcomes. Urban heat islands (UHI) can exacerbate these adverse impacts in cities by amplifying heat exposure during the day and inhibiting the body’s ability to recover at night. Since the UHI intensity varies not only across, but also within cities, intra-city variation may lead to differential impact of urban heat stress on different demographic groups. To examine these differential impacts, we combine satellite observations with census data to evaluate the relationship between distributions of both UHI and income at the neighborhood scale for 25 cities around the world. We find that in most (72%) cases, poorer neighborhoods experience elevated heat exposure, an incidental consequence of the intra-city distribution of income in cities. This finding suggests that policymakers should consider designing city-specific UHI reduction strategies to mitigate its impacts on the most socioeconomically vulnerable populations who may be less equipped to adapt to environmental stressors. Since the strongest contributor of intra-urban UHI variability among the physical characteristics considered in this study is a neighborhood’s vegetation density, increasing green space in lower income neighborhoods is one strategy urban policymakers can adopt to ameliorate some of UHI’s inequitable burden on economically disadvantaged residents.

October 7 | 2019

Residential surrounding green, air pollution, traffic noise and self-perceived general health. 

Klompmaker JO, Janssen NAH, Bloemsma LD, Gehring U, Wijga AH, van den Brink C, Lebret E, Brunekreef B, Hoek G. 

Environ Res. 2019 Sep 17;179(Pt A):108751.[Epub ahead of print] DOI: 10.1016/j.envres.2019.108751



Self-perceived general health (SGH) is one of the most inclusive and widely used measures of health status and a powerful predictor of mortality. However, only a limited number of studies evaluated associations of combined environmental exposures on SGH. Our aim was to evaluate associations of combined residential exposure to surrounding green, air pollution and traffic noise with poor SGH in the Netherlands. We linked data on long-term residential exposure to surrounding green based on the Normalized Difference Vegetation Index (NDVI) and a land-use database (TOP10NL), air pollutant concentrations (including particulate matter (PM10, PM2.5), and nitrogen dioxide (NO2)) and road- and rail-traffic noise with a Dutch national health survey, resulting in a study population of 354,827 adults. We analyzed associations of single and combined exposures with poor SGH. In single-exposure models, NDVI within 300 m was inversely associated with poor SGH [odds ratio (OR) = 0.91, 95% CI: 0.89, 0.94 per IQR increase], while NO2 was positively associated with poor SGH (OR = 1.07, 95% CI: 1.04, 1.11 per IQR increase). In multi-exposure models, associations with surrounding green and air pollution generally remained, but attenuated. Joint odds ratios (JOR) of combined exposure to air pollution, rail-traffic noise and decreased surrounding green were higher than the odds ratios of single-exposure models. Studies including only one of these correlated exposures may overestimate the risk of poor SGH attributed to the studied exposure, while underestimating the risk of combined exposures.