Abstract
Respiratory health is a focus of interdisciplinary studies involving urban planning and public health. Studies have noted that urban built environments have impacts on respiratory health by influencing air quality and human behavior such as physical activity. The aim of this paper was to explore the impact of urban built environments on respiratory health, taking chronic obstructive pulmonary disease (COPD) as one of the typical respiratory diseases for study. A cross-sectional study was conducted including all cases (N = 1511) of death from COPD in the high-density Jing’an district of Shanghai from 2001 to 2010. Proxy variables were selected to measure modifiable features of urban built environments within this typical high-density district in Shanghai. A geographically weighted regression (GWR) model was used to explore the effects of the built environment on the mortality of COPD and the geographical variation in the effects. This study found that land use mix, building width-height ratio, frontal area density, and arterial road density were significantly correlated to the mortality of COPD in high-density urban area. By identifying built environment elements adjustable by urban planning and public policy, this study proposes corresponding environmental intervention for respiratory health.
Highlights
Chronic obstructive pulmonary disease (COPD) is a major chronic respiratory disease, which ranked the third among all causes of death in 2016 according the World Health Organization (WHO) [1].The prevalence of COPD among population ages 20–39 and over 40 were 8.6% and 13.7%, respectively, in China [2]
As for road systems, both total road density and arterial road density were found to be positively correlated with COPD mortality
For spatial form, the frontal area density was negatively correlated with COPD mortality, while the building width-height ratio was positively correlated with
Summary
Chronic obstructive pulmonary disease (COPD) is a major chronic respiratory disease, which ranked the third among all causes of death in 2016 according the World Health Organization (WHO) [1].The prevalence of COPD among population ages 20–39 and over 40 were 8.6% and 13.7%, respectively, in China [2]. Epidemiological studies have demonstrated that the development of COPD is mainly affected by personal characteristics (e.g., genetics, age, gender, and smoking status), exposure to air pollution, socioeconomic status, and physical activity [3,4,5,6,7]. Heart failure, respiratory failure, chronic hypoxia and carbon dioxide retention, increased pulmonary artery pressure, and chronic impairment of lung function are risk factors of death for COPD patients [8,9,10,11,12], and the damage of COPD to human organs increases with aging [12,13,14,15]. Death from COPD presents its significant association with air pollutants [16,17]. The human exposure to air pollution is associated with increased
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