Schoner Jessica, Chapman Jim, Fox Eric H, Iroz-Elardo Nicole, Brookes Allen, MacLeod Kara E, Frank Lawrence D
Urban Design 4 Health Inc., 353 Rockingham St., Rochester, NY 14620, USA.
US Environmental Protection Agency, 200 S.W. 35th Street, Corvallis, OR 97333-4902, USA.
J Transp Health. 2018 Sep;10:401-418. doi: 10.1016/j.jth.2018.04.008.
There is mounting evidence linking land development and transportation investments to physical activity with resulting implications for chronic disease prevention. Links between the physical environment and health have traditionally focused on harmful exposures such as air pollution, noise, and traffic injury. Given limited funds and competition for how and where investments are made, there is a need to prioritize and target resources to maximize health benefits that can include activity related chronic disease prevention. The ability to apply this evidence to decision making has been limited by the complexity and inconsistency of research methods, and lack of a direct connection with the planning contexts in which decisions are made. Scenario planning tools provide a method to apply evidence with spatial planning decisions at a range of geographic scales. The US Environmental Protection Agency commissioned the development of a National Public Health Assessment Model (N-PHAM). This project utilized built and natural environment data at the block-group level and large population surveys to model the relationships of the environment with several health outcomes for a range of age and income groups. N-PHAM is the first health assessment tool that can connect to multiple existing scenario planning platforms utilizing nationally available data and can be consistently applied nationally. Such tools can empower communities to choose investments that have the greatest potential to improve public health and quality of life, reduce health care costs, and address environmental justice related disparities.
越来越多的证据表明，土地开发和交通投资与身体活动相关，从而对慢性病预防产生影响。传统上，物理环境与健康之间的联系主要集中在有害暴露上，如空气污染、噪音和交通伤害。鉴于资金有限以及在投资方式和地点方面存在竞争，有必要对资源进行优先排序和目标定位，以最大限度地提高健康效益，其中可能包括与活动相关的慢性病预防。将这些证据应用于决策的能力受到研究方法的复杂性和不一致性以及与决策所处规划背景缺乏直接联系的限制。情景规划工具提供了一种在一系列地理尺度上，将证据应用于空间规划决策的方法。美国环境保护局委托开发了一个国家公共卫生评估模型（N-PHAM）。该项目利用街区组层面的建成环境和自然环境数据以及大规模人口调查，对一系列年龄和收入群体的环境与多种健康结果之间的关系进行建模。N-PHAM是首个能够利用全国可用数据连接到多个现有情景规划平台，并能在全国范围内持续应用的健康评估工具。此类工具可使社区能够选择那些最有潜力改善公众健康和生活质量、降低医疗成本并解决与环境正义相关差距的投资项目。
