居民时空行为与环境污染暴露对健康影响的研究进展

1 引言

作为世界上最大的发展中国家,中国在过去的30年间经历了快速的城市化过程以及经济发展阶段,GDP 年均增长率达到9%左右,但同时也产生了各种环境污染问题,包括空气污染、水污染、噪音污染、土壤污染、工业废弃物污染等;其中空气污染(例如PM2.5)成为危害居民健康的重大环境问题之一(Gee et al, 2004)。相关研究表明,2010年中国由于空气污染所导致的过早死亡人数达120万左右,约占世界死亡人数总和的40%(Lim et al, 2012)。随着空气污染不断加剧,2014年初,北京市气象局频繁发布霾黄色预警;2015年12月,北京首次启动空气重污染红色预警,并对机动车出行等实施一系列限制措施。

长期以来,关于环境污染与健康的研究一直受到国内外学者的广泛关注。医学、环境流行病学、健康地理学等不同学科侧重点各异,分别从不同侧面对其进行研究。如图1所示,可将环境污染与健康研究主要划分为三大部分：一是宏观区域层面的环境污染与健康指标(如各种疾病发病率、死亡率等)的相关关系研究;二是通过个人时空行为将环境污染与健康关联起来,从微观层面上分别探讨基于个人时空行为轨迹的环境(或空气)污染暴露,以及居民日常交通出行的健康效应(如Body Mass Index, BMI);三是关注社会经济属性,重点探讨不同社会群体,尤其是黑人、儿童、低收入者等弱势群体所承受的环境负面影响,即环境公正(Environmental Justice)和健康不平等(Health Inequality)相关研究。

图1   环境污染与健康研究框架

Fig.1   A framework of research on environmental pollution and health

本文希望通过对国际层面的环境污染与健康研究进行较为系统的梳理与评价,关注生活质量、社会公正、空气污染等热点问题,为今后立足于中国城市独特背景的相关研究提供借鉴;同时,基于时空行为、环境公正等理论视角与学科前沿议题,为解释环境污染与健康影响之间的复杂性与多样性提供较为完整的分析框架,深入挖掘环境污染与居民时空行为的健康影响机理,为减少微观个体居民的环境污染暴露,发展更为公平的、有效的环境健康政策等提供科学依据。

2 宏观区域层面的环境污染与健康研究

该类研究主要运用环境医学以及流行病学等的理论与方法,基于宏观尺度,分析自然因素以及环境污染等因素的时空演变过程及对人类健康的影响规律,重点探讨不同环境因素与人类健康之间的暴露—效应(Dose-response)关系,为制定宏观层面的环境卫生标准以及预防措施等提供依据(杨林生等, 2010; 杨彦等, 2014)。其中,作为环境污染的重要成分之一,空气污染对疾病和健康的影响一直是多学科研究的重点内容。大量研究表明,细颗粒物如PM2.5是对人体健康危害最大的污染物,会对呼吸道疾病、心血管疾病等产生非常显著的负面影响(Pope, 2000; 阚海东等, 2002）。已有研究分别从空气污染与肺癌、慢性/急性支气管炎、心脑血管疾病、住院率、死亡率等与健康紧密相关的多个方面进行实证分析(Pope et al, 2002; Reynolds et al, 2003; Sun et al, 2005; Hart et al, 2013)。这些研究主要基于空间地域单元的视角,从宏观层面验证不同地方的空气污染浓度与汇总层面的各种健康指标之间的相关关系。

关于空气污染暴露的测度与评估是这类研究的重点内容之一。早期采用的方法是利用空气质量固定监测点的数据,基于居住区人口分布特征,假定居民一天24小时停留在同一地方,通常是居住地,利用临近性、替代性等方法间接测量大都市区尺度范围内不同地区居民的潜在空气污染暴露量(Mitchell et al, 2003)。这种间接替代性测度方法较为简单,并未考虑土地利用类型、交通网络、地形等因素,因此测量误差较大。随着计算机技术以及地理信息技术的发展,较为复杂的时空统计模型逐渐应用于空气污染的扩散、传播与测度研究,大大提升了空气污染暴露测度的准确性。近期研究主要根据环境监测点数据,考虑多种地理空间要素,如土地利用类型、人口密度、交通路网、气候等因素,通过对长时段、高精度的空气污染浓度值进行地理空间插值或土地利用回归建模,得出连续的空气污染浓度曲面,进而对微观环境下的居民污染暴露量进行测度与评估(Fang et al, 2011)。

此外,在全球风险因素及环境卫生标准方面,Lim等(2012)通过对世界上21个区域的67个风险因素进行较为系统的健康风险评估,发现从1990年到2010年间全球风险因素对疾病负担的贡献发生较大的转变,主要风险因素从引起儿童传染病的因素转变为引起成人非传染性疾病的风险因素;其中环境颗粒物污染成为全球第九大健康风险因素,但在东亚等国家,该风险因素排名第四(仅次于高血压,吸烟和饮食结构不合理)。由于环境细颗粒物引发的患病率显著增加(Pope et al, 2011),使得美国加紧制定环境细颗粒物标准,将其年平均值从15 μg/m3降低为12 μg/m3。相关研究表明新标准的实施会为其带来巨大的经济收益(主要可减少健康医疗和生活福利大量的运营成本)(U.S EPA, 2012)。相比之下,中国的环境颗粒物标准(35 μg/m3)远远高于WHO建议的年限值(10 μg/m3),对居民健康状况产生巨大威胁,需要综合评估环境保护的经济效益与健康效应,以制定更为合理的环境卫生标准。

总体而言,这类研究主要基于宏观尺度,探讨国家、区域等宏观区域层面的空气污染浓度与健康指标之间的相关关系,未考虑微观个体居民日常的活动—移动行为,因而本质上是一种潜在的空气污染暴露测度,并不能准确地反映个体居民真实的空气污染暴露情况,缺乏从微观层面对个体居民的环境污染暴露及健康效应的正面关注,未能深入挖掘影响居民健康状况的行为机理及其背后复杂的时空场景效应,因此未来研究需要从微观层面将环境、行为与健康关联起来进行综合分析。

3 以时空行为为媒介的环境污染与健康研究

3.1 城市建成环境对交通出行及健康的影响

城市建成环境与居民出行的关系一直是城市地理、城市规划、交通等多学科研究的重要内容。研究表明,城市空间结构(如人口密度、职住关系等)对居民的出行行为会产生显著的影响,不同类型居民的日常活动与行为模式表现为一定程度的社会与空间分异(柴彦威等, 2011; 孟斌等, 2012)。也有部分学者对社区形态、居民出行以及与空气污染有关的城市交通碳排放等进行实证分析(马静等, 2011; 秦波等, 2012; 曹小曙等, 2015)。但是,由于长期缺乏对居民健康状况的关注,关于交通出行与个体居民健康的研究总体而言较为缺乏(Handy et al, 2002; 鲁斐栋等, 2015)。步行、自行车等交通方式作为重要的体力活动形式之一,被认为是防治肥胖、心脑血管疾病等慢性病的有效方法,交通出行是影响人类健康状况的重要的、可干预的因素之一(Saelens et al, 2008; Alvarado et al, 2013)。

国际上关于交通出行与健康的研究近些年发展较快,成为热点问题之一。已有研究主要从体育运动学、城市规划、预防医学等多学科视角,分析交通方式、通勤时间等因素对居民身体健康状况产生的影响(Papas et al, 2007; Macmillan et al, 2013)。例如,基于美国时间利用调查以及饮食健康数据,Yang 等(2013)研究交通出行与身体质量指数(BMI)之间的关系,结果表明长时间使用小汽车出行能显著增加肥胖的比例,而步行、自行车等非机动方式则有助于降低肥胖。其他学者关于通勤方式、出行时间与睡眠质量、精神健康以及自评健康等之间的关系进行的实证研究表明,长距离通勤对健康产生负面影响(Greenberg et al, 2005; Hansson et al, 2011)。另外,也有少量关于收入水平、交通出行与健康关系的研究(Craig, 2005)。

总体而言,近期关于交通出行与健康效应的研究是在传统城市形态与交通出行研究基础上的延伸与拓展,此类研究重点关注城市建成环境方面,通过居民日常交通出行将城市规划与人类健康相关联,探索如何通过城市与交通规划减少道路交通事故和非传染性疾病,提高城市宜居性和居民健康状况。早期研究关注的城市建成环境指标包括密度(Density)、土地利用混合度(Diversity)及道路设计(Design)等,之后的研究逐渐在原有3D指标基础上扩展为6D指标,即增加目的地可达性(Destination Accessibility)、公共交通可达性(Distance to Transit)以及交通出行需求管理(Demand Management)等(Cervero et al, 1997; Ewing et al, 2010)。不同方面的城市与交通规划措施需要在不同层面执行。例如,区域层面涉及就业机会的分布,主要活动地点(医疗、教育、商场等)的可达性,以及停车场的布局和价格政策等;而社区层面则着重考虑居住密度、人行道设计以及公共交通可达性等方面。城市规划主要通过直接或间接地影响居民日常生活和交通模式的选择进而影响居民健康状况,包括肥胖症、心脑血管疾病、癌症等身体健康,以及压力、睡眠质量等精神健康。今后需通过发展紧凑城市,鼓励居民采用步行、自行车、公共交通等绿色出行方式,减少小汽车依赖,通过降低风险暴露量进而减少非传染性疾病及道路交通事故,提升居民整体健康状况及生活质量(Giles-Corti et al, 2016)。

相比之下,国内关于交通出行与健康的研究尚处于起步阶段。少量研究从城市规划的视角出发,分析建成环境对体力活动的影响,以及交通出行的健康效应等(朱菁等, 2014; 孙斌栋等, 2016)。但以上研究对城市建成环境及健康方面的测度较为简单,未能深入挖掘建成环境、交通出行及健康三者之间的内在关系。此外,没有考虑自然环境如空气污染对交通出行及健康的影响。例如,在空气质量良好情况下,步行、自行车等交通方式有利于增加体力活动和减少肥胖等,对健康产生正面影响;但在雾霾天,步行、自行车等交通方式的空气污染指数远大于出租车和私家车,采用步行、自行车方式出行的居民其空气污染暴露总量要显著大于采用小汽车出行的居民(Huang et al, 2012),进而会对其健康状况如呼吸道疾病等产生负面影响。由此可见,交通出行(如交通方式、出行距离、出行时间等）除对居民的健康状况产生直接影响外,还会通过空气污染暴露对居民的健康状况产生间接影响。环境、出行、健康之间存在一个非常复杂的关系。随着中国多数城市频繁发生雾霾现象,远距离、长时间的交通出行使得居民长期暴露在不利的环境中,在一定程度上会增加呼吸道疾病以及心血管疾病等的发病率(林雄斌等, 2015)。需要综合考虑交通出行与空气污染暴露对健康的影响。

3.2 居民日常行为模式与空气污染暴露的健康影响

空气污染暴露(Air Pollution Exposure)是指个体居民与空气污染物直接接触使其暴露在空气污染中的状态或过程(Ott, 1982)。交通出行作为居民日常生活的重要组成部分,除直接关联城市建成环境与健康效应之外,同时也是关联自然环境,如空气污染与健康的关键要素。不同交通方式微观环境(Transport Microenvironment)下的空气污染浓度具有显著差异(Adams et al, 2001),居民选择不同的交通出行模式使其承受的空气污染暴露也很不相同。同时,基于交通出行(尤其是早晚高峰时段)的空气污染暴露占居民日常污染暴露总量的较大比例,会对居民的健康状况,例如呼吸道疾病等产生更为直接和显著的影响(Gulliver et al, 2005)。

基于个体行为研究范式分析居民出行模式与微观行为环境下的空气污染暴露是国际时空行为研究的前沿课题。近年来,已有少量从微观层面研究居民基于交通出行的空气污染暴露的群体差异(Gulliver et al, 2005; Kaur et al, 2007)。例如,Huang等(2012)基于通勤者经常使用的两条固定线路,利用便携式PM2.5实时监测仪对不同交通方式在早晚高峰时段以及中午时段的空气污染指数进行18天的监测,从微观层面研究不同居民基于交通出行的空气污染暴露的社会差异。结果显示,使用出租车方式进行通勤的居民其空气污染暴露度要显著低于采用公共汽车和自行车通勤的居民。如果同时考虑空气污染物吸入率和出行时间,使用自行车方式出行的居民其空气污染暴露总量为最大。此外,Tsai等(2008)通过数名志愿者携带专业微粒质谱仪对台北地区不同通勤方式(如摩托车、小汽车、公交车、快速轨道交通等)进行多时段实时监测,显示不同交通方式的空气污染指数具有显著差异,小汽车为最低。长时间通勤也是影响使用公共交通方式出行的居民空气污染暴露总量较大的重要因素之一。

