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This article introduces a special section comprising papers examining the evolution, current state and potential futures of the subdiscipline of health geography. Geographers’ engagement with ‘health’ has transformed from a strict rooting in the ‘(bio)medical’, coinciding with, and contributing to, a paradigm shift emphasising a recognition of health as multifaceted and shaped by everyday experiential spatial practices, rhythms and identities. The development of this area of geographic scholarship, we argue, has been inextricably linked to the simultaneous growth of the Geographies of Health and Wellbeing Research Group (GHWRG) of the Royal Geographical Society (with the Institute of British Geographers), founded in 1972. Celebrating this golden jubilee, the Research Group initiated a project reflecting on how geographical knowledge on health has been produced and the networks that have influenced thinking. This coincided with an additional anniversary, the twentieth iteration of the ‘Emerging and New Researchers in the Geographies of Health & Impairment’, a conference developed to support new conversations relating to geographical scholarship around ‘health’, playing an important role in the development of ideas, scholarship and community since its inception in 1994. In introducing this special section, we underscore the importance of geographic interrogations of health for addressing contemporary challenges and providing interdisciplinary contributions. The articles in the collection delve into conceptual, theoretical and methodological developments that have shaped health geography, featuring work showcasing the breadth and depth of research within the subdiscipline. Complementing these empirical pieces, the special section traces the history of the GHWRG and its contributions, alongside interviews and conversations with scholars who have played pivotal roles in shaping the evolution of the subdiscipline. Overall, we are keen to celebrate health geography scholarship, question how academic networks shape thinking about interrelationships between health and place, and reflect on potential future directions for geographical scholarship on health and wellbeing. [ABSTRACT FROM AUTHOR]

Relatively little scholarly attention has been given to incorporating geographic principles into investigations of behavioral health intervention efficacy—where, and why, a behavioral health intervention might be more effective in one place versus another. We address this research gap by leveraging data from a randomized controlled trial in a post-hoc analysis to investigate whether socioeconomic deprivation in the residential neighborhood moderates the efficacy of a text-message-delivered (mHealth) depression intervention targeted toward young adults. Ninety-seven participants were recruited from social media sources, randomly assigned to the treatment or control condition, and assessed for depression symptoms and related outcomes at baseline, one month, two months (immediately following treatment completion), and three months. We find that intervention effects for reducing depression symptoms were stronger among participants residing in neighborhoods with higher, as compared to lower, socioeconomic deprivation (β = −0.208, p = 0.013, 95 percent CI [−0.372, −0.044]). Similarly, stronger intervention effects for enhancing behavioral activation (β = 0.150, p = 0.028, 95 percent CI [0.016, 0.284]) and for reducing cognitive distortion (β = −0.476, p = 0.002, 95 percent CI [−0.777, −0.175]), malleable behaviors and thinking processes intended to lessen depression, were found for residents of higher deprivation neighborhoods. We speculate these results reflect an enhanced ability to intervene in processes of self-regulation among those living in higher deprivation neighborhoods, which might stem from the experience of chronic stress in such settings, thus resulting in greater receptivity to intervention components that reduce depressive symptoms. These findings could facilitate geographic targeting to enhance intervention efficacy and guide geographically informed health interventions tailored to specific environmental conditions. [ABSTRACT FROM AUTHOR]

This study describes the development and testing of the Healthy Ageing/Vulnerable Environment (HAVEN) Index, a prototype composite spatial index for South Australia that reflects an area's age‐friendliness. The index incorporates over 40 indicator variables across six variable themes: income and employment; education; health and housing; social connectedness; geographic access; and physical environment. Based on the deficit accumulation approach, the modelling uses area‐level rather than individual‐level data and is compiled through quantitative geospatial methods. Analysis using the HAVEN Index of state‐wide mortality data and hospital emergency department (ED) presentations for Central Adelaide found that vulnerable areas were associated with a higher risk of mortality and ED presentation. Comparisons between the HAVEN Index and a widely used national area‐level measure of socio‐economic differences found that the HAVEN Index compares favourably and provides additional information about local areas, which can inform needs‐based approaches to support the reduction of spatial inequalities and the development of age‐friendly neighbourhoods. [ABSTRACT FROM AUTHOR]

Metal mining is associated with negative social, political, economic, health, and environmental impacts. These individual impacts are generally understood, but a deeper understanding of the combined syndemic effects of mining, particularly in Indigenous communities, is needed, especially as metal mining is expected to grow with the expansion of cleaner energy technologies. Perceptions of environmental risk and human health in Ch'orti' communities of Olopa, Guatemala, that have been impacted by the Cantera Los Manantiales antimony mine were examined via a community-based participatory research approach that included participatory mapping, interviews, and community mapping workshops. Results indicate increased violence and community divisions, increased incidence of health concerns, and an extensive loss of crops and domesticated animals following the introduction of mining operations. Furthermore, participants attributed both water and air contamination to the mine. We argue that our collective results present as a syndemic and represent a continuation of violence toward Indigenous people. Findings will support local leaders and allied research and legal organizations in efforts to effectively access justice and assess health in Indigenous communities impacted by the mine in Olopa. More broadly, this effort demonstrates how participatory mapping methods add nuance to the understanding of syndemics and other environmental health risks. [ABSTRACT FROM AUTHOR]

