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There is a need for conceptual and methodological innovation in food environment-health research. We compared different operationalizations of survey-derived activity space exposures to fast food outlets (FFOs) in associations with use of FFO, diet quality and body mass index (BMI). FFO exposure was determined for home, work and a maximum of sixteen other locations reported by 1728 Dutch adults. Considerable differences in count of FFO between locations were found. Adjusted linear regression analyses resulted in small, unexpected associations with use of FFO, diet quality and BMI, whereby the strength of associations differed between exposure measures. Using home and work areas may be a cost-efficient compromise to capture large parts of the exposure to FFOs.

This research investigates the role air transportation plays in remote community resilience by examining air cargo delivery and flight operations in northern Ontario, Canada. Building off of the Di...

Understanding how coupled adults arrange food-related labor in relation to their daily time allocation is of great importance because different arrangements may have implications for diet-related health and gender equity. Studies from the time-use perspective argue that daily activities such as work, caregiving, and non-food-related housework can potentially compete for time with foodwork. However, studies in this regard are mostly centered on individual-level analyses. They fail to consider cohabiting partners’ time spent on foodwork and non-food-related activities, a factor that could be helpful in explaining how coupled partners decide to allocate time to food activities. Using 108 daily time-use logs from seventeen opposite-gender couples living in Toronto, Canada, this paper examines how male and female partners’ time spent on non-food-related activities impact the total amount of time spent on foodwork by coupled adults and the difference in time spent on foodwork between coupled women and men. Results show that both male and female partners took a higher portion of foodwork when their partner worked longer. When men worked for additional time, the couple-level duration of foodwork decreased. Without a significant impact on the gender difference in foodwork duration, women’s increased caregiving duration was associated with a reduction of total time spent on foodwork by couples. An increase in caregiving and non-food-related chores by men was associated with an increased difference in duration of foodwork between women and men, which helped secure a constant total amount of foodwork at the couple level. These behavioral variations between men and women demonstrate the gender differences in one’s responsiveness to the change of partners’ non-food-related tasks. The associations found among non-food-related activities and foodwork are suggestive of a need to account for partners’ time allocation when studying the time-use dynamics of foodwork and other daily activities.

Geographers and public health researchers have long been interested in social, spatial, and economic factors that drive access and exposure to food retail. A growing body of evidence draws on mobility data to capture locations accessed by individuals beyond the home address. Given that food-related activities are shared by household members and often gendered, taking an individual-level approach might limit researchers��� ability to accurately describe access to food retail. Using data that includes Global Positioning System trajectories of forty-six adults from twenty-one households in Toronto, this study compares access to food retailers at the individual and household levels and evaluates measurement issues that arise when relying on one household member. Spatial and spatiotemporal measures of access were derived from individual and total household activity spaces. Differences in access were tested for men and women and moderating effects of neighborhood, shopping responsibility, car access, and employment status were investigated. Supermarket density was greater for women when compared with men in the household, as well as their total household measure. Additionally, within-household differences in counts of supermarkets were moderated by neighborhood. Future research should consider the role of place and the contributions of household members when measuring access to food at the individual level.

Introduction: An active lifestyle may protect older adults from cognitive decline. Yet, due to the complex nature of outdoor environments, many people living with dementia experience decreased access to outdoor activities. In this context, conceptualizing and measuring outdoor mobility is of great significance. Using the global positioning system (GPS) provides an avenue for capturing the multi-dimensional nature of outdoor mobility. The objective of this study is to develop a comprehensive framework for comparing outdoor mobility patterns of cognitively intact older adults and older adults with dementia using passively collected GPS data. Methods: A total of 7 people with dementia (PwD) and 8 cognitively intact controls (CTLs), aged 65 years or older, carried a GPS device when travelling outside their homes for 4 weeks. We applied a framework incorporating 12 GPS-based indicators to capture spatial, temporal, and semantic dimensions of outdoor mobility. Results: Despite a small sample size, the application of our mobility framework identified several significant differences between the 2 groups. We found that PwD participated in more medical-related (Cliff’s Delta = 0.71, 95% CI: 0.34–1) and fewer sport-related (Cliff’s Delta = −0.78, 95% CI: −1 to −0.32) activities compared to the cognitively intact CTLs. Our results also suggested that longer duration of daily walking time (Cliff’s Delta = 0.71, 95% CI: 0.148–1) and longer outdoor activities at night, after 8 p.m. (Hedges’ g = 1.42, 95% CI: 0.85–1.09), are associated with cognitively intact individuals. Conclusion: Based on the proposed framework incorporating 12 GPS-based indicators, we were able to identify several differences in outdoor mobility in PwD compared with cognitively intact CTLs.

