Gaps in Facility Care for East Asian Cultural Groups in Selected GVRD Communities: A Geographic Information Systems and Focus Group Report

This Highlight Report provides findings on patterns of residential care (RC) and assisted living (AL) utilization in Burnaby, Coquitlam, Port Coquitlam, Port Moody, Richmond, Surrey, Vancouver, and White Rock among persons of East Asian (EA) (defined as Chinese, Japanese, Korean, and Filipino) and non-EA ethnic backgrounds. South Asians were not included in this ethnic grouping due to different cultural service needs. The findings in this report are based on GIS (geographic information system) analyses of census data coupled with data on RC and AL facilities from several sources, including the Office of the Seniors Advocate of BC, the Assisted Living Registry, Health Authorities, and a survey covering 95% of all 111 publically funded facilities (66 RC and 45 AL) for seniors in the catchment area. These data are supplemented with thematic analyses drawn from four focus groups

Spatiotemporal Patterns of Cyclist Collisions in Germany: Variations in Frequency, Severity of Injury, and Type of Collision in 2019

Cycling has gained increasing interest in Germany in recent years due to its manifold environmental, societal, and economic benefits. However, the number of cyclist collisions resulting in injury or death remains high and little is known about regional variations in frequency, severity of injury, and type of collision. This study investigates spatial and temporal patterns and characteristics of cyclist collisions across Germany in 2019. Using a detailed cyclist collision dataset for most German federal states, we identified statistically significant regional differences in frequency, severity of injury, and type of collision. To facilitate this and future cyclist collision surveillance studies in Germany, we developed and published a custom R package to download and combine the collision data with geographical data. Our analysis reveals that densely populated regions exhibit higher collision rates and a higher share of collisions involving turns, but lower severity of injuries and a lower share of collisions whilst driving in a straight line, a higher collision frequency during the work week compared to weekends, and a higher collision frequency peak during morning rush hour. We also observed a markedly high share of fatal bicycle-truck collisions in densely populated regions. In contrast, rural regions show lower collision rates, but a higher share of severe collisions, a higher share of collisions whilst driving in a straight line, as well as higher collision frequencies during weekends and summer months. Our findings underscore the complex and multifaceted geographical variations in collisions involving cyclists. The results of this study suggest that a one-size-fits-all approach to collision prevention infrastructure and policy may be insufficient for addressing variations in risk, and that future efforts to improve cyclist safety should be tailored to the local geographical context.Peer Reviewe

Suburbanisation of Oral Cavity Cancers: Evidence From a Geographically-Explicit Observational Study of Incidence Trends in British Columbia, Canada, 1981–2010

Background Recent studies have demonstrated an elevated risk of oral cavity cancers (OCC) among socioeconomically deprived populations, whose increasing presence in suburban neighbourhoods poses unique challenges for equitable health service delivery. The majority of studies to date have utilised aspatial methods to identify OCC. In this study, we use high-resolution geographical analyses to identify spatio-temporal trends in OCC incidence, emphasising the value of geospatial methods for public health research. Methods Using province-wide population incidence data from the British Columbia Cancer Registry (1981–2009, N  = 5473), we classify OCC cases by census-derived neighbourhood types to differentiate between urban, suburban, and rural residents at the time of diagnosis. We map geographical concentrations by decade and contrast trends in age-adjusted incidence rates, comparing the results to an index of socioeconomic deprivation. Results Suburban cases were found to comprise a growing proportion of OCC incidence. In effect, OCC concentrations have dispersed from dense urban cores to suburban neighbourhoods in recent decades. Significantly higher age-adjusted oral cancer incidence rates are observed in suburban neighbourhoods from 2006 to 2009, accompanied by rising socioeconomic deprivation in those areas. New suburban concentrations of incidence were found in neighbourhoods with a high proportion of persons aged 65+ and/or born in India, China, or Taiwan. Conclusions While the aging of suburban populations provides some explanation of these trends, we highlight the role of the suburbanisation of socioeconomically deprived and Asia-born populations, known to have higher rates of risk behaviours such as tobacco, alcohol, and betel/areca consumption. Specifically, betel/areca consumption among Asia-born populations is suspected to be a primary driver of the observed geographical shift in incidence from urban cores to suburban neighbourhoods. We suggest that such geographically-informed findings are complementary to potential and existing place-specific cancer control policy and targeting prevention efforts for high-risk sub-populations, and call for the supplementation of epidemiological studies with high-resolution mapping and geospatial analysis

