We investigated the effects of living environment on the health status of urban residents using a quantitative model of social determinants of health, focusing on the cognitive mechanism of urban residents. A cross-sectional survey through an online questionnaire was conducted in Koto Ward, Tokyo, Japan (n = 1553). We developed a “social determinants of health” model based on the hypothetical model in the field of social epidemiology by structural equation modeling, which has three layers: social infrastructure layer (macro), community layer (meso), and personal layer (micro). The model also has five main latent factors: social environment, living environment, social capital, self-efficacy, and health status. We estimated the standardization total effects of all the latent factors for investigating the effect of urban living environment on the health status of the residents. We determined that the latent factors, social environment (0.606), living environment (0.723), social capital (0.156), and self-efficacy (0.356), affect the health status with regard to the standardization total effects. The urban living environment had the greatest effect on the health status of the residents among other latent factors. Furthermore, living environment (0.530) affected social capital the most, and social environment (0.500) affected self-efficacy the most. We conclude that improving the urban infrastructure, especially the urban living environment, can promote the health status of urban residents most effectively.

我们使用健康的社会决定因素的定量模型研究了居住环境对城市居民健康状况的影响，重点关注城市居民的认知机制。在日本东京江东区通过在线问卷进行横断面调查（n = 1553）。我们基于社会流行病学领域的假设模型，通过结构方程模型开发了“健康的社会决定因素”模型，该模型分为三层：社会基础层（宏观）、社区层（中观）和个人层（微观） . 该模型还有五个主要的潜在因素：社会环境、生活环境、社会资本、自我效能和健康状况。我们估计了所有潜在因素的标准化总效应，以调查城市生活环境对居民健康状况的影响。我们确定潜在因素，社会环境 (0.606)、生活环境 (0.723)、社会资本 (0.156) 和自我效能 (0.356)，在标准化总效应方面影响健康状况。城市居住环境对居民健康状况的影响最大。此外，生活环境（0.530）对社会资本的影响最大，社会环境（0.500）对自我效能的影响最大。我们得出结论，改善城市基础设施，尤其是城市人居环境，可以最有效地促进城市居民的健康状况。