Abstract
BackgroundPublic health research increasingly acknowledges the influence of built environments (BE) on health; however, it is uncertain how BE change is associated with better population health and whether BE change can help narrow health inequalities. This knowledge gap is partly due to a lack of suitable longitudinal BE data in most countries. We devised a method to quantify BE change longitudinally and explored associations with mortality. The method is replicable in any nation that captures BE vector map data.MethodsOrdnance Survey data were used to categorise small areas as having no change, loss or gain, in buildings, roads, and woodland between 2015 and 2019. We examined individual mortality records for 2012–2015 and 2016–2019, using negative binomial regression to explore associations between BE change and all-cause and cause-specific mortality, adjusting for income deprivation.ResultsBE change varied significantly by deprivation and urbanicity. Change in the BE and change in mortality were not related, however, areas that went on to experience BE change had different baseline mortality rates compared with those that did not. For example, areas that gained infrastructure already had lower mortality rates.ConclusionWe provide new methodology to quantify BE change over time across a nation. Findings provide insight into the health of areas that do/do not experience change, prompting critical perspectives on cross-sectional studies of associations between BE and health. Methods and findings applied internationally could explore the context of BE change and its potential to improve health in areas most in need beyond the UK.
Subject
Public Health, Environmental and Occupational Health,Epidemiology
Reference38 articles.
1. Editorial: Impacts of Our Built Environment on Public Health
2. Defining Greenspace: multiple uses across multiple disciplines;Taylor;Landscape and Urban Planning,2017
3. Pathways from built environment to health: A conceptual framework linking behavior and exposure-based impacts;Frank;Journal of Transport & Health,2019
4. Jimenez MP , DeVille NV , Elliott EG , et al . Associations between nature exposure and health: A review of the evidence. Int J Environ Res Public Health 2021;18. doi:10.3390/ijerph18094790
5. Ward Thompson C , Silveirinha de Oliveira E , Wheeler BW , et al . Urban Green Spaces and Health, A Review of Evidence. Copenhagen: World Health Organisation, 2016.