February 19 | 2019

Health Benefits of Physical Activity Related to an Urban Riverside Regeneration.

Vert C, Nieuwenhuijsen M, Gascon M, Grellier J, Fleming LE, White MP, Rojas-Rueda D.

Int J Environ Res Public Health. 2019 Feb 5;16(3). pii: E462. Doi: 10.3390/ijerph16030462



The promotion of physical activity through better urban design is one pathway by which health and well-being improvements can be achieved. This study aimed to quantify health and health-related economic impacts associated with physical activity in an urban riverside park regeneration project in Barcelona, Spain. We used data from Barcelona local authorities and meta-analysis assessing physical activity and health outcomes to develop and apply the “Blue Active Tool”. We estimated park user health impacts in terms of all-cause mortality, morbidity (ischemic heart disease; ischemic stroke; type 2 diabetes; cancers of the colon and breast; and dementia), disability-adjusted life years (DALYs) and health-related economic impacts. We estimated that 5753 adult users visited the riverside park daily and performed different types of physical activity (walking for leisure or to/from work, cycling, and running). Related to the physical activity conducted on the riverside park, we estimated an annual reduction of 7.3 deaths (95% CI: 5.4; 10.2), and 6.2 cases of diseases (95% CI: 2.0; 11.6). This corresponds to 11.9 DALYs (95% CI: 3.4; 20.5) and an annual health-economic impact of 23.4 million euros (95% CI: 17.2 million; 32.8 million). The urban regeneration intervention of this riverside park provides health and health-related economic benefits to the population using the infrastructure.

February 11 | 2019

Exposure to natural space, sense of community belonging, and adverse mental health outcomes across an urban region.

Rugel EJ, Carpiano RM, Henderson SB, Brauer M.

Environ Res. 2019 Jan 25;171:365-377. DOI: 10.1016/j.envres.2019.01.034


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.

Ambient Air Pollution and the Risk of Childhood-onset Inflammatory Bowel Disease | FEBRUARY 12 | 2019

9am-10am pacific | 12 noon – 1pm eastern


 The incidence of inflammatory bowel disease (IBD) has risen drastically in industrialized nations, such as Canada, over the last half of the 20th century. Although the incidence rate in adults with IBD has plateaued in Canada, the incidence of IBD among Canadian children is continuing to rise. Environmental risk factors, such as air pollution may be involved in IBD development, but epidemiological studies are inconclusive.

This presentation will summarize the results from a study investigating the effects of ambient air pollution on the risk of developing pediatric-onset IBD using Ontario administrative health data. In-utero and childhood residential exposures to nitrogen dioxide (NO2), fine particulate matter (PM2.5) and ozone (O3) were evaluated in terms of their potential associations with IBD diagnosed before the age of 18. Other environmental factors, such as residential exposure to greenness as well as several maternal and individual-level factors were also considered as potential confounders and effect modifiers of these associations.

Michael Elten is currently completing a Master’s degree in Epidemiology in the School of Epidemiology and Public Health at the University of Ottawa. His research focuses on evaluating the effects of air pollution on health, with an emphasis on maternal and early-life exposures.






February 4 | 2019

Neighbourhood walkability and the incidence of diabetes: an inverse probability of treatment weighting analysis.

Booth GL, Creatore M, Luo J, Fazli GS, Johns A, Rosella LC, Glazier RH, Moineddin R, Gozdyra P, Austin PC.

J Epidemiol Community Health. 2019 Jan 29.. [Epub ahead of print]  DOI:10.1136/jech-2018-210510



People living in highly walkable neighbourhoods tend to be more physically active and less likely to be obese. Whether walkable urban design reduces the future risk of diabetes is less clear.


We used inverse probability of treatment weighting to compare 10-year diabetes incidence between residents living in high-walkability and low-walkability neighbourhoods within five urban regions in Ontario, Canada. Adults (aged 30-85 years) who were diabetes-free on 1 April 2002 were identified from administrative health databases and followed until 31 March 2012 (n=958 567). Within each region, weights reflecting the propensity to live in each neighbourhood type were created based on sociodemographic characteristics, comorbidities and healthcare utilisation and incorporated into region-specific Cox proportional hazards models.


