School of Medicine, Griffith University Gold Coast, Building 40, level 8, room 8.38, Gold Coast, QLD, 4222, Australia.
RMIT University, Healthy Liveable Cities Group, Centre for Urban Research, Melbourne, Victoria, Australia.
Int J Behav Nutr Phys Act. 2019 Feb 20;16(1):11. doi: 10.1186/s12966-019-0775-8.
A consensus is emerging in the literature that urban form can impact health by either facilitating or deterring physical activity (PA). However, there is a lack of evidence measuring population health and the economic benefits relating to alternative urban forms. We examined the issue of housing people within two distinct types of urban development forms: a medium-density brownfield development in an established area with existing amenities (e.g. daily living destinations, transit), and a low-density suburban greenfield development. We predicted the health and economic benefits of a brownfield development compared with a greenfield development through their influence on PA.
We combined a new Walkability Planning Support System (Walkability PSS) with a quantitative health impact assessment model. We used the Walkability PSS to estimate the probability of residents' transport walking, based on their exposure to urban form in the brownfield and greenfield developments. We developed the underlying algorithms of the Walkability PSS using multi-level multivariate logistic regression analysis based on self-reported data for transport walking from the Victorian Integrated Survey of Transport and Activity 2009-10 and objectively measured urban form in the developments. We derived the difference in transport walking minutes per week based on the probability of transport walking in each of the developments and the average transport walking time per week among those who reported any transport walking. We then used the well-established method of the proportional multi-cohort multi-state life table model to translate the difference in transport walking minutes per week into health and economic benefits.
If adult residents living in the greenfield neighbourhood were instead exposed to the urban development form observed in a brownfield neighbourhood, the incidence and mortality of physical inactivity-related chronic diseases would decrease. Over the life course of the exposed population (21,000), we estimated 1600 health-adjusted life years gained and economic benefits of A$94 million.
Our findings indicate that planning policies that create walkable neighbourhoods with access to shops, services and public transport will lead to substantial health and economic benefits associated with reduced incidence of physical inactivity related diseases and premature death.
文献中逐渐形成一种共识，认为城市形态可以通过促进或阻碍身体活动（PA）来影响健康。然而，目前缺乏衡量人口健康和与替代城市形态相关的经济效益的证据。我们研究了在两种截然不同的城市发展形式下为人们提供住房的问题：一种是在具有现有便利设施（例如日常生活目的地、交通）的已建成区域中的中密度棕地开发，另一种是低密度郊区绿地开发。我们预测了棕地开发与绿地开发相比对 PA 的影响所带来的健康和经济效益。
我们将一种新的步行能力规划支持系统（Walkability PSS）与定量健康影响评估模型相结合。我们使用 Walkability PSS 根据居民在棕地和绿地开发项目中暴露于城市形态的程度，估算居民交通步行的可能性。我们根据 2009-10 年维多利亚综合交通和活动调查中的交通步行自我报告数据以及开发项目中客观测量的城市形态，使用多层次多变量逻辑回归分析开发了 Walkability PSS 的基本算法。我们根据在每个开发项目中交通步行的可能性和报告任何交通步行的人每周的平均交通步行时间，得出每周交通步行分钟数的差异。然后，我们使用成熟的比例多队列多状态生命表模型方法，将每周交通步行分钟数的差异转化为健康和经济效益。
如果居住在绿地社区的成年居民接触到棕地社区中观察到的城市发展形式，那么与身体活动不足相关的慢性病的发病率和死亡率将会下降。在暴露人群的生命周期（21,000 人）中，我们估计会获得 1600 个健康调整生命年和 9400 万澳元的经济效益。
我们的研究结果表明，规划政策创建了可步行的社区，提供了商店、服务和公共交通，将带来与减少与身体活动不足相关的疾病发病率和过早死亡相关的巨大健康和经济效益。