Background Despite increased attention on retail food environments and fast food consumption, results from previous studies have been inconsistent. Variation in measurement of exposure to retail food environments and the context of the built environment are possible reasons for inconsistencies. The purpose of the current study is to examine the association between exposure to fast food environment and fast food consumption among young adults, and to explore possible associations between built environment and fast food consumption. Methods We employed an observational, cross-sectional study design. Cross-sectional surveys were conducted in 2016 and 2017. In a sample of 591 young adults aged 16–30 years in five Canadian cities, we constructed and computed individual-level time-weighted number and ratio of fast food outlets in activity spaces derived from GPS trajectory data. Negative binomial regression models estimated the associations between exposure measures and frequency of fast food consumption (number of times consuming fast food meals in a seven-day period), controlling for built environment characterization and individual-level characteristics. Results Significant positive associations were found between time-weighted number of fast food outlets and count of fast food meals consumed per week in models using a radius of 500 m (IRR = 1.078, 95% CI: 0.999, 1.163), 1 km (IRR = 1.135, 95% CI: 1.024, 1.259), or 1.5 km (IRR = 1.138, 95% CI: 1.004, 1.289) around GPS tracks, when generating activity spaces. However, time-weighted ratio of fast food outlets was only significantly associated with count of fast food meals consumed when a radius of 500 m is used (IRR = 1.478, 95% CI: 1.032, 2.123). The time-weighted Active Living Environment Index with Transit measure was significantly negatively related to count of fast food meals consumed across all models. Conclusions Our study demonstrated associations of time-weighted activity space-based exposure to fast food outlets and fast food consumption frequency in a sample of young adults in urban Canada, and provides evidence of the association between context of built environment and fast food consumption, furthering discussion on the utility of individual-level, activity space-based data and methods in food environment research. These results imply that both food retail composition and activity spaces in urban areas are important factors to consider when studying diets.

To characterize the distribution of vaping retailers and examine the association between neighbourhood income and vaping retailer availability in Ontario prior to and after regulatory changes to the vaping market in 2018.We quantified vaping access by number of vaping retailers for 19,964 dissemination areas (DAs) in Ontario and percentage of schools near a vaping retailer. We used mixed-effects regression models to examine the associations between vaping access and neighbourhood income in 2018 and 2019.Between 2016 and 2019, the number of vaping retailers in Ontario increased by 22.6% (5999 to 7355), despite a mild drop from 2016 to 2018. In 2019, 59.7% of urban neighbourhoods had one or more vaping retailers within 1000 m of their geographic centre, and 79.4% of elementary, 82.8% of secondary, and 84.2% of post-secondary schools had at least one within 1000 m. Neighbourhood income was associated with access to vaping retailers, with a greater number in low-income regions. In 2019, neighbourhoods in the lowest income quintile had over twice the number of vaping retailers per capita within 1000 m compared to the highest income quintile (adjusted incidence rate ratio 2.40; 95% CI 2.24-2.58). Increases over time in access to vaping retailers did not differ by geographic region, neighbourhood income quintile, or school type.We observed a substantial increase in access to vaping retailers in Ontario including proximity to elementary and secondary schools following the 2018 provincial marketing regulations and federal nicotine regulations. Access to vaping was greatest in low-income neighbourhoods and may contribute to established inequities in vaping-related adverse events.RéSUMé: OBJECTIFS: Caractériser la répartition des détaillants de vapotage et examiner l’association entre le revenu du quartier et la disponibilité des détaillants de vapotage en Ontario avant et après les modifications réglementaires du marché du vapotage en 2018. MéTHODES: Nous avons quantifié l’accès au vapotage selon le nombre de détaillants de vapotage pour 19 964 aires de diffusion (DA) en Ontario et le pourcentage d’écoles à proximité d’un détaillant de vapotage. Nous avons utilisé des modèles de régression à effets mixtes pour examiner les associations entre l’accès au vapotage et le revenu du quartier en 2018 et 2019. RéSULTATS: Entre 2016 et 2019, le nombre de détaillants de vapotage en Ontario a augmenté de 22,6 % (5 999 à 7 355), malgré une légère baisse de 2016 à 2018. En 2019, 59,7 % des quartiers urbains avaient un ou plusieurs détaillants de vapotage à moins de 1 000 m de leur centre géographique, et 79,4 % des écoles élémentaires, 82,8 % des écoles secondaires et 84,2 % des écoles postsecondaires en avaient au moins un détaillant à moins de 1 000 m. Le revenu du quartier était associé à l’accès aux détaillants, avec plus de détaillants dans les régions à faible revenu. En 2019, les quartiers du quintile de revenu le plus bas comptaient plus de deux fois plus de détaillants de vapotage par habitant dans un rayon de 1 000 m par rapport au quintile le plus élevé (rapport de taux d’incidence ajusté 2,40; IC à 95 % 2,24-2,58). Les augmentations au fil du temps de l’accès aux détaillants de vapotage ne différaient pas selon la région géographique, le quintile de revenu du quartier ou le type d’école. CONCLUSION: Nous avons observé une augmentation significative de l’accès aux détaillants de vapotage en Ontario, y compris la proximité des écoles primaires et secondaires à la suite des nouvelles réglementations provinciales sur le marketing et de la réglementation fédérale sur la nicotine en 2018. L’accès au vapotage était le plus élevé dans les quartiers à faible revenu et pourrait contribuer aux inégalités par rapport aux événements indésirables lié au vapotage et tabac.