以上研究从微观层面揭示不同居民由于交通出行模式的不同导致在空气污染暴露程度上具有显著的差异。同时,也证明了空气质量固定监测点的数据并不能很好地代表不同交通方式微观环境下(尤其是早晚高峰时段)的空气污染浓度(Adams et al, 2001; Tsai et al, 2008; Huang et al, 2012)。例如,空气质量固定监测点的数据往往低估了自行车、摩托车以及地铁等交通方式的细颗粒物污染浓度,同时往往高估了出租车和私家车的PM2.5污染浓度。由此可见,不同的交通出行模式决定了不同的情景变量(Contextual Variables),不同类型居民由于其时空行为轨迹的不同会导致其承受的空气污染暴露具有显著差异(关美宝等, 2013; 郭文伯等, 2015),进而也会对其健康效应产生一定的影响。为此,需要从微观层面深入研究基于居民时空行为轨迹的空气污染暴露及其社会分异,并对健康效应的影响机理进行深入研究。

4 环境公正与健康不平等研究

4.1 环境公正

环境公正(Environmental Justice)是基于环境保护和社会公正相结合提出的一套理论概念,试图确保不同社会经济属性的人群,即不论其社会经济地位如何,都应承受同等程度由于社会经济发展所带来的环境负面影响(Cutter, 1995)。环境公正研究起源于美国,标志性事件是1982年在美国北卡罗来纳州一个大型黑人社区反对建立有毒垃圾填埋场。早期环境公正研究仅限于美国,研究对象聚焦于有色人种社区,主要关注垃圾填埋场和工业污染源的不均等分布(Laurent, 2011)。20世纪90年代后期传播到英国等欧洲国家,主要运用贫困(Deprivation)指标来研究环境不公正现象,关注的环境因素不仅包括垃圾填埋场、工业污染源,同时还拓展到空气质量、洪水灾害、道路交通事故,以及公园绿地的可达性等(Martuzzi et al, 2010)。相关研究表明,不同社会经济属性的人群所承受的环境负担存在显著差异。例如,在发达国家,尤其是英美国家,弱势群体(如低收入者、黑人等)通常更多地居住在空气污染比较严重的地方或者有害的工业设施、垃圾填埋场附近,较多地承受了环境负面影响,其健康状况也显著低于平均水平(Mitchell et al, 2003; Brulle et al, 2006)。上述研究,促进了西方发达国家环境公正理论的提出与发展,并制定相应的环境公正政策,以促进社会的可持续发展(UN ECE, 1999)。

然而,也有一些学者认为,在研究环境负担(Environmental Burden)的社会不平等同时,应考虑其社会分布的形成与发展,怎样才算是一种公平的社会分布等。例如,一些人住在有害的工业设施附近,从环境影响的角度来讲对他们是不公平的,但从其他角度考虑,这些人住在这里可以拥有更便宜的住房和享有更多的就业机会等。但在深入考虑环境污染对健康的负面影响的同时,环境公正的理论及研究就会得到更多的支持。Mitchell等(2003)的研究表明,2001年英国大约有250万人口居住在空气质量不符合国家标准的地区;这些人中有超过50%属于社会经济地位较低的群体,他们对空气污染所负的责任很小,但却承受着较多的环境负面影响。由于空气质量标准可看作为政府和市民的一种社会契约,用来保护公众健康,因此政策制定者和城市规划者一定要考虑环境因素所带来的健康不平等的负面影响。

总体而言,关于环境公正的研究表明,边缘社会群体(例如贫困人群、黑人和儿童)为恶劣的环境状况承受了更大的负担,包括垃圾污染、工业排放物及室外空气污染等(Mitchell et al, 2003; Brulle et al, 2006; Pearce et al, 2008)。基于环境公正视角的研究重点关注特定人群,如老年人、儿童、贫困人口以及黑人等弱势群体的环境健康效应,力图证明弱势群体对空气污染所负的责任很小,但却承受着较大程度的环境负面影响(Pearce et al, 2010; Chen et al, 2013)。近期环境公正研究还试图通过长时段的动态分析,了解环境不平等现象的演变过程。例如,Mitchell等(2015)通过对2001-2011年英国空气质量的动态变化以及不同社会人群所承受的污染暴露程度进行实证分析,发现富裕地区空气质量改善最大,而贫困地区空气质量却出现了下降,该状况将会进一步加剧英国的环境不公正以及健康不平等现象。

相比之下,中国是世界上最大的发展中国家,目前正在经历快速的工业化以及城市化进程,同时也产生了严重的环境污染问题,并对居民健康产生较大的负面影响。了解这些环境负担如何在不同的社会人群中分布,以及环境影响与居民健康状况之间的内在关系,对于更好地保护弱势群体(例如老年人、小孩和低收入群体)的健康具有至关重要的作用(Wong et al, 2008; 刘晓霞等, 2012)。目前国内少数关于环境公正的研究主要集中在空气污染的时空分布及对居民出行选择的影响等方面。例如,利用2010年北京两个典型郊区社区居民出行的GPS数据和活动日志调查数据,郭文伯等测度了不同交通方式环境下居民日常出行所受到的空气污染暴露度,并分析了不同人群对于PM2.5空气污染暴露度的差异性(郭文伯等, 2015)。研究结果表明,中低收入群体的出行空气污染暴露量要高于高收入群体,不同社会群体的空气污染暴露度存在显著差异。总体而言,目前大部分的环境公正研究主要集中于西方发达国家,尤其是美国和英国。然而,环境污染问题在发展中国家更为严峻,与公共健康相关的环境不平等现象也逐渐在发展中国家凸显,但关于环境公正与健康不平等的研究在发展中国家却开展较少。

4.2 健康不平等研究

世界卫生组织的相关报告表明,所有的城市环境都会产生“系统性的、社会性的、不公平的”健康不平等现象,这种现象在不同的国家和地区表现特征和不平等程度具有显著差异,一定程度上是由于不同地域的营养水平、人口结构及流行病传播造成的(WHO, 2010)。一般而言,社会经济更为贫困的地区传染性疾病和非传染性疾病的发病率和死亡率更高(Giles-Corti et al, 2016)。Holdaway(2010)对中国面临与环境相关的主要健康风险因素进行了概述,并得出结论：“需要深入研究环境问题、贫困和健康不平等之间的关系,总之,我们需要知道更多关于中国环境健康风险的地理和人口的差异性,以及找出哪些群体的健康状况更易受到环境问题的影响”。利用抽样调查数据或多时间序列观察数据,在国家、区域、城市等不同空间尺度上对环境污染和健康不平等的分析表明,环境污染的负面影响在社会、经济和人口层面上分布不均匀,脆弱或贫困群体,特别是老年人和流动人口等弱势群体承担着环境污染所导致的更大的健康风险和伤害。另外,社会经济属性与城市建成环境具有内在联系,不同社会经济属性的人群居住地(和就业地)具有显著差异,而不同地方的空间特征、可达性等背景因素对健康不平等产生重要影响(Chakraborty et al, 2011; Chen et al, 2013; Ma et al, 2017)。

此外,交通出行方式通过影响环境、社会以及行为等多种风险暴露因素,是造成城市内部和城市之间健康不平等现象产生、持续以及加剧的重要因素之一(Stevenson et al, 2016)。低收入者、老年人、残疾人等弱势群体较少能享受到由于小汽车发展而带来的交通便利、舒适度等各种福利,但他们却很有可能承受了更多的由于机动交通依赖所产生的各种负外部性,如空气污染、噪音污染、道路交通伤害等,对他们的健康状况产生严重危害(Giles-Corti et al, 2016)。在城市规划、交通发展以及环境健康政策等的制定与实施过程中,需要优先考虑弱势群体的需求与利益,创建适宜绿色出行的紧凑城市,减少健康不平等现象,促进社会可持续发展(Sallis et al, 2016)。

整体而言,目前关于环境公正与健康不平等的研究相对较为缺乏,尤其是在发展中国家,比如中国,关于环境负担的社会与空间分布,以及环境不公正现象如何对居民健康不平等产生影响的研究甚少。这主要原因是受数据限制。在中国,有关环境污染和健康数据是由不同的政府部分或机构为不同目的收集的,这些数据通常不能公开访问或跨平台共享(Holdaway, 2010)。环境污染统计数据(例如空气质量,工业废弃物,垃圾填埋场等）主要在较大空间地域单元如城市尺度上公布,因此无法用于研究城市内部不同人群暴露于环境危害的社会与空间差异性(Chen et al, 2013)。此外,中国没有针对所有人口进行的健康普查数据,而医院的病历数据也难以获取。因此,在缺乏政府支持的情况下,学者很难获得大样本微观空间尺度的环境风险和健康数据,在一定程度上限制了中国环境公正与健康不平等研究的开展(Ma et al, 2017)。

然而,作为世界上最大的发展中国家,中国是研究环境公正及健康不平等的重要案例地区。从环境公正的角度看,中国是一个追求社会主义市场经济的国家,也是世界上消费经济增长最快和中产阶级比例上升最快的国家,在政治上倡导平等主义原则,也就意味着所有环境不平等现象是不公正的。目前中国正面临重大的环境污染问题,严重危害居民的健康状况,在发展环境保护、公共卫生和更广泛的社会政策等方面,研究环境污染、健康不平等和人口结构之间的内在关系是紧迫而必要的。需要从微观层面深入了解各种环境危害的社会与空间分布,以及环境公正与健康不平等之间的内在关系,有助于帮助政府决策者更好地制定针对相应风险灾害、人群和地方的环境保护和公共健康政策。

5 结论与讨论

总体而言,已有环境污染与健康研究主要集中于宏观区域层面,以空间(通常是居住地)作为研究单元,缺乏从微观层面对个体居民、即“人”这一行为主体的时空行为及其健康效应的关注。例如,已有空气污染研究主要利用空气质量固定监测点数据验证不同地方的空气污染浓度与宏观区域层面的健康指标之间的关系,缺乏对微观个体居民活动—移动行为的正面关注,忽略交通出行作为连接空气污染暴露与健康机制这一关键要素,较少考虑微观个体居民时空行为模式及空气污染暴露等方面的社会分异,及其对健康不平等产生的影响。近年来,部分研究逐渐转向微观层面的分析,关注城市建成环境对居民出行模式及健康效应的影响,以及基于居民时空行为轨迹的空气污染暴露测度与评估。研究视角逐渐多样化,采用的方法也更为复杂,但整体缺乏对居民健康影响机理的微观行为分析及综合评价。

基于多学科研究范式,本文尝试构建环境、行为与健康研究的综合分析框架。如图2所示,时空行为是连接环境风险与健康效应的关键要素。城市建成环境主要通过直接影响居民日常生活方式及时空行为模式的选择,进而对居民健康状况,如肥胖症、心脑血管疾病、精神压力等产生间接影响。与此同时,自然环境如空气污染、噪音污染、水污染等因素除对居民健康状况产生直接影响之外,还可通过居民时空行为模式差异影响其环境污染暴露量,进而对居民健康状况,如呼吸道疾病等产生间接影响。由此可见,环境、行为与健康三者之间的关系非常复杂,需要多学科、跨视角的综合分析。未来研究可利用GPS、便携式环境质量监测仪、信息通讯网络等技术与手段,基于个体时空行为视角,将环境要素、居民日常行为模式与健康直接关联,从微观层面深入挖掘居民时空行为与环境污染暴露的健康影响机理,更好地理解影响居民健康效应的微观行为机制及环境因素,通过调控交通政策、规划措施等手段以及优化居民行为模式等鼓励居民绿色出行,减少环境污染暴露量,提高居民整体生活质量及健康状况,促进城市和社会的可持续发展。

图2   环境、行为与健康三者的关系

Fig.2   Relationship between environment, behavior, and health

此外,中国正在经历快速郊区化以及城市空间重构过程,不同类型居民由于受不同程度的宏观制度性因素(如户籍制度、郊区保障性住房政策)的影响以及自身经济能力的制约,居民在日常活动与行为模式等方面产生一定的社会与空间分异。在宏观的环境污染背景下,微观个体居民所承受的各种环境污染暴露量是否具有显著差异?低收入者、流动人口、老年人等弱势群体是否承受了较大程度的环境负面影响?不同类型居民在生活质量及健康状况等方面是否又具有显著的社会与空间分异?其影响机制是什么?这些问题的研究有助于从微观层面深化对环境公正的理解与认识,更好地挖掘环境公正与健康不平等之间的内在关系;同时也将为制定发展更为有效的、公正的环境与健康政策提供科学依据。

The authors have declared that no competing interests exist.