Key Challenges for Land Use Planning and Its Environmental Assessments in the Abuja City-Region, Nigeria

Land use planning as strategic instruments to guide urban dynamics faces particular challenges in the Global South, including Sub-Saharan Africa, where urgent interventions are required to improve urban and environmental sustainability. This study investigated and identified key challenges of land use planning and its environmental assessments to improve the urban and environmental sustainability of city-regions. In doing so, we combined expert interviews and questionnaires with spatial analyses of urban and regional land use plans, as well as current and future urban land cover maps derived from Geographic Information Systems and remote sensing. By overlaying and contrasting land use plans and land cover maps, we investigated spatial inconsistencies between urban and regional plans and the associated urban land dynamics and used expert surveys to identify the causes of such inconsistencies. We furthermore identified and interrogated key challenges facing land use planning, including its environmental assessment procedures, and explored means for overcoming these barriers to rapid, yet environmentally sound urban growth. The results illuminated multiple inconsistencies (e.g., spatial conflicts) between urban and regional plans, most prominently stemming from conflicts in administrative boundaries and a lack of interdepartmental coordination. Key findings identified a lack of Strategic Environmental Assessment and inadequate implementation of land use plans caused by e.g., insufficient funding, lack of political will, political interference, corruption as challenges facing land use planning strategies for urban and environmental sustainability. The baseline information provided in this study is crucial to improve strategic planning and urban/environmental sustainability of city-regions in Sub-Saharan Africa and across the Global South, where land use planning faces similar challenges to address haphazard urban expansion patterns.Peer Reviewe

Simulating Urban Land Expansion in the Context of Land Use Planning in the Abuja City-Region, Nigeria

In the Global South, including the Sub-Saharan African city-regions, the possible future urban expansion patterns may pose a challenge towards improving environmental sustainability. Land use planning strategies and instruments for regulating urban expansion are faced with challenges, including insufficient data availability to offer insights into the possible future urban expansion. This study integrated empirical data derived from Geographic Information Systems, Remote Sensing, and surveys of experts to offer insights into the possible future urban expansion under spatial planning scenarios to support land use planning and environmental sustainability of city-regions. We analyzed the spatial determinants of urban expansion, calibrated the land cover model using the Multi-Layer Perceptron Neural Network and Markov, and developed three scenarios to simulate land cover from 2017 to 2030 and to 2050. The scenarios include Business As Usual that extrapolates past trends; Regional Land Use Plan that restricts urban expansion to the land designated for urban development, and; Adjusted Urban Land that incorporates the leapfrogged settlements into the land designated for urban development. Additionally, we quantified the potential degradation of environmentally sensitive areas by future urban expansion under the three scenarios. Results indicated a high, little, and no potential degradation of environmentally sensitive areas by the future urban expansion under the Business As Usual, Adjusted Urban Land, and Regional Land Use Plan scenarios respectively. The methods and the baseline information provided, especially from the Adjusted Urban Land scenario showed the possibility of balancing the need for urban expansion and the protection of environmentally sensitive areas. This would be useful to improve the environmental sustainability of the Sub-Saharan African city-regions and across the Global South, where insufficient data availability challenges land use planning.Peer Reviewe

Intentional injury and violence in Cape Town, South Africa : an epidemiological analysis of trauma admissions data

While violence has been the subject of great study, data remains limited on the impacts and nature of interpersonal injury. Injury continues to be a global health issue, however. Through the analysis of injury surveillance of hospital admissions in South Africa, this study presents evidence-based interventions to reduce the burden of intentional injury. Researchers find a strong link between young males, substance use and violence, and link these trends to the context of increased urban migration and inequality in the Khayelitsha township

Epidemiological and Spatial Characteristics of Interpersonal Physical Violence in a Brazilian City: A Comparative Study of Violent Injury Hotspots in Familial Versus Non-Familial Settings, 2012-2014