The objective of this study was to create the Canadian Food Environment Dataset (Can-FED) and to demonstrate its validity.Food outlet data were extracted from Statistics Canada's Business Register (BR) in 2018. Retail food environment access measures (both absolute and relative measures) were calculated using network buffers around the centroid of 56,589 dissemination areas in Canada. A k-medians clustering approach was used to create categorical food environment variables that were easy to use and amenable to dissemination. Validity of the measures was assessed by comparing the food environment measures from Can-FED with measures created using Enhanced Points of Interest data by DMTI Spatial Inc. and data from a municipal health inspection list. Validity was also assessed by calculating the geographic variability in food environments across census metropolitan areas (CMAs) and assessing associations between CMA-level food environments and CMA-level health indicators.Two versions of Can-FED were created: a researcher file that must be accessed within a secure Statistics Canada environment and a general-use file available online. Agreement between Can-FED food environment measures and those derived from a proprietary dataset and a municipal health inspection list ranged from rCan-FED is a valid and accessible dataset of pan-Canadian food environment measures that was created from the BR, a data source that has not been explored fully for health research.

The aim of our study is to utilise longitudinal and representative national data to explore the extent that the association between the fast food environment and overweight in adolescents is confounded by neighbourhood deprivation. Longitudinal data from the Millennium Cohort Study for England were obtained for waves 5 (ages 11/12; 2011/12; n=13,469) and 6 (ages 14/15; 2014/15; n=11,884). Our outcome variable was overweight/obesity defined using age and sex-specific International Obesity Task Force cut points. Individuals were linked, based on their residential location, to data on the density of fast food outlets and neighbourhood deprivation. Structural Equation Models were used to model associations at both ages and explicitly test for confounding. While we found some evidence for an association between the number of fast food outlets and overweight, any associations disappeared following accounting for the confounding nature of neighbourhood deprivation. Neighbourhood deprivation was consistently associated to overweight, with adolescents who resided in deprived areas more likely to be overweight. Results were largely consistent depending on different methodological decisions. Our findings suggest that policy efforts should prioritise focusing on tackling the social determinants of excess body mass which will be more effective than interventions aimed at the built environment.

Research into the potential impact of the food environment on liver cancer incidence has been limited, though there is evidence showing that specific foods and nutrients may be potential risk or preventive factors. Data on hepatocellular carcinoma (HCC) cases were obtained from the Surveillance, Epidemiology, and End Results (SEER) cancer registries. The county-level food environment was assessed using the Modified Retail Food Environment Index (mRFEI), a continuous score that measures the number of healthy and less healthy food retailers within counties. Poisson regression with robust variance estimation was used to calculate incidence rate ratios (IRRs) and 95% confidence intervals (CIs) for the association between mRFEI scores and HCC risk, adjusting for individual- and county-level factors. The county-level food environment was not associated with HCC risk after adjustment for individual-level age at diagnosis, sex, race/ethnicity, year, and SEER registry and county-level measures for health conditions, lifestyle factors, and socioeconomic status (adjusted IRR: 0.99, 95% CI: 0.96, 1.01). The county-level food environment, measured using mRFEI scores, was not associated with HCC risk.

