...coming soon!

Wijesundera J, Ball G, Wray A, Gilliland J, Savu A, Dover D, Haqq A, & Kaul P. 2024. Childhood Obesity

Background: The built environment can impact health outcomes. Our purpose was to examine relationships between built environment variables related to physical activity and excess weight in preschoolers. Methods: In this retrospective, population-level study of 4- to 6-year-olds, anthropometric measurements were taken between 2009 and 2017 in Calgary and Edmonton, Alberta, Canada. Based on BMI z-scores (BMIz), children were classified as normal weight (-2 ≤ BMIz <1) or excess weight (BMIz ≥1; overweight and obesity). Physical activity-related built environment variables were calculated (distances to nearest playground, major park, school; street intersection density; number of playgrounds and major parks within an 800 m buffer zone). Binomial logistic regression models estimated associations between physical activity-related built environment variables and excess weight. Results: Our analysis included 140,368 participants (females: n = 69,454; Calgary: n = 84,101). For Calgary, adjusted odds ratios (aORs) showed the odds of excess weight increased 1% for every 100-intersection increase [1.010 (1.006-1.015); p < 0.0001] and 13.6% when there were ≥4 playgrounds (vs. 0 or 1) within an 800 m buffer zone [1.136 (1.037-1.243); p = 0.0059]. For Edmonton, aORs revealed lower odds of excess weight for every 100 m increase in distances between residences to nearest major park [0.991 (0.986-0.996); p = 0.0005] and school [0.992 (0.990-0.995); p < 0.0001]. The odds of excess weight decreased as the number of major parks within the 800 m buffer zone increased from 0 to 1 [0.943 (0.896-0.992); p = 0.023] and from 0 to ≥3 [0.879 (0.773-0.999); p = 0.048]. Conclusion: The physical activity-related built environment was associated with excess weight in preschoolers, although relationships varied between cities that differed demographically and geographically. 

https://doi.org/10.1089/chi.2024.0211

Revington N & Wray A. 2024. Perspectives in Public Health

We thank Lynch et al. for their excellent essay that ascribes importance to postsecondary student perspectives in scholarship on housing and health. We found their critique of the common framings of students as the ‘problem’ with studentification to be a position of strength in their reflections. They raise numerous challenges associated with this stage of the life course, proposing several lines of inquiry about housing conditions, physical health, mental wellbeing, social connectedness, and place attachment. We concur that postsecondary students are often exposed to considerable risk that is directly related to the inadequacy of their accommodations in the private rental sector as well as the poor condition of the built environments surrounding these housing units. In short, they have identified a critical research gap. We aim to provide further reflections on Lynch et al.'s essay that will clarify the potential lines of inquiry to address the individual and socio-environmental determinants of student health as it relates to housing and the built environment.

https://doi.org/10.1177/17579139231202865

Wray A, Martin G, Nelson Ferguson K, Coen S, Seabrook J, & Gilliland J. 2023. Cities & Health

The impacts of the COVID-19 pandemic on youth mental health and stress levels warrants urgent attention. In Canada, as elsewhere in the world, public health measures in the early stages of the pandemic dramatically transformed the everyday geographies of young people. In the hyper-localisation of everyday life, surrounding neighbourhood features like parks and food-related stores may have provided the only outlets for physical activity, social interaction, and relaxation outside of the home. We examine how health-related behaviours, neighbourhood features, and demographic factors may relate to changes in youth mental health and stress levels during the first six months of the pandemic. A cross-sectional youth-informed online survey was conducted with youth, aged 13–19, in London, Ontario, Canada. Respondents were surveyed about their mental health and stress levels before and during the first six months of the COVID-19 pandemic. From 279 respondents, we identified how age, gender, ethnicity, dietary habits, physical activity levels, and availability of parks, fast food, convenience stores and grocery stores could correlate with mental health and stress levels. Given the role played by public spaces, our work underscores the importance of including youth perspectives in the planning of the public realm which contributes to healthy and thriving communities. 

https://doi.org/10.1080/23748834.2023.2282850

Summary in The Conversation

Overvelde A, McEachern L, Wray A, & Gilliland J. 2023. SSM - Qualitative Research in Health

