IN-PERSON London. Section A

Abstract

Vitamin D (VD) deficiency is a well-recognised public health concern due to the undisputed impact on musculoskeletal health. Low VD is also associated with severe COVID-19, cancer and other morbidities. Currently, 1 in 5 adults in the UK have low VD, with the deficiency higher amongst ethnic minorities. Given the role of VD levels as predictors of health outcomes, there is a risk of widening existing ethnic health disparities. Despite an emphasis on dietary and behavioural recommendations, adherence is poor and calls for novel approaches. VD deficiency has persisted in the UK ever since the increase of urbanisation during the post-medieval period. Whilst VD is acquired most efficiently through sunlight, this can be difficult in urban areas with high population and building density. Furthermore, air pollution may interfere with VD synthesis by blocking UVB photons. Given that over 68% of the global population are expected to live in cities by 2050, it is essential to explore environmental barriers and opportunities to prevent low VD. Drawing upon data from the UK Biobank and UK Data Service, we conducted a geographically weighted regression (GWR) analysis to predict features of the built environment that may contribute to VD deficiency across London. Our GWR model is the first to identify heterogeneity in the relationship between air pollution and VD across London and suggests this can be explained by the hyperlocal built environment. Our results describe several significant modifiable predictors of VD at the Middle Layer Super Output Area, including greenspace, air pollution and road network variables (p<0.05). Our findings highlight that public health approaches must consider the hyperlocal built environment to address VD deficiency and improve health outcomes across divides.