参考文献

[43]Ott W R.1982.

Concepts of human exposure to air pollution

[J]. Environment International, 7(3): 179-196.

https://doi.org/10.1016/0160-4120(82)90104-0    URL     [本文引用: 1]    摘要

In recent years, considerable attention has focused on the concept of “human exposure” to environmental pollutants, but different investigators seem to have developed different definitions of this concept and used different approaches for estimating it. This paper reviews a number of “exposure” studies in a single environmental medium—air pollution—to see how others have defined this concept in the literature. Many previous investigators unfortunately calculate “exposures” by relying on data from fixed air monitoring stations, and they assume that people are located in the same place, usually their residential address, throughout a 24-h period. However, a second body of literature shows that fixed air monitoring stations do not necessarily reflect human exposures, because concentrations observed indoors—in homes, offices, factories, and motor vehicles—differ from those observed at fixed stations, and people usually spend considerable time in these locations. In an effort to standardize the nomenclature dealing with exposures, a definition is proposed in which the pollutant must come into contact with the physical boundary of the person. Then, exposure of person i to pollutant concentration c is viewed as two events occurring jointly: person i is present at a particular location, and concentration c is present at the same location. Mathematical definitions for “integrated exposure,” “average exposure,” and “standardized exposure” with various averaging periods also are introduced. Finally, two different yet compatible research approaches are suggested for determining human exposures to air pollution.

[44]Papas M A, Alberg A J, Ewing R, et al.2007.

The built environment and obesity

[J]. Epidemiologic Reviews, 29(1): 129-143.

https://doi.org/10.1093/epirev/mxm009    URL     [本文引用: 1]    

[45]Pearce J R, Kingham S.2008.

Environmental inequalities in New Zealand: A national study of air pollution and environmental justice

[J]. Geoforum, 39(2): 980-993.

https://doi.org/10.1016/j.geoforum.2007.10.007    URL     [本文引用: 1]    摘要

Research has established that many socially deprived, low income and ethnic minority communities are exposed to disproportionately high levels of outdoor air pollution. Whilst there is a burgeoning literature documenting these environmental disparities, most previous studies have taken place in North America and few researchers have examined local scale variations across an entire country. Further, there has been little work systematically evaluating disparities in the local exposure to air pollution from different sources. In this New Zealand research we use mean annual estimates of outdoor particulate air pollution for different sources for neighbourhoods across urban New Zealand to evaluate whether air pollution varies between local areas of differing socioeconomic circumstances. We find that outdoor pollution levels are higher in socially deprived areas (using a neighbourhood measure of disadvantage) and neighbourhoods with a high proportion of low income households. However, although ethnicity was also related to mean total pollution, levels were elevated in areas where the proportion European was higher and other ethnic groups (including Māori) were lower. We also find that the disparities in pollution levels are specific to the pollution source. The results are discussed in the context of the policy framework in New Zealand, including the tensions fashioned by the Resource Management Act 1991, which have effectively ‘desocialised’ environmental concerns. We argue that the regulatory framework is fixated on ‘environmental bottom lines’ rather than social concerns that are integral to the environmental justice framework. Some priorities for future research into environmental justice in New Zealand are also considered.

[46]Pearce J R, Richardson E A, Mitchell R J, et al.2010.

Environmental justice and health: The implications of the socio-spatial distribution of multiple environmental deprivation for health inequalities in the United Kingdom

[J]. Transactions of the Institute of British Geographers, 35(4): 522-539.

https://doi.org/10.1111/j.1475-5661.2010.00399.x    URL     [本文引用: 1]    摘要

Abstract Understanding persistent and increasing spatial inequalities in health is an important field of academic enquiry for geographers, epidemiologists and public health researchers. Delivering robust explanations for the growing spatial divide in health offers potential for improving health outcomes across the social spectrum, but particularly among disadvantaged groups. One potential driver for the increasing geographical differences in health is the disparity in exposure to key characteristics of the physical environment that are either health promoting or health damaging. While the framework of ‘environmental justice’ has long been used to consider whether disadvantaged groups bear a disproportionate burden of environmental disamenities, perhaps surprisingly, the research fields of environmental justice and health inequalities have remained largely separate realms. In this paper we examine the confluence of environmental characteristics that potentially function as key mechanisms to account for the socio-economic gradient in health outcomes in the UK. We developed the Multiple Environmental Deprivation Index (MEDIx), an area-based measure that represented the multiple dimensions of health-related environmental disamenities for census wards across the UK. By comparing the index to an area measure of income deprivation, we found that, at the national level, multiple environmental deprivation increased as the degree of income deprivation rose. Using mortality records we also found that MEDIx had an effect on health that remained after taking into account the age, sex and socio-economic profile of each area. Area-level health progressively worsened as the multiple environmental deprivation increased. However, this effect was most pronounced in least income-deprived areas. Our findings emphasise the importance of the physical environment in shaping health, and the need to consider the social and political processes that lead to income-deprived populations bearing a disproportionate burden of multiple environmental deprivation. Future research should simultaneously consider the ‘triple jeopardy’ of social, health and environmental inequalities.

[47]Pope C A III.2000.

Invited commentary: Particulate matter-mortality exposure-response relations and threshold

[J]. American Journal of Epidemiology, 152(5): 407-412.

https://doi.org/10.1093/aje/152.5.407    URL     [本文引用: 1]    

[48]Pope C A III, Burnett R T, Thun M J, et al.2002.

Lung cancer, cardiopulmonary mortality, and long-term exposure to fine particulate air pollution

[J]. JAMA, 287(9): 1132-1141.

https://doi.org/10.1001/jama.287.9.1132.    URL    PMID: 11879110     [本文引用: 1]    摘要

Abstract CONTEXT: Associations have been found between day-to-day particulate air pollution and increased risk of various adverse health outcomes, including cardiopulmonary mortality. However, studies of health effects of long-term particulate air pollution have been less conclusive. OBJECTIVE: To assess the relationship between long-term exposure to fine particulate air pollution and all-cause, lung cancer, and cardiopulmonary mortality. DESIGN, SETTING, AND PARTICIPANTS: Vital status and cause of death data were collected by the American Cancer Society as part of the Cancer Prevention II study, an ongoing prospective mortality study, which enrolled approximately 1.2 million adults in 1982. Participants completed a questionnaire detailing individual risk factor data (age, sex, race, weight, height, smoking history, education, marital status, diet, alcohol consumption, and occupational exposures). The risk factor data for approximately 500 000 adults were linked with air pollution data for metropolitan areas throughout the United States and combined with vital status and cause of death data through December 31, 1998. MAIN OUTCOME MEASURE: All-cause, lung cancer, and cardiopulmonary mortality. RESULTS: Fine particulate and sulfur oxide--related pollution were associated with all-cause, lung cancer, and cardiopulmonary mortality. Each 10-microg/m(3) elevation in fine particulate air pollution was associated with approximately a 4%, 6%, and 8% increased risk of all-cause, cardiopulmonary, and lung cancer mortality, respectively. Measures of coarse particle fraction and total suspended particles were not consistently associated with mortality. CONCLUSION: Long-term exposure to combustion-related fine particulate air pollution is an important environmental risk factor for cardiopulmonary and lung cancer mortality.

[49]Pope C A III, Burnett R T, Turner M C, et al.2011.

Lung cancer and cardiovascular disease mortality associated with ambient air pollution and cigarette smoke: Shape of the exposure-response relationships

[J]. Environmental Health Perspectives, 119(11): 1616-1621.

https://doi.org/10.1289/ehp.1103639    URL    PMID: 21768054     [本文引用: 1]    摘要

Lung cancer and cardiovascular disease (CVD) mortality risks increase with smoking, secondhand smoke (SHS), and exposure to fine particulate matter 40 among long-term heavy smokers. Excess risks for CVD mortality increased steeply at low exposure levels and leveled off at higher exposures, reaching RRs of approximately 2-3 for cigarette smoking.The exposure-response relationship associated with PM60.63 is qualitatively different for lung cancer versus cardiovascular mortality. At low exposure levels, cardiovascular deaths are projected to account for most of the burden of disease, whereas at high levels of PM60.63, lung cancer becomes proportionately more important.

[50]Reynolds P, von Behren J, Gunier R B, et al.2003.

Childhood cancer incidence rates and hazardous air pollutants in California: An exploratory analysis

[J]. Environmental Health Perspectives, 111(4): 663-668.

https://doi.org/10.1289/ehp.5986    URL    PMID: 1241461     [本文引用: 1]    摘要

Hazardous air pollutants (HAPs) are compounds shown to cause cancer or other adverse health effects. We analyzed population-based childhood cancer incidence rates in California (USA) from 1988 to 1994, by HAP exposure scores, for all California census tracts. For each census tract, we calculated exposure scores by combining cancer potency factors with outdoor HAP concentrations modeled by the U.S. Environmental Protection Agency. We evaluated the relationship between childhood cancer rates and exposure scores for 25 potentially carcinogenic HAPs emitted from mobile, area, and point sources and from all sources combined. Our study period saw 7,143 newly diagnosed cancer cases in California; of these, 6,989 (97.8%) could be assigned to census tracts and included in our analysis. Using Poisson regression, we estimated rate ratios (RRs) adjusted for age, race/ethnicity, and sex. We found little evidence for elevated cancer RRs for all sites or for gliomas among children living in high-ranking combined-source exposure areas. We found elevated RRs and a significant trend with increasing exposure level for childhood leukemia in tracts ranked highest for exposure to the combined group of 25 HAPs (RR = 1.21; 95% confidence interval, 1.03, 1.42) and in tracts ranked highest for point-source HAP exposure (RR = 1.32; 95% confidence interval, 1.11, 1.57). Our findings suggest an association between increased childhood leukemia rates and high HAP exposure, but studies involving more comprehensive exposure assessment and individual-level exposure data will be important for elucidating this relationship.

[51]Saelens B E, Handy S L.2008.

Built environment correlates of walking: A review

[J]. Medicine and Science in Sports and Exercise, 40(7 Suppl.): S550-S566.

https://doi.org/10.1249/MSS.0b013e31817c67a4    URL    PMID: 2921187     [本文引用: 1]    摘要

INTRODUCTION: The past decade has seen a dramatic increase in empirical investigation into the relations between built environment and physical activity. To create places that facilitate and encourage walking, practitioners need an understanding of the specific characteristics of the built environment that correlate most strongly with walking. This article reviews evidence on the built environment correlates with walking. METHOD: Included in this review were 13 reviews published between 2002 and 2006 and 29 original studies published in 2005 and up through May 2006. Results were summarized based on specific characteristics of the built environment and transportation walking versus recreational walking. RESULTS: Previous reviews and newer studies document consistent positive relations between walking for transportation and density, distance to nonresidential destinations, and land use mix; findings for route/network connectivity, parks and open space, and personal safety are more equivocal. Results regarding recreational walking were less clear. CONCLUSIONS: More recent evidence supports the conclusions of prior reviews, and new studies address some of the limitations of earlier studies. Although prospective studies are needed, evidence on correlates appears sufficient to support policy changes.

[52]Sallis J F, Bull F, Burdett R, et al.2016.

Use of science to guide city planning policy and practice: How to achieve healthy and sustainable future cities

[J]. The Lancet, 388: 2936-2947.

https://doi.org/10.1016/S0140-6736(16)30068-X    URL    PMID: 27671670     [本文引用: 1]    摘要

Land-use and transport policies contribute to worldwide epidemics of injuries and non-communicable diseases through traffic exposure, noise, air pollution, social isolation, low physical activity, and sedentary behaviours. Motorised transport is a major cause of the greenhouse gas emissions that are threatening human health. Urban and transport planning and urban design policies in many cities do not reflect the accumulating evidence that, if policies would take health effects into account, they could benefit a wide range of common health problems. Enhanced research translation to increase the influence of health research on urban and transport planning decisions could address many global health problems. This paper illustrates the potential for such change by presenting conceptual models and case studies of research translation applied to urban and transport planning and urban design. The primary recommendation of this paper is for cities to actively pursue compact and mixed-use urban designs that encourage a transport modal shift away from private motor vehicles towards walking, cycling, and public transport. This Series concludes by urging a systematic approach to city design to enhance health and sustainability through active transport and a move towards new urban mobility. Such an approach promises to be a powerful strategy for improvements in population health on a permanent basis.

