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The Impact of Urban Development on Disparities in Exposures and Health in Xi'an, China.

机译：中国西安城市发展对暴露和健康差异的影响。

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摘要

China's cities have been growing both in size and population at an unprecedented rate over the last three decades. The evolving urban landscape has important consequences for public health. However, the relationships among the physical environment, human behaviors, environmental exposures, and health are understudied in Chinese populations. Furthermore, more evidence from Chinese studies is needed to inform the design of urban environments and public health programs that promote and improve both mental and physical health.;This dissertation examines how urban development trends in China affect health and quality of life. I approached this question by conducting a cross-sectional socio-behavioral and health survey of 1608 adults in 20 neighborhoods in Xi'an, China in 2013. This cross-sectional study includes residents of four types of neighborhoods that represent different stages of China's urbanization: work-units, lane and courtyard housing, and two forms of commodity housing (high-density high rises and low-density high rises) neighborhoods. Although cross-sectional in design, this dissertation leverages the temporal history of the neighborhoods present in Xi'an to explore the relationships of development trends with behaviors and health. In particular, I examine the relationships between the natural and built environments and urban health. In addition, I identify neighborhood-specific factors that public health practitioners and urban planners might target to improve health.;First, I apply land use regression (LUR) methodology and the deletion/substitution/addition (DSA) algorithm to select predictive models and create concentration surfaces for four pollutants: PM2.5, NO2, SO2, and O3. The LUR models identified substantial areas of Xi'an that had annual PM2.5, SO2, and NO2 concentrations exceeding current health standards set by the World Health Organization (WHO), providing more evidence for the potential health risks from ambient air pollution in Chinese cities.;Because consistent and reliable air quality monitoring networks are rarely able to keep pace with urbanization in China, new technologies are needed to complement the existing methods of environmental management in cities. Thus, I also test the validity of a new low cost particulate matter sensor (PUWP) for use in high concentration areas like Xi'an. The PUWP sensor performed well as compared to mature PM monitors and could be used to rapidly screen for air pollution "hotspots" in large areas where setting up extensive monitoring stations is challenging. The analysis also observed a sinusoidal relationship between sensor response and PM2.5 concentrations, indicating gradual saturation in the optical sensor's ability to detect ambient concentrations in high PM environments above 300 microg/m 3.;In addition, I present the results of the cross-sectional socio-behavioral and health survey where I examine the associations between self-reported perceptions of the built environment and quality of life, and assess whether these associations differ across the four types of neighborhoods. Neighborhood built environment was strongly associated with both mental and physical-health related quality of life in the commodity housing neighborhoods (high and low-density). In particular, pedestrian infrastructure, diversity of resources, access to and from the neighborhood, and neighborhood safety had the highest positive associations with increased mental health in the high-density high-rise neighborhoods. In the work-unit neighborhoods, increased access to and from the neighborhood was found to be a significantly associated with both mental and physical health. Pedestrian infrastructure, diversity of neighborhood resources, and esthetics were found to be positively associated with mental health in lane/courtyard neighborhoods.;Finally, results from the LUR analysis are also used in an exposure assessment of ambient air pollution for the 20 surveyed neighborhoods. I examine the role of neighborhood air pollution in modifying the associations between leisure-time physical activity (LTPA) and adverse health impact and quality of life. Neighborhood ambient air pollution is included in health effects models in two ways: 1) categorical single pollutant and 2) categorical mixtures models. Increasing LTPA levels are associated with lower odds of adverse health impacts and higher reported quality of life. However, the health and quality of life benefits of physical activity are potentially lower in areas where ambient PM 2.5 and O3 are elevated. In addition, single pollutant models are poor proxies of mixtures of pollutants, which indicate a need for considering multi-pollutant exposures in epidemiological studies.;Collectively, these results suggest the built, natural, and social environments should be considered simultaneously as potential targets of intervention to improve quality of life and health in Chinese cities.
机译：在过去的三十年中，中国城市的规模和人口都在以前所未有的速度增长。不断变化的城市景观对公共卫生产生重要影响。但是，中国人口对自然环境，人类行为，环境暴露和健康之间的关系的研究不足。此外，还需要更多来自中国研究的证据来指导旨在促进和改善身心健康的城市环境和公共卫生计划的设计。本文研究了中国城市发展趋势如何影响健康和生活质量。为了解决这个问题，我在2013年对中国西安20个社区的1608名成年人进行了横断面的社会行为和健康调查。该横断面研究包括代表中国城市化不同阶段的四种类型社区的居民：工作单元，车道和庭院住宅以及两种形式的商品住宅（高密度高层住宅和低密度高层住宅）社区。尽管在设计上是横断面的，但本文还是利用了西安社区的时间历史来探讨发展趋势与行为和健康之间的关系。我特别研究了自然和建筑环境与城市健康之间的关系。此外，我确定了公共卫生从业人员和城市规划人员可能针对改善健康的社区特定因素。首先，我使用土地利用回归（LUR）方​​法和删除/替代/增加（DSA）算法选择预测模型，为四种污染物创建浓度表面：PM2.5，NO2，SO2和O3。 LUR模型确定了西安的大部分区域，这些区域的PM2.5，SO2和NO2的年度浓度超过了世界卫生组织（WHO）设定的当前健康标准，从而为中国人受到环境空气污染的潜在健康风险提供了更多证据由于一致，可靠的空气质量监测网络很少能跟上中国城市化的步伐，因此需要新技术来补充城市中现有的环境管理方法。因此，我还测试了在西安等高浓度地区使用的新型低成本颗粒物传感器（PUWP）的有效性。与成熟的PM监测器相比，PUWP传感器的性能良好，可用于在需要设置大量监测站的大区域中快速筛查空气污染“热点”。分析还观察到传感器响应与PM2.5浓度之间呈正弦关系，这表明光学传感器在300 µg / m 3以上的高PM环境中检测环境浓度的能力逐渐饱和。区域性的社会行为和健康调查，其中我检查了自我报告的对建筑环境的看法与生活质量之间的关联，并评估了在四种类型的社区中这些关联是否不同。在商品住宅区（高密度和低密度）中，邻里建筑环境与心理和身体健康相关的生活质量密切相关。特别是，在高密度高层社区中，行人基础设施，资源的多样性，进出社区以及社区安全与提高心理健康程度之间具有最高的正相关关系。在工作单位社区中，增加进出社区的机会与身心健康显着相关。行人基础设施，社区资源的多样性以及美学与行车道/庭院社区的心理健康呈正相关。最后，LUR分析的结果还用于对20个被调查社区的环境空气污染暴露评估。我研究了邻里空气污染在改善休闲时间体育活动（LTPA）与不良健康影响和生活质量之间的关联中的作用。健康影响模型以两种方式包括附近环境空气污染：1）分类单一污染物和2）分类混合物模型。 LTPA水平的提高与不良健康影响的几率降低以及所报告的生活质量更高有关。但是，在周围PM 2.5和O3升高的地区，体育锻炼对健康和生活质量的好处可能会降低。此外，单一污染物模型不能很好地代表污染物的混合物，这表明在流行病学研究中需要考虑多种污染物的暴露。总体而言，这些结果表明，应将建筑，自然和社会环境同时考虑为潜在的目标。干预以改善中国城市的生活质量和健康状况。

著录项

  • 作者

    Gao, Meiling.;

  • 作者单位

    University of California, Berkeley.;

  • 授予单位 University of California, Berkeley.;
  • 学科 Environmental health.;Public health.
  • 学位 Ph.D.
  • 年度 2015
  • 页码 175 p.
  • 总页数 175
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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