This article presents an analysis of the territorial dynamics of the specialized healthcare network, focusing on medium and high complexity care in hospitals in the municipalities that make up the Belém Metropolitan Region. The analysis is based on secondary data from DATASUS available on the National Health Facility Registry (CNES) up to January 2022. The findings show that the private network accounts for the largest proportion of services in the region; however, the service capacity of the SUS is greater than that of the private sector due to the large volume of services outsourced to private facilities via public- private partnerships, with philanthropic hospitals allocating the largest proportion of services to public patients. This should not be confused with universal coverage, as public patient access to private services may be restricted by legal and institutional barriers depending on the form of access (open-door or closed-door). [ABSTRACT FROM AUTHOR]

The long-term economic viability of modern health care systems is uncertain, in part due to costs of health care at the end of life and increasing health care utilization associated with an increasing population prevalence of multiple chronic diseases. Control of health care spending and sustaining delivery of health care services will require strategic investments in prevention to reduce the risk of disease and its complications over an individual's life course. Behavior change interventions aimed at reducing a range of harmful and risky health-related behaviors including smoking, physical inactivity, excess alcohol consumption, and excess weight, are one approach that has proven effective at reducing risk and preventing chronic disease. However, large-scale efforts to reduce population-level chronic diseases are challenging and have not been very successful at reducing the burden of chronic diseases. A new approach is required to identify when, where, and how to intervene to disrupt patterns of behavior associated with high-risk factors using context-specific interventions that can be scaled. This paper introduces the need to integrate theoretical and methodological principles of health geography and behavioral economics as opportunities to strengthen behavior change interventions for the prevention of chronic diseases. We discuss how health geography and behavioral economics can be applied to expand existing behavior change frameworks and how behavior change interventions can be strengthened by characterizing contexts of time and activity space. [ABSTRACT FROM AUTHOR]

This study investigates the relationship between neighborhood Socioeconomic Position (SEP) and the prevalence of hypertension and coronary heart disease (CHD) across New York City's community districts. By using a composite SEP index derived from multiple socioeconomic indicators, the research seeks to uncover health disparities that may be obscured in broader geographic analyses. A primary objective is to identify community districts where hypertension and CHD prevalence is significantly higher than expected, even after adjusting for SEP. This focus helps pinpoint areas where targeted public health interventions may be urgently required, especially when the anticipated inverse relationship between SEP and health outcomes does not hold. A linear mixed-effects model (LMM) was used to analyze the association between SEP and these health outcomes, incorporating both fixed and random effects to account for variation across the city's 59 community districts. The analysis revealed a significant negative association between SEP and both hypertension and CHD, with higher SEP levels generally correlating with lower prevalence rates. However, some districts exhibited high random effects, indicating a higher-than-expected prevalence of these conditions, even after controlling for SEP. The authors suspect that additional factors-such as environmental exposures, healthcare accessibility, or community infrastructure-may contribute to these unexplained disparities. The findings emphasize the need for public health strategies that are sensitive to local contexts and the multifactorial nature of health inequities. Understanding the complex drivers behind these disparities can inform policies aimed at reducing health inequities in diverse urban environments.

Built environments have complex effects on the public's physical and mental health. Revealing the mechanisms and pathways through which the urban built environment influences public health can provide a basis for optimizing built environments. This helps avoid issues, such as environmental pollution, lack of social interaction, and insufficient physical activity, ultimately contributing to the enhancement of public health. Western academia has a more established foundation for research, whereas domestic endeavors are currently in the exploratory phase. A comparative analysis of relevant domestic and international studies can help elucidate the developmental trajectory of research in this field, identify common issues and characteristics, and guide the direction for advancing domestic research. Therefore, based on the Web of Science and China National Knowledge Infrastructure databases, this study systematically reviewed 658 English and Chinese studies published from 2000 to 2022 in the fields of urban and rural planning, geographic sciences, health medicine, and environmental psychology, focusing on the impact of the built environment on public health. Utilizing "Citespace" software, this study conducted a quantitative analysis and systematic review of the theoretical framework, study topics, and emerging trends in the research. The findings revealed disparities between Western and Chinese academies in terms of theoretical innovation, study groups, and research content. Specifically, international studies have pioneered theoretical perspectives, such as social welfare and environmental justice. Guided by these theories, researchers have explored the mechanisms through which the built environment affects public health in diverse population groups. Although domestic studies exhibit a relative lack of theoretical innovation, their primary focus has been the introduction and empirical application of Western theories in the Chinese context. These studies often concentrate on the transmission paths of the impacts on the older and women groups through static empirical evidence, lacking dynamism in their approaches. Furthermore, drawing upon the previously stated theoretical underpinnings, methodological approach, and research content, this paper summarized the analytical framework of "Built Environment Elements, Mediated Impacts, and Public Health." It meticulously examined the differential effects of three spatial elements—green space, land use, and road traffic—on public health. This study provides a detailed analysis of the mechanisms involved, highlighting the ecological and psychological benefits arising from exposure to and interactions with green spaces. It also analyzes how judiciously designed and compact land use patterns shape travel preferences, reduce travel distances, mitigate reliance on motor vehicles, and enhance the frequency of individual activities. Furthermore, the study outlines the ramifications for optimizing the road network system and transitioning travel modes to ameliorate traffic pollution, alleviate traffic pressure, and mitigate pedestrian injuries, among other variables. The purpose of this study was to systematically comprehend the current status and disparities in domestic and international research concerning the impact of the built environment on public health and to explore a series of health issues triggered by the built environment from the perspective of urban planning, with the hope of promoting health geography in China, offering guidance for future academic directions, and prompting local management authorities to formulate precision policies addressing public health challenges.