Low-walkability areas were more affluent and had more South Asian residents (6.4%vs3.6%, p<0.001) but fewer residents from other minority groups (16.6%vs21.7%, p<0.001). Baseline characteristics were well balanced between low-walkability and high-walkability neighbourhoods after applying individual weights (standardised differences all <0.1). In each region, high walkability was associated with lower diabetes incidence among adults aged <65 years (overall weighted incidence: 8.2vs9.2 per 1000; HR 0.85, 95% CI 0.78 to 0.93), but not among adults aged ≥65 years (weighted incidence: 20.7vs19.5 per 1000; HR 1.01, 95% CI 0.91 to 1.12). Findings were consistent regardless of income and immigration status.


Younger adults living in high-walkability neighbourhoods had a lower 10-year incidence of diabetes than similarly aged adults living in low-walkability neighbourhoods. Urban designs that support walking may have important benefits for diabetes prevention.

Interactive Mapping of Environmental Health Assessments | MARCH 19 | 2019

9am-10am pacific | 12 noon – 1pm eastern

Non communicable diseases including cardiovascular disease, diabetes, and cancer are the leading causes of morbidity and mortality among populations in high income countries. The rapid increase of overweight and obesity among Canadians and its associated consequences, including hypertension and diabetes is a major public health problem, and threaten to halt the declines in cardiovascular disease deaths Canada has experienced in the past 30 years.

Knowledge gaps exist regarding the impact of the built environment in relation to individual risk factor development, and the variation of these built environments across Canada by region and rurality. In order to address these gaps in our knowledge, we convened the Canadian Alliance of Healthy Hearts and Minds – a prospective cohort of men and women recruited from existing cohorts in Canada and through recruitment of a new First Nations cohort study.

As part of the knowledge translation plan of the Canadian Alliance for Healthy Hearts and Minds project, we developed and released an on-line, interactive map of 2,074 communities across Canada that conveys the information from our community contextual health audits. In this presentation, I will describe the development of the map, and describe how to access and use the tools embedded in the map.

Russell de Souza is an Assistant Professor in the Department of Health Research Methods, Evidence, and Impact at McMaster University.  He is a registered dietitian, and his research focuses on dietary patterns, health, and how the food environment shapes food choice and risk of cardiovascular disease.

Developing Apps for Population Health Research | APRIL 17 | 2019

9am – 10am pacific | 12 noon – 1pm eastern | 1:30pm – 2:30pm NFLD



Advances in technology, including mobile apps, have provided researchers with new ways to collect data. Health researchers are increasingly interested in developing and using mobile apps for research data collection. However, many challenges exist for health researchers when developing mobile apps. The purpose of this webinar is provide an overview of results of a report interviewing 8 researchers who have developed mobile apps. We will also provide recommendations for researchers who are planning to develop a health research apps.


Melissa Tobin is a Master of Science in Kinesiology student at Memorial University and an INTERACT Trainee. She is a graduate of the Bachelor of Kinesiology Honours (Co-op) Degree from Memorial University. Melissa’s master’s research will focus on how exposure to active transportation infrastructure influences physical activity levels. Melissa is very passionate about increasing physical activity levels for all members of our community.


Daniel Fuller is Canada Research Chair in Population Physical Activity in the School of Human Kinetics and Recreation at Memorial University. His research is focused on using wearable technologies to study physical activity, transportation interventions, and equity in urban spaces. He focuses his methodological work on methods for natural experiments, and machine learning.



January 28 | 2019

The heat penalty of walkable neighbourhoods. 

O’Brien GA, Ross NA, Strachan IB.

Int J Biometeorol. 2019 Jan 24.. [Epub ahead of print] DOI: 10.1007/s00484-018-01663-0



“Walkability” or walking-friendliness is generally considered a favourable attribute of a neighbourhood that supports physical activity and improves health outcomes. Walkable neighbourhoods tend to have high-density infrastructure and relatively high amounts of concrete and pavement for sidewalks and streets, all of which can elevate local urban temperatures. The objective of this study was to assess whether there is a “heat penalty” associated with more walkable neighbourhoods in Montréal, Québec, Canada, using air temperature measurements taken in real time at street level during a heat event. The mean temperature of “Car-Dependent” neighbourhoods was 26.2 °C (95% CI 25.8, 26.6) whereas the mean temperature of “Walker’s Paradise” neighbourhoods was 27.9 °C (95% CI 27.8, 28.1)-a difference of 1.7 °C (95% CI 1.3, 2.0). There was a strong association between higher walkability of Montréal neighbourhoods and elevated temperature (r = 0.61, p < 0.01); suggestive of a heat penalty for walkable neighbourhoods. Planning solutions that support increased walking-friendliness of neighbourhoods should consider simultaneous strategies to mitigate heat to reduce potential health consequences of the heat penalty.

