School of Geography and Planning, Sun Yat-Sen University, Guangzhou, 510275, China.
Guangdong Key Laboratory for Urbanization and Geo-simulation, Sun Yat-Sen University, Guangzhou, China.
Int J Equity Health. 2019 Nov 21;18(1):178. doi: 10.1186/s12939-019-1081-4.
Exposure to natural outdoor environments (NOE) has been shown to be beneficial to older adults' health and functioning, yet this assertion has rarely been tested in China. We investigated the relationships between exposure to NOE and older adults' self-rated health in Shanghai, China and examined whether these relationships varied by sex, age, education and hukou status.
This cross-sectional study used micro-data sample of the 2010 Shanghai population census, including 7962 older adults nested within 3345 neighbourhoods. Self-rated health was the outcome variable. Four NOE exposure indicators were calculated for each neighbourhood: the amount of surrounding greenness/blueness and proximity to large green/blue spaces. Multilevel logistic regression was employed to explore the association between natural outdoor environment exposure and self-rated health, adjusting for individual-level and neighbourhood-level covariates. Stratified analyses were used to examine variations by sex, age, education and hukou status.
Older adults living in neighbourhoods with higher surrounding greenness and higher proximity to both green spaces and blue spaces were more likely to report good health. Residential surrounding blueness was not significantly related to self-rated health. Females, those aged 60-69 years, those who had elementary school or junior high school education and those with non-local hukou benefit more from residential surrounding greenness, and those aged 70-79 years and who had elementary school or junior high school education benefit more from residential proximity to blue spaces.
Higher residential greenness and proximity to both green spaces and blue spaces were associated with better self-rated health, particularly for females, younger older adults, the low educated and non-local hukou holders. Our findings suggest that urban green spaces and urban blue spaces have different effects on health among Chinese older adults and that the assessment of exposure matters to the investigation of NOE-health relationships.
已证实接触自然户外环境（NOE）有益于老年人的健康和功能，但这一说法在中国很少得到验证。我们调查了中国上海老年人接触自然户外环境与自我报告健康之间的关系，并检验了这些关系是否因性别、年龄、教育程度和户籍状况而异。
本横断面研究使用了 2010 年上海市人口普查的微观数据样本，其中包括 7962 名嵌套在 3345 个街区中的老年人。自我报告健康是因变量。为每个街区计算了四项自然户外环境暴露指标：周围绿化/蓝色程度和靠近大型绿色/蓝色空间的程度。采用多水平逻辑回归模型来探讨自然户外环境暴露与自我报告健康之间的关联，同时调整了个体和街区层面的协变量。采用分层分析来检验性别、年龄、教育程度和户籍状况的变化。
居住在周围绿化程度较高、靠近绿色空间和蓝色空间的老年人更有可能报告健康状况良好。居住周围蓝色程度与自我报告健康状况无显著相关性。女性、60-69 岁、小学或初中教育程度和非本地户籍者从居住周围绿化程度中获益更多，而 70-79 岁和小学或初中教育程度者从居住靠近蓝色空间中获益更多。
更高的居住绿化程度和靠近绿色空间和蓝色空间都与更好的自我报告健康状况相关，尤其是对女性、年轻老年人、受教育程度较低者和非本地户籍者而言。我们的研究结果表明，城市绿地和城市蓝色空间对中国老年人的健康有不同的影响，并且暴露评估对研究自然户外环境与健康之间的关系至关重要。
