ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Center for Advancing Research in Transportation Emissions, Energy, and Health (CARTEEH), Texas A&M Transportation Institute (TTI), College Station, TX, USA.
Environ Int. 2018 Dec;121(Pt 1):931-941. doi: 10.1016/j.envint.2018.10.017. Epub 2018 Oct 20.
Cities have unique geographic, environmental and sociocultural characteristics that influence the health status of their citizens. Identification and modification of these characteristics may help to promote healthier cities.
We estimated premature mortality impacts of breaching international exposure guidelines for physical activity (PA), air pollution, noise and access to green space for Bradford (UK) adult residents (n = 393,091).
We applied the Urban and TranspOrt Planning Health Impact Assessment (UTOPHIA) methodology and estimated mortality, life expectancy (LE) and economic impacts of non-compliance with recommended exposure levels. We also investigated the distribution of the mortality burden among the population, focusing on socioeconomic position (SEP) as defined by deprivation status and ethnicity.
We estimated that annually almost 10% of premature mortality (i.e. 375 deaths, 95% CI: 276-474) in Bradford is attributable to non-compliance with recommended exposure levels. Non-compliance was also estimated to result in over 300 days of LE lost (95% CI: 238-432), which translated in economic losses of over £50,000 per person (95% CI: 38,518-69,991). 90% of the premature mortality impact resulted from insufficient PA performance. Air and noise pollution and the lack of green space had smaller impacts (i.e. 48 deaths). Residents of lower SEP neighborhoods had the highest risks for adverse exposure and premature death. A larger number of deaths (i.e. 253 and 145, respectively) could be prevented by reducing air and noise pollution levels well below the guidelines.
Current urban and transport planning related exposures result in a considerable health burden that is unequally distributed among the Bradford population. Improvements in urban and transport planning practices including the reduction of motor traffic and the promotion of active transport together with greening of the district, particularly in areas of lower SEP, are promising strategies to increase PA performance and reduce harmful environmental exposures.
城市具有独特的地理、环境和社会文化特征，这些特征影响着市民的健康状况。识别和改变这些特征可能有助于建设更健康的城市。
我们估计了违反英国布拉德福德（Bradford）成年人居民的体力活动（PA）、空气污染、噪音和绿地可达性国际暴露指南（PA）对过早死亡的影响（n=393091）。
我们应用城市和交通规划健康影响评估（UTOPHIA）方法，估计了不符合推荐暴露水平的死亡率、预期寿命（LE）和经济影响。我们还调查了人口中死亡负担的分布情况，重点关注贫困状况和族裔定义的社会经济地位（SEP）。
我们估计，每年布拉德福德约有 10%的过早死亡率（即 375 人死亡，95%CI：276-474）归因于不符合推荐的暴露水平。非合规性还估计导致超过 300 天的 LE 丧失（95%CI：238-432），这导致每人超过 50000 英镑（95%CI：38518-69991）的经济损失。90%的过早死亡影响归因于体力活动表现不足。空气和噪音污染以及缺乏绿地的影响较小（即 48 人死亡）。社会经济地位较低社区的居民面临不利暴露和过早死亡的风险最高。通过将空气和噪音污染水平降低到远远低于指导水平，可以预防更多的死亡（即分别减少 253 人和 145 人）。
当前与城市和交通规划相关的暴露导致了相当大的健康负担，而这些负担在布拉德福德人口中分布不均。改善城市和交通规划实践，包括减少机动车交通和促进积极交通，以及绿化该地区，特别是在社会经济地位较低的地区，是提高 PA 表现和减少有害环境暴露的有希望的策略。
