Richard Mitchell

University of California System

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H-Index

i-10 index

Research Trends

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Document Type

Co-Authors

Niamh Shortt

University of Edinburgh

Jamie Pearce

University of Edinburgh

Elizabeth Richardson

Hartford Hospital

Jonathan Olsen

MRC/CSO Social and Public Health Sciences Unit

Catharine Ward Thompson

Edinburgh College

Jenny Roe

University of Virginia

Danny Dorling

University of Oxford

David Martín

Klinik und Poliklinik für Kinder- und Jugendmedizin

Esther Rind

University of Tübingen

Hannes Taubenböck

University of Würzburg

Cooperative Institutions

University of Glasgow

University of Edinburgh

Barcelona Institute for Global Health

Pompeu Fabra University

Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública

Medical Research Council

University of Washington

University of Cambridge

London School of Hygiene & Tropical Medicine

MRC Epidemiology Unit

Author Statistics

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i-10 index

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Particulate air pollution and health inequalities: a Europe-wide ecological analysis

International Journal of Health Geographics (2013)

Elizabeth Richardson Jamie Pearce Helena Tunstall Richard Mitchell Niamh Shortt

Abstract Background Environmental disparities may underlie the unequal distribution of health across socioeconomic groups. However, this assertion has not been tested across a range of countries: an important knowledge gap for a transboundary health issue such as air pollution. We consider whether populations of low-income European regions were a) exposed to disproportionately high levels of particulate air pollution (PM 10 ) and/or b) disproportionately susceptible to pollution-related mortality effects. Methods Europe-wide gridded PM 10 and population distribution data were used to calculate population-weighted average PM 10 concentrations for 268 sub-national regions (NUTS level 2 regions) for the period 2004–2008. The data were mapped, and patterning by mean household income was assessed statistically. Ordinary least squares regression was used to model the association between PM 10 and cause-specific mortality, after adjusting for regional-level household income and smoking rates. Results Air quality improved for most regions between 2004 and 2008, although large differences between Eastern and Western regions persisted. Across Europe, PM 10 was correlated with low household income but this association primarily reflected East–West inequalities and was not found when Eastern or Western Europe regions were considered separately. Notably, some of the most polluted regions in Western Europe were also among the richest. PM 10 was more strongly associated with plausibly-related mortality outcomes in Eastern than Western Europe, presumably because of higher ambient concentrations. Populations of lower-income regions appeared more susceptible to the effects of PM 10 , but only for circulatory disease mortality in Eastern Europe and male respiratory mortality in Western Europe. Conclusions Income-related inequalities in exposure to ambient PM 10 may contribute to Europe-wide mortality inequalities, and to those in Eastern but not Western European regions. We found some evidence that lower-income regions were more susceptible to the health effects of PM 10 .

10.1186/1476-072x-12-34

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Citations (84)

Spatiotemporal access to emergency medical services in Wuhan, China: accounting for scene and transport time intervals

International Journal of Health Geographics (2020)

Weicong Luo Jing Yao Richard Mitchell Xiaoxiang Zhang

Access as a primary indicator of Emergency Medical Service (EMS) efficiency has been widely studied over the last few decades. Most previous studies considered one-way trips, either getting ambulances to patients or transporting patients to hospitals. This research assesses spatiotemporal access to EMS at the shequ (the smallest administrative unit) level in Wuhan, China, attempting to fill a gap in literature by considering and comparing both trips in the evaluation of EMS access.

Catchment area

Kilometer

10.1186/s12942-020-00249-7

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Citations (23)

2001 census: The geography of housing in Britain

Geographical Review (2006)

BW Wheeler Richard Mitchell Megan L. Shaw Danny Dorling

Urban Geography

Source

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Citations (0)

A Regional Measure of Neighborhood Multiple Environmental Deprivation: Relationships with Health and Health Inequalities

The Professional Geographer (2012)

Elizabeth Richardson Jamie Pearce Richard Mitchell Niamh Shortt

The health impacts of simultaneous exposure to multiple adverse environmental factors are of concern in the United Kingdom. UK-wide indicators exist, but context-specific finer resolution measures are lacking. An environmental deprivation index was developed for 398 neighborhoods (average population = 760) in a Scottish council area, including measures of air pollution, noise pollution, traffic environment, undesirable land uses, and crime. Adverse environmental conditions were related to ill health in the region and implicated in wider socioeconomic health inequalities. The results suggest an independent role for environmental deprivation in explaining poor health and health inequalities.

