Department of Epidemiology and Health Statistics, School of Public Health, Southwest Medical University, No.1, Section 1, Xianglin Road, Longmatan District, Luzhou, 646000, Sichuan, People's Republic of China.
Sci Rep. 2024 Jan 18;14(1):1643. doi: 10.1038/s41598-024-52282-2.
This ecological study examined the individual and joint impacts of natural-human factors on the spatial patterns of maternal and child health status in China at the provincial scale in 2020. We considered natural factors (forest coverage, average temperature, and total sulfur dioxide and particulate matter emissions) and human factors (economic development, urbanization, healthcare access, and education level). We combined maternal, infant, and under-five mortality rates into a composite maternal and child health index using the entropy method. The spatial autocorrelation analysis of this index highlighted distinct health patterns across provinces, whereas the geodetector method assessed the effects of natural-human factors on the patterns. A notable east-central-west stepwise decline in health status was observed. Global Moran's I showed positive spatial clustering, with high-high clustering areas in the Yangtze River Delta and low-low clustering areas in western regions. Factor detection identified eight significant natural-human factors impacting maternal and child health, with total sulfur dioxide emission density having the greatest impact. The interaction between average schooling years and total sulfur dioxide emission notably affected maternal and child health patterns. The study concludes that natural-human factors critically affect the spatial distribution of maternal and child health.
本生态研究以 2020 年中国省级尺度为例，探讨了自然-人为因素对母婴健康状况空间格局的单独和联合影响。我们考虑了自然因素（森林覆盖率、平均气温以及总二氧化硫和颗粒物排放量）和人为因素（经济发展、城市化、医疗保健可及性和教育水平）。我们采用熵值法将孕产妇死亡率、婴儿死亡率和五岁以下儿童死亡率综合为一个母婴健康综合指数。该指数的空间自相关分析突出了各省之间明显的健康模式，而地理探测器方法则评估了自然-人为因素对这些模式的影响。研究发现，健康状况呈现出明显的东-中-西逐步下降的趋势。全局 Moran's I 显示出正空间聚类，长三角地区呈现高-高聚类，西部地区呈现低-低聚类。因子探测确定了 8 个对母婴健康有显著影响的自然-人为因素，其中二氧化硫排放总量密度的影响最大。平均受教育年限和二氧化硫排放总量之间的相互作用显著影响母婴健康模式。研究得出结论，自然-人为因素对母婴健康的空间分布有重要影响。
