城市的便利性还是社会不平等? 在米兰,建筑环境和2型糖尿病的多层空间分析
David Consolazio1,2, Miriam Serini3, Ahmed Alsayed1
1Department of Social and Political Sciences, University of Milan, Milan, Italy.
概括
研究了建筑环境与米兰2型糖尿病 (T2DM) 患病率的关联. 虽然发现了一些联系,但在考虑邻里教育水平后,它们消失了,这表明教育是关键因素.
科学领域:
- 环境流行病学环境流行病学
- 城市健康 城市健康
- 公共卫生 公共卫生
背景情况:
- 2型糖尿病 (T2DM) 呈现出社会梯度,城市环境因素可能会影响其流行.
- 了解建筑环境在T2DM中的作用对于在城市环境中进行有针对性的公共卫生干预至关重要.
研究的目的:
- 调查建筑环境特征与意大利米兰T2DM患病率之间的关联.
- 检查社区层面的特征,包括食物获取,体育活动基础设施和医疗保健可访问性,如何与T2DM相关.
主要方法:
- 利用了2019年米兰人口的行政医疗保健数据和开放式领土信息.
- 使用道路网络缓冲器的空间分析来评估获得卫生资源的机会.
- 应用了多层次的波桑回归模型,按年龄和性别分层,根据邻居的教育程度进行调整.
主要成果:
- 一些建筑环境指标显示,最初与T2DM患病率存在显著关联.
- 当邻里级教育成就被纳入模型时,这些协会失去了统计意义.
- 调查结果表明,教育成就可能会调解或混米兰建筑环境和T2DM之间的关系.
结论:
- 建筑环境对米兰T2DM的影响可能比在其他环境中观察到的要少,这可能是由于教育的调解作用.
- 在米兰,与更大,更异质的美国大都市或低收入国家农村城市差距相比,特定的环境因素塑造了这些健康协会.
- 需要进一步的研究,以了解社会经济因素和城市环境在T2DM差异上的复杂相互作用.
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