This study investigated the pandemic-related modifications to food hospitality businesses in Ontario, Canada and their effects on the health and wellbeing of workers. Semi-structured interviews were conducted with 22 food hospitality employees in Ontario between June 2020 and May 2021 as part of the Food Retail Environment Study for Health and Economic Resiliency (FRESHER). Transcripts were analyzed inductively using grounded theory as a means of allowing themes to be distilled organically from this relatively new area of research. Therapeutic landscapes emerged as a framework for the resultant themes. The three main themes in this analysis are compromised based on the physical, social, and symbolic spaces of a therapeutic landscape: physical aspects of food hospitality businesses as influencers of wellbeing, social relationships as sources of support and stress, and symbols of fear and safety within food hospitality workplaces. Results indicate that, for food hospitality employees, the workplace was an imperfect therapeutic landscape with a mix of benefits and threats to wellbeing. Further study is needed to understand how these spaces might be reconstructed to better promote wellbeing. 

https://doi.org/10.1016/j.ssmqr.2023.100334

Revington N, & Wray A. 2022. Housing Policy Debate

Student housing represents a contentious local policy issue in university cities in North America and beyond, related to both the conversion of existing housing to student rentals and the development of private purpose-built student accommodations. Yet little research has considered the variety of approaches municipalities across an urban system have adopted to address student housing issues through land-use planning and their subsequent influence on development patterns. Through an analysis of planning documents in all 15 Ontario urban areas with a primary campus of the province’s 20 public universities, we identify four broad approaches. These range from minimal intervention to covertly restricting student housing development, directing student housing away from established neighborhoods, and enabling high-density redevelopment of a residential district to accommodate students. Municipalities’ approaches reflect local context, notably their relationship to the province’s regional growth management plans. Case studies demonstrate how each approach has shaped purpose-built student accommodation development locally.

https://doi.org/10.1080/10511482.2022.2093939

Summary in The Conversation

Wray A, Martin G, Doherty S, & Gilliland J. 2021. Health & Place

Exposure assessment in the context of mobility-oriented health research often is challenged by the type of spatial measurement technique used to estimate exposures to environmental features. The purpose of this study is to compare smartphone global positioning system (GPS), shortest network path mobility, and buffer-based approaches in estimating exposure to outdoor food and beverage advertising among a sample of 154 teenagers involved in the SmartAPPetite study during 2018 in London, Ontario, Canada. Participants were asked to report their home postal code, age, gender identity, ethnicity, and number of purchases they had made at a retail food outlet in the past month. During the same time period, a mobile phone application was used to log their mobility and specifically record when a participant was in close proximity to outdoor advertising. The results of negative binomial regression modelling reveal significant differences in estimates of advertising exposure, and the relationship to self-reported purchasing. Spatial exposure estimation methods showed differences across regression models, with the buffer and observed GPS approaches delivering the best fitting models, depending on the type of retail food outlet. There is a clear need for more robust research of spatial exposure measurement techniques in the context of mobility and food (information) environment research. 

https://doi.org/10.1016/j.healthplace.2021.102641

Everitt H, van der Werf P, Seabrook J, Wray A, Gilliland A. 2021. Socio-Economic Planning Sciences

The COVID-19 pandemic may have amplified the environmental, social, and economic implications of household food waste. A better understanding of household food wasting during the pandemic is needed to improve the management of waste and develop best practices for municipal waste management programs under crisis circumstances. A waste composition study was undertaken with 100 single-family households across the city of London, Ontario, Canada to determine the quantity and composition of household food waste disposed in June 2020, during the first wave of the COVID-19 pandemic. This study examines how household demographic, socioeconomic, and neighbourhood food environment characteristics influence household food wasting. On average, each household sent 2.81 kg of food waste to landfill per week, of which 52% was classified as avoidable food waste and 48% as unavoidable food waste. The quantity and composition of household food waste was found to be strongly influenced by the number of people and children in a household, and somewhat influenced by socioeconomic factors and neighbourhood food environment characteristics, including the availability, density, and proximity of retail food outlets. 

https://doi.org/10.1016/j.seps.2021.101110

Martin G, Bowman D, Graat M, Clark A, Wray A, Askwith Z, Seabrook J, & Gilliland J. 2021. Canadian Journal of Public Health

