Brown Scott C, Lombard Joanna, Wang Kefeng, Byrne Margaret M, Toro Matthew, Plater-Zyberk Elizabeth, Feaster Daniel J, Kardys Jack, Nardi Maria I, Perez-Gomez Gianna, Pantin Hilda M, Szapocznik José
Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida; University of Miami School of Architecture, Coral Gables, Florida.
Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida; University of Miami School of Architecture, Coral Gables, Florida.
Am J Prev Med. 2016 Jul;51(1):78-89. doi: 10.1016/j.amepre.2016.02.008. Epub 2016 Apr 6.
Prior studies suggest that exposure to the natural environment may impact health. The present study examines the association between objective measures of block-level greenness (vegetative presence) and chronic medical conditions, including cardiometabolic conditions, in a large population-based sample of Medicare beneficiaries in Miami-Dade County, Florida.
The sample included 249,405 Medicare beneficiaries aged ≥65 years whose location (ZIP+4) within Miami-Dade County, Florida, did not change, from 2010 to 2011. Data were obtained in 2013 and multilevel analyses conducted in 2014 to examine relationships between greenness, measured by mean Normalized Difference Vegetation Index from satellite imagery at the Census block level, and chronic health conditions in 2011, adjusting for neighborhood median household income, individual age, gender, race, and ethnicity.
Higher greenness was significantly associated with better health, adjusting for covariates: An increase in mean block-level Normalized Difference Vegetation Index from 1 SD less to 1 SD more than the mean was associated with 49 fewer chronic conditions per 1,000 individuals, which is approximately similar to a reduction in age of the overall study population by 3 years. This same level of increase in mean Normalized Difference Vegetation Index was associated with a reduced risk of diabetes by 14%, hypertension by 13%, and hyperlipidemia by 10%. Planned post-hoc analyses revealed stronger and more consistently positive relationships between greenness and health in lower- than higher-income neighborhoods.
Greenness or vegetative presence may be effective in promoting health in older populations, particularly in poor neighborhoods, possibly due to increased time outdoors, physical activity, or stress mitigation.
先前的研究表明，接触自然环境可能会影响健康。本研究调查了佛罗里达州迈阿密-戴德县大量基于人群的医疗保险受益样本中，街区层面绿地率（植被覆盖率）的客观测量值与慢性疾病（包括心脏代谢疾病）之间的关联。
样本包括249,405名年龄≥65岁的医疗保险受益人，他们在2010年至2011年期间在佛罗里达州迈阿密-戴德县的位置（邮政编码+4）未发生变化。数据于2013年获取，并于2014年进行多水平分析，以研究通过人口普查街区层面的卫星图像测量的绿地率与2011年慢性健康状况之间的关系，并对邻里家庭收入中位数、个人年龄、性别、种族和民族进行了调整。
在对协变量进行调整后，更高的绿地率与更好的健康状况显著相关：街区层面平均归一化植被指数从低于平均值1个标准差增加到高于平均值1个标准差，每1000人慢性疾病减少49例，这大致相当于整个研究人群年龄降低3岁。平均归一化植被指数同样水平的增加与糖尿病风险降低14%、高血压风险降低13%和高脂血症风险降低10%相关。计划中的事后分析显示，在低收入社区，绿地率与健康之间的关系比高收入社区更强且更一致地呈正相关。
绿地率或植被覆盖率可能对促进老年人群的健康有效，尤其是在贫困社区，这可能是由于户外活动时间增加、体育锻炼或压力减轻所致。
