Foley Louise, Prins Richard, Crawford Fiona, Humphreys David, Mitchell Richard, Sahlqvist Shannon, Thomson Hilary, Ogilvie David
MRC Epidemiology Unit & UKCRC Centre for Diet and Activity Research (CEDAR), School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom.
NHS Greater Glasgow & Clyde and Glasgow Centre for Population Health, Glasgow, United Kingdom.
PLoS One. 2017 Apr 5;12(4):e0174882. doi: 10.1371/journal.pone.0174882. eCollection 2017.
Health and wellbeing are partly shaped by the neighbourhood environment. In 2011, an eight kilometre (five mile) extension to the M74 motorway was opened in Glasgow, Scotland, constructed through a predominantly urban, deprived area. We evaluated the effects of the new motorway on wellbeing in local residents.
This natural experimental study involved a longitudinal cohort (n = 365) and two cross-sectional samples (baseline n = 980; follow-up n = 978) recruited in 2005 and 2013. Adults from one of three study areas-surrounding the new motorway, another existing motorway, or no motorway-completed a postal survey. Within areas, individual measures of motorway proximity were calculated. Wellbeing was assessed with the mental (MCS-8) and physical (PCS-8) components of the SF-8 scale at both time points, and the short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS) at follow-up only.
In multivariable linear regression analyses, cohort participants living nearer to the new M74 motorway experienced significantly reduced mental wellbeing over time (MCS-8: -3.6, 95% CI -6.6 to -0.7) compared to those living further away. In cross-sectional and repeat cross-sectional analyses, an interaction was found whereby participants with a chronic condition living nearer to the established M8 motorway experienced reduced (MCS-8: -3.7, 95% CI -8.3 to 0.9) or poorer (SWEMWBS: -1.1, 95% CI -2.0 to -0.3) mental wellbeing compared to those living further away.
We found some evidence that living near to a new motorway worsened local residents' wellbeing. In an area with an existing motorway, negative impacts appeared to be concentrated in those with chronic conditions, which may exacerbate existing health inequalities and contribute to poorer health outcomes. Health impacts of this type of urban regeneration intervention should be more fully taken into account in future policy and planning.
健康和幸福在一定程度上受到邻里环境的影响。2011年,苏格兰格拉斯哥市M74高速公路延长了8公里(5英里),该路段穿过一个主要为城市贫困地区。我们评估了这条新建高速公路对当地居民幸福感的影响。
这项自然实验研究涉及一个纵向队列(n = 365)以及2005年和2013年招募的两个横断面样本(基线样本n = 980;随访样本n = 978)。从三个研究区域之一——新建高速公路周边、另一条现有高速公路周边或无高速公路区域——招募成年人,让他们完成一份邮寄调查问卷。在各个区域内,计算个人与高速公路的接近程度指标。在两个时间点均使用SF - 8量表的心理(MCS - 8)和身体(PCS - 8)分量表评估幸福感,仅在随访时使用简短的沃里克 - 爱丁堡心理健康量表(SWEMWBS)。
在多变量线性回归分析中,与居住在较远位置的队列参与者相比,居住在靠近新建M74高速公路附近的参与者随时间推移心理健康显著下降(MCS - 8:-3.6,95%置信区间 -6.6至 -0.7)。在横断面分析和重复横断面分析中,发现了一种交互作用,即患有慢性病且居住在靠近现有M8高速公路附近的参与者与居住在较远位置的参与者相比,心理健康下降(MCS - 8:-3.7,95%置信区间 -8.3至0.9)或较差(SWEMWBS:-1.1,95%置信区间 -2.0至 -0.3)。
我们发现一些证据表明,居住在新建高速公路附近会使当地居民的幸福感恶化。在有现有高速公路的区域,负面影响似乎集中在患有慢性病的人群中,这可能会加剧现有的健康不平等现象,并导致更差的健康结果。在未来的政策和规划中,应更充分地考虑这类城市更新干预措施对健康的影响。