Pearce Jamie, Witten Karen, Bartie Phil
GeoHealth Laboratory, Department of Geography, University of Canterbury, Private Bag 4800, Christchurch 8020, New Zealand.
J Epidemiol Community Health. 2006 May;60(5):389-95. doi: 10.1136/jech.2005.043281.
Recent studies suggest an association between the contextual attributes of neighbourhoods and the health status of residents. However, there has been a scarcity of studies that have directly measured the material characteristics of neighbourhoods theorised to have an impact on health and health inequalities. This paper describes the development of an innovative methodology to measure geographical access to a range of community resources that have been empirically linked to health. Geographical information systems (GIS) were applied to develop precise measures of community resource accessibility for small areas at a national scale.
Locational access to shopping, education, recreation, and health facilities was established for all 38,350 census meshblocks across New Zealand. Using GIS, distance measures were calculated from the population weighted centroid of each meshblock to 16 specific types of facilities theorised as potentially health related. From these data, indices of community resource accessibility for all New Zealand neighbourhoods were constructed.
Clear regional variations in geographical accessibility to community resources exist across the country, particularly between urban and rural areas of New Zealand. For example, the average travel time to the nearest food shop ranged from less than one minute to more than 244 minutes. Noticeable differences were also apparent between neighbourhoods within urban areas.
Recent advances in GIS and computing capacity have made it feasible to directly measure access to health related community resources at the neighbourhood level. The construction of access indices for specific community resources will enable health researchers to examine with greater precision, variations in the material characteristics of neighbourhoods and the pathways through which neighbourhoods impact on specific health outcomes.
近期研究表明社区的环境属性与居民健康状况之间存在关联。然而，直接测量那些被认为会对健康及健康不平等产生影响的社区物质特征的研究却很匮乏。本文描述了一种创新方法的开发过程，该方法用于衡量获取一系列经实证研究与健康相关的社区资源的地理可达性。利用地理信息系统（GIS）来精确测量全国范围内小区域获取社区资源的情况。
确定了新西兰所有38350个普查网格街区获取购物、教育、娱乐和医疗设施的位置可达性。利用GIS计算了从每个网格街区的人口加权质心到16种特定类型设施（理论上与健康相关）的距离测量值。根据这些数据，构建了新西兰所有社区的社区资源可达性指数。
全国各地在获取社区资源的地理可达性方面存在明显的区域差异，尤其是新西兰的城乡之间。例如，到最近食品店的平均出行时间从不到一分钟到超过244分钟不等。城市地区内部的社区之间也存在显著差异。
GIS和计算能力的最新进展使得在社区层面直接测量获取与健康相关的社区资源成为可能。构建特定社区资源的可达性指数将使健康研究人员能够更精确地研究社区物质特征的差异以及社区影响特定健康结果的途径。
