Shen Yu-Sheng, Lung Shih-Chun Candice, Cui Shenghui
Key Lab of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen, China; Xiamen Key Lab of Urban Metabolism, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen, China; University of Chinese Academy of Sciences, Beijing, China.
Research Center for Environmental Changes, Academia Sinica, Taipei, Taiwan; Department of Atmospheric Sciences, Taiwan University, Taipei, Taiwan; Institute of Environmental Health, Taiwan University, Taipei, Taiwan.
Environ Pollut. 2022 Feb 1;294:118642. doi: 10.1016/j.envpol.2021.118642. Epub 2021 Dec 6.
Public health is threatened by air pollution and high temperature, especially in urban areas and areas impacted by climate change. Well-designed urban forms have co-benefits on promoting human health and mediating atmospheric environment-related threats (e.g., high temperature and air pollution). Previous studies overlooked these mediating effects of urban form on suicide mortality. This study used partial least squares modeling and countywide data in Taiwan to identify the crucial influences and pathways of urban environment, socioeconomic status, and diseases on suicide mortality. The model considered the impact of the characteristics of urban form (i.e., urban development intensity, land mix, and urban sprawl), urban industrial status (i.e., industrial level), urban greening (i.e., green coverage), disease (i.e., important diseases morbidity of human immunodeficiency virus [HIV], cerebrovascular disease [CVD], chronic liver disease and cirrhosis [CLDC], nephritis, nephrotic syndrome and nephrosis [NNSN], malignant tumor [MT]), socioeconomic status (i.e., income level and aging population rate), and the atmospheric environment (i.e., air pollution and high temperature) on suicide mortality. Optimizing land mix and minimizing urban development intensity and urban sprawl have been found to reduce suicide mortality. The mediating effect of urban form on suicide mortality originated from air pollution and high temperature, and mediating air pollution was greater than high temperature. Furthermore, industrial level, important diseases (HIV, CVD, CLDC, NNSN, and MT) morbidity, an aging population rate, air pollution, and high temperature were associated with an increase in suicide mortality, whereas green coverage and income level were associated with a reduction in suicide rates. The findings demonstrate that appropriate urban policy and urban planning may lower suicide mortality, be useful strategies for suicide prevention, and be a foundation for building a healthy city. Moreover, this study provides clarity on the complex relationship of suicide and the urban environment while identifying crucial factors.
空气污染和高温对公共卫生构成威胁，尤其是在城市地区以及受气候变化影响的地区。精心设计的城市形态在促进人类健康和缓解与大气环境相关的威胁（如高温和空气污染）方面具有协同效益。以往的研究忽视了城市形态对自杀死亡率的这些调节作用。本研究使用偏最小二乘模型和台湾的县级数据，以确定城市环境、社会经济地位和疾病对自杀死亡率的关键影响及途径。该模型考虑了城市形态特征（即城市发展强度、土地混合利用和城市蔓延）、城市产业状况（即产业水平）、城市绿化（即绿地覆盖率）、疾病（即人类免疫缺陷病毒[HIV]、脑血管疾病[CVD]、慢性肝病和肝硬化[CLDC]、肾炎、肾病综合征和肾病[NNSN]、恶性肿瘤[MT]的重要疾病发病率）、社会经济地位（即收入水平和老年人口率）以及大气环境（即空气污染和高温）对自杀死亡率的影响。研究发现，优化土地混合利用并尽量减少城市发展强度和城市蔓延可降低自杀死亡率。城市形态对自杀死亡率的调节作用源自空气污染和高温，且调节空气污染的作用大于高温。此外，产业水平、重要疾病（HIV、CVD、CLDC、NNSN和MT）发病率、老年人口率、空气污染和高温与自杀死亡率上升相关，而绿地覆盖率和收入水平与自杀率降低相关。研究结果表明，适当的城市政策和城市规划可能降低自杀死亡率，是预防自杀的有用策略，也是建设健康城市的基础。此外，本研究在确定关键因素的同时，阐明了自杀与城市环境之间的复杂关系。
