Perceived built environment, health-related quality of life and health care utilization.

Paco Cerletti,Paola M Gasche-Soccal,Emmanuel Schaffner,Medea Imboden,Nicole Probst-Hensch,Ikenna C Eze,Dirk Keidel,Daiana Stolz,Thomas Rothe,Brecht Devleesschauwer

doi:10.1371/journal.pone.0251251

Abstract

Previous research has shown that the built environment plays a crucial role for health-related quality of life (HRQoL) and health care utilization. But, there is limited evidence on the independence of this association from lifestyle and social environment. The objective of this cross-sectional study was to investigate these associations, independent of the social environment, physical activity and body mass index (BMI). We used data from the third follow-up of the Swiss study on Air Pollution and Lung and Heart diseases In Adults (SAPALDIA), a population based cohort with associated biobank. Covariate adjusted multiple quantile and polytomous logistic regressions were performed to test associations of variables describing the perceived built environment with HRQoL and health care utilization. Higher HRQoL and less health care utilization were associated with less reported transportation noise annoyance. Higher HRQoL was also associated with greater satisfaction with the living environment and more perceived access to greenspaces. These results were independent of the social environment (living alone and social engagement) and lifestyle (physical activity level and BMI). This study provides further evidence that the built environment should be designed to integrate living and green spaces but separate living and traffic spaces in order to improve health and wellbeing and potentially save health care costs.

Highlights

The environment, which can range from the natural, built or physical environment to the social environment, serves as the context of life, and contributes to its quality in terms of health, well-being and diseases [1,2]
We investigated the effect of additional adjustment for the social environment— living status of the participants and social engagement; the specific questions are displayed in Table A1 in S1 Appendix
Few participants were current smoker (15%) and nearly two third (64%) met the WHO guidelines for physical activity. 52% of the study population reported being satisfied with their apartment and neighborhood

Summary

Introduction

The environment, which can range from the natural (greenspaces, lightly populated), built or physical environment (man-made, densely populated) to the social environment (family, peers, community engagement), serves as the context of life, and contributes to its quality in terms of health, well-being and diseases [1,2]. The built environment impacts exposures such as noise, environmental pollutants and general neighborhood conditions including infrastructural adequacy, which can facilitate or hinder physical and psychological functioning [1,2,3,4,5,6]. Multiple health outcomes including headaches, arthritis and various respiratory morbidities were associated to the built environment [7,8]. The study could not have been done without the help of the study participants, technical and administrative support and the medical teams and field workers at the local study sites

Methods

Results

Discussion

Conclusion