■由于增加了获得医疗保健的机会,城市生活与更好的健康结果相关联。交通运输,人类发展机遇。然而,空间不平等导致差异,导致城市健康优势和惩罚。需要了解健康与城市发展之间的关系,以产生促进健康老龄化人口的经验证据。本研究使用中国不同主要城市的流行病学证据进行了比较分析,研究随着时间的推移,他们独特的城市发展轨迹如何影响老龄居民的健康。
■我们跟踪了空气污染(NO2,PM2.5,O3)的变化,绿色空间(通过NDVI测量),道路基础设施(环路区域),和夜间照明超过20年在中国的六个主要城市。我们对超过16,824人年的4992名老年参与者(平均年龄87.8岁)进行了纵向队列研究。我们采用Cox比例风险回归来评估寿命,评估14个变量,包括年龄,性别,种族,婚姻状况,residence,家庭收入,职业,教育,吸烟,酒精消费,锻炼,以及与医学相关的设施的兴趣点(POI)计数,体育,和休闲服务相关的地方,和5公里半径缓冲区内的景点。
■在地理上接近兴趣点可以显着提高生存率。与POI贫困地区的老年人相比,居住在POI丰富地区附近的老年人的死亡风险降低了34.6%-35.6%,与最低四分位数相比,最高的四分位数。然而,POI丰富地区的空气污染水平较高,包括PM2.5和NO2,分别与增加10μg/m3的死亡风险增加21%和10%相关。城市生活的好处在单中心城市有更高的效果估计,有明确的中心区域,与多中心布局相比,拥有多个卫星城市中心。
■空间不平等对某些人造成城市健康优势,对另一些人造成惩罚。靠近公共设施和经济活动与健康益处有关,并可能抵消较低的绿色空间和较高的空气污染对健康的负面影响。我们的经验证据表明,年龄友好型城市环境的最佳健康收益来自基础设施的平衡,兴趣点,绿色空间,低空气污染。
■北京市自然科学基金(IS23105),国家自然科学基金(82250610230,72061137004),世界卫生组织(2024/1463606-0),研究基金万科清华大学公共卫生学院(2024JC002),北京泰康益彩公益基金会,国家重点研发计划(2018YFC2000400).
UNASSIGNED: Urban living is linked to better health outcomes due to a combination of enhanced access to healthcare, transportation, and human development opportunities. However, spatial inequalities lead to disparities, resulting in urban health advantages and penalties. Understanding the relationship between health and urban development is needed to generate empirical evidence in promoting healthy aging populations. This study provides a comparative analysis using epidemiological evidence across diverse major Chinese cities, examining how their unique urban development trajectories over time have impacted the health of their aging residents.
UNASSIGNED: We tracked changes in air pollution (NO2, PM2.5, O3), green space (measured by NDVI), road infrastructure (ring road areas), and nighttime lighting over 20 years in six major cities in China. We followed a longitudinal cohort of 4992 elderly participants (average age 87.8 years) over 16,824 person-years. We employed Cox proportional hazard regression to assess longevity, assessing 14 variables, including age, sex, ethnicity, marital status, residence, household income, occupation, education, smoking, alcohol consumption, exercise, and points of interest (POI) count of medicine-related facilities, sports, and leisure service-related places, and scenic spots within a 5 km-radius buffer.
UNASSIGNED: Geographic proximity to points of interest significantly improves survival. Elderly living in proximity of the POI-rich areas had a 34.6%-35.6% lower mortality risk compared to those in POI-poor areas, for the highest compared to the lowest quartile. However, POI-rich areas had higher air pollution levels, including PM2.5 and NO2, which was associated with a 21% and 10% increase in mortality risk for increase of 10 μg/m3, respectively. The benefits of urban living had higher effect estimates in monocentric cities, with clearly defined central areas, compared to polycentric layouts, with multiple satellite city centers.
UNASSIGNED: Spatial inequalities create urban health advantages for some and penalties for others. Proximity to public facilities and economic activities is associated with health benefits, and may counterbalance the negative health impacts of lower green space and higher air pollution. Our empirical evidence show optimal health gains for age-friendly urban environments come from a balance of infrastructure, points of interest, green spaces, and low air pollution.
UNASSIGNED: Natural Science Foundation of Beijing (IS23105), National Natural Science Foundation of China (82250610230, 72061137004), World Health Organization (2024/1463606-0), Research Fund Vanke School of Public Health Tsinghua University (2024JC002), Beijing TaiKang YiCai Public Welfare Foundation, National Key R&D Program of China (2018YFC2000400).