Almeida Luciene Fátima Fernandes, Barreto Sandhi Maria, Conceição Chagas Almeida Maria, Bensenor Isabela Judith, Lotufo Paulo Andrade, Molina Maria Del Carmen Bisi, Cardoso Letícia de Oliveira, Giatti Luana
Laboratory of Health and Environment Education, Oswaldo Cruz Institute, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil.
Faculty of Medicine and Clinical Hospital/EBSER, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
J Urban Health. 2024 Dec;101(6):1155-1165. doi: 10.1007/s11524-024-00896-2. Epub 2024 Aug 6.
We investigated whether neighborhood greenspaces were associated with physical activity in adulthood over 3 cohort visits after considering perceived safety and neighborhood contextual factors. We also evaluated whether the association with greenspace varied by neighborhood socioeconomic status. Participants (N = 4,800) from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) residing in two Brazilian state capitals were evaluated in Visits 1 (2008-2010), 2 (2012-2014) and 3 (2017-2019). Greenspaces were categorized by quintiles of positive Normalized Difference Vegetation Index (NDVI) scores. Physical activity frequency was given by the number of visits at which participants reported moderate/vigorous physical activity (none, 1 or 2, and 3 visits). We used multinomial logistic regression. After adjustment for age, sex, education, research center, residence in slums, individuals in the 4th and 5th NDVI quintiles showed 73% higher odds of physical activity over 3 visits than those in the 1st quintile (4th quintile: 95%CI = 1.24-2.43; 5th quintile: 95%CI = 1.24-2.41). The strength of the association was attenuated after adjustment for perceived safety. After adjustment for contextual factors quantity of sidewalks and streetlights, the OR for the 4th and 5th NDVI quintiles decreased to 1.66 (95%CI = 1.18-2.33) and 1.62 (95%CI = 1.16-2.28), respectively. Finally, after including average household income per capita, the OR for physical activity in 3 visits for the 4th and 5th NDVI quintiles decreased to 1.48 (95%CI = 1.04-2.12) and 1.43 (95%CI = 1.00-2.04; p = 0.053), respectively. Greater greenspace contributed to sustained physical activity during the eight years of follow-up, indicating the potential contribution of public greenspaces to reducing health-related inequalities.
在考虑了感知到的安全性和邻里环境因素后，我们通过三次队列随访调查了邻里绿地空间是否与成年后的身体活动相关。我们还评估了绿地空间与身体活动之间的关联是否因邻里社会经济地位而异。对来自巴西成人健康纵向研究（ELSA-Brasil）的4800名居住在巴西两个州首府的参与者进行了三次随访评估，分别为第一次随访（2008 - 2010年）、第二次随访（2012 - 2014年）和第三次随访（2017 - 2019年）。根据归一化植被指数（NDVI）阳性得分的五分位数对绿地空间进行分类。身体活动频率由参与者报告进行中度/剧烈身体活动的随访次数给出（无、1或2次、3次）。我们使用多项逻辑回归分析。在对年龄、性别、教育程度、研究中心、贫民窟居住情况进行调整后，处于NDVI第4和第5五分位数的个体在三次随访中进行身体活动的几率比处于第1五分位数的个体高73%（第4五分位数：95%置信区间 = 1.24 - 2.43；第5五分位数：95%置信区间 = 1.24 - 2.41）。在对感知到的安全性进行调整后，这种关联强度减弱。在对人行道和路灯数量等环境因素进行调整后，第4和第5 NDVI五分位数的比值比分别降至1.66（95%置信区间 = 1.18 - 2.33）和1.62（95%置信区间 = 1.16 - 2.28）。最后，在纳入人均家庭收入后，第4和第5 NDVI五分位数在三次随访中进行身体活动的比值比分别降至1.48（95%置信区间 = 1.04 - 2.12）和1.43（95%置信区间 = 1.00 - 2.04；p = 0.053）。更大的绿地空间有助于在八年的随访期间维持身体活动，这表明公共绿地空间对减少与健康相关的不平等现象具有潜在贡献。
