Abstract
We investigated the association and underlying pathways between urban population density and mortality in a compact mid-sized university city in the Netherlands. Baseline data from the GLOBE cohort study (N = 10,120 residents of Eindhoven) were linked to mortality after 23 years of follow up and analyzed in multilevel models. Higher population density was modestly related to increased mortality, independently of baseline socioeconomic position and health. Higher population density was related to more active transport, more perceived urban stress and smoking. Increased active transport suppressed the mortality-increasing impact of higher population density. Overall, in dense cities with good infrastructure for walking and cycling, high population density may negatively impact mortality.
Highlights
Today, over 70% of Europeans reside in cities and this number is expected to increase in the coming decades (The World Bank, 2017)
The aim of this paper is to investigate the influence of population density on all-cause and cause specific mortality in a densely populated European city: the city of Eindhoven, a middle-sized city hosting a technical university situated in the South-East of the Netherlands, which grew from 190,000 inhabitants in 1990 to 227,100 inhabitants in 2017 - which makes it the fifth largest city in the Netherlands currently
The surveyed neighbourhoods had an average population density of 46.58 residents per hectare (4658 per km2), and an average of 118 people per neighbourhood participated in the GLOBE baseline measurement
Summary
Over 70% of Europeans reside in cities and this number is expected to increase in the coming decades (The World Bank, 2017). The paradox of intensification states that “ceteris paribus, urban intensification which increases population density will reduce per capita car use, with benefits to the global environment, but will increase concentrations of motor traffic, worsening the local environment in those locations where it occurs.”(Melia et al, 2011) living close together may be associated with more urban stress, e.g. due to noise pollution, vandalism, crime or lower quality housing These urban stressors could affect health in a negative way via perceived stress, a bad internal climate, or through unhealthy coping behaviours, such as smoking and alcohol consumption (Lederbogen et al, 2011; Peen et al, 2010; Putrik et al, 2015; Park and Iacocca, 2014). A closer proximity to shops and facilities may increase the proximity to tobacco and alcohol outlets which can enhance smoking or drinking behaviour (Finan et al, 2018; Fone et al, 2016)
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