On January 1, 2020, the Government of Ontario passed a regulation banning vaping advertisements by retailers, apart from specialty shops. A motivation for this ban was to limit youth exposure to vaping advertisements. The primary goal of this research was to evaluate the impact of this ban on the number and density of vaping advertisements surrounding secondary schools. Additionally, we examined whether the number of vaping advertisements varied by school socio-demographic characteristics. This study used a pre-post design. Audits were conducted December 2019 (pre-ban) and again January to February 2020 (post-ban), to identify vaping advertisements within 800 m surrounding secondary schools (n = 18) in London, Ontario. Prior to the ban, there were 266 vaping advertisements within 800 m of secondary schools. After the ban, this was reduced to 58, a 78.2% reduction. The mean number of vaping advertisements surrounding schools significantly decreased from 18.1 before the ban to 3.6 after the ban (p < 0.001). A significant positive correlation was found, prior to the ban, between the number of vaping advertisements surrounding schools and school-level residential instability (r = 0.42, p = 0.02). After the ban, no significant correlations were found between the number of vaping advertisements and school socio-demographic characteristics. The provincial ban of vaping advertisements in select retail settings significantly reduced the number of vaping advertisements in the areas surrounding secondary schools in London, Ontario. The ban also reduced socio-demographic inequities in youths’ potential exposure to marketing of vaping products. Continued monitoring of the geographic accessibility and promotion of vaping products is warranted. 

https://doi.org/10.17269/s41997-020-00453-9

Wray A, Fleming J, & Gilliland J. 2020. Cities & Health

The public realm is a well-recognized contributor to positive health and wellbeing. Public parks and recreational spaces are now some of the main outlets for people to get outdoors, however COVID-19 has created challenges in these spaces. We classify local government responses around maintaining physical distancing in the public realm using a preliminary conceptual map of theories and actions to identify variations in these approaches around the globe. This pilot classification approach provides a useful lens to examine pandemic responses, with future work building upon this map to potentially inform how cities may react to other complex planetary health issues. 

https://doi.org/10.1080/23748834.2020.1790260

Wray A, Martin G, Ostermeier E, Medeiros A, Little M, Reilly K, & Gilliland J. 2020. Health Promotion and Chronic Disease Prevention in Canada: Research, Policy and Practice

Contact with nature and play are integral elements of interventions that effectively promote higher physical activity and improve social connectedness among children and youth in outdoor spaces. Technology is an emerging delivery mechanism for outdoor-based interventions that target physical activity and social connectedness outcomes among primary school (5–12 years old) and teenage (13– 19 years old) populations. Youth are an understudied population for interventions with physical activity and social connectedness outcomes. Canadian-specific research about physical activity and social connectedness among children and youth in outdoor spaces is limited, even though there is government policy tailored to address these activities. 

https://www.canada.ca/en/public-health/services/reports-publications/health-promotion-chronic-disease-prevention-canada-research-policy-practice/vol-40-no-4-2020/physical-activity-social-connectedness-interventions.html

Ziegler B, Wray A, & Luginaah I. 2020. International Journal of Drug Policy

We analyze the ongoing debate surrounding supervised injection sites in Ontario, Canada and changing policies that impact host communities. Despite a plethora of evidence proving the effectiveness of supervised injection sites on harm reduction strategy, the topic remains highly controversial with constantly changing rhetoric in the Ontario drug policy landscape. We reviewed government reports, policies, and media sources spanning from prior to the establishment of the first Canadian supervised injection site in 2000 to early 2019, adopting an advocacy coalition framework approach to this policy analysis. Various advocacy coalitions emerge from this analysis, including all three levels of government, law enforcement, health practitioners, and community groups. We describe the narratives constructed by these coalitions, analyzing the supervised injection site model as a harm reduction strategy within a continually shifting socio-political landscape. Emerging from the analysis are competing narratives put forward by various stakeholders within the policy subsystem. We find policy-makers tend to leverage scientific uncertainty as a tool to defend the interests of the most powerful actor in the subsystem. Despite an increase in the number of deaths due to the opioid crisis and evidence highlighting the efficacy of supervised injection sites as a harm reduction tool, various stakeholders are locked in a battle of claims and counter-claims about the appropriate policy response to opioids. These findings have broad implications for drug policy in other contexts. Our case study demonstrates the strength of stopgap measures, like supervised injection, to reduce harm from controlled substances. 