This article traces the past, present and future of health geography through the career journeys of three notable academics, Sarah Curtis (SC), Julia Jones (JJ) and Graham Moon (GM). All three of these scholars have had entanglements with the Geographies of Health and Wellbeing Research Group (GHWRG) of the Royal Geographical Society (with the Institute of British Geographers) (RGS‐IBG) throughout their careers, enabling them to shape health geography into the contemporary sub‐discipline that we know today. GHWRG has, for the last 50 years, offered a lively and supportive network for all those interested in the geographies of health and health care, medical geography and all other areas of scholarship related to health and wellbeing that engage with geographical concerns. [ABSTRACT FROM AUTHOR]

Large‐scale housing developments (LHD) are increasingly being used to accommodate population growth in (sub)urban Aotearoa, but their market‐oriented and delivery‐focused approach raises questions about whether resulting housing supplies meet residents' expectations for a healthy living environment. Based on a mixed‐methods survey with expert and non‐expert residents in the Wellington Region, this research critically examines LHD and underscores the pressing need for a stronger emphasis on health promotion in rapidly growing (sub)urban environments. The study reveals a strong desire among study participants for more social infrastructure in LHD and greater responsibility on the part of LHD developers towards communal values and community engagement. [ABSTRACT FROM AUTHOR]

Built environments have complex effects on the public's physical and mental health. Revealing the mechanisms and pathways through which the urban built environment influences public health can provide a basis for optimizing built environments. This helps avoid issues, such as environmental pollution, lack of social interaction, and insufficient physical activity, ultimately contributing to the enhancement of public health. Western academia has a more established foundation for research, whereas domestic endeavors are currently in the exploratory phase. A comparative analysis of relevant domestic and international studies can help elucidate the developmental trajectory of research in this field, identify common issues and characteristics, and guide the direction for advancing domestic research. Therefore, based on the Web of Science and China National Knowledge Infrastructure databases, this study systematically reviewed 658 English and Chinese studies published from 2000 to 2022 in the fields of urban and rural planning, geographic sciences, health medicine, and environmental psychology, focusing on the impact of the built environment on public health. Utilizing "Citespace" software, this study conducted a quantitative analysis and systematic review of the theoretical framework, study topics, and emerging trends in the research. The findings revealed disparities between Western and Chinese academies in terms of theoretical innovation, study groups, and research content. Specifically, international studies have pioneered theoretical perspectives, such as social welfare and environmental justice. Guided by these theories, researchers have explored the mechanisms through which the built environment affects public health in diverse population groups. Although domestic studies exhibit a relative lack of theoretical innovation, their primary focus has been the introduction and empirical application of Western theories in the Chinese context. These studies often concentrate on the transmission paths of the impacts on the older and women groups through static empirical evidence, lacking dynamism in their approaches. Furthermore, drawing upon the previously stated theoretical underpinnings, methodological approach, and research content, this paper summarized the analytical framework of "Built Environment Elements, Mediated Impacts, and Public Health." It meticulously examined the differential effects of three spatial elements--green space, land use, and road traffic--on public health. This study provides a detailed analysis of the mechanisms involved, highlighting the ecological and psychological benefits arising from exposure to and interactions with green spaces. It also analyzes how judiciously designed and compact land use patterns shape travel preferences, reduce travel distances, mitigate reliance on motor vehicles, and enhance the frequency of individual activities. Furthermore, the study outlines the ramifications for optimizing the road network system and transitioning travel modes to ameliorate traffic pollution, alleviate traffic pressure, and mitigate pedestrian injuries, among other variables. The purpose of this study was to systematically comprehend the current status and disparities in domestic and international research concerning the impact of the built environment on public health and to explore a series of health issues triggered by the built environment from the perspective of urban planning, with the hope of promoting health geography in China, offering guidance for future academic directions, and prompting local management authorities to formulate precision policies addressing public health challenges. [ABSTRACT FROM AUTHOR]

Children's school journeys can provide a daily source of physical activity, social interaction, and independence. Many studies focus on quantitative analyses of factors influencing active school travel (AST) from an adult-centric perspective. This study analyses children's and adults' perspectives on school travel behaviour and route perceptions using qualitative walking interviews. We conducted 14 go-along interviews with primary school children and their parents along different routes to school in Leipzig, Germany. We transcribed the interviews, analysed the factors perceived to support or hinder AST and mapped the route perceptions. The results of our study provide detailed insights into individual, family and route environment-related factors of AST. Perceived traffic safety along the routes was most relevant for all parents we interviewed. The other factors differed according to the mode of transport and accompaniment. Children who regularly walk to school report on numerous positively perceived places, e.g. associated with social interaction, play, and hiding activities. Our findings suggest that enabling children to gain positive experiences along their routes might be a chance to increase active and independent school travel. [ABSTRACT FROM AUTHOR]

