自然環境への曝露が健康上の不平等に与える影響:観察的集団研究
Richard Mitchell1, Frank Popham
1Public Health and Health Policy, University of Glasgow, Glasgow, UK.
Lancet (London, England)
|November 11, 2008
まとめ
緑地へのより大きな曝露は,所得の不足に関連した健康格差を大幅に軽減します. 緑豊かな地域に住むことは,特に貧困層の人々にとって,あらゆる原因および循環器疾患による死亡リスクを下げます.
科学分野:
- 環境衛生 環境衛生 環境衛生
- 公衆衛生は公衆衛生である.
- 健康の社会経済的決定要因
背景:
- 自然環境 (緑の空間) に曝露することは,独立して健康と行動に影響を与えます.
- 緑のスペースへのアクセスは,社会経済的地位が低いことから生じる健康格差を軽減することができます.
- この研究は,収入関連の健康格差の軽減における緑の空間の役割を調査しています.
研究 の 目的:
- 収入関連の健康格差が,緑地への曝露のレベルによって異なるかどうかを調べる.
- 緑地が所得不足と死亡率との関連性を変化させるかどうかを判断する.
- すべての原因および特定の原因による死亡率に対する緑地の影響を評価する.
主な方法:
- 英国の4000万人以上の個人を対象に,所得の不足と緑地への曝露によって分類した分析.
- 2001-2005年の個人死亡記録 (36万6千件以上) を利用した.
- 緑の空間への曝露による死亡率 (全原因,循環器疾患,肺がん,自傷) の変動を分析するために,混同要因を制御するために,階層化されたモデルを使用しました.
主要な成果:
- 収入不足と死亡率の関連性は,あらゆる原因による死亡率 (p<0.0001) と循環器疾患 (p=0.0212) に関する緑地への曝露によって著しく変化した.
- 健康上の不平等は,最も緑色な地域ではより低く,最も貧しい四分の一の死亡リスク比率は1.43 (全原因) と,最も緑色でない地域では1.93であった.
- 肺がんや故意の自傷などの環境要因の影響を受ける可能性が低い死因については,緑地の有意な効果は観察されなかった.
結論:
- 最も緑の環境にある人口は,所得関連の健康格差が最も低いレベルを示しています.
- 健康を促進するアクセシブルな緑の環境は,社会経済的健康格差の軽減に不可欠です.
- 都市計画と公衆衛生のイニシアチブは,健康上の不平等に対処するために,緑のスペースの開発を優先すべきである.
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