January 21 | 2019

Residential greenness and mortality in oldest-old women and men in China: a longitudinal cohort study.

John S Ji ScD, Anna Zhu MSc, Chen Bai PhD, Chih-Da Wu PhD, Lijing Yan PhD, Prof Shenglan Tang PhD, Prof Yi Zeng PhD, Peter James ScD.

The Lancet Planetary Health,Volume 3, Issue 1, January 2019, Pages e17-e25 https://doi.org/10.1016/S2542-5196(18)30264-X




Exposure to natural vegetation, or greenness, might affect health through several pathways, including increased physical activity and social engagement, improved mental health, and reductions in exposure to air pollution, extreme temperatures, and noise. Few studies of the effects of greenness have focused on Asia, and, to the best of our knowledge, no study has assessed the effect on vulnerable oldest-old populations. We assessed the association between residential greenness and mortality in an older cohort in China.


We used five waves (February, 2000–October, 2014) of the China Longitudinal Healthy Longevity Survey (CLHLS), a prospective cohort representative of the general older population in China. We assessed exposure to greenness through satellite-derived Normalised Difference Vegetation Index (NDVI) values in the 250 m and 1250 m radius around the residential address for each individual included in the study. We calculated contemporaneous NDVI values, cumulative NDVI values, and changes in NDVI from the start of the study over time. The health outcome of the study was all-cause mortality, excluding accidental deaths. Mortality rate ratios were estimated with Cox proportional hazards models, adjusted for age, sex, ethnicity, marital status, geographical region, childhood and adult socioeconomic status, social and leisure activity, smoking status, alcohol consumption, and physical activity.


Among 23 754 individuals (mean age at baseline 93 years [SD 7·5]) totaling 80 001 person-years, we observed 18 948 deaths during 14 years of follow-up, between June, 2000, and December, 2014. Individuals in the highest quartile of contemporaneous NDVI values had 27% lower mortality than those in the lowest quartile for the 250 m radius (hazard ratio [HR] 0·73, 95% CI 0·70–0·76), and 30% lower mortality for the 1250 m radius (0·70, 0·67–0·74). No clear association was observed for cumulative NDVI measurements and mortality. We did not detect an association between area-level changes in NDVI and mortality.


Our research suggests that proximity to more green space is associated with increased longevity, which has policy implications for the national blueprint of ecological civilisation and preparation for an ageing society in China.

January 14 | 2019

Residential noise exposure and the longitudinal risk of hospitalization for depression after pregnancy: Postpartum and beyond. 

He S, Smargiassi A, Low N, Bilodeau-Bertrand M, Ayoub A, Auger N.

Environ Res. 2018 Dec 3;170:26-32. doi: 10.1016/j.envres.2018.12.001  [Epub ahead of print]



Depression is a major public health concern, but the link with the built environment is unclear. We sought to determine the relationship between residential noise during pregnancy and later risk of severe depression in women.


We analyzed a population-based cohort of 140,456 women with no documented history of mental illness who were pregnant in Montreal between 2000 and 2016. We obtained residential noise estimates (LAeq. 24 h, Lden, Lnight) from land use regression models, and followed the women over time for up to 18 years after pregnancy to identify subsequent hospitalizations for depression or other mental disorders. We used Cox regression to compute hazard ratios and 95% confidence intervals (CI) adjusted for maternal characteristics.


There were 8.0 incident hospitalizations for depression and 16.4 for other mental disorders per 10,000 person-years in women exposed to an LAeq. 24 h of 60-64.9 dB(A). The incidence was lower for noise at < 55 dB(A), with 7.4 hospitalizations for depression and 13.8 for other mental disorders per 10,000 person-years. Compared with 50 dB(A), an LAeq. 24 h of 60 dB(A) was associated with 1.16 times (95% CI 0.84-1.62) the risk of depression hospitalization, and 1.34 times (95% CI 1.04-1.74) the risk of other mental disorders. Associations were more prominent for Lnight, with 1.32 times (95% CI 1.08-1.63) the risk of depression hospitalization at 60 dB(A) and 1.68 times the risk (95% CI 1.05-2.67) at 70 dB(A).


Pregnant women exposed to noise, especially nighttime noise, have a greater risk of hospitalization for depression and other mental disorders later in life. Residential noise may be a risk factor for depression after pregnancy.


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