While telemedicine infrastructure was in place within the Veterans Health Administration (VHA) healthcare system before the onset of the COVID-19 pandemic, geographically varying ordinances/closures disrupted vital care for chronic disease patients such as those with type 2 diabetes. We created a national cohort of 1,647,158 non-Hispanic White, non-Hispanic Black, and Hispanic veterans with diabetes including patients with at least one primary care visit and HbA1c lab result between 3.5% and 20% in the fiscal year (FY) 2018 or 2019. For each VAMC, the proportion of telehealth visits in FY 2019 was calculated. Two logistic Bayesian spatial models were employed for in-person primary care or telehealth primary care in the fourth quarter of the FY 2020, with spatial random effects incorporated at the VA medical center (MC) catchment area level. Finally, we computed and mapped the posterior probability of receipt of primary care for an "average" patient within each catchment area. Non-Hispanic Black veterans and Hispanic veterans were less likely to receive in-person primary care but more likely to receive tele-primary care than non-Hispanic white veterans during the study period. Veterans living in the most socially vulnerable areas were more likely to receive telehealth primary care in the fourth quarter of FY 2020 compared to the least socially vulnerable group but were less likely to receive in-person care. In summary, racial minorities and those in the most socially vulnerable areas were less likely to receive in-person primary care but more likely to receive telehealth primary care, potentially indicating a disparity in the impact of the pandemic across these groups. [ABSTRACT FROM AUTHOR]

Putting research and reflection on prison experience into conversation with the subfields of carceral and health geography, we discuss the "somatic carceral condition" as a viseral, bodily effect of prisonization. In doing so, we call for increased reliance on data derived from somatic experience as well as autoethnographic insight on imprisonment. More broadly, we argue, an embrace of somatic data used to tell the story of marginalization and captivity experienced in prison and across the carceral continuum can help advance the discipline of geography theoretically, methodologically, and in terms of contributing to praxis-based interventions. [ABSTRACT FROM AUTHOR]

Since its inception in 1991, the mission of the National Breast and Cervical Cancer Early Detection Program's (NBCCEDP) mission is to improve access to mammography. This program has demonstrated evidence showing that it has improved breast cancer screening rates for women who are uninsured and underinsured. However, the literature has shown that NBCCEDP screenings are decreasing, and only reach a portion of eligible women. Reliable estimates at the sub-county level are needed to identify and reach eligible women. Our work builds upon previous estimates by integrating uninsured and insurance status into spatially adaptive filters. We use spatially adaptive filters to create small area estimates of standardized incidence ratios describing the utilization rate of NBCCEDP services in Minnesota. We integrate the American Community Survey (2010–2014) insurance status data to account for the percentage that an individual is uninsured. We test five models that integrate insurance status by age, sex, and race/ethnicity. Our composite model, which adjusts for age, sex, and race/ethnicity insurance statuses, reduces 95% of the estimation error. We estimate that there approximately 49,913.7 women eligible to receive services for Minnesota. We also create small geography (i.e., county and sub-county) estimates for Minnesota. The integration of the insurance data improved our utilization estimate. The development of these methods will allow state programs to more efficiently use their resources and understand their reach. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has had wide-ranging implications on the academic community and there have been numerous commentaries on the effects of the pandemic on qualitative health research. However, the vulnerabilities faced by participants and researchers during the pandemic have remained underexplored. Addressing this gap, this reflective article discusses the intersecting challenges and opportunities arising for participants and researchers in qualitative health research during the pandemic through the lens of layered vulnerability. Vulnerability, as a layered concept, provides novel insight to discussions on the effects of the pandemic as it provides a depth of insight into the multifaceted and dynamic nature of vulnerabilities, while considering individual differences and contexts. Reflecting on the research we conducted during the pandemic, we draw out the layers of vulnerability that both participants and researchers faced during the research process, as well as the obligations and strategies we developed to mitigate these vulnerabilities. We discuss the intersectionality of individual characteristics and the digitisation of work and life, including the impact of moving qualitative health research online and the use of creative methodological approaches. Our article highlights how, through engaging with their own vulnerabilities throughout the research process, researchers can develop creative and new solutions for qualitative research which mitigate the increased vulnerabilities participants faced during the pandemic.

Both food insecurity and diabetes are important public health concerns. For example, diabetes remained a leading cause of mortality both in the United States (U.S.) and globally during the past decade. Meanwhile, an estimated 11% of households endured food insecurity in the U.S. in 2021 with higher rates in the Southeast region. While significant advancements have occurred in better understanding food insecurity, its relationship with diabetes has yielded mixed results. Due to these inconsistent findings, a better understanding of how food insecurity may be associated with diabetes, particularly at the county-level, can improve population health and well-being. This study advanced such an area by undertaking a cross-sectional observational study for the Southeastern region of the U.S. (e.g. Alabama, Arkansas, Mississippi, and Tennessee with 319 counties as the unit of analysis), an area disproportionately impacted by both food insecurity and diabetes. The overall design applied the socio-ecological perspective within a multiscale geographically weighted regression framework or MGWR. MGWR is a recent development and a more advanced approach which allowed adjustments for geographic space and scale. Results showed food insecurity (estimate of 0.28) was positively associated with diabetes but the relation varied in magnitude and significance across space (range of −0.10 to 1.19). That is, food insecurity exhibited a strong, positive association for northwestern Arkansas, a mild association for central Mississippi and Tennessee, and a weaker association for southern Alabama and eastern Tennessee. Households without internet access also exhibited a positive association (estimate of 0.15), as did convenience stores per thousand (estimate of 0.12). These findings add value to our understanding of how geographic space and scale matter when examining health. Public health practitioners can recognize such variations when devising targeted interventions for food insecurity and diabetes care. [ABSTRACT FROM AUTHOR]