[53]Stevenson M, Thompson J, de Sá T H, et al.2016.

Land use, transport, and population health: Estimating the health benefits of compact cities

[J]. The Lancet, 388: 2925-2935.

https://doi.org/10.1016/S0140-6736(16)30067-8    URL    PMID: 27671671     [本文引用: 1]    摘要

Using a health impact assessment framework, we estimated the population health effects arising from alternative land-use and transport policy initiatives in six cities. Land-use changes were modelled to reflect a compact city in which land-use density and diversity were increased and distances to public transport were reduced to produce low motorised mobility, namely a modal shift from private motor vehicles to walking, cycling, and public transport. The modelled compact city scenario resulted in health gains for all cities (for diabetes, cardiovascular disease, and respiratory disease) with overall health gains of 420-826 disability-adjusted life-years (DALYs) per 10064000 population. However, for moderate to highly motorised cities, such as Melbourne, London, and Boston, the compact city scenario predicted a small increase in road trauma for cyclists and pedestrians (health loss of between 34 and 41 DALYs per 10064000 population). The findings suggest that government policies need to actively pursue land-use elements-particularly a focus towards compact cities-that support a modal shift away from private motor vehicles towards walking, cycling, and low-emission public transport. At the same time, these policies need to ensure the provision of safe walking and cycling infrastructure. The findings highlight the opportunities for policy makers to positively influence the overall health of city populations.Copyright 08 2016 Elsevier Ltd. All rights reserved.

[54]Sun Q H, Wang A X, Jin X M, et al.2005.

Long-term air pollution exposure and acceleration of atherosclerosis and vascular inflammation in an animal model

[J]. JAMA, 294(23): 3003-3010.

https://doi.org/10.1001/jama.294.23.3003    URL     [本文引用: 1]    

[55]Tsai D H, Wu Y J, Chan C C.2008.

Comparisons of commuter's exposure to particulate matters while using different transportation modes

[J]. Science of the Total Environment, 405(1-3): 71-77.

https://doi.org/10.1016/j.scitotenv.2008.06.016    URL    PMID: 18657850     [本文引用: 1]    摘要

This study compared commuters' exposures to particulate matter (PM) while using motorcycles, cars, buses, and the mass rapid transit (MRT) on the same routes in Taipei, Taiwan. Motorcycle commuters who had the shortest travel time (28.4 ± 4.202min) were exposed to the highest concentrations of PM 10 (112.8 ± 38.302μg/m 3), PM 2.5 (67.5 ± 31.302μg/m 3), and PM 1.0 (48.4 ± 24.702μg/m 3) among four commuting modes. By contrast, car commuters were exposed to the lowest PM concentrations and had the second shortest travel time among them. Motorcycle commuters' high trip-averaged PM concentrations and bus commuters' long commuting time (43.1 ± 5.102min) resulted in their high whole-trip PM exposures. Size fractions of PM were relatively consistent across PM exposures of the four commuting modes with fine particles (PM 2.5) contributing to 53–60% of PM 10 and submicron particle (PM 1) contributing to 39–43% of PM 10. Motorcycles idled at traffic lights and bus doors opened at stops increased commuters' PM exposures. Fixed-site monitoring data explained well the variation of whole-trip PM 10 exposure of car ( r 2 = 0.63) and MRT ( r 2 = 0.52) commuters, and of whole-trip PM 2.5 exposure of car ( r 2 = 0.76), MRT ( r 2 = 0.73) and motorcycle ( r 2 = 0.64) commuters in regression analyses. The coefficients (slopes) of regression between fixed-site monitoring data and PM 2.5 exposures were less than 1 for car and MRT commuters but greater than 1 for motorcycle commuters. In conclusion, proximity to traffic emissions contributes to a person's high PM exposure during his or her daily commute. This proximity occurs when people use motorcycles on roads and when bus/MRT commuters walk or wait along commuting routes. Fixed-site air monitoring data can under-estimate motorcycle commuters' PM 2.5 exposures but over-estimate car and MRT commuters' PM 2.5 exposures.

[56]UN ECE.1999.

Convention on access to information, public participation in decision-making and access to justice in environmental matters

[R]. Geneva, Switzerland: United Nations Economic Commission for Europe.

[本文引用: 1]    

[1]曹小曙, 杨文越, 黄晓燕. 2015.

基于智慧交通的可达性与交通出行碳排放: 理论与实证

[J]. 地理科学进展, 34(4): 418-429.

https://doi.org/10.11820/dlkxjz.2015.04.003    URL     [本文引用: 1]    摘要

信息与通信技术的发展推动了智慧交通建设,并将进一步提高城市交通可达性和影响居民出行。在全球应对气候变化、减少碳排放的共识背景下,由于"智慧交通—可达性—出行行为(碳排放)"间复杂的影响作用机制,已有的研究难以判断智慧化背景下的城市交通可达性提高将增加抑或减少出行碳排放。如何通过提高城市交通可达性来缓解交通拥堵,保障城市交通运输系统的有效运行,并提高居民出行效率,减少出行碳排放是当前中国智慧交通发展面临的关键问题之一。针对以上科学问题,本文尝试提出基于智慧交通的可达性与交通出行碳排放的理论框架,并以广州为研究案例地,研究了社区居民通勤碳排放特征及其影响机理,社区出行低碳指数格局及其影响因素的空间异质性,以及基于碳排放—位置分配模型的公共中心规划支持系统设计与应用,可为今后的相关研究提供借鉴。

[Cao X S, Yang W Y, Huang X Y.2015.

Accessibility and CO2 emissions from travel of smart transportation: Theory and empirical studies

[J]. Progress in Geography, 34(4): 418-429.]

https://doi.org/10.11820/dlkxjz.2015.04.003    URL     [本文引用: 1]    摘要

信息与通信技术的发展推动了智慧交通建设,并将进一步提高城市交通可达性和影响居民出行。在全球应对气候变化、减少碳排放的共识背景下,由于"智慧交通—可达性—出行行为(碳排放)"间复杂的影响作用机制,已有的研究难以判断智慧化背景下的城市交通可达性提高将增加抑或减少出行碳排放。如何通过提高城市交通可达性来缓解交通拥堵,保障城市交通运输系统的有效运行,并提高居民出行效率,减少出行碳排放是当前中国智慧交通发展面临的关键问题之一。针对以上科学问题,本文尝试提出基于智慧交通的可达性与交通出行碳排放的理论框架,并以广州为研究案例地,研究了社区居民通勤碳排放特征及其影响机理,社区出行低碳指数格局及其影响因素的空间异质性,以及基于碳排放—位置分配模型的公共中心规划支持系统设计与应用,可为今后的相关研究提供借鉴。

[57]U.S. Environmental Protection Agency (EPA). 2012.

Regulatory impact analysis for the final revisions to the national ambient air quality standards for particulate matter

[R]. EPA-452/R-12-005, Research Triangle Park, NC: U.S. EPA Office of Air Quality Planning and Standards Health and Environmental Impacts Division.

[本文引用: 1]    

[58]Wong C M, Ou C Q, Chan K P, et al.2008.

The effects of air pollution on mortality in socially deprived urban areas in Hong Kong, China

[J]. Environmental Health Perspectives, 116(9): 1189-1194.

https://doi.org/10.1289/ehp.10850    URL    PMID: 2535621     [本文引用: 1]    摘要

Poverty is a major determinant of population health, but little is known about its role in modifying air pollution effects. We set out to examine whether people residing in socially deprived communities are at higher mortality risk from ambient air pollution. This study included 209 tertiary planning units (TPUs), the smallest units for town planning in the Special Administrative Region of Hong Kong, China. The socioeconomic status of each TPU was measured by a social deprivation index (SDI) derived from the proportions of the population witha) unemployment,b) monthly household income < US$250,c) no schooling at all,d) one-person household,e) never-married status, andf) subtenancy, from the 2001 Population Census. TPUs were classified into three levels of SDI: low, middle, and high. We performed time-series analysis with Poisson regression to examine the association between changes in daily concentrations of ambient air pollution and daily number of deaths in each SDI group for the period from January 1996 to December 2002. We evaluated the differences in pollution effects between different SDI groups using a case-only approach with logistic regression. We found significant associations of nitrogen dioxide, sulfur dioxide, particulate matter with aerodynamic diameter < 10 m, and ozone with all nonaccidental and cardiovascular mortality in areas of middle or high SDI (p< 0.05). Health outcomes, measured as all nonaccidental, cardiovascular, and respiratory mortality, in people residing in high SDI areas were more strongly associated with SO2and NO2compared with those in middle or low SDI areas. Neighborhood socioeconomic deprivation increases mortality risks associated with air pollution.

[59]World Health Organization (WHO). 2010.

UN-Habitat. Hidden cities: unmasking and overcoming health inequities in urban settings

[R]. Geneva, Switzerland: WHO.

[本文引用: 1]    

[60]Yang J W, French S.2013.

The travel: Obesity connection: Discerning the impacts of commuting trips with the perspective of individual energy expenditure and time use

[J]. Environment and Planning B: Planning and Design, 40(4): 617-629.

https://doi.org/10.1068/b38076    URL    摘要

It has been widely reported that individual travel has significant implications for obesity. In this research we try to clarify the connection between travel and obesity from an individual energy-expenditure perspective. It is hypothesized here that individual travel affects the likelihood of becoming obese not only directly through a reliance on automobile-based travel that requires low amounts of individual energy expenditure, but also indirectly through the fatigue and stress stemming from driving, which reduces time available for physical activities and exercise. We use the American Time Use Survey (http://www.bls.gov/tus/) for 2003-08 and its Eating and Health Module for 2006 and 2007 to examine individual travel, energy expenditure, and obesity. Empirical analysis illustrates how individual body mass index (BMI) and individual travel are correlated and how this correlation can be explained from the perspective of individual energy expenditure. In addition, a distinction is drawn between commuting and noncommuting trips: commuting trips have a relatively larger impact on individual BMI. Analysis results point to a potential to reduce obesity rates through planning efforts at the regional level.

[2]柴彦威, 张艳, 刘志林. 2011.

职住分离的空间差异性及其影响因素研究

[J]. 地理学报, 66(2): 157-166.

https://doi.org/10.11821/xb201102002    URL     [本文引用: 1]    摘要

制度转型与空间重构背景下,中国大城市的居住与就业空间关系发生明显变化,职住分离现象逐渐凸显。尽管城市地理学者逐步关注转型期城市居住与就业空间关系的变化对居民通勤行为的影响,然而深入探讨微观个体所承受的职住分离程度的差异性及其影响因素的实证研究仍然缺乏。基于对北京城市520户家庭、806个通勤样本的问卷调查数据,本文借助多元回归模型验证了居住区类型、家庭及住房状况、以及其他社会经济属性等居民职住分离程度差异性的影响,从而折射城市转型过程中宏观制度性及结构性因素（如土地市场化改革、住房政策、单位制度改革、城市空间扩展等）对个体日常生活经历差异性的影响。

[Chai Y W, Zhang Y, Liu Z L.2011.

Spatial differences of home-work separation and the impacts of housing policy and urban sprawl: Evidence from household survey data in Beijing

[J]. Acta Geographica Sinica, 66(2): 157-166.]

https://doi.org/10.11821/xb201102002    URL     [本文引用: 1]    摘要

制度转型与空间重构背景下,中国大城市的居住与就业空间关系发生明显变化,职住分离现象逐渐凸显。尽管城市地理学者逐步关注转型期城市居住与就业空间关系的变化对居民通勤行为的影响,然而深入探讨微观个体所承受的职住分离程度的差异性及其影响因素的实证研究仍然缺乏。基于对北京城市520户家庭、806个通勤样本的问卷调查数据,本文借助多元回归模型验证了居住区类型、家庭及住房状况、以及其他社会经济属性等居民职住分离程度差异性的影响,从而折射城市转型过程中宏观制度性及结构性因素（如土地市场化改革、住房政策、单位制度改革、城市空间扩展等）对个体日常生活经历差异性的影响。

[3]关美宝, 郭文伯, 柴彦威. 2013.