Population Health

10.1080/00330124.2012.660457

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Citations (20)

Green Space and Stress: Evidence from Cortisol Measures in Deprived Urban Communities

International Journal of Environmental Research and Public Health (2013)

Jenny Roe Catharine Ward Thompson Peter J. Aspinall Mark Brewer E. I. Duff

Contact with green space in the environment has been associated with mental health benefits, but the mechanism underpinning this association is not clear. This study extends an earlier exploratory study showing that more green space in deprived urban neighbourhoods in Scotland is linked to lower levels of perceived stress and improved physiological stress as measured by diurnal patterns of cortisol secretion. Salivary cortisol concentrations were measured at 3, 6 and 9 h post awakening over two consecutive weekdays, together with measures of perceived stress. Participants (n = 106) were men and women not in work aged between 35-55 years, resident in socially disadvantaged districts from the same Scottish, UK, urban context as the earlier study. Results from linear regression analyses showed a significant and negative relationship between higher green space levels and stress levels, indicating living in areas with a higher percentage of green space is associated with lower stress, confirming the earlier study findings. This study further extends the findings by showing significant gender differences in stress patterns by levels of green space, with women in lower green space areas showing higher levels of stress. A significant interaction effect between gender and percentage green space on mean cortisol concentrations showed a positive effect of higher green space in relation to cortisol measures in women, but not in men. Higher levels of neighbourhood green space were associated with healthier mean cortisol levels in women whilst also attenuating higher cortisol levels in men. We conclude that higher levels of green space in residential neighbourhoods, for this deprived urban population of middle-aged men and women not in work, are linked with lower perceived stress and a steeper (healthier) diurnal cortisol decline. However, overall patterns and levels of cortisol secretion in men and women were differentially related to neighbourhood green space and warrant further investigation.

Urban Green Space

Neighbourhood (mathematics)

Disadvantaged

10.3390/ijerph10094086

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Citations (578)

Use of natural environments is associated with reduced inequalities in child mental wellbeing: A cross-sectional analysis using global positioning system (GPS) data

Environment International (2024)

Fiona M. Caryl Paul McCrorie Jonathan Olsen Richard Mitchell

Exposure to natural environments may benefit child mental wellbeing whilst offering a lever to reduce health inequalities. However, understanding of these relationships is limited by evidence from indirect measures of exposure. We objectively measured children's direct use of natural environments-and use in low or high physical activity (PA) states-and associated this with their mental wellbeing. We then examined moderation by sex and household income. Using global positioning system and accelerometry data from children (n = 640), we measured mean daily time in natural environments ('total use'), which we stratified by PA level as 'passive use' (sedentary and light PA) and 'active use' (moderate and vigorous PA). Logistic regression associated exposures with dichotomised Strengths and Difficulties Questionnaire outcomes (internalising difficulties; externalising difficulties; prosocial behaviour), with interactions to examine moderation. A 10-minute increase in total use was associated with 10.5 % lower risk of abnormal internalising outcomes (OR: 0.895; 95 % CI 0.809, 0.990), and 13.2 % lower risk of abnormal externalising outcomes (OR: 0.868; 95 % CI 0.776, 0.990). This suggests that ∼ 60 min of daily total use was associated with 50 % lower risk of abnormal internalising and externalising outcomes. The relative effects of passive and active use were equal, but their associations were moderated by income independently for specific outcomes. For externalising outcomes, the risk of abnormal scores in lower-income children reduced as passive use increased (P = 0.027) but remained constant for higher-income children. For prosocial outcomes, the likelihood of normal scores increased with active use in lower-income children, but not higher-income children (P = 0.005). Sex did not moderate these associations. The findings suggest that targeted interventions supporting disadvantaged children to use natural environments could help address inequalities in mental wellbeing. Further, the moderated associations with types of use suggest the equigenic effects of natural environments may operate through multiple pathways.

Cross-sectional study

10.1016/j.envint.2024.108847

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Citations (2)

The role of public and private natural space in children's social, emotional and behavioural development in Scotland: A longitudinal study

Environmental Research (2017)

Elizabeth Richardson Jamie Pearce Niamh Shortt Richard Mitchell

Poor mental health in childhood has implications for health and wellbeing in later life. Natural space may benefit children's social, emotional and behavioural development. We investigated whether neighbourhood natural space and private garden access were related to children's developmental change over time. We asked whether relationships differed between boys and girls, or by household educational status.We analysed longitudinal data for 2909 urban-dwelling children (aged 4 at 2008/9 baseline) from the Growing Up in Scotland (GUS) survey. The survey provided social, emotional and behavioural difficulty scores (Strengths and Difficulties Questionnaire (SDQ)), and private garden access. Area (%) of total natural space and parks within 500m of the child's home was quantified using Scotland's Greenspace Map. Interactions for park area, total natural space area, and private garden access with age and age2 were modelled to quantify their independent contributions to SDQ score change over time.Private garden access was strongly related to most SDQ domains, while neighbourhood natural space was related to better social outcomes. We found little evidence that neighbourhood natural space or garden access influenced the trajectory of developmental change between 4 and 6 years, suggesting that any beneficial influences had occurred at younger ages. Stratified models showed the importance of parks for boys, and private gardens for the early development of children from low-education households.We conclude that neighbourhood natural space may reduce social, emotional and behavioural difficulties for 4-6 year olds, although private garden access may be most beneficial.