Aims: Medical nutrition therapy is recommended for people living with HIV/AIDS to improve health and wellness; however, there is a lack of food and nutrition programs for people living with HIV/AIDS in Nova Scotia, Canada. The aim of this study was to explore the beliefs, values, and experiences of people living with HIV/AIDS in relation to food and nutrition programs. Methods: A critical social theory lens with two disciplinary contexts: critical health geography and critical dietetics guided this research. Semi‐structured interviews were conducted with 12 people living with HIV/AIDS and analysed for themes. Results: The three main themes were identified: (1) intersections of social determinants of health, wellness, and food security; (2) discursive shaping of food and nutrition in relation to HIV; and (3) the dynamic nature of HIV care. Conclusions: Participants offered recommendations on how food and nutrition programs might be reimagined to be more accessible, inclusive, and effective for people living with HIV/AIDS. [ABSTRACT FROM AUTHOR]

ABSTRACTBoth food insecurity and diabetes are important public health concerns. For example, diabetes remained a leading cause of mortality both in the United States (U.S.) and globally during the past decade. Meanwhile, an estimated 11% of households endured food insecurity in the U.S. in 2021 with higher rates in the Southeast region. While significant advancements have occurred in better understanding food insecurity, its relationship with diabetes has yielded mixed results. Due to these inconsistent findings, a better understanding of how food insecurity may be associated with diabetes, particularly at the county-level, can improve population health and well-being. This study advanced such an area by undertaking a cross-sectional observational study for the Southeastern region of the U.S. (e.g. Alabama, Arkansas, Mississippi, and Tennessee with 319 counties as the unit of analysis), an area disproportionately impacted by both food insecurity and diabetes. The overall design applied the socio-ecological perspective within a multiscale geographically weighted regression framework or MGWR. MGWR is a recent development and a more advanced approach which allowed adjustments for geographic space and scale. Results showed food insecurity (estimate of 0.28) was positively associated with diabetes but the relation varied in magnitude and significance across space (range of −0.10 to 1.19). That is, food insecurity exhibited a strong, positive association for northwestern Arkansas, a mild association for central Mississippi and Tennessee, and a weaker association for southern Alabama and eastern Tennessee. Households without internet access also exhibited a positive association (estimate of 0.15), as did convenience stores per thousand (estimate of 0.12). These findings add value to our understanding of how geographic space and scale matter when examining health. Public health practitioners can recognize such variations when devising targeted interventions for food insecurity and diabetes care.

Abstract Background The exponential growth of location-based social media (LBSM) data has ushered in novel prospects for investigating the urban food environment in health geography research. However, previous studies have primarily relied on word dictionaries with a limited number of food words and employed common-sense categorizations to determine the healthiness of those words. To enhance the analysis of the urban food environment using LBSM data, it is crucial to develop a more comprehensive list of food-related words. Within the context, this study delves into the exploration of expanding food-related words along with their associated energy densities. Methods This study addresses the aforementioned research gap by introducing a novel methodology for expanding the food-related word dictionary and predicting energy densities. Seed words are generated from official and crowdsourced food composition databases, and new food words are discovered by clustering food words within the word embedding space using the Gaussian mixture model. Machine learning models are employed to predict the energy density classifications of these food words based on their feature vectors. To ensure a thorough exploration of the prediction problem, ten widely used machine learning models are evaluated. Results The approach successfully expands the food-related word dictionary and accurately predicts food energy density (reaching 91.62%.). Through a comparison of the newly expanded dictionary with the initial seed words and an analysis of Yelp reviews in the city of Toronto, we observe significant improvements in identifying food words and gaining a deeper understanding of the food environment. Conclusions This study proposes a novel method to expand food-related vocabulary and predict the food energy density based on machine learning and word embedding. This method makes a valuable contribution to building a more comprehensive list of food words that can be used in geography and public health studies by mining geotagged social media data.

Little is known about longer-term changes to community participation since the COVID-19 pandemic onset and potential implications for health and wellbeing in later life. This multi-method investigation analyzes national data from the COVID-19 Coping Study. Statistical analyses of survey data (n = 1,630; mean age 67.9 years; data collected April/May 2022) identified that adults residing in the US still tended to stay inside their homes more often since the pandemic onset. Overall, participants decreased their engagement with amenities such as eateries, gyms, and arts and cultural sites. Reflexive thematic analysis of semi-structured in-depth interviews (n = 57; mean age 70.7 years; data collected May-July 2021) identified altered community participation with perceived long-term impacts on physical, mental, and social health and wellbeing. The results provide novel insights about the critical nature of ‘third places’ to support later life, and policy implications to strengthen community environments. Investment in outdoor, well-ventilated, and distanced third places may support wellbeing.