This study explores both epidemiological and spatial characteristics of domestic and communityinterpersonal violence. We evaluated three years of violent trauma data in themedium-sized city of Campina Grande in North-Eastern Brazil. 3559 medical and police recordswere analysed and 2563 cases were included to identify socioeconomic and geographicpatterns. The associations between sociodemographic, temporal, and incidentcharacteristics and domestic violence were evaluated using logistic regression. Using GeographicalInformation Systems (GIS), we mapped victims’ household addresses to identifyspatial patterns. We observed a higher incidence of domestic violence among female,divorced, or co-habitant persons when the violent event was perpetrated by males. Therewas only a minor chance of occurrence of domestic violence involving firearms. 8 out of 10victims of domestic violence were women and the female/male ratio was 3.3 times greaterthan that of community violence (violence not occurring in the home). Unmarried coupleswere twice as likely to have a victim in the family unit (OR = 2.03), compared to married couples.Seven geographical hotspots were identified. The greatest density of hotspots wasfound in the East side of the study area and was spatially coincident with the lowest averagefamily income. Aggressor sex, marital status, and mechanism of injury were most associatedwith domestic violence, and low-income neighbourhoods were coincident with bothdomestic and non-domestic violence hotspots. These results provide further evidence thateconomic poverty may play a significant role in interpersonal, and particularly domesticviolence

Spatial-temporal epidemiology of violent trauma in urban environments

The World Health Organization has declared violence to be a significant public health problem (2002). This thesis uses a spatial epidemiology approach to investigate clusters of violent injury in the Metro Vancouver area.Trauma registry data were analysed using a visually-enhanced ranking method in geographic information systems to identify violent injury hotspots. The identified hotspots were then examined using environmental, spatial-temporal, victim, and deprivation variables. Data from hotspot observations, victim and incident records, and the use of a Vancouver-specific deprivation index were included.Alcohol availability, time of day, and social deprivation are several of the factors found to be strongly related to violent injury hotspots. However, the hotspots were found to occur in several disparate geographical contexts, each of which is characterised to produce a series of multidimensional profiles of urban spaces of violent injury. To conclude, the emergence of a non-statistical, exploratory paradigm in geographic information science is promoted

Towards a suburban spatial epidemiology: differentiating geographical patterns of cancer incidence, patient access, and surgical treatment in Canada’s urban fringe

Epidemiological studies have traditionally categorised study populations as urban or rural. However, a growing proportion of the global population resides in spaces that are neither dense urban cores nor rural/remote regions. These interstices are distinctly suburban, featuring a low density of services, poor walkability, and spatial isolation relative to their urban counterparts. Contrary to the dominant imaginary of the affluent ‘American Dream’, Canada’s suburbs are increasingly becoming home to socioeconomically deprived populations. Following from the well-established links between socioeconomic status and health geographies, this dissertation presents quantitative geographical evidence that the suburbs differ from their urban and rural counterparts, constituting a third, epidemiologically distinct space. The first substantive chapter provides an introductory tracing of the suburb’s socioeconomic history, laying the contextual foundation for a distinct categorisation. The following three chapters then draw upon this categorisation to differentiate spatial epidemiological patterns of cancer along both urban/suburban/rural and socioeconomic axes. The second chapter uses exploratory temporal mapping to document a recent emergence of oral cancer cases in British Columbia’s suburbs, geographically coincident with immigration from betel quid-chewing regions and an increase in local socioeconomic deprivation. The third chapter then explores head and neck cancer patients’ spatial access to cancer treatment centres across the province, highlighting significantly greater travel times among the most deprived suburban and rural populations. The fourth chapter evaluates whether these spatial and socioeconomic disparities reflect actual treatment rates, focussing on resection surgeries for five cancer types across Canada, excluding Québec. Resection rates were positively associated with socioeconomic deprivation in rural areas and inversely associated in urban areas, while the highest overall rates were observed in middle-SES suburban populations. Drawing upon these three cancer studies, this dissertation proposes a suburban spatial epidemiology, in which suburbs are differentiated from urban and rural spaces. I conclude by asserting that the suburbs’ unique placial contexts merit standalone attention in health research, calling for further examination of suburban spaces in epidemiological research