Institute for Global Health (ISGlobal), Barcelona, Spain; École des Hautes Études en Santé Publique (EHESP), Paris, France.
Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
Environ Res. 2021 May;196:110988. doi: 10.1016/j.envres.2021.110988. Epub 2021 Mar 6.
The population living in urban areas is growing rapidly. The level of exposure to adverse environmental factors is detrimental to human health and is directly related to urban and transport planning practices.
To estimate the premature mortality burden of non-compliance with international exposure guidelines for air pollution, noise, access to green space and heat for Barcelona and Madrid (Spain), and its distribution among the population by the socioeconomic status (SES).
The Urban and TranspOrt planning Health Impact Assessment (UTOPHIA) tool was applied and the attributable premature mortality due to non-compliance with recommended exposure levels was estimated. The distribution of the attributable mortality burden among the population by SES was investigated through Generalized Additive Models (GAMs) adjusting for spatial autocorrelation and a cluster analysis was performed to identify attributable mortality hot spots.
Annually, 7.1% and 3.4% of premature mortality in Barcelona and Madrid, respectively, could be attributed to non-compliance with the international exposure recommendations for air pollution, noise, heat and access to green space. In addition, analysis by SES showed that in Barcelona lower SES areas had an overall greater attributable mortality rate, while in Madrid, the distribution of the attributable mortality burden by SES varied by exposure.
This study shows the impact of environmental exposures on mortality and highlights the importance of taking integrated actions when designing cities considering the health impacts, but also the specificities of each city such as the socio-demographic context. Moreover, the high precision scale of the analysis enables the identification of environmental hazards and mortality hot spots providing a powerful tool to support priority-setting and guide policymakers towards a healthy, sustainable and just city for all of their residents.
城市人口增长迅速。人们接触不利环境因素的程度对人类健康有害，并直接关系到城市和交通规划实践。
评估巴塞罗那和马德里（西班牙）不遵守空气污染、噪声、接触绿地和热暴露国际暴露指南对人群造成的过早死亡负担及其在社会经济地位（SES）人群中的分布情况。
应用城市和交通规划健康影响评估（UTOPHIA）工具，估计因不符合建议的暴露水平而导致的过早死亡归因。通过广义加性模型（GAMs）调整空间自相关，调查 SES 人群中归因于过早死亡负担的分布情况，并进行聚类分析以识别归因于过早死亡的热点。
巴塞罗那和马德里每年分别有 7.1%和 3.4%的过早死亡可归因于不遵守空气污染、噪声、热和接触绿地的国际暴露建议。此外，SES 分析表明，巴塞罗那的低 SES 地区整体归因死亡率较高，而马德里的 SES 人群归因死亡率分布因暴露情况而异。
本研究表明了环境暴露对死亡率的影响，强调了在设计城市时采取综合行动的重要性，考虑到健康影响，但也要考虑每个城市的具体情况，如社会人口背景。此外，分析的高精度尺度能够识别环境危害和死亡热点，为确定优先事项提供了有力工具，并为政策制定者提供了指导，以实现所有居民健康、可持续和公平的城市。