For many, transportation is considered a place between places, where the flows of people and materials are distributed and organized in ways that enable the structures of modern society to exist. But with the almost complete stoppage of nonessential international and regional travel, and severe restrictions placed on the movements of people around their residences, the pandemic has highlighted the interlocking and interdependent components of transportation systems, the roles of people within them, and the inequities these systems produce. As flows of people and goods change, the places those flows construct are inevitably changing as well, but for how long and to what extent? Moving across spatial scales, this chapter engages with how global and local transportation networks have transformed under pandemic conditions, what these changes may mean for the future of mobility, and how this evolution has affected (and will affect) multiple dimensions of health and well-being.

We compare the results of a survey of transit riders during COVID-19 against a regional household travel survey. The Facebook sample over-represents women and car-less respondents compared to the household survey. We also compare the demographics of a subset of Facebook survey respondents, those still riding transit during COVID-19, against a similar survey conducted by Transit app of its users. The picture of post-COVID transit riders is older and of higher incomes in the Facebook sample compared to the Transit app sample. Finally, we replicate a model of vehicle ownership produced with the household travel survey using the Facebook survey.

Understanding older adults’ relationships with their environments and the way this relationship evolves over time have been increasingly acknowledged in gerontological research. This relationship is often measured in terms of life-space, defined as the spatial area through which a person moves within a specific period of time. Life-space is traditionally reported using questionnaires or travel diaries and is, thus, subject to inaccuracies. More recently, studies are using a global positioning system to accurately measure life-space. Although life-space provides useful insights into older adults’ relationships with their environment, it does not capture the inherent complexities of environmental exposures. In the fields of travel behaviour and health geography, a substantial amount of research has looked at people’s spatial behaviour using the notion of “Activity Space,” allowing for increasing sophistication in understanding older adults’ experience of their environment. This manuscript discusses developments and directions for extending the life-space framework in environmental gerontology by drawing on the advancements in the activity space framework.

We examine trends in words/terms published in Health & Place between 1995 and 2018. Terms used have diversified over this period, including a decline in ‘health’ overall, as well as greater usage of ‘diet’, ‘alcohol’ and ‘depression’. There was a noticeable increase in using ‘neighbourhood’ to describe context. Topic modelling reveals that papers are increasingly concerned with specific aspects of place (e.g. the built environment). Our findings emphasise that Health & Place has matured into the leading outlet for examining the geographical dimensions of health with important and enduring insights that continue to inform research and policy.

Studies employing ‘activity space’ measures of the built environment do not always account for how individuals self-select into different residential and non-residential environments when testing associations with physical activity. To date, no study has examined whether preferences for walkable residential neighborhoods predict exposure to other walkable neighborhoods in non-residential activity spaces. Using a sample of 9783 university students from Toronto, Canada, we assessed how self-reported preferences for a walkable neighborhood predicted their exposure to other walkable, non-residential environments, and further whether these preferences confounded observed walkability-physical activity associations. We found that residential walkability preferences and non-residential walkability were significant associated (β = 0.42, 95% CI: (0.37, 0.47)), and further that these preferences confounded associations between non-residential walkability exposure and time spent walking (reduction in association = 10.5%). These results suggest that self-selection factors affect studies of non-residential built environment exposures.

The spatial structure of a region is known to affect the degree of face-to-face interaction opportunities for a city’s residents. These interaction opportunities are important building blocks in as...

In commuting research the geographic area under investigation is of central importance. When examining commutes occurring in a region of interest, the selection and use of different city, county, or metropolitan region boundaries will have a large impact on analyses of travel times and distances, whether a transit network provides adequate access to jobs, levels of congestion, and so on. This research examines two cluster detection methods to delineate the commuter shed of Miami, Florida and Cincinnati, Ohio. These clusters are then compared to a series of government delineated boundaries often used in commuting research for a jobs-housing balance analysis of each. The results of the clustering methods are different for the two regions due to the differing urban forms of each. The results demonstrate that the decision of what boundary to use for research on commuting can lead to drastically different results. While there is not necessarily any correct boundary, one may be more appropriate and the rationale for such should be more thoroughly discussed.

