Melis Giulia, Gelormino Elena, Marra Giulia, Ferracin Elisa, Costa Giuseppe
Environmental Heritage and Urban Redevelopment Unit, SiTI-Higher Institute on Territorial Systems for Innovation, via Boggio 61, 10138 Torino, Italy.
ASL Torino 5, Local Public Health Agency, piazza S. Pellico 1, 10023 Chieri, Italy.
Int J Environ Res Public Health. 2015 Nov 20;12(11):14898-915. doi: 10.3390/ijerph121114898.
Mental health (MH) has a relevant burden on the health of populations. Common MH disorders (anxiety and non-psychotic depression) are well associated to socioeconomic individual and neighborhood characteristics, but little is known about the influence of urban structure. We analyzed among a Turin (Northwest Italy) urban population the association at area level of different urban structure characteristics (density, accessibility by public transport, accessibility to services, green and public spaces) and consumption of antidepressants. Estimates were adjusted by individual socio-demographic variables (education, housing tenure, employment) and contextual social environment (SE) variables (social and physical disorder, crime rates). Data was extracted from the Turin Longitudinal Study (TLS)-a census-based cohort study following up prospectively the mortality and morbidity of the population. As expected, individual characteristics show the strongest association with antidepressant drug consumption, while among built environment (BE) indicators accessibility by public transport and urban density only are associated to MH, being slightly protective factors. Results from this study, in agreement with previous literature, suggest that BE has a stronger effect on MH for people who spend more time in the neighborhood. Therefore, this research suggests that good accessibility to public transport, as well as a dense urban structure (versus sprawl), could contribute to reduced risk of depression, especially for women and elderly, by increasing opportunities to move around and have an active social life.
心理健康（MH）对人群健康有着重大影响。常见的心理健康障碍（焦虑症和非精神病性抑郁症）与个体社会经济及社区特征密切相关，但城市结构的影响却鲜为人知。我们在意大利西北部都灵的城市人口中分析了不同城市结构特征（密度、公共交通可达性、服务可达性、绿地和公共空间）与抗抑郁药消费在区域层面的关联。估计值通过个体社会人口统计学变量（教育程度、住房 tenure、就业情况）和背景社会环境（SE）变量（社会和身体紊乱、犯罪率）进行了调整。数据取自都灵纵向研究（TLS）——一项基于人口普查的队列研究，前瞻性地跟踪人群的死亡率和发病率。正如预期的那样，个体特征与抗抑郁药消费的关联最为强烈，而在建筑环境（BE）指标中，只有公共交通可达性和城市密度与心理健康相关，且为轻微的保护因素。本研究结果与先前文献一致，表明建筑环境对在社区中花费更多时间的人心理健康影响更大。因此，本研究表明，良好的公共交通可达性以及密集的城市结构（相对于城市扩张），可以通过增加出行和积极社交生活的机会，有助于降低抑郁症风险，尤其是对女性和老年人而言。
