School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai 200030, China.
Institute of Space and Earth Information Science, The Chinese University of Hong Kong, Hong Kong 999077, China.
Int J Environ Res Public Health. 2022 Mar 3;19(5):2960. doi: 10.3390/ijerph19052960.
Public rental housing (PRH) for low-income families has been shown in several studies to be associated with poor health status and obesity. However, the causes of this health disparity are controversial, and the associations and pathways between PRH and obesogenic behaviors remain unknown. Using cross-sectional survey data of 1977 adults living in Hong Kong (aged or over 18) together with multi-source GIS-based environmental data, we examined the associations between PRH and obesogenic behaviors and the extent to which those associations can be explained by neighborhood food and physical environment. The unhealthy food environment, which relates with infrequent fruit and vegetables consumption, was calculated based on the relative density of fast food restaurants and convenience stores to grocery stores. The physical activity environment, which relates to physical inactivity and prolonged sitting, was assessed in terms of density of sports facilities and street greenery, separately. Regressions and mediation analyses show that PRH was negatively associated with physical inactivity directly and also indirectly via higher sports facilities density; however, PRH was positively associated with unhealthy diet largely directly and positively associated with prolonged sitting indirectly via less street greenery. We advanced the international literature of PRH health impact assessment and its environmental health pathways by providing evidence from the least housing-affordable city in the world. The findings provide planning implications in formulating a healthier PRH community for these low-income PRH households and mitigating health disparities induced by housing type.
公共租赁住房（PRH）为低收入家庭提供了保障，多项研究表明，它与健康状况不佳和肥胖有关。然而，造成这种健康差距的原因存在争议，PRH 与致肥胖行为之间的关联和途径仍不清楚。本研究使用香港 1977 名成年人（年龄在 18 岁及以上）的横断面调查数据和多源 GIS 环境数据，检验了 PRH 与致肥胖行为之间的关联，以及这些关联在多大程度上可以用邻里食品和物理环境来解释。不健康的食物环境与水果和蔬菜摄入频率较低有关，是根据快餐店和便利店与杂货店的相对密度来计算的。体育设施密度评估了与缺乏运动和久坐时间过长有关的身体活动环境；街道绿化密度则评估了与身体活动不足和久坐时间过长有关的身体活动环境。回归和中介分析表明，PRH 与缺乏身体活动直接相关，与较高的体育设施密度也间接相关；然而，PRH 与不健康的饮食有很大的直接关联，与较少的街道绿化间接相关，这导致了久坐时间延长。本研究从全球住房负担能力最低的城市提供了证据，推进了 PRH 对健康影响评估及其环境健康途径的国际文献，为这些低收入 PRH 家庭制定更健康的 PRH 社区提供了规划启示，并减轻了住房类型引起的健康差距。