This paper reports on the effects of inaccessibility on Syrian refugees in Durham Region, a municipality abutting the City of Toronto. The transport and social exclusion framework is applied to determine whether transport poverty leads to inaccessibility, and how this impacts participation in daily activities and the wellbeing of recently landed refugees. A mixed methodological approach consisting of focus groups, survey data collection, and accessibility analysis provides a thorough and valid depiction of the topics investigated. The findings clearly depict evidence of subjective inaccessibility and its negative impact on participation in social and discretionary activities. At the same time, inaccessibility was not determined to be effecting participation rates in many mandatory activities such as daily English language classes or childcare-related tasks. Most of the respondents overwhelmingly felt that their transportation situation was having a strong negative impact on several dimensions of wellbeing, including loneliness and sadness. Despite the strong subjective and emotional responses to perceived inaccessibility, GIS-based accessibility scores show that the survey respondents had higher levels of objectively-measured access to destinations when compared to the broader population of Durham Region, indicating the importance of qualitative assessments of perceived access. Overall, the research confirms the validity of the transport and social exclusion framework and its usefulness in understanding participation and settlement outcomes among refugee migrants within a suburban, North American context.

ObjectiveTo examine the potential links between activity spaces, the food retail environment and food shopping behaviours for the population of young, urban adults.DesignParticipants took part in the Canada Food Study, which collected information on demographics, food behaviour, diet and health, as well as an additional smartphone study that included a seven-day period of logging GPS (global positioning system) location and food purchases. Using a time-weighted, continuous representation of participant activity spaces generated from GPS trajectory data, the locations of food purchases and a geocoded food retail data set, negative binomial regression models were used to explore what types of food retailers participants were exposed to and where food purchases were made.SettingToronto, Montreal, Vancouver, Edmonton and Halifax, Canada.SubjectsYoung adults aged 16–30 years (n496). These participants were a subset of the larger Canada Food Study.ResultsDemographics, household food shopper status and city of residence were significantly associated with different levels of exposure to various types of food retailers. Food shopping behaviours were also statistically significantly associated with demographics, the activity space-based food environment, self-reported health and city of residence.ConclusionsThe study confirms that food behaviours are related to activity space-based food environment measures, which provide a more comprehensive accounting of food retail exposure than home-based measures. In addition, exposure to food retail and food purchasing behaviours of an understudied population are described.

Background During the COVID-19 pandemic, many urban residents stopped riding public transit despite their reliance on it to reach essential services like healthcare. Few studies have examined the implications of public transit reliance on riders’ ability to reach healthcare when transit is disrupted. To understand how shocks to transportation systems impact healthcare access, this study measures the impact of avoiding public transit on the ability of riders to access healthcare and pharmacy services during lockdowns. Methods We deployed a cross-sectional survey of residents of Toronto and Vancouver in May 2020 through Facebook advertisements and community list-serves. Eligibility criteria included riding transit at least weekly prior to the pandemic and subsequent cessation of transit use during the pandemic. We applied multivariable modified Poisson models to identify socio-demographic, transportation, health-related, and neighborhood predictors of experiencing increased difficulty accessing healthcare and getting prescriptions while avoiding public transit. We also predicted which respondents reported deferring medical care until they felt comfortable riding transit again. Results A total of 4367 former transit riders were included (64.2% female, 56.1% Toronto residents). Several factors were associated with deferring medical care including: being non-White (Toronto, APR, 1.14; 95% CI, 1.00-1.29; Vancouver, APR, 1.52; 95% CI, 1.26-1.84), having a physical disability (Toronto, APR, 1.20; 95% CI, 1.00-1.45; Vancouver, APR, 1.42; 95% CI, 1.08-1.87), having no vehicle access (Toronto, APR, 1.74; 95% CI, 1.51-2.00; Vancouver, APR, 2.74; 95% CI, 2.20-3.42), and having low income (Toronto, APR, 1.77; 95% CI, 1.44-2.17; Vancouver, APR, 1.51; 95% CI, 1.06-2.14). Discussion During COVID-19 in two major Canadian cities, former transit riders from marginalized groups were more likely to defer medical care than other former riders. COVID-19 related transit disruptions may have imposed a disproportionate burden on the health access of marginalized individuals. Policymakers should consider prioritizing healthcare access for vulnerable residents during crises.

