Environmental Research Center, Duke Kunshan University, Kunshan, Jiangsu, China; Nicholas School of the Environment, Duke University, Durham, NC, USA.
Environmental Research Center, Duke Kunshan University, Kunshan, Jiangsu, China.
Lancet Planet Health. 2019 Jan;3(1):e17-e25. doi: 10.1016/S2542-5196(18)30264-X.
Exposure to natural vegetation, or greenness, might affect health through several pathways, including increased physical activity and social engagement, improved mental health, and reductions in exposure to air pollution, extreme temperatures, and noise. Few studies of the effects of greenness have focused on Asia, and, to the best of our knowledge, no study has assessed the effect on vulnerable oldest-old populations. We assessed the association between residential greenness and mortality in an older cohort in China.
We used five waves (February, 2000-October, 2014) of the China Longitudinal Healthy Longevity Survey (CLHLS), a prospective cohort representative of the general older population in China. We assessed exposure to greenness through satellite-derived Normalised Difference Vegetation Index (NDVI) values in the 250 m and 1250 m radius around the residential address for each individual included in the study. We calculated contemporaneous NDVI values, cumulative NDVI values, and changes in NDVI from the start of the study over time. The health outcome of the study was all-cause mortality, excluding accidental deaths. Mortality rate ratios were estimated with Cox proportional hazards models, adjusted for age, sex, ethnicity, marital status, geographical region, childhood and adult socioeconomic status, social and leisure activity, smoking status, alcohol consumption, and physical activity.
Among 23 754 individuals (mean age at baseline 93 years [SD 7·5]) totaling 80 001 person-years, we observed 18 948 deaths during 14 years of follow-up, between June, 2000, and December, 2014. Individuals in the highest quartile of contemporaneous NDVI values had 27% lower mortality than those in the lowest quartile for the 250 m radius (hazard ratio [HR] 0·73, 95% CI 0·70-0·76), and 30% lower mortality for the 1250 m radius (0·70, 0·67-0·74). No clear association was observed for cumulative NDVI measurements and mortality. We did not detect an association between area-level changes in NDVI and mortality.
Our research suggests that proximity to more green space is associated with increased longevity, which has policy implications for the national blueprint of ecological civilisation and preparation for an ageing society in China.
Bill & Melinda Gates Foundation, US National Institute on Aging, US National Institute of Health, Natural Science Foundation of China, UN Population Fund, China Social Sciences Foundation, and Hong Kong Research Grants Council.
接触自然植被或绿化可能会通过多种途径影响健康，包括增加身体活动和社会参与度、改善心理健康以及减少暴露于空气污染、极端温度和噪音中。很少有研究关注亚洲的绿化效果，据我们所知，也没有研究评估绿化对脆弱的高龄人群的影响。我们评估了在中国一个老年队列中，居住绿化与死亡率之间的关联。
我们使用了中国长寿纵向研究（CLHLS）的五轮（2000 年 2 月至 2014 年 10 月）数据，该研究是中国老年人群的代表性前瞻性队列。我们通过卫星衍生的归一化差异植被指数（NDVI）值来评估暴露于绿化的情况，该指数值在研究个体的居住地址周围 250 米和 1250 米的半径范围内进行评估。我们计算了同期 NDVI 值、累积 NDVI 值以及从研究开始到那时的 NDVI 值变化。该研究的健康结果是全因死亡率，不包括意外死亡。使用 Cox 比例风险模型估计死亡率比，调整了年龄、性别、种族、婚姻状况、地理位置、儿童和成人社会经济地位、社会和休闲活动、吸烟状况、饮酒状况和身体活动。
在纳入的 23754 名（基线时平均年龄 93 岁[SD 7.5]）个体中，我们观察到在 14 年的随访期间（2000 年 6 月至 2014 年 12 月）共有 18948 人死亡。与居住在 250 米半径最低四分位的个体相比，居住在同期 NDVI 值最高四分位的个体的死亡率低 27%（风险比[HR]0.73，95%CI0.70-0.76），而居住在 1250 米半径的个体的死亡率低 30%（0.70，0.67-0.74）。对于累积 NDVI 测量值与死亡率之间，我们没有观察到明确的关联。我们没有发现区域层面 NDVI 变化与死亡率之间存在关联。
我们的研究表明，接近更多的绿色空间与长寿有关，这对中国生态文明国家蓝图和老龄化社会准备具有政策意义。
比尔及梅琳达·盖茨基金会、美国国家老龄化研究所、美国国立卫生研究院、中国国家自然科学基金会、联合国人口基金、中国社会科学基金会和香港研究资助局。
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