Healthy Liveable Cities Group, Centre for Urban Research, RMIT University, 124 La Trobe Street, Melbourne, Victoria, 3000, Australia.
School of GeoSciences, University of Edinburgh, Old College, South Bridge, Edinburgh, EH8 9YL, United Kingdom.
Soc Sci Med. 2019 Jul;232:94-105. doi: 10.1016/j.socscimed.2019.05.001. Epub 2019 May 2.
The aspiration of liveable cities, underpinned by the New Urban Agenda, is gaining popularity as a mechanism to enhance population health and wellbeing. However, less attention has been given to understanding how urban liveability may provide an opportunity to redress health inequities. Using an environmental justice lens, this paper investigates whether urban liveability poses an opportunity or threat to reducing health inequities and outlines a future research agenda. Selected urban liveability attributes, being: education; employment; food, alcohol, and tobacco; green space; housing; transport; and walkability, were investigated to understand how they can serve to widen or narrow inequities. Some domains showed consistent evidence, others suggested context-specific associations that made it difficult to draw general conclusions, and some showed a reverse patterning with the social gradient, but with poorer outcomes. This suggests urban liveability attributes have equigenic potential, but operate within a complex system. We conclude more disadvantaged neighbourhoods and their residents likely have additional policy and design considerations for optimising outcomes, especially as changes to the contextual environment may impact neighbourhood composition through displacement and/or pulling up effects. Future research needs to continue to explore downstream associations using longitudinal and natural experiments, and also seek to gain a deeper understanding of the urban liveability system, including interactions, feedback loops, and non-linear and linear responses. There is a need to monitor neighbourhood population changes over time to understand how liveability impacts the most vulnerable. Other areas worthy of further investigation include applying a life course approach and understanding liveability within the context of other adversities and contextual settings.
宜居城市的目标，以新城市议程为支撑，作为提高人口健康和福祉的一种机制越来越受欢迎。然而，人们对理解城市宜居性如何为纠正健康不平等提供机会的关注较少。本文从环境正义的角度出发，探讨了城市宜居性是否为减少健康不平等提供了机会或威胁，并概述了未来的研究议程。选择了一些城市宜居性属性，包括教育、就业、食品、酒精和烟草、绿地、住房、交通和可步行性，以了解它们如何扩大或缩小不平等。一些领域有一致的证据，其他领域则表明存在特定于上下文的关联，这使得很难得出一般性结论，还有一些领域则呈现出与社会梯度相反的模式，但结果较差。这表明城市宜居性属性具有平等基因潜力，但在复杂的系统中运作。我们得出的结论是，较贫困的社区及其居民可能需要更多的政策和设计考虑因素来优化结果，特别是因为环境的变化可能会通过流离失所和/或拉动效应影响社区的组成。未来的研究需要继续使用纵向和自然实验来探索下游关联，并深入了解城市宜居性系统，包括相互作用、反馈循环以及非线性和线性响应。需要随着时间的推移监测社区人口的变化，以了解宜居性对最脆弱群体的影响。其他值得进一步研究的领域包括应用生命历程方法，以及在其他逆境和背景环境中理解宜居性。