人类移动性与健康研究中的时间问题

[J]. 地理科学进展, 32(9): 1344-1351.

https://doi.org/10.11820/dlkxjz.2013.09.004    URL    Magsci     [本文引用: 1]    摘要

随着地理信息科学的发展,地理学围绕着社会热点问题不断向其他学科交叉渗透,同时学科的交叉也为地理学研究本身注入了热量。空间一直是地理学研究中的基本问题,而时间与空间密不可分,从时间维度研究人类移动性及其丰富内涵具有重要意义。本文在总结人类移动性热点问题的基础上,重点从时间维度探讨了可达性、出行体验与幸福感、人类健康与疾病等问题的研究内容和方法,并从低收入者社区医疗保健可达性研究和阿帕拉契亚乡村地区吸烟者影响因素研究等案例进行详细阐释,最后对人类移动性与健康研究的发展方向进行了展望。

[Kwan M P, Guo W B, Chai Y W.2013.

Temporally integrated human mobility and health research

[J]. Progress in Geography, 32(9): 1344-1351.]

https://doi.org/10.11820/dlkxjz.2013.09.004    URL    Magsci     [本文引用: 1]    摘要

随着地理信息科学的发展,地理学围绕着社会热点问题不断向其他学科交叉渗透,同时学科的交叉也为地理学研究本身注入了热量。空间一直是地理学研究中的基本问题,而时间与空间密不可分,从时间维度研究人类移动性及其丰富内涵具有重要意义。本文在总结人类移动性热点问题的基础上,重点从时间维度探讨了可达性、出行体验与幸福感、人类健康与疾病等问题的研究内容和方法,并从低收入者社区医疗保健可达性研究和阿帕拉契亚乡村地区吸烟者影响因素研究等案例进行详细阐释,最后对人类移动性与健康研究的发展方向进行了展望。

[4]郭文伯, 张艳, 柴彦威. 2015.

城市居民出行的空气污染暴露测度及其影响机制: 北京市郊区社区的案例分析

[J]. 地理研究, 34(7): 1310-1318.

https://doi.org/10.11821/dlyj201507010    URL     [本文引用: 2]    摘要

健康一直是社会各界广泛关注的议题，出行污染暴露研究是人类移动性与健康研究结合的新热点.本文利用2010北京郊区居民GPS出行与活动调查数据和不同交通环境下PM2.5和CO污染暴露强度数据对居民出行空气污染暴露进行测度并分析了郊区居民不同人群PM2.s污染暴露度和CO污染暴露度差异，并通过构建结构方程模型解释和分析影响郊区居民PM2.s污染暴露度和CO污染暴露度的机制.研究发现：(1)郊区社区不同人群每人每天平均CO污染暴露度和PM2.5污染暴露度，中等收入群体显著高于低收入群体和高收入群体，租房者显著高于住房者；未婚群体PM2.s污染暴露度显著高于已婚群体，驾照持有群体CO污染暴露度高于无驾照群体；(2)机动化出行率决定出行总时间和出行次数，与出行总时问和出行次数成正关系，说明机动化出行率高的居民在出行机会选择上拥有更多机会，同样增加了出行时间，另一个可能的原因是机动化出行率紧选取汽车出行次数占一天出行次数的比例，城市内汽车出行速度与公共交通速度接近，且一般低于地铁出行速度；职住距离与每日出行总时间成正关系，职住距离增加会增加机动化出行率，机动化出行率同职住距离、出行时间、出行次数一样增加了郊区居民每日PM2.s和CO污染暴露程度；(3)家里有18岁以下小孩需要照料时会显著增加家长出行过程的PM2.5污染暴露度和CO污染暴露度，私家车或驾照状况是影响机动化出行的重要因素，进而影响郊区居民出行过程中的PM2.s污染暴露度和CO污染暴露度；收入状况仅对PM2.s污染暴露度存在显著性影响，教育程度差异对CO污染暴露度有显著性影响.最后在总结文章不足的基础上对研究进行总结和展望，鼓励健康城市规划与管理，引导健康的生活方式，提升居民健康水平、促进健康公平.

[Guo W B, Zhang Y, Chai Y W.2015.

Measurement of residents' daily travel air pollution exposure and its mechanism: A case study of suburban communities in Beijing

[J]. Geographical Research, 34(7): 1310-1318.]

https://doi.org/10.11821/dlyj201507010    URL     [本文引用: 2]    摘要

健康一直是社会各界广泛关注的议题，出行污染暴露研究是人类移动性与健康研究结合的新热点.本文利用2010北京郊区居民GPS出行与活动调查数据和不同交通环境下PM2.5和CO污染暴露强度数据对居民出行空气污染暴露进行测度并分析了郊区居民不同人群PM2.s污染暴露度和CO污染暴露度差异，并通过构建结构方程模型解释和分析影响郊区居民PM2.s污染暴露度和CO污染暴露度的机制.研究发现：(1)郊区社区不同人群每人每天平均CO污染暴露度和PM2.5污染暴露度，中等收入群体显著高于低收入群体和高收入群体，租房者显著高于住房者；未婚群体PM2.s污染暴露度显著高于已婚群体，驾照持有群体CO污染暴露度高于无驾照群体；(2)机动化出行率决定出行总时间和出行次数，与出行总时问和出行次数成正关系，说明机动化出行率高的居民在出行机会选择上拥有更多机会，同样增加了出行时间，另一个可能的原因是机动化出行率紧选取汽车出行次数占一天出行次数的比例，城市内汽车出行速度与公共交通速度接近，且一般低于地铁出行速度；职住距离与每日出行总时间成正关系，职住距离增加会增加机动化出行率，机动化出行率同职住距离、出行时间、出行次数一样增加了郊区居民每日PM2.s和CO污染暴露程度；(3)家里有18岁以下小孩需要照料时会显著增加家长出行过程的PM2.5污染暴露度和CO污染暴露度，私家车或驾照状况是影响机动化出行的重要因素，进而影响郊区居民出行过程中的PM2.s污染暴露度和CO污染暴露度；收入状况仅对PM2.s污染暴露度存在显著性影响，教育程度差异对CO污染暴露度有显著性影响.最后在总结文章不足的基础上对研究进行总结和展望，鼓励健康城市规划与管理，引导健康的生活方式，提升居民健康水平、促进健康公平.

[5]阚海东, 陈秉衡. 2002.

我国大气颗粒物暴露与人群健康效应的关系

[J]. 环境与健康杂志, 19(6): 422-424.

https://doi.org/10.3969/j.issn.1001-5914.2002.06.002    URL     [本文引用: 1]    摘要

目的综合分析我国大气颗粒物暴露与人群健康效应的流行病学资料,以获取我国颗粒物-健康效应的暴露-反应关系.方法在联机检索文献的基础上,确定各健康效应终点的定量暴露-反应关系,多篇文献的综合评价采用Meta分析的方法进行.结果建立了从发病到死亡各个健康效应终点上,大气颗粒物浓度每升高一定单位,人群不良健康效应发生的相对危险度.结论该文建立的暴露-反应关系,可用于我国大气颗粒物污染的健康危险度评价工作.

[Kan H D, Chen B H.2002.

Analysis of exposure-response relationships of air particulate matter and adverse health outcomes in China

[J]. Journal of Environment and Health, 19(6): 422-424.]

https://doi.org/10.3969/j.issn.1001-5914.2002.06.002    URL     [本文引用: 1]    摘要

目的综合分析我国大气颗粒物暴露与人群健康效应的流行病学资料,以获取我国颗粒物-健康效应的暴露-反应关系.方法在联机检索文献的基础上,确定各健康效应终点的定量暴露-反应关系,多篇文献的综合评价采用Meta分析的方法进行.结果建立了从发病到死亡各个健康效应终点上,大气颗粒物浓度每升高一定单位,人群不良健康效应发生的相对危险度.结论该文建立的暴露-反应关系,可用于我国大气颗粒物污染的健康危险度评价工作.

[6]林雄斌, 杨家文. 2015.

北美都市区建成环境与公共健康关系的研究述评及其启示

[J]. 规划师, 31(6): 12-19.

https://doi.org/10.3969/j.issn.1006-0022.2015.06.002    URL     [本文引用: 1]    摘要

我国工业化、城市化和机动化的快速发展显著改变了城市建成环境的特征,带来居民体力活动缺乏和环境污染等问题,导致肥胖、心血管等慢性疾病的增加。建成环境作为城市规划建设在空间上的反映,是影响居民体力活动和健康的重要载体。从建成环境规划与优化的视角来鼓励公众体力活动、提升健康水平,成为国外城市规划新的理念。北美都市区对"建成环境—公共健康"互动关系的研究已有丰富成果,并实施应对健康问题的体力活动建议导则与建成环境规划设计策略。研究重点论述土地利用、交通系统等建成环境因素对体力活动和健康的影响作用机制,进而借鉴北美都市区的公共健康问题的规划应对,为缓解我国城市健康问题和推进健康城市建成环境规划提供借鉴。

[Lin X B, Yang J W.2015.

Built environment and public health review and planning in North American metropolitan areas

[J]. Planners, 31(6): 12-19.]

https://doi.org/10.3969/j.issn.1006-0022.2015.06.002    URL     [本文引用: 1]    摘要

我国工业化、城市化和机动化的快速发展显著改变了城市建成环境的特征,带来居民体力活动缺乏和环境污染等问题,导致肥胖、心血管等慢性疾病的增加。建成环境作为城市规划建设在空间上的反映,是影响居民体力活动和健康的重要载体。从建成环境规划与优化的视角来鼓励公众体力活动、提升健康水平,成为国外城市规划新的理念。北美都市区对"建成环境—公共健康"互动关系的研究已有丰富成果,并实施应对健康问题的体力活动建议导则与建成环境规划设计策略。研究重点论述土地利用、交通系统等建成环境因素对体力活动和健康的影响作用机制,进而借鉴北美都市区的公共健康问题的规划应对,为缓解我国城市健康问题和推进健康城市建成环境规划提供借鉴。

[7]刘晓霞, 邹小华, 王兴中. 2012.

国外健康地理学研究进展

[J]. 人文地理, 27(3): 23-27.

[本文引用: 1]    

[Liu X X, Zou X H, Wang X Z.2012.

Progress of health geography in Western Countries

[J]. Human Geography, 27(3): 23-27.]

[本文引用: 1]    

[8]鲁斐栋, 谭少华. 2015.

建成环境对体力活动的影响研究: 进展与思考

[J]. 国际城市规划, 30(2): 62-70.

[本文引用: 1]    

[Lu F D, Tan S H.2015.

Built environment's influence on physical activity: Review and thought

[J]. Urban Planning International, 30(2): 62-70.]

[本文引用: 1]    

[9]马静, 柴彦威, 刘志林. 2011.

基于居民出行行为的北京市交通碳排放影响机理

[J]. 地理学报, 66(8): 1023-1032.

https://doi.org/10.11821/xb201108002    URL     [本文引用: 1]    摘要

近年来低碳城市逐渐成为众多学科关注的焦点所在,国内外学者从多个角度对其开展一系列的理论与实证研究,但从微观层面深入探讨城市交通碳排放的影响机理的研究相对较为缺乏。利用北京市居民活动日志调查获取的第一手数据,基于居民日常出行行为计算微观层面的城市交通碳排放,并采用结构方程模型深入挖掘居住空间、个体行为以及交通碳排放三者之间的内在关系。结果表明,出行距离、机动出行概率对交通碳排放产生显著的正效应,而出行频率的影响并不显著;同时,出行结构的影响要远远大于出行总量的影响。另外,城市空间结构对城市交通碳排放产生显著影响,单位社区居民的出行行为整体具有＂低碳＂性质,应从低碳视角对单位社区进行重新审视。

[Ma J, Chai Y W, Liu Z L.2011.

