Maryland Transportation Institute, University of Maryland, College Park, MD 20742, USA.
Int J Environ Res Public Health. 2022 Jul 26;19(15):9102. doi: 10.3390/ijerph19159102.
As physical inactivity statistics for the U.S. population show an alarming trend, many health problems have been increasing among Americans in recent decades. Thus, identification of the factors that influence people's physical activity levels and health outcomes has become ever more essential to promote public health. The built envSFironment is among the main factors that impact individuals' health outcomes. However, little is known about the health impacts of built environment factors at large geographical scales such as those of the metropolitan area of residence. Further, the health impacts of travel behavior such as telecommuting and teleshopping remain unclear. This study uses an ecological model framework to probe the roles of travel behavior and built as well as social environments at different spatial levels in health. Instrumental variable binary probit models have been developed to examine the complex interlinks between measures of travel behavior, physical activity levels, built and social environment characteristics, and individuals' health outcomes. Findings indicate that built and social environment factors at different spatial levels, including the metropolitan area, are correlated with individuals' health outcomes. Additionally, the findings suggest that increased levels of telecommuting and teleshopping within communities may lead to unfavorable health outcomes. The findings shed light on the most promising policy interventions that can promote public health through modifications targeting people's travel choices as well as the built and social environments within urban areas.
随着美国人口的身体活动统计数据显示出令人担忧的趋势，近几十年来，美国人的许多健康问题一直在增加。因此，确定影响人们身体活动水平和健康结果的因素对于促进公共健康变得越来越重要。建成环境是影响个人健康结果的主要因素之一。然而，对于居住在大都市区等大地理尺度上的建成环境因素对健康的影响，人们知之甚少。此外，远程办公和电视购物等出行行为对健康的影响仍不清楚。本研究使用生态模型框架来探究不同空间水平的出行行为、建成环境和社会环境在健康中的作用。本研究开发了工具变量二元概率模型，以检验出行行为、身体活动水平、建成和社会环境特征与个人健康结果之间的复杂相互关系。研究结果表明，不同空间水平的建成环境和社会环境因素，包括大都市区，与个人的健康结果相关。此外，研究结果表明，社区内远程办公和电视购物水平的提高可能导致不利的健康结果。研究结果揭示了最有希望的政策干预措施，通过针对人们的出行选择以及城市地区内的建成和社会环境的目标修改，可以促进公共健康。
