Barcelona Institute for Global Health (ISGlobal), Doctor Aiguader 88, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Doctor Aiguader 88, 08003, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Melchor Fern'andez Almagro, 3-5, 28029, Madrid, Spain.
Delft University of Technology, Mekelweg 5, 2628, Delft, Netherlands.
Environ Res. 2024 Sep 15;257:119324. doi: 10.1016/j.envres.2024.119324. Epub 2024 Jun 4.
As the world becomes increasingly urbanised, there is recognition that public and planetary health relies upon a ubiquitous transition to sustainable cities. Disentanglement of the complex pathways of urban design, environmental exposures, and health, and the magnitude of these associations, remains a challenge. A state-of-the-art account of large-scale urban health studies is required to shape future research priorities and equity- and evidence-informed policies.
The purpose of this review was to synthesise evidence from large-scale urban studies focused on the interaction between urban form, transport, environmental exposures, and health. This review sought to determine common methodologies applied, limitations, and future opportunities for improved research practice.
Based on a literature search, 2958 articles were reviewed that covered three themes of: urban form; urban environmental health; and urban indicators. Studies were prioritised for inclusion that analysed at least 90 cities to ensure broad geographic representation and generalisability. Of the initially identified studies, following expert consultation and exclusion criteria, 66 were included.
The complexity of the urban ecosystem on health was evidenced from the context dependent effects of urban form variables on environmental exposures and health. Compact city designs were generally advantageous for reducing harmful environmental exposure and promoting health, with some exceptions. Methodological heterogeneity was indicative of key urban research challenges; notable limitations included exposure and health data at varied spatial scales and resolutions, limited availability of local-level sociodemographic data, and the lack of consensus on robust methodologies that encompass best research practice.
Future urban environmental health research for evidence-informed urban planning and policies requires a multi-faceted approach. Advances in geospatial and AI-driven techniques and urban indicators offer promising developments; however, there remains a wider call for increased data availability at local-levels, transparent and robust methodologies of large-scale urban studies, and greater exploration of urban health vulnerabilities and inequities.
随着世界日益城市化，人们认识到公共卫生和地球健康依赖于向可持续城市的普遍转变。解开城市设计、环境暴露和健康之间复杂的关系及其关联的程度仍然是一个挑战。需要对大规模城市健康研究进行最新的评估，以确定未来的研究重点和公平与循证政策。
本综述的目的是综合大规模城市研究中关于城市形态、交通、环境暴露和健康之间相互作用的证据。本综述旨在确定所应用的常见方法、局限性以及改进研究实践的未来机会。
根据文献检索，综述了涵盖城市形态、城市环境卫生和城市指标三个主题的 2958 篇文章。为确保广泛的地理代表性和普遍性，优先考虑分析了至少 90 个城市的研究进行纳入。在最初确定的研究中，经过专家咨询和排除标准，有 66 项研究被纳入。
城市形态变量对环境暴露和健康的影响因背景而异，这表明城市生态系统对健康的复杂性。紧凑的城市设计通常有利于减少有害的环境暴露和促进健康，但也有一些例外。方法学的异质性表明了关键的城市研究挑战；值得注意的局限性包括在不同的空间尺度和分辨率上的暴露和健康数据、有限的当地社会人口数据可用性以及缺乏涵盖最佳研究实践的稳健方法的共识。
未来需要采取多方面的方法进行循证的城市规划和政策的城市环境卫生研究。地理空间和人工智能驱动技术和城市指标的进步提供了有希望的发展；然而，仍然需要在地方一级增加数据的可用性、具有透明度和稳健性的大规模城市研究方法，以及更深入地探讨城市健康脆弱性和不平等问题。