The mechanism of CO2 emissions from urban transport based on individuals' travel behavior in Beijing

[J]. Acta Geographica Sinica, 66(8): 1023-1032.]

https://doi.org/10.11821/xb201108002    URL     [本文引用: 1]    摘要

近年来低碳城市逐渐成为众多学科关注的焦点所在,国内外学者从多个角度对其开展一系列的理论与实证研究,但从微观层面深入探讨城市交通碳排放的影响机理的研究相对较为缺乏。利用北京市居民活动日志调查获取的第一手数据,基于居民日常出行行为计算微观层面的城市交通碳排放,并采用结构方程模型深入挖掘居住空间、个体行为以及交通碳排放三者之间的内在关系。结果表明,出行距离、机动出行概率对交通碳排放产生显著的正效应,而出行频率的影响并不显著;同时,出行结构的影响要远远大于出行总量的影响。另外,城市空间结构对城市交通碳排放产生显著影响,单位社区居民的出行行为整体具有＂低碳＂性质,应从低碳视角对单位社区进行重新审视。

[10]孟斌, 于慧丽, 郑丽敏. 2012.

北京大型居住区居民通勤行为对比研究: 以望京居住区和天通苑居住区为例

[J]. 地理研究, 31(11): 2069-2079.

[本文引用: 1]    

[Meng B, Yu H L, Zheng L M.2012.

The analysis of commuting behavior in the huge residential districts: A case study of Wangjing and Tiantongyuan in Beijing

[J]. Geographical Research, 31(11): 2069-2079.]

[本文引用: 1]    

[11]秦波, 邵然. 2012.

城市形态对居民直接碳排放的影响: 基于社区的案例研究

[J]. 城市规划, 36(6): 33-38.

URL     [本文引用: 1]    摘要

基于北京1400份居民的建筑和出行能源消费行为问卷数据,利用空间统计工具LISA确定高(低)直接碳排放居民的聚集社区,进而通过五个社区的案例研究,探讨居民直接碳排放和城市形态之间的关系。结果显示,建筑密度、土地利用形态、就业可达性和公交可达性均对居民的直接碳排放产生显著影响,这说明合理规划空间形态是构建低碳城市的重要政策手段。

[Qin B, Shao R.2012.

The impacts of urban form on household carbon emissions: A case study on neighborhoods

[J]. City Planning Review, 36(6): 33-38.]

URL     [本文引用: 1]    摘要

基于北京1400份居民的建筑和出行能源消费行为问卷数据,利用空间统计工具LISA确定高(低)直接碳排放居民的聚集社区,进而通过五个社区的案例研究,探讨居民直接碳排放和城市形态之间的关系。结果显示,建筑密度、土地利用形态、就业可达性和公交可达性均对居民的直接碳排放产生显著影响,这说明合理规划空间形态是构建低碳城市的重要政策手段。

[12]孙斌栋, 阎宏, 张婷麟. 2016.

社区建成环境对健康的影响: 基于居民个体超重的实证研究

[J]. 地理学报, 71(10): 1721-1730.

https://doi.org/10.11821/dlxb201610005    URL     [本文引用: 1]    摘要

随着中国经济发展和居民生活水平的提升,超重和肥胖问题开始显现,严重影响到居民的身体健康。基于中国家庭追踪调查的全国抽样数据,采用结构方程模型检验社区建成环境对居民个体超重的影响。研究发现,控制社会经济属性后,提高社区人口密度或设施可达性、缩短居民到公交站距离,可以通过减少个体机动化出行倾向而间接降低超重的可能性,但对超重的直接效应及总效应为正。这一结论与西方发达国家的经验不同,因此制定健康政策需要基于中国自身国情和规律,在建成环境方面应重点提高室外空间可步行性和休闲吸引力。

[Sun B D, Yan H, Zhang T L.2016.

Impact of community built environment on residents' health: A case study on individual overweight

[J]. Acta Geographica Sinica, 71(10): 1721-1730.]

https://doi.org/10.11821/dlxb201610005    URL     [本文引用: 1]    摘要

随着中国经济发展和居民生活水平的提升,超重和肥胖问题开始显现,严重影响到居民的身体健康。基于中国家庭追踪调查的全国抽样数据,采用结构方程模型检验社区建成环境对居民个体超重的影响。研究发现,控制社会经济属性后,提高社区人口密度或设施可达性、缩短居民到公交站距离,可以通过减少个体机动化出行倾向而间接降低超重的可能性,但对超重的直接效应及总效应为正。这一结论与西方发达国家的经验不同,因此制定健康政策需要基于中国自身国情和规律,在建成环境方面应重点提高室外空间可步行性和休闲吸引力。

[13]杨林生, 李海蓉, 李永华, 等. 2010.

医学地理和环境健康研究的主要领域与进展

[J]. 地理科学进展, 29(1): 31-44.

https://doi.org/10.11820/dlkxjz.2010.01.005    Magsci     [本文引用: 1]    摘要

<p>通过对近年国内外医学地理和环境健康相关领域的文献检索分析发现，人口健康是当前国际地理学和环境科学研究的核心内容之一，其研究趋势可以归纳为以下几个方面：①重视全球环境变化对人类健康的影响。包括全球大气组成改变(气候变化和臭氧层耗散)对健康的影响、土地利用/土地覆被变化与健康、全球环境变化与传染病、食物生产系统改变与健康和城市化与健康等；②环境健康风险评估领域进一步拓展，除重金属、持久性有机污染物等有毒有害污染物的健康风险外，有关生态、灾害和场地环境污染对健康影响的综合风险评估日益受到重视；③重视社会人文因素与自然因素交互作用对健康的影响，特别是经济发展和城市化过程中收入、产品和服务分配不均造成的卫生不公平对健康的影响；④重视人口老龄化过程的时空差异及其对社会的影响和老龄人口的健康、医疗与养老需求及其可达性研究；⑤地理信息系统和模型等技术被广泛用于疾病和健康的空间数据管理、空间分布规律和空间影响因素分析等领域，并为疾病监测、卫生管理和卫生规划提供了强有力的技术支撑。随着国内在相关领域需求和国际交流的增加，我国近年的相关研究有了较大的发展并得到国际社会的认可，医学地理作为一门学科，在我国人口健康研究中正发挥越来越重要的作用。</p>

[Yang L S, Li H R, Li Y H, et al.2010.

Progress of medical geography and environmental health studies

[J]. Progress in Geography, 29(1): 31-44.]

https://doi.org/10.11820/dlkxjz.2010.01.005    Magsci     [本文引用: 1]    摘要

<p>通过对近年国内外医学地理和环境健康相关领域的文献检索分析发现，人口健康是当前国际地理学和环境科学研究的核心内容之一，其研究趋势可以归纳为以下几个方面：①重视全球环境变化对人类健康的影响。包括全球大气组成改变(气候变化和臭氧层耗散)对健康的影响、土地利用/土地覆被变化与健康、全球环境变化与传染病、食物生产系统改变与健康和城市化与健康等；②环境健康风险评估领域进一步拓展，除重金属、持久性有机污染物等有毒有害污染物的健康风险外，有关生态、灾害和场地环境污染对健康影响的综合风险评估日益受到重视；③重视社会人文因素与自然因素交互作用对健康的影响，特别是经济发展和城市化过程中收入、产品和服务分配不均造成的卫生不公平对健康的影响；④重视人口老龄化过程的时空差异及其对社会的影响和老龄人口的健康、医疗与养老需求及其可达性研究；⑤地理信息系统和模型等技术被广泛用于疾病和健康的空间数据管理、空间分布规律和空间影响因素分析等领域，并为疾病监测、卫生管理和卫生规划提供了强有力的技术支撑。随着国内在相关领域需求和国际交流的增加，我国近年的相关研究有了较大的发展并得到国际社会的认可，医学地理作为一门学科，在我国人口健康研究中正发挥越来越重要的作用。</p>

[14]杨彦, 陆晓松, 李定龙. 2014.

我国环境健康风险评价研究进展

[J]. 环境与健康杂志, 31(4): 357-363.

URL     [本文引用: 1]    

[Yang Y, Lu X S, Li D L.2014.

Research progress of environmental health risk assessment in China

[J]. Journal of Environment and Health, 31(4): 357-363.]

URL     [本文引用: 1]    

[15]朱菁, 高鹏华, 吴潇, 等. 2014.

大城市居民通勤行为的健康效应研究: 以西安市为例

[J]. 城市规划学刊, (6): 46-51.

[本文引用: 1]    

[Zhu J, Gao P H, Wu X, et al.2014.

The commuting effects to people's health: A case study of Xi'an

[J]. Urban Planning Forum, (6): 46-51.]

[本文引用: 1]    

[16]Adams H S, Nieuwenhuijsen M J, Colvile R N, et al.2001.

Fine particle (PM2.5) personal exposure levels in transport microenvironments, London, UK

[J]. Science of the Total Environment, 279(1-3): 29-44.

https://doi.org/10.1016/S0048-9697(01)00723-9    URL     [本文引用: 2]    

[17]Alvarado M, Lofgren K T.2013.

How can city planners improve health and reduce mortality in Alameda County, California? A cross-sectional analysis

[J]. The Lancet, 381(S2): S7.

https://doi.org/10.1016/S0140-6736(13)61261-1    URL     [本文引用: 1]    摘要

None.

[18]Brulle R J, Pellow D N.2006.

Environmental justice: Human health and environmental inequalities

[J]. Annual Review of Public Health, 27(1): 103-124.

https://doi.org/10.1146/annurev.publhealth.27.021405.102124    URL    PMID: 16533111     [本文引用: 2]    摘要

In this review, we provide an introduction to the topics of environmental justice and environmental inequality. We provide an overview of the dimensions of unequal exposures to environmental pollution (environmental inequality), followed by a discussion of the theoretical literature that seeks to explain the origins of this phenomenon. We also consider the impact of the environmental justice movement in the United States and the role that federal and state governments have developed to address environmental inequalities. We conclude that more research is needed that links environmental inequalities with public health outcomes.

[19]Cervero R, Kockelman K.1997.

Travel demand and the 3Ds: Density, diversity, and design

[J]. Transportation Research Part D: Transport and Environment, 2(3): 199-219.

https://doi.org/10.1016/S1361-9209(97)00009-6    URL     [本文引用: 1]    摘要

The built environment is thought to influence travel demand along three principal dimensions —density, diversity, and design. This paper tests this proposition by examining how the ‘3Ds’ affect trip rates and mode choice of residents in the San Francisco Bay Area. Using 1990 travel diary data and land-use records obtained from the U.S. census, regional inventories, and field surveys, models are estimated that relate features of the built environment to variations in vehicle miles traveled per household and mode choice, mainly for non-work trips. Factor analysis is used to linearly combine variables into the density and design dimensions of the built environment. The research finds that density, land-use diversity, and pedestrian-oriented designs generally reduce trip rates and encourage non-auto travel in statistically significant ways, though their influences appear to be fairly marginal. Elasticities between variables and factors that capture the 3Ds and various measures of travel demand are generally in the 0.06 to 0.18 range, expressed in absolute terms. Compact development was found to exert the strongest influence on personal business trips. Within-neighborhood retail shops, on the other hand, were most strongly associated with mode choice for work trips. And while a factor capturing ‘walking quality’ was only moderately related to mode choice for non-work trips, those living in neighborhoods with grid-iron street designs and restricted commercial parking were nonetheless found to average significantly less vehicle miles of travel and rely less on single-occupant vehicles for non-work trips. Overall, this research shows that the elasticities between each dimension of the built environment and travel demand are modest to moderate, though certainly not inconsequential. Thus it supports the contention of new urbanists and others that creating more compact, diverse, and pedestrian-orientated neighborhoods, in combination, can meaningfully influence how Americans travel.

[20]Chakraborty J, Maantay J A, Brender J D.2011.

Disproportionate proximity to environmental health hazards: Methods, models, and measurement

[J]. American Journal of Public Health, 101(S1): S27-S36.

https://doi.org/10.2105/AJPH.2010.300109    URL    PMID: 21836113     [本文引用: 1]    摘要

Abstract We sought to provide a historical overview of methods, models, and data used in the environmental justice (EJ) research literature to measure proximity to environmental hazards and potential exposure to their adverse health effects. We explored how the assessment of disproportionate proximity and exposure has evolved from comparing the prevalence of minority or low-income residents in geographic entities hosting pollution sources and discrete buffer zones to more refined techniques that use continuous distances, pollutant fate-and-transport models, and estimates of health risk from toxic exposure. We also reviewed analytical techniques used to determine the characteristics of people residing in areas potentially exposed to environmental hazards and emerging geostatistical techniques that are more appropriate for EJ analysis than conventional statistical methods. We concluded by providing several recommendations regarding future research and data needs for EJ assessment that would lead to more reliable results and policy solutions.

[21]Chen J, Chen S, Landry P F.2013.