Neighbourhood (mathematics)

Longitudinal Study

Child Development

Natural experiment

10.1016/j.envres.2017.07.038

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Citations (122)

Enhancing Health Through Access to Nature: How Effective are Interventions in Woodlands in Deprived Urban Communities? A Quasi-experimental Study in Scotland, UK

Sustainability (2019)

Catharine Ward Thompson Aldo Elizalde Steven Cummins Alastair H. Leyland Willings Botha

High prevalence of poor mental health is a major public health problem. Natural environments may contribute to mitigating stress and enhancing health. However, there is little evidence on whether community-level interventions intended to increase exposure to natural environments can improve mental health and related behaviours. In the first study of its kind, we evaluated whether the implementation of a programme designed to improve the quality of, and access to, local woodlands in deprived communities in Scotland, UK, was associated with lower perceived stress or other health-related outcomes, using a controlled, repeat cross-sectional design with a nested prospective cohort. Interventions included physical changes to the woodlands and community engagement activities within the woodlands, with data collected at baseline (2013) and post-intervention (2014 and 2015). The interventions were, unexpectedly, associated with increased perceived stress compared to control sites. However, we observed significantly greater increases in stress for those living >500 m from intervention sites. Visits to nearby nature (woods and other green space) increased overall, and moderate physical activity levels also increased. In the intervention communities, those who visited natural environments showed smaller increases in stress than those who did not; there was also some evidence of increased nature connectedness and social cohesion. The intervention costs were modest but there were no significant changes in quality of life on which to base cost-effectiveness. Findings suggest factors not captured in the study may have contributed to the perceived stress patterns found. Wider community engagement and longer post-intervention follow-up may be needed to achieve significant health benefits from woodland interventions such as those described here. The study points to the challenges in evidencing the effectiveness of green space and forestry interventions to enhance health in urban environments, but also to potential benefits from more integrated approaches across health and landscape planning and management practice.

Natural experiment

10.3390/su11123317

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Citations (30)

More green space is linked to less stress in deprived communities: Evidence from salivary cortisol patterns

Landscape and Urban Planning (2012)

Catharine Ward Thompson Jenny Roe Peter Aspinall Richard Mitchell Angela Clow

Green space has been associated with a wide range of health benefits, including stress reduction, but much pertinent evidence has relied on self-reported health indicators or experiments in artificially controlled environmental conditions. Little research has been reported using ecologically valid objective measures with participants in their everyday, residential settings. This paper describes the results of an exploratory study (n = 25) to establish whether salivary cortisol can act as a biomarker for variation in stress levels which may be associated with varying levels of exposure to green spaces, and whether recruitment and adherence to the required, unsupervised, salivary cortisol sampling protocol within the domestic setting could be achieved in a highly deprived urban population. Self-reported measures of stress and general wellbeing were also captured, allowing exploration of relationships between cortisol, wellbeing and exposure to green space close to home. Results indicate significant relationships between self-reported stress (P < 0.01), diurnal patterns of cortisol secretion (P < 0.05), and quantity of green space in the living environment. Regression analysis indicates percentage of green space in the living environment is a significant (P < 0.05) and independent predictor of the circadian cortisol cycle, in addition to self-reported physical activity (P < 0.02). Results also show that compliance with the study protocol was good. We conclude that salivary cortisol measurement offers considerable potential for exploring relationships between wellbeing and green space and discuss how this ecologically valid methodology can be developed to confirm and extend findings in deprived city areas to illuminate why provision of green space close to home might enhance health.

Urban Green Space

10.1016/j.landurbplan.2011.12.015

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Citations (998)

Socioeconomic inequality in Scottish children’s exposure to and use of natural space and private gardens, measured by GPS

Landscape and Urban Planning (2022)

Jonathan Olsen Fiona M. Caryl Paul McCrorie Richard Mitchell

The objectives of this study were to: (i) determine, by distance from home, the proportion of time children spent in natural space (NS), private gardens (PG) and natural space/private garden (NS/PG); (ii) calculate availability of these environments surrounding homes, and (iii) explore variation in availability and use by socio-economic status (SES). Detailed mobility data for 10/11-year-old children (n = 667) were obtained. Children wore GPS devices and locations were spatially joined to UK national mapping data (Ordnance Survey) to identify if each one was within NS, PG or NS/PG. Euclidean distance between GPS points and home was measured and discretised into 100 m bands (100 m to 800 m). Children spent 15% of their total outdoor, non-school wear time in NS, but 41% in NS/PG. Both time spent in NS & NS/PG and its distance from home varied by SES. Children living in the most deprived areas spent 17% of their total wear time in NS/PG within 100 m from home, and 4.4% in NS/PG over 800 m from home. In contrast, children from the least deprived areas spent 19% of wear time in NS/PG less than 100 m from home and 10.7% in NS/PG over 800 m from home. An increase in the availability of NS and NS/PG around the home was weakly associated with increased use. NS and PG provide a key location that children spend their outdoor time, particularly in areas close to home for those from more deprived areas. Children from the least deprived areas have greater exposure to NS, most of which occurs away from home.

Natural experiment

10.1016/j.landurbplan.2022.104425

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Citations (9)