Background: The exponential growth of location-based social media (LBSM) data has ushered in novel prospects for investigating the urban food environment in health geography research. However, previous studies have primarily relied on word dictionaries with a limited number of food words and employed common-sense categorizations to determine the healthiness of those words. To enhance the analysis of the urban food environment using LBSM data, it is crucial to develop a more comprehensive list of food-related words. Within the context, this study delves into the exploration of expanding food-related words along with their associated energy densities. Methods: This study addresses the aforementioned research gap by introducing a novel methodology for expanding the food-related word dictionary and predicting energy densities. Seed words are generated from official and crowdsourced food composition databases, and new food words are discovered by clustering food words within the word embedding space using the Gaussian mixture model. Machine learning models are employed to predict the energy density classifications of these food words based on their feature vectors. To ensure a thorough exploration of the prediction problem, ten widely used machine learning models are evaluated. Results: The approach successfully expands the food-related word dictionary and accurately predicts food energy density (reaching 91.62%.). Through a comparison of the newly expanded dictionary with the initial seed words and an analysis of Yelp reviews in the city of Toronto, we observe significant improvements in identifying food words and gaining a deeper understanding of the food environment. Conclusions: This study proposes a novel method to expand food-related vocabulary and predict the food energy density based on machine learning and word embedding. This method makes a valuable contribution to building a more comprehensive list of food words that can be used in geography and public health studies by mining geotagged social media data. [ABSTRACT FROM AUTHOR]

This study evaluated whether neighborhood-level disorder, social cohesion, and perceived safety, were associated with days of cannabis use in the prior month in a representative sample of young adults in Alameda and San Francisco Counties in California (N = 1272). We used multiscale geographically weighted regression, modeled by county, to measure associations between cannabis use days and neighborhood attributes, adjusting for sociodemographic characteristics and self-rated health. Positive associations were found between number of cannabis use days and neighborhood disorder, and greater perceived safety. Higher levels of social cohesion predicted fewer cannabis use days. Racial/ethnic, sex and, socioeconomic compositions of participants residing in areas with significant neighborhood-level associations varied substantially, suggesting that risk factors for young adult cannabis use may be highly localized. Public health efforts in cannabis education and intervention should be tailored to fit the culture and composition of local neighborhoods.

Background The trend of prevalence and severity of the overweight problem in young children, reduces the general quality of the future population to a certain extent, inducing a great risk to the sustainable development of health human capital stock in China. Objective To scientifically understand the spatio-temporal evolutionary patterns and future development trends of overweight rates among children under 5 in China, in order to provide support for controlling overweight in children, improve the efficiency of local governance and support for the implementation of precise interventions. Methods In April 2022, the 5 km×5 km gridded dataset in 105 middle-and low-income countries provided by the Institute for Health and Evaluation at the University of Washington (IHME) was used as the data source to extract the gridded data of overweight rates among children under 5 in China (excluding Hong Kong Special Administrative Region, Macao Special Administrative Region and Taiwan District) from 2000 to 2019 in this study. The average overweight rate of children under 5 from 2000 to 2019 was calculated pixel-to-pixel, the Theil-Sen estimator, Mann-Kendall test and Hurst index estimation method was used to characterize the spatio-temporal evolutionary patterns and future development trends among children under 5 pixel-to-pixel. Results Overweight among children under 5 is more prevalent in most regions of Shandong Province, Hunan Province and local regions of Fujian Province, Guangdong Province, Hainan Province, Beijing Municipality and Tianjin Municipality during the 20-year period from 2000 to 2019, with the average overweight rate of children under 5 in Hunan Province reaching 29.42%. The area of the regions with significant increase in overweight rates among children under 5 accounts for 60.59% of the total area of the regions in the study (excluding regions with missing data) . The area of the central and eastern regions with a significantly increasing trend in the overweight rates among children under 5 accounts for a higher proportion of the total area of central and eastern regions (excluding regions with missing data) than the proportion accounted by the area of the western regions with a significantly increasing trend in the overweight rates among children under 5 of the total area of western regions (excluding regions with missing data) . The area of the regions with no significant change in the evolution trend of overweight rates accounts for 25.33% of the total area of the regions in the study, which is scattered in patches in parts of provinces, such as cities cluster in the middle reaches of the Yangtze River urban agglomeration. The area of the regions with significant change in the evolution trend of overweight rates accounts for 14.08% of the total area of the regions in the study, concentrated in some regions in the Xinjiang Uygur Autonomous Region, Qinghai Province, Sichuan Province and Yunnan Province in the west of China, and local regions of Hebei Province, Liaoning Province and Shandong Province in the east of China. According to the Hurst index, the area of the regions with persistent or trend-enhancing characteristics of the time series of overweight rates of children under 5 accounts for 84.87% of the total area of the regions in the study. Conclusion The spatial heterogeneity of overweight rates among children under 5 in China is obvious. There is a synergistic "U"-shaped association between the overweight rates of children under 5 and the overall level of regional development, the association implies a multi-stage, cascading developmental process of "declining stage of stunting" "stabilization stage" "rising stage of overweight with overnutrition". Focusing on social problems derived from the coupling of multidimensional factors of overweight in young children, the results of the study provide scientific support and policy reference for the government to formulate region-specific policies, build a three-level governance network of "government policy regulation - social concept penetration - family health management", and scientifically and precisely solve the overweight problem among children under 5.

