Recent accumulating epidemiological evidence underlines the important role of environmental exposures on kidney diseases. Among environmental exposures, this study addresses “Green space,” which has been recognized as one of the major environmental exposures at the population level. We review a total of seven epidemiological studies currently published on greenness and kidney disease. We also discuss knowledge gaps in the epidemiological evidence in relation to study design, greenness exposure index, emerging kidney outcomes, and inequalities. With an increase in public attention regarding environmental risks and climate change, an improved understanding of the beneficial effects of green space can play an important role in promoting kidney health.

Both insufficient and excessive sleep durations have been recognized as important risk factors for mortality. Nevertheless, the impact of sleep duration on cause-specific mortality and potential effect modifiers has not been investigated extensively. Therefore, this study aimed to assess the association between sleep duration and mortality categorized by cause of death and potential effect modifiers using data from the National Health and Nutrition Examination Survey (NHANES). Methods: We established a prospective cohort based on NHANES participants aged 50 years or older, linked to the National Death Index (NDI) in the United States between 2009 and 2018. The NDI included all-cause, cardiovascular, and respiratory deaths. Sleep duration was assessed during the NHANES examination period. A survey-weighted Cox proportional hazards model was used to evaluate the association between sleep and mortality. Results: A total of 13,947 participants with available NHANES data were included in this study. A U-shaped association between sleep duration and mortality was observed for all-cause and cardiovascular mortality, meanwhile, respiratory mortality was linked to moderately short sleep (>5 and <7 hours). For total mortality, the association with severe short sleep (5 hours or less; p<0.01) was generally stronger than the association with long sleep (>8 hours; p=0.029), with the effect of severe short sleep being significantly prominent in males (p<0.01), non-Hispanic White (0.001), high-income (0.056), and those with a body mass index ≥23.0 kg/m2 (0.001) than those in their counterparts. Conclusions: This study suggests that sleep duration is associated with the mortality risk. Our results provide evidence for a more targeted allocation of public health resources to improve sleep and health.

Both insufficient and excessive sleep durations have been recognized as important risk factors for mortality. Nevertheless, the impact of sleep duration on cause-specific mortality and potential effect modifiers has not been investigated extensively. Therefore, this study aimed to assess the association between sleep duration and mortality categorized by cause of death and potential effect modifiers using data from the National Health and Nutrition Examination Survey (NHANES). Methods: We established a prospective cohort based on NHANES participants aged 50 years or older, linked to the National Death Index (NDI) in the United States between 2009 and 2018. The NDI included all-cause, cardiovascular, and respiratory deaths. Sleep duration was assessed during the NHANES examination period. A survey-weighted Cox proportional hazards model was used to evaluate the association between sleep and mortality. Results: A total of 13,947 participants with available NHANES data were included in this study. A U-shaped association between sleep duration and mortality was observed for all-cause and cardiovascular mortality, meanwhile, respiratory mortality was linked to moderately short sleep (>5 and <7 hours). For total mortality, the association with severe short sleep (5 hours or less; p<0.01) was generally stronger than the association with long sleep (>8 hours; p=0.029), with the effect of severe short sleep being significantly prominent in males (p<0.01), non-Hispanic White (0.001), high-income (0.056), and those with a body mass index ≥23.0 kg/m2 (0.001) than those in their counterparts. Conclusions: This study suggests that sleep duration is associated with the mortality risk. Our results provide evidence for a more targeted allocation of public health resources to improve sleep and health.

