Accounting for the co-occurrence of multiple environmental influences is a more accurate reflection of population exposure than considering isolated influences, aiding in understanding the complex interactions between environments, behaviour and health. This study examines how environmental ‘goods’ such as green spaces and environmental ‘bads’ such as alcohol outlets co-occur to develop a nationwide area-level healthy location index (HLI) for New Zealand. Nationwide data were collected, processed, and geocoded on a comprehensive range of environmental exposures. Health-constraining ‘bads’ were represented by: (i) fast-food outlets, (ii) takeaway outlets, (iii) dairy outlets and convenience stores, (iv) alcohol outlets, (v) and gaming venues. Health-promoting ‘goods’ were represented by: (i) green spaces, (ii) blue spaces, (iii) physical activity facilities, (iv) fruit and vegetable outlets, and (v) supermarkets. The HLI was developed based on ranked access to environmental domains. The HLI was then used to investigate socio-spatial patterning by area-level deprivation and rural/urban classification. Results showed environmental ‘goods’ and ‘bads’ co-occurred together and were patterned by area-level deprivation. The novel HLI shows that the most deprived areas of New Zealand often have the most environmental ‘bads’ and less access to environmental ‘goods’. The index, that is now publicly available, is able to capture both inter-regional and local variations in accessibility to health-promoting and health-constraining environments and their combination. Results in this study further reinforce the need to embrace the multidimensional nature of neighbourhood and place not only when designing health-promoting places, but also when studying the effect of existing built environments on population health.

中文翻译：

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好的，坏的和环境：在新西兰制定基于地区的获取健康促进和健康约束环境的措施

与考虑孤立的影响相比，考虑多种环境影响的同时发生是对人口暴露的更准确反映，有助于理解环境，行为和健康之间的复杂相互作用。这项研究研究了绿色环境等环境“商品”和酒精店等环境“不良”如何共同发展，从而为新西兰制定了全国性的区域健康位置指数（HLI）。在广泛的环境暴露范围内，收集，处理和地理编码了全国范围的数据。限制健康的“坏食品”的代表是：（i）快餐店，（ii）外卖店，（iii）乳品店和便利店，（iv）酒类店，（v）和游戏场所。促进健康的“商品”的代表是：（i）绿色空间，（ii）蓝色空间，（iii）体育活动设施，（iv）水果和蔬菜商店，以及（v）超级市场。HLI是根据对环境领域的排名访问而开发的。然后，将HLI用于通过区域一级的剥夺和农村/城市分类对社会空间格局进行调查。结果表明，环境“好”和“坏”同时发生，并以区域一级的剥夺为特征。小说《人类生活指数》表明，新西兰最贫困的地区通常具有最多的环境“坏处”，而获得环境“商品”的机会较少。该指数现已公开提供，它能够捕获区域之间和区域之间在促进健康和健康方面的环境及其组合的可及性方面的差异。