While telemedicine infrastructure was in place within the Veterans Health Administration (VHA) healthcare system before the onset of the COVID-19 pandemic, geographically varying ordinances/closures disrupted vital care for chronic disease patients such as those with type 2 diabetes. We created a national cohort of 1,647,158 non-Hispanic White, non-Hispanic Black, and Hispanic veterans with diabetes including patients with at least one primary care visit and HbA1c lab result between 3.5% and 20% in the fiscal year (FY) 2018 or 2019. For each VAMC, the proportion of telehealth visits in FY 2019 was calculated. Two logistic Bayesian spatial models were employed for in-person primary care or telehealth primary care in the fourth quarter of the FY 2020, with spatial random effects incorporated at the VA medical center (MC) catchment area level. Finally, we computed and mapped the posterior probability of receipt of primary care for an “average” patient within each catchment area. Non-Hispanic Black veterans and Hispanic veterans were less likely to receive in-person primary care but more likely to receive tele-primary care than non-Hispanic white veterans during the study period. Veterans living in the most socially vulnerable areas were more likely to receive telehealth primary care in the fourth quarter of FY 2020 compared to the least socially vulnerable group but were less likely to receive in-person care. In summary, racial minorities and those in the most socially vulnerable areas were less likely to receive in-person primary care but more likely to receive telehealth primary care, potentially indicating a disparity in the impact of the pandemic across these groups.

Background: Seasonal floods pose a commonly-recognised barrier to women's access to maternal services, resulting in increased morbidity and mortality. Despite their importance, previous GIS models of healthcare access have not adequately accounted for floods. This study developed new methodologies for incorporating flood depths, velocities, and extents produced with a flood model into network- and raster-based health access models. The methodologies were applied to the Barotse Floodplain to assess flood impact on women's walking access to maternal services and vehicular emergency referrals for a monthly basis between October 2017 and October 2018. Methods: Information on health facilities were acquired from the Ministry of Health. Population density data on women of reproductive age were obtained from the High Resolution Settlement Layer. Roads were a fusion of OpenStreetMap and data manually delineated from satellite imagery. Monthly information on floodwater depth and velocity were obtained from a flood model for 13-months. Referral driving times between delivery sites and EmOC were calculated with network analysis. Walking times to the nearest maternal services were calculated using a cost-distance algorithm. Results: The changing distribution of floodwaters impacted the ability of women to reach maternal services. At the peak of the dry season (October 2017), 55%, 19%, and 24% of women had walking access within 2-hrs to their nearest delivery site, EmOC location, and maternity waiting shelter (MWS) respectively. By the flood peak, this dropped to 29%, 14%, and 16%. Complete inaccessibility became stark with 65%, 76%, and 74% unable to access any delivery site, EmOC, and MWS respectively. The percentage of women that could be referred by vehicle to EmOC from a delivery site within an hour also declined from 65% in October 2017 to 23% in March 2018. Conclusions: Flooding greatly impacted health access, with impacts varying monthly as the floodwave progressed. Additional validation and application to other regions is still needed, however our first results suggest the use of a hydrodynamic model permits a more detailed representation of floodwater impact and there is great potential for generating predictive models which will be necessary to consider climate change impacts on future health access. [ABSTRACT FROM AUTHOR]

In this study we designed, implemented, and evaluated a Problem-based Learning (PBL) course to teach undergraduate students about Viral Hepatitis from a Health Geography perspective. The course was attended by undergraduate students with no previous experience with PBL from a college in the Brazilian Amazon state of Acre. The course design was based on a combination of features from different PBL frameworks, allowing the students to gradually switch from a content-centered educational environment to a student-centered one. The PBL unit was based on an ill-structured real-life problem concerning the division of a hypothetical budget among actions to fight Viral Hepatitis in the state's municipalities. Student problem solutions indicated that they learned basic Viral Hepatitis and Health Geography concepts. Furthermore, perceptions of their own learning demonstrated that students regarded their acquired problem-solving skills and their knowledge of the course subject as their main educational outcomes. We argue that the combination of different PBL frameworks, the gradual transition from lectures to active learning and the social relevance of the course subject to students are among the putative factors that contributed to the course's success. This study, therefore, provides insights into the design of PBL courses for students inexperienced in active learning. [ABSTRACT FROM AUTHOR]

This paper explores embodied experiences of survivability in kidney transfer. By drawing on interviews with, and photography produced by, people on dialysis or with a kidney transplant, this paper counters biomedical approaches to survival by examining the fluid, dynamic, and shifting relations and affects of living on and with kidney transfer. Through an engagement with vitalist thinking, it is argued that kidney transfer is an ongoing process of becoming. In doing so, three characteristics of becoming in kidney transfer are identified: first, becoming in kidney transfer is characterized by material embodied experiences, which occur across and between the intersecting registers of the bodily interior, exterior, and body-in-space; second, experiences of survivability in kidney transfer are shaped through highly relational and dynamic engagements with other people, the more-than-human, and place; and third, becoming in kidney transfer involves developing new relationships to time and temporality. [ABSTRACT FROM AUTHOR]

