Background

Cities have unique geographic, environmental and sociocultural characteristics that influence the health status of their citizens. Identification and modification of these characteristics may help to promote healthier cities.

Objective

We estimated premature mortality impacts of breaching international exposure guidelines for physical activity (PA), air pollution, noise and access to green space for Bradford (UK) adult residents (n = 393,091).

Methods

We applied the Urban and TranspOrt Planning Health Impact Assessment (UTOPHIA) methodology and estimated mortality, life expectancy (LE) and economic impacts of non-compliance with recommended exposure levels. We also investigated the distribution of the mortality burden among the population, focusing on socioeconomic position (SEP) as defined by deprivation status and ethnicity.

Results

We estimated that annually almost 10% of premature mortality (i.e. 375 deaths, 95% CI: 276–474) in Bradford is attributable to non-compliance with recommended exposure levels. Non-compliance was also estimated to result in over 300 days of LE lost (95% CI: 238–432), which translated in economic losses of over £50,000 per person (95% CI: 38,518–69,991). 90% of the premature mortality impact resulted from insufficient PA performance. Air and noise pollution and the lack of green space had smaller impacts (i.e. 48 deaths). Residents of lower SEP neighborhoods had the highest risks for adverse exposure and premature death. A larger number of deaths (i.e. 253 and 145, respectively) could be prevented by reducing air and noise pollution levels well below the guidelines.

Discussion

Current urban and transport planning related exposures result in a considerable health burden that is unequally distributed among the Bradford population. Improvements in urban and transport planning practices including the reduction of motor traffic and the promotion of active transport together with greening of the district, particularly in areas of lower SEP, are promising strategies to increase PA performance and reduce harmful environmental exposures.

中文翻译：

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城市和交通规划相关风险和死亡率中的社会经济不平等：英国布拉德福德的健康影响评估研究

背景

城市具有影响其公民健康状况的独特地理、环境和社会文化特征。识别和修改这些特征可能有助于促进更健康的城市。

客观的

我们估计了违反国际接触指南对布拉德福德（英国）成年居民（ n  = 393,091）的身体活动（PA）、空气污染、噪音和绿地使用权的过早死亡影响。

方法

我们应用了城市和交通规划健康影响评估 (UTOPHIA) 方法，并估计了不遵守建议暴露水平的死亡率、预期寿命 (LE) 和经济影响。我们还调查了人口中死亡率负担的分布，重点关注由剥夺状况和种族定义的社会经济地位（SEP）。

结果

我们估计，布拉德福德每年近 10% 的过早死亡（即 375 人死亡，95% CI：276-474）可归因于不遵守推荐的暴露水平。据估计，违规行为还会导致超过 300 天的 LE 损失（95% CI：238-432），这意味着每人的经济损失超过 50,000 英镑（95% CI：38,518-69,991）。90% 的过早死亡影响是由于 PA 性能不足造成的。空气和噪音污染以及缺乏绿色空间的影响较小（即 48 人死亡）。较低 SEP 社区的居民遭受不良暴露和过早死亡的风险最高。通过将空气和噪音污染水平降低到远低于指导方针的水平，可以避免更多的死亡（即分别为 253 和 145）。

讨论

当前与城市和交通规划相关的暴露导致相当大的健康负担，在布拉德福德人口中分布不均。城市和交通规划实践的改进，包括减少机动车交通和促进主动交通以及该地区的绿化，特别是在 SEP 较低的地区，是提高 PA 绩效和减少有害环境暴露的有希望的战略。