Background As part of a long-standing line of research regarding how peer density affects health, researchers have sought to understand the multifaceted ways that the density of contemporaries living and interacting in proximity to one another influence social networks and knowledge diffusion, and subsequently health and well-being. This study examined peer density effects on oral health for racial/ethnic minority older adults living in northern Manhattan and the Bronx, New York, NY. Methods Peer age-group density was estimated by smoothing US Census data with 4 kernel bandwidths ranging from 0.25 to 1.50 mile. Logistic regression models were developed using these spatial measures and data from the ElderSmile oral and general health screening program that serves predominantly racial/ethnic minority older adults at community centers in northern Manhattan and the Bronx. The oral health outcomes modeled as dependent variables were ordinal dentition status and binary self-rated oral health. After construction of kernel density surfaces and multiple imputation of missing data, logistic regression analyses were performed to estimate the effects of peer density and other sociodemographic characteristics on the oral health outcomes of dentition status and self-rated oral health. Results Overall, higher peer density was associated with better oral health for older adults when estimated using smaller bandwidths (0.25 and 0.50 mile). That is, statistically significant relationships (p

A healthy food environment is an important component in helping people access and maintain healthy diets, which may reduce the prevalence of chronic disease. With few exceptions, studies on healthy food access in urban regions typically ignore how time of day impacts access to food. Similarly, most extant research ignores the complexities of accounting for the role of transportation in spatial access. Examining healthy food access is important, especially for populations whose day-to-day schedules do not align with a typical work schedule. This study profiles novel methods that can be used to examine the daily dynamics of food access in Toronto, Ontario, using grocery stores as a case study to examine the changing geographies of food access over a 24-h period, and the impact of a changing public transit schedule on food access. Walking and automobile travel times are also reported. Results indicate that access to grocery stores is severely diminished for large parts of the city in the late night and early morning, and that public transit travel times are higher and more variable in the early morning hours. Ultimately, this research demonstrates the need for further study on how residents with nonconventional schedules experience, and are affected by, the dynamic food and transportation environments. Future research should build upon the methods presented here to include a broader range of food retailers.

Advancements in geospatial technologies including geographic information systems and global positioning system (GPS) devices have provided insights on how the retail food environment might be contributing to the ongoing obesity epidemic. Caution has been raised, however, around the potential for research that uses GPS-captured activity spaces to overestimate the impact that exposure to food retailers has on food choices and behaviour. This phenomenon, where it is difficult to discern whether an individual is passively exposed to a space or actively seeks it out, is referred to as a ‘selective (daily) mobility bias’. Researchers’ understanding of this bias is relatively new and understudied, particularly in the food environment literature, where the bias could have serious implications. This chapter reviews 14 peer-reviewed papers and two doctoral theses to identify and critique the methods proposed for handling this bias and offer recommendations to consider as the use of GPS-activity space studies continues to grow.

Background The geographic distribution of sexually transmitted infections (STI) reflects the underlying social process of sexual partner selection. Our purpose was to explore the social geography of sexual partner selection among sexual minority men and use the results to develop a mid-level theory of urban-non-urban mixing patterns between sexual partners. Methods This integrated mixed methods study involved in-depth interviews with 31 sexual minority men who lived, worked, or socialized in Toronto, Canada, during June and July 2016. We asked participants to describe how they found sexual partners and to reconstruct their egocentric sexual networks for the previous three months. Interviews were conducted iteratively and until theoretical saturation. A social constructionist approach to grounded theory was used to analyze the qualitative data. Egocentric maps were analyzed to determine and describe movement and mixing patterns between sexual partners. Results Geography influenced the social process of partner selection in three important ways: (1) participants expressed a desire to travel the shortest distance possible to meet or hook up with partners (“geographic proximity”); (2) the density of sexual minority men in a participant’s community directly impacted participants social and sexual isolation, and thus how often they had sex (“degree of geosexual isolation”); and 3) geosexual isolation directly impacted the distance a participant was willing to search, and travel, to meet or hook up with partners, thus influencing the sexual mixing pattern (“convection mixing”). The geography of partner selection was also impacted by changes in sexual minority men use of space (“changing use of space”). Conclusion Geosexually isolated participants demonstrated “convection mixing”, with repeated movement from peripheral, to downtown, back to peripheral areas. More attention should be paid to identifying STI reservoirs outside of core areas. Disclosure No significant relationships.