Migration, environmental hazards, and health outcomes in China

[J]. Social Science & Medicine, 80: 85-95.

https://doi.org/10.1016/j.socscimed.2012.12.002    URL    PMID: 23273408     [本文引用: 3]    摘要

China's rapid economic growth has had a serious impact on the environment. Environmental hazards are major sources of health risk factors. The migration of over 200 million people to heavily polluted urban areas is likely to be significantly detrimental to health. Based on data from the 2009 national household survey hinese Attitudes toward Inequality and Distributive Injustice (N=2866) and various county-level and municipal indicators, we investigate the disparities in subjective exposure to environmental hazards and associated health outcomes in China. This study focuses particularly on migration-residency status and county-level socio-economic development. We employ multiple regressions that account for the complex multi-stage survey design to assess the associations between perceived environmental hazards and individual and county-level indicators and between perceived environmental hazards and health outcomes, controlling for physical and social environments at multiple levels. We find that perceived environmental hazards are associated with county-level industrialization and economic development: respondents living in more industrialized counties report greater exposure to environmental hazards. Rural-to-urban migrants are exposed to more water pollution and a higher measure of overall environmental hazard. Perceived environmental risk factors severely affect the physical and mental health of the respondents. The negative effects of perceived overall environmental hazard on physical health are more detrimental for rural-to-urban migrants than for urban residents. The research findings call for restructuring the household registration system in order to equalize access to public services and mitigate adverse environmental health effects, particularly among the migrant population.

[22]Craig N.2005.

Exploring the generalisability of the association between income inequality and self-assessed health

[J]. Social Science & Medicine, 60(11): 2477-2488.

https://doi.org/10.1016/j.socscimed.2004.11.018    URL    PMID: 15814173     [本文引用: 1]    摘要

A growing between- and within-country literature suggests that the association between income inequality and health reflects individual- or area-level characteristics with which income inequality is associated, rather than the effects of income inequality per se. These studies also suggest that the association between income inequality and health is country-specific. Unresolved methodological issues include the geographical level at which to model the effects of income inequality, and the appropriate statistical methods to use. This study compares the results of single-level and multi-level logistic regression models estimating the association between income inequality and self-assessed health in local authorities in Scotland. The results suggest that there is a significant positive association between income inequality and health across local authorities in Scotland, even after adjusting for individual-level socio-economic status. They also suggest that there is significant local authority-level variation in self-assessed health, but this is small compared to the variation at the individual level. Income and other measures of individuals socio-economic status are more strongly associated with self-assessed health than income inequality. This study provides further evidence that the income inequality:health association is place-specific. It also suggests that methodological choices regarding the ways of estimating the association between self-assessed health, individual-level socio-economic status and area-level income inequality may not make a substantive difference to the results when contextual effects are small. Further work is required to test the sensitivity of these conclusions to alternative levels of geographical aggregation.

[23]Cutter S L.1995.

Race, class and environmental justice

[J]. Progress in Human Geography, 19(1): 111-122.

https://doi.org/10.1177/030913259501900111    URL     [本文引用: 1]    摘要

First page of article

[24]Ewing R, Cervero R.2010.

Travel and the built environment

[J]. Journal of the American Planning Association, 76(3): 265-294.

https://doi.org/10.1080/01944361003766766    URL     [本文引用: 1]    摘要

Problem: Localities and states are turning to land planning and urban design for help in reducing automobile use and related social and environmental costs. The effects of such strategies on travel demand have not been generalized in recent years from the multitude of available studies. Purpose: We conducted a meta-analysis of the built environment-travel literature existing at the end of 2009 in order to draw generalizable conclusions for practice. We aimed to quantify effect sizes, update earlier work, include additional outcome measures, and address the methodological issue of self-selection. Methods: We computed elasticities for individual studies and pooled them to produce weighted averages. Results and conclusions: Travel variables are generally inelastic with respect to change in measures of the built environment. Of the environmental variables considered here, none has a weighted average travel elasticity of absolute magnitude greater than 0.39, and most are much less. Still, the combined effect of several such variables on travel could be quite large. Consistent with prior work, we find that vehicle miles traveled (VMT) is most strongly related to measures of accessibility to destinations and secondarily to street network design variables. Walking is most strongly related to measures of land use diversity, intersection density, and the number of destinations within walking distance. Bus and train use are equally related to proximity to transit and street network design variables, with land use diversity a secondary factor. Surprisingly, we find population and job densities to be only weakly associated with travel behavior once these other variables are controlled. Takeaway for practice: The elasticities we derived in this meta-analysis may be used to adjust outputs of travel or activity models that are otherwise insensitive to variation in the built environment, or be used in sketch planning applications ranging from climate action plans to health impact assessments. However, because sample sizes are small, and very few studies control for residential preferences and attitudes, we cannot say that planners should generalize broadly from our results. While these elasticities are as accurate as currently possible, they should be understood to contain unknown error and have unknown confidence intervals. They provide a base, and as more built-environment/travel studies appear in the planning literature, these elasticities should be updated and refined. Research support: U.S. Environmental Protection Agency.

[25]Fang T B, Lu Y M.2011.

Constructing a near real-time space-time cube to depict urban ambient air pollution scenario

[J]. Transactions in GIS, 15(5): 635-649.

https://doi.org/10.1111/j.1467-9671.2011.01283.x    URL     [本文引用: 1]    摘要

This study adopts a near real-time space-time cube approach to portray a dynamic urban air pollution scenario across space and time. Originating from time geography, space-time cubes provide an approach to integrate spatial and temporal air pollution information into a 3D space. The base of the cube represents the variation of air pollution in a 2D geographical space while the height represents time. This way, the changes of pollution over time can be described by the different component layers of the cube from the base up. The diurnal ambient ozone (O3) pollution in Houston, Texas is modeled in this study using the space-time air pollution cube. Two methods, land use regression (LUR) modeling and spatial interpolation, were applied to build the hourly component layers for the air pollution cube. It was found that the LUR modeling performed better than the spatial interpolation in predicting air pollution level. With the availability of real-time air pollution data, this approach can be extended to produce real-time air pollution cube is for more accurate air pollution measurement across space and time, which can provide important support to studies in epidemiology, health geography, and environmental regulation.

[26]Gee G C, Payne-Sturges D C.2004.

Environmental health disparities: A framework integrating psychosocial and environmental concepts

[J]. Environmental Health Perspectives, 112(17): 1645-1653.

https://doi.org/10.1289/ehp.7074    URL    PMID: 1253653     [本文引用: 1]    摘要

Although it is often acknowledged that social and environmental factors interact to produce racial and ethnic environmental health disparities, it is still unclear how this occurs. Despite continued controversy, the environmental justice movement has provided some insight by suggesting that disadvantaged communities face greater likelihood of exposure to ambient hazards. The exposure-disease paradigm has long suggested that differential "vulnerability" may modify the effects of toxicants on biological systems. However, relatively little work has been done to specify whether racial and ethnic minorities may have greater vulnerability than do majority populations and, further, what these vulnerabilities may be. We suggest that psychosocial stress may be the vulnerability factor that links social conditions with environmental hazards. Psychosocial stress can lead to acute and chronic changes in the functioning of body systems (e.g., immune) and also lead directly to illness. In this article we present a multidisciplinary framework integrating these ideas. We also argue that residential segregation leads to differential experiences of community stress, exposure to pollutants, and access to community resources. When not counterbalanced by resources, stressors may lead to heightened vulnerability to environmental hazards.

[27]Giles-Corti B, Vernez-Moudon A, Reis R, et al.2016.

City planning and population health: A global challenge

[J]. The Lancet, 388: 2912-2924.

https://doi.org/10.1016/S0140-6736(16)30066-6    URL    PMID: 27671668     [本文引用: 3]    摘要

Significant global health challenges are being confronted in the 21st century, prompting calls to rethink approaches to disease prevention. A key part of the solution is city planning that reduces non-communicable diseases and road trauma while also managing rapid urbanisation. This Series of papers considers the health impacts of city planning through transport mode choices. In this, the first paper, we identify eight integrated regional and local interventions that, when combined, encourage walking, cycling, and public transport use, while reducing private motor vehicle use. These interventions are destination accessibility, equitable distribution of employment across cities, managing demand by reducing the availability and increasing the cost of parking, designing pedestrian-friendly and cycling-friendly movement networks, achieving optimum levels of residential density, reducing distance to public transport, and enhancing the desirability of active travel modes (eg, creating safe attractive neighbourhoods and safe, affordable, and convenient public transport). Together, these interventions will create healthier and more sustainable compact cities that reduce the environmental, social, and behavioural risk factors that affect lifestyle choices, levels of traffic, environmental pollution, noise, and crime. The health sector, including health ministers, must lead in advocating for integrated multisector city planning that prioritises health, sustainability, and liveability outcomes, particularly in rapidly changing low-income and middle-income countries. We recommend establishing a set of indicators to benchmark and monitor progress towards achievement of more compact cities that promote health and reduce health inequities.

[28]Greenberg M, Renne J, Lane R, et al.2005.

Physical activity and use of suburban train stations: An exploratory analysis

[J]. Journal of Public Transportation, 8(3): 89-116.

https://doi.org/10.5038/2375-0901.8.3.5    URL     [本文引用: 1]    摘要

Physical inactivity contributes to a growing proportion of illness and premature death in the United States. Only about 45 percent of Americans meet the recommended national standard for physical activity. Yet, analysis of 300 surveys collected from train riders at three walkable New Jersey suburban train stations showed that 78 percent met the activity guidelines. A new train station that allows these riders to save time in their commute has attracted new riders and has led existing commuters to change their commute. One-third of those surveyed reported additional physical activity primarily because they walked more after leaving the train in mid-town New York City. Only 8 percent reported less physical activity. The analysis revealed that the new public transit station and personal factors associated with a greater likelihood of using mass transit led to more physical activity.

[29]Gulliver J, Briggs D J.2005.

Time-space modeling of journey-time exposure to traffic-related air pollution using GIS

[J]. Environmental Research, 97(1): 10-25.

https://doi.org/10.1016/j.envres.2004.05.002    URL    PMID: 15476729     [本文引用: 2]    摘要

Abstract Journey-time exposures represent an important, though as yet little-studied, component of human exposure to traffic-related air pollution, potentially with important health effects. Methods for assessing journey-time exposures, either as part of epidemiological studies or for policy assessment, are, however, poorly developed. This paper describes the development and testing of a GIS-based system for modeling human journey-time exposures to traffic-related air pollution: STEMS (Space-Time Exposure Modeling System). The model integrates data on source activity, pollutant dispersion, and travel behavior to derive individual- or group-level exposure measures to atmospheric pollution. The model, which is designed to simulate exposures of people as they move through a changing air pollution field, was developed, validated, and trialed in Northampton, UK. The system currently uses ArcInfo to couple four separate submodels: a source activity/emission model (SATURN), a proprietary atmospheric dispersion model (ADMS-Urban), an empirically derived background air pollution model, and a purposely designed time-activity-based exposure model (TOTEM). This paper describes the structure of the modeling system; presents results of field calibration, validation, and sensitivity analysis; and illustrates the use of the model to analyze journey-time exposures of schoolchildren.

[30]Handy S L, Boarnet M G, Ewing R, et al.2002.

How the built environment affects physical activity: Views from urban planning

[J]. American Journal of Preventive Medicine, 23(2): 64-73.

https://doi.org/10.1016/S0749-3797(02)00475-0    URL     [本文引用: 1]    

[31]Hansson E, Mattisson K, Björk J, et al.2011.

Relationship between commuting and health outcomes in a cross-sectional population survey in Southern Sweden

[J]. BMC Public Health, 11: 834.

https://doi.org/10.1186/1471-2458-11-834    URL    PMID: 22039952     [本文引用: 1]    摘要

Abstract BACKGROUND: The need for a mobile workforce inevitably means that the length of the total work day (working and traveling time) will increase, but the health effects of commuting have been surprisingly little studied apart from perceived stress and the benefits of physically active commuting. METHODS: We used data from two cross-sectional population-based public health surveys performed in 2004 and 2008 in Scania, Sweden (56% response rate). The final study population was 21, 088 persons aged 18-65, working > 30 h/week. Duration (one-way) and mode of commuting were reported. The outcomes studied were perceived poor sleep quality, everyday stress, low vitality, mental health, self-reported health, and absence from work due to sickness during the past 12 months. Covariates indicating socioeconomic status and family situation, overtime, job strain and urban/rural residency were included in multivariate analyses. Subjects walking or cycling to work 60 min odds ratios (ORs) ranged from 1.2 - 1.6 for the different outcomes. For car commuting, the relationships were concave downward or flat, with increasing subjective health complaints up to 30-60 min (ORs ranging from 1.2 - 1.4), and lower ORs in the > 60 min category. A similar concave downward relationship was observed for sickness absence, regardless of mode of transport. CONCLUSIONS: The results of this study are concordant with the few earlier studies in the field, in that associations were found between commutation and negative health outcomes. This further demonstrates the need to consider the negative side-effects of commuting when discussing policies aimed at increasing the mobility of the workforce. Studies identifying population groups with increased susceptibility are warranted.

