School of Earth and Environmental Sciences, University of Queensland, Brisbane, Queensland, Australia; Graduate School of Interdisciplinary Information Studies, University of Tokyo, Tokyo, Japan.
Centre for Social Policy & Social Change, Lingnan University, Hong Kong.
Sci Total Environ. 2023 May 1;871:162005. doi: 10.1016/j.scitotenv.2023.162005. Epub 2023 Feb 8.
Environmental stressors including high temperature and air pollution cause health problems. However, understanding how the combined exposure to heat and air pollution affects both physical and mental health remains insufficient due to the complexity of such effects mingling with human society, urban and natural environments. Our study roots in the Social Ecological Theory and employs a tri-environmental conceptual framework (i.e., across social, built and natural environment) to examine how the combined exposure to heat and air pollution affect self-reported physical and mental health via, for the first time, the fine-grained nationwide investigation in Australia and highlight how such effects vary across inter- and intra-urban areas. We conducted an ecological study to explore the importance of heat and air quality to physical and mental health by considering 48 tri-environmental confounders through the global and local random forest regression models, as advanced machine learning methods with the advantage of revealing the spatial heterogeneity of variables. Our key findings are threefold. First, the social and built environmental factors are important to physical and mental health in both urban and rural areas, and even more important than exposure to heat and air pollution. Second, the relationship between temperature and air quality and health follows a V-shape, reflecting people's different adaptation and tolerance to temperature and air quality. Third, the important roles that heat and air pollution play in physical and mental health are most obvious in the inner-city and near inner-city areas of the major capital cities, as well as in the industrial zones in peri-urban regions and in Darwin city with a low-latitude. We draw several policy implications to minimise the inter- and intra-urban differences in healthcare access and service distribution to populations with different sensitivity to heat and air quality across urban and rural areas. Our conceptual framework can also be applied to examine the relationship between other environmental problems and health outcomes in the era of a warming climate.
环境压力源，包括高温和空气污染，会导致健康问题。然而，由于这些影响与人类社会、城市和自然环境交织在一起的复杂性，对于热和空气污染的联合暴露如何影响身心健康，我们的理解仍然不足。我们的研究根植于社会生态理论，并采用三环境概念框架（即社会、建筑和自然环境），首次通过在澳大利亚进行的全国性调查，研究热和空气污染的联合暴露如何通过精细的全国性调查影响自我报告的身心健康，并强调这种影响如何在城乡地区之间以及城乡内部地区有所不同。我们进行了一项生态研究，通过全球和局部随机森林回归模型考虑 48 个三环境混杂因素，探索热和空气质量对身心健康的重要性，这些模型是先进的机器学习方法，具有揭示变量空间异质性的优势。我们的主要发现有三个方面。首先，社会和建筑环境因素对城乡地区的身心健康都很重要，甚至比热和空气污染的暴露更重要。其次，温度和空气质量与健康之间的关系呈 V 形，反映了人们对温度和空气质量的不同适应和容忍能力。第三，热和空气污染在身心健康中发挥的重要作用在主要城市的内城和近内城地区以及城市周边地区的工业区以及低纬度的达尔文市最为明显。我们提出了一些政策建议，以尽量减少城乡之间在医疗保健获取和服务分配方面的差异，以便为对热和空气质量敏感程度不同的城乡地区的人口提供服务。我们的概念框架也可以应用于在气候变暖的时代，研究其他环境问题与健康结果之间的关系。
