Centre for Research in Environmental Epidemiology (CREAL), Barcelona Institute for Global Health (ISGlobal), Barcelona Biomedical Research Park, Dr. Aiguader, 88, 08003, Barcelona, Spain.
MRC Epidemiology Unit, University of Cambridge, Cambridge, UK.
Curr Environ Health Rep. 2022 Mar;9(1):90-103. doi: 10.1007/s40572-021-00324-6. Epub 2021 Sep 13.
Features and attributes of the built environment (BE) impact positively and negatively on health, especially in cities facing unprecedented urban population growth and mass motorization. A common approach to assess the health impacts of built environment is health impact assessment (HIA), but it is rarely used in low- and middle-income countries (LMICs) where urbanization rates are fastest. This article reviews selected HIA case studies from LMICs and reports the methods and tools used to support further implementation of quantitative HIAs in cities of LMICs.
In total, 24 studies were reviewed across Algeria, Brazil, China, India, Iran, Kenya, Thailand, Turkey, and Mauritius. HIAs examine specific pathways through which the built environment acts: air pollution, noise, physical activity, and traffic injury. Few HIAs of BE addressed more than one exposure pathway at a time, and most studies focused on air pollution across the sectors of transport and energy. A wide number of tools were used to conduct exposure assessment, and different models were applied to assess health impacts of different exposures. Those HIAs rely on availability of local concentration data and often use models that have set exposure-response functions (ERFs). ERFs were not adapted to local populations except for HIAs conducted in China. HIAs of BE are being successfully conducted in LMICs with a variety of tools and datasets. Scaling and expanding quantitative health impact modeling in LMICs will require further study on data availability, adapted models/tools, low technical capacity, and low policy demand for evidence from modeling studies. As case studies with successful use of evidence from modeling emerge, the uptake of health impact modeling of BE is likely to increase in favor of people and planet.
综述目的： 建成环境（BE）的特点和属性对健康有积极和消极的影响，尤其是在面临前所未有的城市人口增长和大规模机动化的城市。评估建成环境对健康影响的常用方法是健康影响评估（HIA），但在城市化速度最快的中低收入国家（LMIC）中很少使用。本文综述了来自 LMIC 的选定 HIA 案例研究，并报告了支持在 LMIC 城市进一步实施定量 HIA 的方法和工具。
最近发现： 共综述了来自阿尔及利亚、巴西、中国、印度、伊朗、肯尼亚、泰国、土耳其和毛里求斯的 24 项研究。HIA 研究了建成环境作用的特定途径：空气污染、噪音、身体活动和交通伤害。很少有 HIA 同时研究了超过一种暴露途径，大多数研究集中在交通和能源部门的空气污染。用于进行暴露评估的工具种类繁多，不同的模型用于评估不同暴露对健康的影响。这些 HIA 依赖于当地浓度数据的可用性，并且经常使用具有设定暴露-反应函数（ERF）的模型。除了在中国进行的 HIA 外，这些 ERF 并未针对当地人群进行调整。LMIC 中正在成功进行 BE 的 HIA，使用了各种工具和数据集。在 LMIC 中扩大和扩展定量健康影响建模需要进一步研究数据可用性、适应性模型/工具、低技术能力以及对建模研究证据的低政策需求。随着具有成功使用建模证据的案例研究的出现，对 BE 健康影响建模的采用可能会增加，以造福人类和地球。
