Institute for Global Health (ISGlobal), Barcelona, Spain; Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, Netherlands.
Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
Environ Res. 2020 Apr;183:109238. doi: 10.1016/j.envres.2020.109238. Epub 2020 Feb 6.
Each year, The Economist Intelligence Unit (EIU) computes the Global Liveability Index and determines the most liveable cities around the world. Vienna, Austria, was ranked by the EIU as the most liveable city worldwide in 2018 and 2019. However, the relationship between a liveable as well as healthy and environmentally-just city has not been previously explored. To explore whether the most liveable city is also a healthy and environmentally-just one, we estimated the premature mortality burden related to non-compliance with international exposure level recommendations for physical activity (PA), air pollution (PM and NO), road traffic noise, green space and heat for Vienna, as well as its distribution by socioeconomic status (SES). We applied the Urban and TranspOrt Planning Health Impact Assessment (UTOPHIA) methodology and estimated the annual mortality, life expectancy (LE) and economic impact of non-compliance with exposure guidelines for the Viennese adult population ≥ 20 years. We compared current with recommended exposure levels, quantified the association between exposures and mortality and calculated attributable health impact fractions. Eight percent of premature mortality (i.e. 1239 deaths, 95% CI: 679-1784) was estimated to be attributable to non-compliance with the recommended exposure levels. Seventy-six percent of the attributable premature mortality was due to PM exposure and insufficient PA. Non-compliance also resulted in an average of 199 days of LE lost for the adult population (95% CI: 111-280) and an economic impact of 4.6 (95% CI: 2.5-6.7) billion 2015€ annually. Overall, residents of lower SES neighbourhoods faced higher risk of premature mortality due to higher exposure to NO, road traffic noise, heat and less green space. Despite high liveability standards according to EIU definition, a considerable premature mortality burden was attributable to non-compliance with exposure recommendations, and socioeconomic inequalities were estimated. Although the exposure attributable mortality burden was lower than in other European cities and local Viennese policies favour the reduction of motorized traffic, alongside the promotion of active and public transport and urban greening, there is room for further alignment of liveability, environmental health and justice objectives.
每年，经济学人智库（EIU）都会计算全球宜居指数，并确定全球最宜居的城市。2018 年和 2019 年，奥地利维也纳被 EIU 评为全球最宜居的城市。然而，宜居城市与健康和环境公正城市之间的关系尚未被探讨。为了探究最宜居的城市是否也是一个健康和环境公正的城市，我们估算了与不符合体力活动（PA）、空气污染（PM 和 NO）、道路交通噪音、绿地和热暴露国际推荐水平相关的过早死亡负担，以及维也纳及其按社会经济地位（SES）分布的情况。我们应用城市和交通规划健康影响评估（UTOPHIA）方法，估算了不符合维也纳 20 岁及以上成年人暴露指南的年死亡率、预期寿命（LE）和经济影响。我们比较了当前与推荐的暴露水平，量化了暴露与死亡率之间的关联，并计算了归因于健康影响的分数。估计有 8%的过早死亡（即 1239 人死亡，95%CI：679-1784）归因于不符合推荐的暴露水平。归因于过早死亡的 76%是由于 PM 暴露和体力活动不足。不符合规定还导致成年人平均 LE 损失 199 天（95%CI：111-280），每年经济损失 46 亿欧元（95%CI：25-67 亿欧元）。总体而言，SES 较低社区的居民由于接触更多的 NO、道路交通噪音、热和较少的绿地，面临更高的过早死亡风险。尽管根据 EIU 的定义，维也纳的宜居标准很高，但由于不符合暴露建议，仍有相当大的过早死亡负担，并且估计存在社会经济不平等。尽管归因于暴露的死亡率低于其他欧洲城市，并且当地维也纳政策有利于减少机动车交通，同时促进积极和公共交通以及城市绿化，但在宜居性、环境健康和公正目标方面还有进一步协调的空间。
