NHS Health Scotland, Glasgow, UK.
NHS Health Scotland, Glasgow, UK.
Public Health. 2017 Jul;148:69-87. doi: 10.1016/j.puhe.2017.02.022. Epub 2017 Apr 18.
To identify and synthesise what is known about the impacts of regeneration on health, health inequalities and their socio-economic determinants.
Rapid, structured literature review.
A rapid, structured approach was undertaken to identifying relevant studies involving a search of peer-reviewed literature databases, an Internet search to identify relevant grey literature, and a review of articles citing two key systematic reviews. The identified citations were screened, critically appraised according to the research design and narratively synthesised.
Of the 1382 identified citations, 46 were screened as relevant to the review and included in the synthesis. Fifteen citations were reviews but most of the evidence identified or included within the reviews was of medium or low quality due to a lack of longitudinal follow-up, low response rates or attrition. The evidence base on the impacts of regeneration is generally not of high quality and is prone to bias. However, it is theorised as being an important means of addressing the socio-economic determinants of health. Housing refurbishment (generally, and for specific improvements) seems likely to lead to small improvements in health, whereas rehousing and mixed-tenure approaches have less clear impacts on health and carry risks of disruption to social networks and higher rents. Changes in the social composition of communities (gentrification) is a common outcome of regeneration and some 'partnership' approaches to regeneration have been shown to have caused difficulties within communities.
The evidence base for regeneration activities is limited but they have substantial potential to contribute to improving population health. Better quality evidence is available for there being positive health impacts from housing-led regeneration programmes involving refurbishment and specific housing improvements. There is also some evidence of the potential harms of regeneration activities, including social stratification (gentrification and residualisation) and the destabilisation of existing community organisations. Broader labour market and housing policy approaches are also likely to be important as a context for understanding impacts. Regeneration programmes require careful design, implementation and evaluation if they are to contribute to improved health and reduced health inequalities.
确定并综合再生对健康、健康不平等及其社会经济决定因素的影响。
快速、结构化文献综述。
采用快速、结构化的方法，从同行评议文献数据库中搜索、在互联网上搜索以确定相关灰色文献，并查阅引用了两项系统评价的文章，以确定相关研究。对确定的引文进行筛选，根据研究设计进行批判性评估，并进行叙述性综合。
在 1382 篇已识别的引文中有 46 篇被筛选为与综述相关，并纳入综合分析。有 15 篇引文是综述，但由于缺乏纵向随访、低应答率或流失，确定或纳入综述的大部分证据质量中等或较低。关于再生影响的证据基础通常质量不高，容易产生偏差。然而，它被认为是解决健康的社会经济决定因素的重要手段。房屋翻新（一般而言，以及具体改进）似乎可能导致健康状况略有改善，而重新安置和混合租赁方式对健康的影响不太明确，并存在破坏社会网络和提高租金的风险。社区社会构成的变化（高档化）是再生的常见结果，一些“伙伴关系”再生方法已被证明在社区内造成了困难。
再生活动的证据基础有限，但它们具有很大的潜力为改善人口健康做出贡献。有更多的高质量证据表明，住房主导的再生计划涉及翻新和特定住房改善，对健康有积极影响。再生活动也存在潜在危害的证据，包括社会分层（高档化和残余化）和现有社区组织的不稳定。更广泛的劳动力市场和住房政策方法也可能是理解影响的重要背景。如果要为改善健康和减少健康不平等做出贡献，再生计划需要精心设计、实施和评估。
