An Ruopeng, Li Xinye, Jiang Ning
Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL 61820, USA.
Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
Int J Environ Res Public Health. 2017 Oct 31;14(11):1326. doi: 10.3390/ijerph14111326.
Physical inactivity is a major modifiable risk factor for morbidity, disability and premature mortality worldwide. This study assessed the geographical variations in the impact of environmental quality on physical inactivity among U.S. adults. Data on county-level prevalence of leisure-time physical inactivity came from the Behavioral Risk Factor Surveillance System. County environment was measured by the Environmental Quality Index (EQI), a comprehensive index of environmental conditions that affect human health. The overall EQI consists of five subdomains-air, water, land, social, and built environment. Geographically weighted regressions (GWRs) were performed to estimate and map county-specific impact of overall EQI and its five subdomains on physical inactivity prevalence. The prevalence of leisure-time physical inactivity among U.S. counties was 25% in 2005. On average, one standard deviation decrease in the overall EQI was associated with an increase in county-level prevalence of leisure-time physical inactivity by nearly 1%. However, substantial geographical variations in the estimated environmental determinants of physical inactivity were present. The estimated changes of county-level prevalence of leisure-time physical inactivity resulted from one standard deviation decrease of the overall EQI ranged from an increase of over 3% to a decrease of nearly 2% across U.S. counties. Analogous, the estimated changes of county-level prevalence of leisure-time physical inactivity resulted from one standard deviation decrease of the EQI air, water, land, social, and built environment subdomains ranged from an increase of 2.6%, 1.5%, 2.9%, 3.3%, and 1.7% to a decrease of 2.9%, 1.4%, 2.4%, 2.4%, and 0.8% across U.S. counties, respectively. Given the substantial heterogeneities in the environmental determinants of physical inactivity, locally customized physical activity interventions are warranted to address the most concerning area-specific environmental issue.
缺乏身体活动是全球范围内导致发病、残疾和过早死亡的一个主要可改变风险因素。本研究评估了环境质量对美国成年人缺乏身体活动影响的地理差异。休闲时间身体活动不足的县级患病率数据来自行为风险因素监测系统。县环境通过环境质量指数（EQI）来衡量，这是一个影响人类健康的环境条件综合指数。总体EQI由五个子领域组成——空气、水、土地、社会和建筑环境。进行了地理加权回归（GWR）以估计并绘制总体EQI及其五个子领域对身体活动不足患病率的县特定影响。2005年美国各县休闲时间身体活动不足的患病率为25%。平均而言，总体EQI每降低一个标准差，与县级休闲时间身体活动不足患病率增加近1%相关。然而，在身体活动不足的估计环境决定因素方面存在显著的地理差异。总体EQI每降低一个标准差，导致的县级休闲时间身体活动不足患病率估计变化在美国各县范围内从增加超过3%到降低近2%不等。类似地，EQI的空气、水、土地、社会和建筑环境子领域每降低一个标准差，导致的县级休闲时间身体活动不足患病率估计变化在美国各县范围内分别从增加2.6%、1.5%、2.9%、3.3%和1.7%到降低2.9%、1.4%、2.4%、2.4%和0.8%不等。鉴于身体活动不足的环境决定因素存在显著异质性，有必要进行针对当地情况的身体活动干预，以解决最令人担忧的特定地区环境问题。