[32]Hart J E, Garshick E, Smith T J, et al.2013.

Ischaemic heart disease mortality and years of work in trucking industry workers

[J]. Occupational and Environmental Medicine, 70(8): 523-528.

https://doi.org/10.1136/oemed-2011-100017    URL    PMID: 22992341     [本文引用: 1]    摘要

Objectives Evidence from general population-based studies and occupational cohorts has identified air pollution from mobile sources as a risk factor for cardiovascular disease. In a cohort of US trucking industry workers, with regular exposure to vehicle exhaust, the authors previously observed elevated standardised mortality ratios for ischaemic heart disease (IHD) compared with members of the general US population. Therefore, the authors examined the association of increasing years of work in jobs with vehicle exhaust exposure and IHD mortality within the cohort.Methods The authors calculated years of work in eight job groups for 30?758 workers using work records from four nationwide companies. Proportional hazard regression was used to examine relationships between IHD mortality, 1985-2000, and employment duration in each job group.Results HRs for at least 1year of work in each job were elevated for dockworkers, long haul drivers, pick-up and delivery drivers, combination workers, hostlers, and shop workers. There was a suggestion of an increased risk of IHD mortality with increasing years of work as a long haul driver, pick-up and delivery driver, combination worker, and dockworker.Conclusion These results suggest an elevated risk of IHD mortality in workers with a previous history of regular exposure to vehicle exhaust.

[33]Holdaway J.2010.

Environment and health in China: An introduction to an emerging research field

[J]. Journal of Contemporary China, 19(63): 1-22.

https://doi.org/10.1080/10670560903335728    URL     [本文引用: 2]    摘要

This paper is an introduction to the special issue. It provides an overview of the major environment-related health risks China faces, and a review of some of the responses currently being made by the government and societal actors. The paper concludes with a discussion of the contributions that the social sciences might make to our understanding of these issues.

[34]Huang J, Deng F R, Wu S W, Guo X B.2012.

Comparisons of personal exposure to PM2.5 and CO by different commuting modes in Beijing, China

[J]. Science of the Total Environment, 425: 52-59.

https://doi.org/10.1016/j.scitotenv.2012.03.007    URL    PMID: 22472140     [本文引用: 2]    摘要

Abstract BACKGROUND: Epidemiological studies have shown that commuting in traffic is associated with adverse health effects. It is vital to investigate commuters' exposure to traffic-related air pollutants before considering potential health risks. However, there are relatively few publications considering commuters' personal exposure in China. METHOD: We carried out a field investigation measuring commuters' personal exposure to particulate matter ≤2.5 μm in aerodynamic diameter (PM(2.5)) and carbon monoxide (CO) by three commuting modes in Beijing. Both PM(2.5) and CO personal concentrations and whole trip exposures were compared among the three commuting modes. RESULTS: After controlling confounding factors, we found that taxi commuters were exposed to lower concentrations of PM(2.5) (31.64±20.77 μg/m(3)) compared with bus commuters (42.40±23.36 μg/m(3)) and cyclists (49.10±26.60 μg/m(3)). By contrast, CO personal concentrations were significantly higher when commuting by taxi (5.21±1.52 ppm) than by bus (2.41±0.99 ppm) and bicycle (1.90±0.55 ppm). However, when inhalation rates and trip duration were taken into consideration, cyclists experienced the highest whole trip exposures to both PM(2.5) and CO (p<0.05). We also found fixed site monitoring data were not appropriate surrogates for personal exposure while commuting, especially during traffic heavy times. CONCLUSION: PM(2.5) and CO personal concentrations were greatly influenced by the commuting mode. Furthermore, the highest whole trip exposures to PM(2.5) and CO which cyclists experienced indicates it is not preferable to commute by bicycle in a relatively high air polluted environment. Cyclists are possibly subject to greater health risks than other commuters. Thus further research needs to be conducted to investigate the health risks associated with cycling. Copyright 08 2012 Elsevier B.V. All rights reserved.

[35]Kaur S, Nieuwenhuijsen M J, Colvile R N.2007.

Fine particulate matter and carbon monoxide exposure concentrations in urban street transport microenvironments

[J]. Atmospheric Environment, 41(23): 4781-4810.

https://doi.org/10.1016/j.atmosenv.2007.02.002    URL     [本文引用: 1]    摘要

Personal exposure studies are crucial alongside microenvironment and ambient studies in order to get a better understanding of the health risks posed by fine particulate matter and carbon monoxide in the urban transport microenvironment and for making informed decisions to manage and reduce the health risks. Studies specifically assessing the PM2.5, ultrafine particle count and carbon monoxide personal exposure concentrations of adults in an urban transport microenvironment have steadily increased in number over the last decade. However, no recent collective summary is available, particularly one which also considers ultrafine particles; therefore, we present a review of the personal exposure concentration studies for the above named pollutants on different modes of surface transportation (walking, cycling, bus, car and taxi) in the urban transport microenvironment. Comparisons between personal exposure measurements and concentrations recorded at fixed monitoring sites are considered in addition to the factors influencing personal exposure in the transport microenvironment. In general, the exposure studies examined revealed pedestrians and cyclists to experience lower fine particulate matter and CO exposure concentrations in comparison to those inside vehicles he vehicle shell provided no protection to the passengers. Proximity to the pollutant sources had a significant impact on exposure concentration levels experienced, consequently individuals should be encouraged to use back street routes. Fixed monitoring stations were found to be relatively poor predictors of CO and PM2.5 exposure concentration levels experienced by individuals in the urban transport microenvironment. Although the mode of transport, traffic and meteorology parameters were commonly identified as significant factors influencing exposure concentrations to the different pollutants under examination, a large amount of the exposure concentration variation in the exposure studies remained unexplaine

[36]Laurent É.2011.

Issues in environmental justice within the European Union

[J]. Ecological Economics, 70(11): 1846-1853.

https://doi.org/10.1016/j.ecolecon.2011.06.025    URL     [本文引用: 1]    摘要

This paper surveys pressing issues facing current and future social policies in the European Union (EU) at the juncture of social justice demands and environmental concerns. European policy-makers have in fact only recently acknowledged the notions of environmental justice and environmental inequalities, which have been part of the US policy arsenal for almost two decades. Yet, challenges to equality and fairness in the environmental domain are many and growing within the European Union. After having defined environmental justice and environmental inequalities in the European context, the paper addresses two contemporary dimensions of those challenges for EU social policies: vulnerability and exposure to environmental disaster and risk; and fairness in environmental taxation and the related issue of fuel poverty.Highlights? Issues within the European Union (EU) at the juncture of social justice demands and environmental concerns. ? Definition of environmental justice and environmental inequalities in the European context. ? Focus on vulnerability and exposure to environmental disaster and risk. ? Focus on fairness in environmental taxation, including fuel poverty.

[37]Lim S S, Vos T, Flaxman A D, et al.2012.

A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1999-2010: A systematic analysis for the Global Burden of Disease Study 2010

[J]. The Lancet, 380(9859): 2224-2260.

https://doi.org/10.1016/S0140-6736(12)61766-8    URL     [本文引用: 2]    

[38]Ma J, Mitchell G, Dong G P, Zhang W Z.2017.

Inequality in Beijing: A spatial multilevel analysis of perceived environmental hazard and self-rated health

[J]. Annals of the American Association of Geographers, 107(1): 109-129.

https://doi.org/10.1080/24694452.2016.1224636    URL     [本文引用: 2]    摘要

Environmental pollution is a major problem in China, subjecting people to significant health risk. However, surprisingly little is known about how these risks are distributed spatially or socially. Drawing upon a large-scale survey conducted in Beijing in 2013, we examine how environmental hazards and health, as perceived by residents, are distributed at fine (sub-district) scale in urban Beijing, and investigate association between hazards, health and geographical context. A Bayesian spatial multilevel logistic model is developed to account for spatial dependence in unobserved contextual influences (eighbourhood effects) on health. Results reveal robust associations between exposure to environmental hazards and health. A unit decrease on a 5-point Likert scale in exposure is associated with increases of 15.2% (air pollution), 17.5% (noise) and 9.3% (landfills) in the odds of reporting good health, with marginal groups including migrant workers reporting greater exposure. Health inequality is also evident, and associated with age, income, educational attainment and housing characteristics. Geographical context (neighbourhood features like local amenity) also plays a role in shaping the social distribution of health inequality. Results are discussed in the context of developing environmental justice policy within a Chinese social market system that experiences tension between its egalitarian roots and its pragmatic approach to tackling grand public policy challenges.

[39]Macmillan A K, Hosking J, Connor J L, et al.2013.

A Cochrane systematic review of the effectiveness of organisational travel plans: Improving the evidence base for transport decisions

[J]. Transport Policy, 29: 249-256.

https://doi.org/10.1016/j.tranpol.2012.06.019    URL     [本文引用: 1]    

[40]Martuzzi M, Mitis F, Forastiere F.2010.

Inequalities, inequities, environmental justice in waste management and health

[J]. European Journal of Public Health, 20(1): 21-61.

https://doi.org/10.1093/eurpub/ckp216    URL    PMID: 20061348     [本文引用: 1]    摘要

The scientific evidence on the health effects of waste-related exposure is not conclusive. Differential exposure to waste by socio-economic status (SES) is often documented, but the interplay between environmental and social factors, crucial for policy making, is not well known. This review aims at investigating the role of health inequalities and inequities in waste management. Grey and peer-reviewed literature, published after 1983, was reviewed from Europe and the USA. Available data provide consistent indications that waste facilities are often disproportionally more located in areas with more deprived residents, or from ethnical minorities. This applies to waste incinerators, landfills, hazardous waste sites, legal and illegal. In studies considering health effects (mainly from Europe), risks are estimated with standardization for SES. Such standardization almost always decreases risk estimates for several cancers and reproductive outcomes. However, effect modification is not investigated in these studies. The patterns of association between waste-related environmental pressures and SES suggest that some of the observed inequalities in exposure and health represent a case of environmental injustice as they are the result of social processes and may be prevented, at least partly. Disentangling the possible health effects remains difficult, due to limitations in the methodology. It seems important to investigate if disadvantaged people are more vulnerable, i.e. risks differ in different social groups living in the same area. Notwithstanding these open questions, public health officers and decision makers should identify waste management policies to minimize their potential health impacts and their unequal distribution.

[41]Mitchell G, Dorling D.2003.

An environmental justice analysis of British air quality

[J]. Environment and Planning A, 35(5): 909-929.

https://doi.org/10.1068/a35240    URL     [本文引用: 3]    

[42]Mitchell G, Norman P, Mullin K.2015.

Who benefits from environmental policy? An environmental justice analysis of air quality change in Britain, 2001-2011

[J]. Environmental Research Letters, 10(10): 105009.

https://doi.org/10.1088/1748-9326/10/10/105009    URL    摘要

Air quality in Great Britain has improved in recent years, but not enough to prevent the European Commission (EC) taking legal action for non-compliance with limit values. Air quality is a national public health concern, with disease burden associated with current air quality estimated at 29 000 premature deaths per year due to fine particulates, with a further burden due to NO. National small-area analyses showed that in 2001 poor air quality was much more prevalent in socio-economically deprived areas. We extend this social distribution of air quality analysis to consider how the distribution changed over the following decade (2001鈥2011), a period when significant efforts to meet EC air quality directive limits have been made, and air quality has improved. We find air quality improvement is greatest in the least deprived areas, whilst the most deprived areas bear a disproportionate and rising share of declining air quality including non-compliance with air quality standards. We discuss the implications for health inequalities, progress towards environmental justice, and compatibility of social justice and environmental sustainability objectives.

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