Noise is one of the most frequent complaints and represents a public health hazard. While traffic-related noise has been studied extensively, research on construction noise has been lacking. In this study, we examined the relationship between construction activities and noise annoyance and tested whether this relationship is stronger after working hours. Data were drawn from a historical inventory of major development projects and crowdsourced citizen complaints data (311 calls) in Vancouver, Canada from 2011 to 2016. Mixed effects models were developed with an interaction between construction activities and after-hours report. Results show that neighborhood noise complaints were significantly associated with major constructions (IRR = 1.062, 95% CI = 1.024–1.097). A significant interaction effect was also found between construction activities and after-hours reporting (IRR = 1.050 CI = 1.012–1.087). To our knowledge, this is one of the first studies to empirically show the adverse effects of urban development on noise annoyance. The results imply that existing noise bylaws may not be effective in restricting construction activities at night and during sleeping hours, which may cause adverse health effects.

Schedule padding is the extra time added to transit schedules to reduce the risk of delay. Where there is more random delay, there should be more schedule padding. While schedule padding is a product of transit planners, a method for detecting when and where it exists could provide valuable feedback as transit agencies continually develop their networks. By analyzing transit schedules and real-time vehicle location data at the level of stop-to-stop segments, we can locate padding in space and time and identify the places that may be most effected by stochastic delay. Such information could be used to target delay-reduction interventions such as fare prepayment or transit-only rights of way. The Toronto Transit Commission is used as a case study, and initial results suggest that highly delayed segments appear mostly in the expected, but some surprising, places.

Research on access to healthy foods often emphasizes the spatial proximity of residents to food stores like supermarkets as a way to gauge overall accessibility. Much of the literature has focused on locating the closest facility, assuming that access to one food store is sufficient. Given evidence that access to multiple healthy food stores can improve diets, however, this article examines how closest facility measures differ from cumulative opportunity accessibility measures across space in a medium-sized U.S. city. Differences in access between automobile and transit riders, using realistic travel time costs, are also considered. Results demonstrate that the two types of accessibility measures produce different accessibility geographies and that there are disparities in access for those dependent on transit. These findings indicate that researchers should carefully consider whether access to one supermarket opportunity is enough and pay special attention to the mode residents rely on to access food.

During the past few decades, there has been a surge of interest in research seeking to understand how personal and public health are affected by transportation systems. A large and diverse literature has recently emerged as a result, which complements a rich literature developed beginning in the early 20th century. In this manuscript, we identify five unique research trajectories in health and transportation that, in many cases, seem unrelated. After exploring these five areas, we argue that a holistic viewpoint that links all of the ways transportation systems impact health will provide new opportunities for health and transport researchers. To do this, we present a causal loop diagram, which illustrates a systems perspective on the complex relationships between health and transportation. Finally, a discussion on future directions points out ways that such a perspective will benefit researchers going forward.

The geographic distribution of sexually transmitted infections reflects the underlying social process of sexual partner selection. This qualitative study explored the social geography of partner selection among sexual minority men and used the results to develop a mid-range theory of STI transmission. In-depth interviews with 31 sexual minority men who lived, worked, or socialized in Toronto, Canada, occurred in June and July 2016. Participants were asked how they found sexual partners and reconstructed their egocentric sexual networks for the previous 3 months. Participants described an iterative process of partner selection involving intention (sex versus dating), connecting with community, and selecting a partner based on intersecting partner characteristics (external, internal, and emergent feelings when interacting with potential partners) and personal preferences. Geography influenced partner selection three ways: (1) participant search patterns maximized the number of potential partners in the shortest distance possible; (2) the density of sexual minority men in a participant’s community directly impacted participant’s social and sexual isolations; and (3) geosexual isolation influenced sexual mixing patterns. Participants described “convection mixing,” where assortative urban mixing nested within disassortative suburban mixing resulted in movement from the suburbs to downtown and back to the suburbs. We theorize that convection mixing may be contributing to the persistence of STI epidemics in core and outbreak areas by creating STI reservoirs outside of, and connected to, core and outbreak areas.