Health, Architecture and Wellbeing: building bridges between health and the design of living spaces

Abstract Background Health is determined by where we live. Nevertheless, medical and architecture students often ignore the relation between health, housing and urban planning. In order to bridge these areas, we designed an interdisciplinary course for students of University of Porto Medical and Architecture schools, winning a 2021 Pedagogic Innovation courses call. Objectives ”Health, Architecture and Wellbeing” aimed to explore the effect of living spaces in health, combining the health and architecture perspectives in the analysis of case studies, and discussing strategies to improve health and wellbeing of the population. By exposing students to tools for designing healthy, sustainable, efficient and accessible spaces, and to public participation strategies, we aimed to foster awareness and share knowledge among complementary scientific fields. Results Students were exposed to theoretical and practical sessions with experts from the medical, architecture, landscape architecture, and geography areas, as well as to field visits in social neighbourhoods, collective housing, and green spaces. Besides introducing students to concepts, as health needs and determinants, and to healthy and accessible design methods, students interacted with inhabitants, gathering experiences on how they lived in those spaces, understanding its impact on their wellbeing, while exploring the enablers and barriers of participation strategies. Students were encouraged to complement technical architecture competences with public health evidence, and social participation leading to the development of design proposals improving the existing living environments. Conclusions “Health, Architecture and Wellbeing” interdisciplinary course connected public health expertise with architecture, promoting knowledge dissemination and awareness among health and architecture students. This experience may be reproduced in other countries, as health continues to be determined by living and public spaces. Key messages • Bridging public health with other disciplines is fundamental to understand the origin of health issues, namely living conditions, and maximise the opportunities of acting near their root causes. • This course allowed architecture and medical students to gain awareness about the impact of housing and urban design on people’s health, and to learn how to propose and design healthier environments.


Background:
Studies revealed an implication of air pollution in neurodegenerative disorders, although this link remains unclear.Here, we investigated this testing multiple pollutants simultaneously.Methods: In the Moli-sani cohort (N = 24,325; !35 years; 51.9% women, baseline 2005-2010), we estimated yearly levels of exposure to nitrogen oxides (NOX, NO, NO2), ozone (O3), particulate matter (PM10) and BTX hydrocarbons (benzene, toluene and xylene) in 2006-2018, applying residence geolocalization of participants and Kriging interpolation algorithm to land measurements of air pollutants.We performed a principal component analysis and tested association of the resulting principal components (PCs) with the incident risk of Parkinson (PD) and Alzheimer disease (AD), through multivariable Cox PH regressions adjusted for age, sex and education level completed.

Conclusions:
This evidence supports an influence of air pollution -especially PM10 -on increased neurodegenerative risk in the Italian population, independent on concurring risk factors.This suggests reducing PM10 pollution as a potential strategy to reduce neurodegenerative risk.

Key messages:
PM10 levels are associated with increased Parkinson and Alzheimer disease risk.This suggests to act on air pollution to reduce neurodegenerative risk in the general population.
Abstract citation ID: ckac129.299Health, Architecture and Wellbeing: building bridges between health and the design of living spaces how they lived in those spaces, understanding its impact on their wellbeing, while exploring the enablers and barriers of participation strategies.Students were encouraged to complement technical architecture competences with public health evidence, and social participation leading to the development of design proposals improving the existing living environments.

Conclusions:
''Health, Architecture and Wellbeing'' interdisciplinary course connected public health expertise with architecture, promoting knowledge dissemination and awareness among health and architecture students.This experience may be reproduced in other countries, as health continues to be determined by living and public spaces.

Key messages:
Bridging public health with other disciplines is fundamental to understand the origin of health issues, namely living conditions, and maximise the opportunities of acting near their root causes.This course allowed architecture and medical students to gain awareness about the impact of housing and urban design on people's health, and to learn how to propose and design healthier environments.

Background:
The provision of eHealth has increased in the COVID-19 era with the aim of improving access to care without the risk of infection.Perceiving eHealth beneficial may affect the use.This study examined which patient-related factors are associated with the perception that eHealth facilitates access to care.

Methods:
A nationwide survey was sent to 61,600 Finnish residents during the COVID-19 pandemic (September 2020-February 2021).Binary logistic regression analysis was used to examine whether the service needs (self-rated health, met service needs, challenges accessing traditional care) and eHealth experience (e-visits, need for guidance, data security concerns) were associated with perceiving that eHealth facilitates access to care.The model was adjusted for age, gender and education.

Results:
The study included 21,409 respondents who had used healthcare services in the past 12 months (55.0%female, mean age 52.88, SE .18).The majority (63.8%) agreed with the benefit that eHealth facilitates access to care.Patients in good health (OR 1.24, 95% CI 1.13-1.37),whose service needs were met (OR 1.34, 95% CI 1.19-1.52)and who had no challenges in accessing traditional care (OR 1.18, 95% CI 1.02-1.36)had greater odds of perceiving the benefit compared to their counterparts.Patients with experience of e-visits (OR 2.60, 95% CI 2.28-2.96)and without need for guidance (OR 1.71, 95% CI 1.52-1.91)had greater odds of perceiving the benefit compared to their counterparts.

Conclusions:
Patients in good health, with met service needs and with easy access to traditional care appear to perceive eHealth more beneficial than their counterparts, which might exacerbate the already existing inequalities in healthcare access and health outcomes.Promotion of eHealth skills might increase equitable opportunities to benefit from eHealth for those patients whose service needs could be met without traditional face-to-face encounter.

Key messages:
Patients in good health, with met service needs and without difficulties accessing traditional healthcare appear to find eHealth more beneficial than their underprivileged counterparts.
Promotion of eHealth skills might increase equitable opportunities to benefit from eHealth for those patients whose service needs could be met without traditional faceto-face encounter.
Conclusions:High quality SRs are needed for making public health decisions.AMSTAR2 assigns mostly low and critically low OCR to SRs of DIs for PA promotion.These SRs should not be