The literature on older migrants often focuses on identifying the characteristics of ethnic groups that constitute 'barriers' for members of these populations to access care. This paper offers an alternative conceptualisation of access to care, by combining relational approaches to place and the notion of super-diversity. From this perspective, 'access to care' is perceived as an outcome of an individual's embeddedness in relationships of care in urban places. The objective of the study is to identify relationships of care that facilitate access to aged care for older first-generation migrants. Thirty-two semi-structured interviews were conducted with older migrants who were residents of Nijmegen or The Hague, The Netherlands. All interviewees had accessed home care, home aid and/or day care. Both relationships with minority-specific services and informal relationships of care, particularly those within local minority communities, were found to facilitate access to aged care. Past experiences with health and social care were also found to influence current relationships with formal care providers. This study, therefore, suggests that policy makers and care organisations should build long-term positive relationships with new and incoming migrant groups. In addition, it argues that policy makers and care providers should identify locally relevant shared migration-related (rather than ethnic) identities around which communities can be mobilised and targeted with appropriate services. [ABSTRACT FROM AUTHOR]

Reflecting on different theoretical premises within geographies of care, this paper develops their connections and responds to the normativity and universalism in care literature through conceptualising live‐in elder care (LEC). Considering the relationality of differential contributions to care, we propose a conceptualisation of multiple interrelated approaches by: (1) extending the critical frameworks of care to understand the broader frames of institution, market, and morality in mediating interpersonal connectedness of elder care; (2) thinking care relationally, we challenge the dominant conceptualisation of care and power as unidirectional flows and elder care relationships as a receiver–giver dyad; (3) emplacing care, we focus on the actual conditions of care through which ethics are assembled in their geo‐historical context; (4) treating care as grounded, we centre voices from both older people and LEC workers and how ethics of care are comprehended in the everyday rather than prescribed for commodified care. Our thematic analysis starts with a commodification process where LEC is negotiated in tensions; yet moving beyond arguments around systems of dominance and ideal ethics of care, findings show LEC also creates a space of care where LEC workers and older people constantly negotiate norms, boundaries, and care as a relational process. Conceptually, this paper recognises the role of power in shaping the market and intimate relationships of elder care by elaborating on the inequities of age, gender, and place (not just gender). Moving beyond critiques, this paper emphasises the entangled and relational nature of care as grounded in a series of everyday concerns and resistance, where ethics of difference are negotiated and a cultural‐historical configuration of care still perpetuates in its locale. Finally, this paper speaks to the active yet overlooked role of age and ageing in constructing an ethics of care. This paper recognises the role of power in shaping the market and intimate relationships of elder care by elaborating on the inequities of age, gender, and place (not just gender). Moving beyond critiques, this paper emphasises the relational nature of care as grounded and emplaced in a series of everyday concerns and resistance, where ethics of difference are negotiated and a cultural‐historical configuration of care still perpetuates in its locale. Finally, this paper speaks to the active yet overlooked role of age and ageing in constructing an ethics of care. [ABSTRACT FROM AUTHOR]

Objective: The goal of our article was to systematise studies that investigated the impact of living conditions in large national regions on individual alcohol consumption. Methods: The objectives of the scoping review, the criteria and methods for selecting articles were defined in advance and recorded in the protocol PROSPERO CRD42021234874. We sought publications on the research topic in PubMed, Google Scholar, OpenGrey, Crossref and eLibrary databases from the moment they were created until December 31, 2021. The final sample included 81 publications. Results: The majority of ultimately selected papers were published after 2010 (62 articles), represented the USA (68 articles), and considered samples of children and youths, either the younger population or the general adult population (65 articles). High quality was characteristic for 19 studies, whereas satisfactory quality was exhibited by 46 publications. The most consistent associations with individual alcohol consumption were revealed for the legislative environment (especially for integral scales and indices), alcohol pricing policy, the prevalence of alcohol consumption and binge drinking in the population, and unemployment rate. Conclusion: The review made it possible to systematise the results of studies on the impact of the characteristics of large national regions on alcohol consumption, including a description of these characteristics and results, samples and designs of studies, their quality, as well as to summarise the results of these studies. [ABSTRACT FROM AUTHOR]

Abstract Background Colonially imposed jurisdictional boundaries that have little meaning to Indigenous peoples in Canada may confound tuberculosis (TB) prevention and care activities. This study explores how inter-jurisdictional mobility and the current accommodation of mobility through policies and programming sustain a regional TB epidemic in northwestern Saskatchewan, and northeastern Alberta. Methods A qualitative instrumental case study was performed using a community based participatory approach. Semi-structured interviews were conducted with First Nations peoples from a high-incidence community in Canada including community-based healthcare workers. These interview data are presented in the context of a multi-level document analysis of TB program guidelines. Results The location of the community, and related lack of access to employment, services and care, necessitates mobility across jurisdictional boundaries. There are currently no formal federal or provincial guidelines in place to accommodate highly mobile patients and clients within and across provincial TB prevention and care programs. As a result, locally developed community-based protocols, and related ad-hoc strategies ensure continuity of care. Conclusion Indigenous peoples living in remote communities face unique push/pull factors that motivate mobility. When these motivations exist in communities with increased risk of contagion by communicable infectious diseases such as TB, public health risks extend into increasingly large areas with competing jurisdictional authority. Such mobility poses several threats to TB elimination. We have identified a gap in TB services to systematically accommodate mobility, with specific implications for Indigenous peoples and reconciliation. We recommend clearly defined communication paths and inter-jurisdictional coordination to ensure maintenance of care for mobile populations.