Background

Both social and physical neighbourhood factors may affect residents' health, but few studies have considered the combination of several exposures in relation to individual health status.

Aim

To assess a range of different potentially relevant physical and social environmental characteristics in a sample of small neighbourhoods in the Netherlands, to study their mutual correlations and to explore associations with morbidity of residents using routinely collected general practitioners' (GPs') data.

Methods

For 135 neighbourhoods in 43 Dutch municipalities, we could assess area-level social cohesion and collective efficacy using external questionnaire data, urbanisation, amount of greenspace and water areas, land use diversity, air pollution (particulate matter (PM) with a diameter <10 μm (PM₁₀), PM <2.5 μm (PM_2.5) and nitrogen dioxide (NO₂), and noise (from road traffic and from railways). Health data of the year 2013 from GPs were available for 4450 residents living in these 135 neighbourhoods, that were representative for the entire country. Morbidity of 10 relevant physical or mental health groupings was considered. Individual-level socio-economic information was obtained from Statistics Netherlands. Associations between neighbourhood exposures and individual morbidity were quantified using multilevel mixed effects logistic regression analyses, adjusted for sex, age (continuous), household income and socio-economic status (individual level) and municipality and neighbourhood (group level).

Results

Most physical exposures were strongly correlated with degree of urbanisation. Social cohesion and collective efficacy tended to be higher in less urbanised municipalities. Degree of urbanisation was associated with higher morbidity of all disease groupings. A higher social cohesion at the municipal level coincided with a lower prevalence of depression, migraine/severe headache and Medically Unexplained Physical Symptoms (MUPS). An increase in both natural and agricultural greenspace in the neighbourhood was weakly associated with less morbidity for all conditions. A high land use diversity was consistently associated with lower morbidities, in particular among non-occupationally active individuals.

Conclusion

A high diversity in land use of neighbourhoods may be beneficial for physical and mental health of the inhabitants. If confirmed, this may be incorporated into urban planning, in particular regarding the diversity of greenspace.

中文翻译：

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社会资本，土地使用，空气污染和噪声对荷兰社区个人发病率的影响

背景

社会和物理邻里因素都可能影响居民的健康，但是很少有研究考虑到与个人健康状况相关的几种暴露的组合。

目的

为了评估荷兰小社区样本中一系列不同的潜在相关的自然和社会环境特征，研究它们之间的相互关系，并使用常规收集的全科医生（GPs）数据探讨与居民发病率的关联。

方法

对于荷兰43个城市的135个社区，我们可以使用外部问卷调查数据，城市化，绿地和水域数量，土地利用多样性，空气污染（直径小于10的颗粒物（PM））来评估区域级社会凝聚力和集体效力μm（PM ₁₀），PM <2.5μm（PM _2.5 ）和二氧化氮（NO ₂ ），以及噪声（来自道路交通和铁路）.2013年来自全科医生的健康数据适用于这135位居民中的4450名居民代表整个国家的邻里十种相关的身心健康的发病率考虑了分组。个人水平的社会经济信息是从荷兰统计局获得的。使用多级混合效应逻辑回归分析对邻里暴露与个体发病率之间的关联进行定量，并针对性别，年龄（连续），家庭收入和社会经济地位（个人）以及市镇和邻里（群体级别）进行调整。

结果

大多数物理暴露与城市化程度密切相关。在城市化程度较低的城市中，社会凝聚力和集体效能往往较高。城市化程度与所有疾病分组的较高发病率相关。在市政一级，较高的社会凝聚力与抑郁症，偏头痛/严重头痛和医学上无法解释的身体症状（MUPS）的患病率较低相吻合。在所有情况下，附近自然和农业绿地的增加与发病率的降低均存在弱关联。较高的土地利用多样性与较低的发病率相关联，特别是在非职业活跃人群中。

结论

社区土地利用的高度多样性可能有益于居民的身心健康。如果得到确认，则可以将其纳入城市规划中，尤其是在绿地多样性方面。