Both insufficient and excessive sleep durations have been recognized as important risk factors for mortality. Nevertheless, the impact of sleep duration on cause-specific mortality and potential effect modifiers has not been investigated extensively. Therefore, this study aimed to assess the association between sleep duration and mortality categorized by cause of death and potential effect modifiers using data from the National Health and Nutrition Examination Survey (NHANES). Methods: We established a prospective cohort based on NHANES participants aged 50 years or older, linked to the National Death Index (NDI) in the United States between 2009 and 2018. The NDI included all-cause, cardiovascular, and respiratory deaths. Sleep duration was assessed during the NHANES examination period. A survey-weighted Cox proportional hazards model was used to evaluate the association between sleep and mortality. Results: A total of 13,947 participants with available NHANES data were included in this study. A U-shaped association between sleep duration and mortality was observed for all-cause and cardiovascular mortality, meanwhile, respiratory mortality was linked to moderately short sleep (>5 and <7 hours). For total mortality, the association with severe short sleep (5 hours or less; p<0.01) was generally stronger than the association with long sleep (>8 hours; p=0.029), with the effect of severe short sleep being significantly prominent in males (p<0.01), non-Hispanic White (0.001), high-income (0.056), and those with a body mass index ≥23.0 kg/m2 (0.001) than those in their counterparts. Conclusions: This study suggests that sleep duration is associated with the mortality risk. Our results provide evidence for a more targeted allocation of public health resources to improve sleep and health.

OBJECTIVES: Smoking and passive smoking have been extensively reported as risk factors of cardiovascular morbidity and mortality. Despite the biological mechanisms underlying the impact of hazardous chemical substances contained in tobacco in cardiovascular diseases (CVD), studies investigating the association between smoking and passive smoking with morbidity are at an inchoate stage in Korea. Therefore, this study aimed to estimate the risks of smoking and passive smoking on cardiovascular morbidity at the national and regional levels.METHODS: This study calculated sex-standardized and age-standardized prevalence of CVD and smoking indices in 253 community health centers (si/gun/gu) in Korea using the 2008-2013 Korea Community Health Survey data. Furthermore, a Bayesian hierarchical model was used to estimate the association of smoking and passive smoking with the prevalence of CVD from the national and regional community health centers.RESULTS: At the national level, smoking was significantly associated with stroke (relative risk [RR], 1.060) and hypertension (RR, 1.016) prevalence, whilst passive smoking at home and work were also significantly associated with prevalence of stroke (RR, 1.037/1.013), angina (RR, 1.016/1.006), and hypertension (RR, 1.010/1.004). Furthermore, the effects of smoking and passive smoking were greater in urban-industrial areas than in rural areas.CONCLUSIONS: The findings of this study would provide grounds for national policies that limit smoking and passive smoking, as well as regionally serve as the basis for region-specific healthcare policies in populations with high CVD vulnerability.
Cardiovascular Diseases ; Community Health Centers ; Delivery of Health Care ; Health Surveys ; Hypertension ; Korea ; Mortality ; Prevalence ; Risk Factors ; Smoke ; Smoking ; Stroke ; Tobacco ; Tobacco Smoke Pollution

OBJECTIVES: Smoking and passive smoking have been extensively reported as risk factors of cardiovascular morbidity and mortality. Despite the biological mechanisms underlying the impact of hazardous chemical substances contained in tobacco in cardiovascular diseases (CVD), studies investigating the association between smoking and passive smoking with morbidity are at an inchoate stage in Korea. Therefore, this study aimed to estimate the risks of smoking and passive smoking on cardiovascular morbidity at the national and regional levels. METHODS: This study calculated sex-standardized and age-standardized prevalence of CVD and smoking indices in 253 community health centers (si/gun/gu) in Korea using the 2008-2013 Korea Community Health Survey data. Furthermore, a Bayesian hierarchical model was used to estimate the association of smoking and passive smoking with the prevalence of CVD from the national and regional community health centers. RESULTS: At the national level, smoking was significantly associated with stroke (relative risk [RR], 1.060) and hypertension (RR, 1.016) prevalence, whilst passive smoking at home and work were also significantly associated with prevalence of stroke (RR, 1.037/1.013), angina (RR, 1.016/1.006), and hypertension (RR, 1.010/1.004). Furthermore, the effects of smoking and passive smoking were greater in urban-industrial areas than in rural areas. CONCLUSIONS: The findings of this study would provide grounds for national policies that limit smoking and passive smoking, as well as regionally serve as the basis for region-specific healthcare policies in populations with high CVD vulnerability.
Cardiovascular Diseases* ; Community Health Centers ; Delivery of Health Care ; Health Surveys* ; Hypertension ; Korea* ; Mortality ; Prevalence ; Risk Factors ; Smoke* ; Smoking* ; Stroke ; Tobacco ; Tobacco Smoke Pollution*