中国区域城市成年人的居住密度与身体活动之间的关联。
The association between residential density and physical activity among urban adults in regional China.
机构信息
Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China.
Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Xiamen University, Xiamen, China.
出版信息
BMC Public Health. 2019 Oct 7;19(1):1279. doi: 10.1186/s12889-019-7593-4.
BACKGROUND
Studies from Western countries reported a positive relationship between residential density (RD) and physical activity (PA) among adults. There was no such study from China, a rapidly-urbanizing country in the world. This study aimed to investigate the RD-PA association among urban adults in China.
METHODS
A multistage sampling approach was used to randomly select participants (aged 35-74 years old) in urban areas of Nanjing in 2017. The outcome variable was PA (dichotomized into "sufficient" or "insufficient"), while the independent variable was RD (tertiled into three sub-groups). Odds ratios (OR) and 95% confidence interval (CI) were computed to examine the RD-PA association using mixed-effects logistic regression models with adjustment for age, sex, nationality, marriage, educational attainment, employment status, body weight status, green space and neighborhood-level clustering effects.
RESULTS
Of the 1568 eligible participants, 1551 were interviewed (response rate = 98.9%), with the mean age (standard deviation) of 54.7 (11.1) years old, and 46% of men. After adjustment for potential confounders and community-level clustering effects, participants lived in communities with higher (OR = 0.31, 95% CI = 0.21, 0.47) and middle (OR = 0.70, 95% CI = 0.50, 0.99) residential density were significantly less likely to achieve sufficient physical activity relative to their counterparts lived in the lower densed communities. Similar negative RD-PA association was examined for men or women, separately. The difference in the ORs between the middle and higher RD tertiles was also statistically significant (P < 0.01).
CONCLUSIONS
A negatively gradient RD-PA association, independent of body weight status and green space, was observed among urban adults in regional China. It has public health implications for China to help residents' promote and maintain physical activity through planning and constructing PA-/health-friendly built environment in future.
背景
来自西方国家的研究报告称，成年人的居住密度（RD）与身体活动（PA）之间存在正相关关系。而在中国，作为世界上城市化发展最快的国家之一，尚未有此类研究。本研究旨在探讨中国城市成年人的 RD-PA 关联。
方法
采用多阶段抽样方法，于 2017 年在南京市城区随机选择参与者（年龄 35-74 岁）。因变量为 PA（分为“充足”或“不足”），自变量为 RD（分为三个亚组）。采用混合效应逻辑回归模型，调整年龄、性别、国籍、婚姻状况、受教育程度、就业状况、体重状况、绿地和邻里层次聚类效应后，计算比值比（OR）和 95%置信区间（CI），以检验 RD-PA 关联。
结果
在 1568 名合格参与者中，有 1551 名接受了访谈（应答率为 98.9%），平均年龄（标准差）为 54.7（11.1）岁，其中 46%为男性。调整潜在混杂因素和社区层次聚类效应后，与居住在低密度社区的参与者相比，居住在高密度（OR=0.31，95%CI=0.21，0.47）和中密度（OR=0.70，95%CI=0.50，0.99）社区的参与者，更不可能达到足够的身体活动水平。对于男性或女性，分别进行了类似的负 RD-PA 关联检验。中密度和高密度 RD 三分位组之间的 OR 差异也具有统计学意义（P<0.01）。
结论
在中国区域性城市成年人中，存在与体重状况和绿地无关的负向 RD-PA 关联。这对于中国来说具有公共卫生意义，因为未来需要通过规划和建设促进和维持身体活动的 PA-/健康友好型建成环境。
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