Measuring the Impact of Environment on the Health of Large Cities.

Christine Stauber,Ellis Adams,John Heath,Scott Weaver,Ruiyan Luo,Dajun Dai,Amit Prasad,Richard Rothenberg,Megumi Kano

doi:10.3390/ijerph15061216

Abstract

The relative significance of indicators and determinants of health is important for local public health workers and planners. Of similar importance is a method for combining and evaluating such markers. We used a recently developed index, the Urban Health Index (UHI), to examine the impact of environmental variables on the overall health of cities. We used the UHI to rank 57 of the world’s largest cities (based on population size) in low- and middle-income countries. We examined nine variables in various combinations that were available from the Demographic and Health Surveys conducted in these countries. When arranged in ascending order, the distribution of UHIs follows the previously described pattern of gradual linear increase, with departures at each tail. The rank order of cities did not change materially with the omission of variables about women’s health knowledge or childhood vaccinations. Omission of environmental variables (a central water supply piped into homes, improved sanitation, and indoor solid fuel use) altered the rank order considerably. The data suggest that environmental indicators, measures of key household level risk to health, may play a vital role in the overall health of urban communities.

Highlights

There is growing evidence that environmental conditions will play an important role in global population health, especially in rapidly urbanizing low- and middle-income countries
We focused on the comparison of the Urban Health Index (UHI)-9 with 3 versions of a UHI-6, each of which contained a different combination of 6 of the 9 variables: UHI-6A included environmental and women’s health variables, UHI-6B included women’s health variables and childhood vaccine coverage variables, and UHI-6C included environmental and vaccine coverage variables
Using data on UHI-9, gross national income (GNI), and the Gini Index of income inequality (Supplementary Table S3), we examined the relationship of the UHI-9 to per capita GNI (Figure 3) and level of income inequality (Figure 4)

Summary

Introduction

There is growing evidence that environmental conditions will play an important role in global population health, especially in rapidly urbanizing low- and middle-income countries. The Lancet Commission on Pollution and Health estimated that pollution was responsible for 9 million premature deaths in 2015 alone, and that most of these (92%) occurred in low- and middle-income countries [1]. Cities are severely impacted by pollution, as they occupy increasingly important roles in housing dense populations and in economic and industrial activity. The health and well-being of urban dwellers result from the complex structures that shape their cities. As an early step in the process of disentangling these elements, we examined the relationship of urban health, income, and income inequality to try to classify patterns of urban “success” in 57 cities across the world

Methods

Discussion

Conclusion