https://doi.org/10.1016/j.drugpo.2019.09.006

Dean J, Wray A, Braun L, Casello J, McCallum L, & Gower J. 2019. BMC Public Health

Automated Vehicles (AVs) are central to the new mobility paradigm that promises to transform transportation systems and cities across the globe. To date, much of the research on AVs has focused on technological advancements with little emphasis on how this emerging technology will impact population-level health. This scoping study examines the potential health impacts of AVs based on the existing literature. Using Arksey and O’Malley’s scoping protocol, we searched academic and ‘grey’ literature to anticipate the effects of AVs on human health. There is general agreement that AVs will improve road safety overall, thus reducing injuries and fatalities from human errors in operating motorized vehicles. However, the relationships with air quality, physical activity, and stress, among other health factors may be more complex. The broader health implications of AVs will be dependent on how the technology is adopted in various transportation systems. Regulatory action will be a significant determinant of how AVs could affect health, as well as how AVs influence social and environmental determinants of health. It is important that stakeholders, including public health agencies work to ensure that population health outcomes and equitable distribution of health impacts are priority considerations as regulators develop their response to AVs. We recommend that public health and transportation officials actively monitor trends in AV introduction and adoption, regulators focus on protecting human health and safety in AV implementation, and researchers work to expand the body of evidence surrounding AVs and population health. 

https://dx.doi.org/10.1186%2Fs12889-019-7580-9

Wray A & Minaker L. 2019. Cancer

The built environment is a significant determinant of human health. Globally, the growing prevalence of preventable cancers suggests a need to understand how features of the built environment shape exposure to cancer development and distribution within a population. This scoping review examines how researchers across disparate fields understand and discuss the built environment in primary and secondary cancer prevention. It is focused exclusively on peer-reviewed sources published from research conducted in Australia, Canada, Ireland, New Zealand, the United Kingdom, and the United States from 1990 to 2017. The review captured 9958 potential results in the academic literature, and this body of results was scoped to 268 relevant peer-reviewed journal articles indexed across 13 subject databases. Spatial proximity, transportation, land use, and housing are well-understood features of the built environment that shape cancer risk. Built-environment features predominantly influence air quality, substance use, diet, physical activity, and screening adherence, with impacts on breast cancer, lung cancer, colorectal cancer, and overall cancer risk. The majority of the evidence fails to provide direct recommendations for advancing cancer prevention policy and program objectives for municipalities. The expansion of interdisciplinary work in this area would serve to create a significant population health impact. 

https://doi.org/10.1002/cncr.32376

Wray A, Olstad D, & Minaker L. 2018. Cities

Smart and connected communities (SCC) describe the shift in urbanism towards technological solutions and the production of knowledge-based industries. Local governments are recognizing the opportunity of this paradigm shift to improve services, create more efficient policies, and increase the wellbeing of their citizens. These new tools create the possibility for local governments to respond differently to “wicked problems” facing cities, including increasing chronic disease prevalence. Using lung and skin cancers as case studies, we present smart prevention as a novel approach that uses smart city-enabled built environment monitoring to trigger local cancer-prevention policies. First, we present results of a scoping review we conducted to describe mechanisms by which features in urban built and social environments are hypothesized to contribute to lung cancer and skin cancer. We systematically searched fourteen electronic databases, yielding 47 articles that examined associations between built and social environment features and lung cancer (n = 34), and/or built and social environment features and skin cancer (n = 13). Second, we present a narrative review of smart city theory and governance. Third, we use findings from both reviews to draw conceptual links between cancer prevention and SCC – presenting a hypothetical suite of built environment and policy interventions to prevent lung and skin cancer. 

https://doi.org/10.1016/j.cities.2018.02.022

French S & Wray A. 2017. In M Moos & R Walter-Joseph, Still Detached and Subdivided? Suburban Ways of Living in 21st Century North America

An accessible yet rigorous debate, designed to make you rethink your preconceptions about what suburban means. 

http://www.worldcat.org/oclc/995159065