Does where you live matter to your health? Investigating factors that influence the self-rated health of urban and rural Chinese residents: evidence drawn from Chinese General Social Survey data.
Does where you live matter to your health? Investigating factors that influence the self-rated health of urban and rural Chinese residents: evidence drawn from Chinese General Social Survey data.
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您居住的地方对您的健康重要吗？
DOI：
10.1186/s12955-017-0658-0
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发表时间：
2017-04-21
影响因子：
3.6
通讯作者：
Li Z
中科院分区：
文献类型：
--
作者：
Chen H;Liu Y;Zhu Z;Li Z
中国过去几十年的快速城市化加剧了环境退化和健康差距问题。然而，很少有研究分析城乡居民在环境质量如何影响健康结果方面的差异。本研究探讨了中国人对环境质量的认知与其健康自评之间的关系，特别关注城乡居民在环境与健康关系方面的差异。使用逻辑回归模型和2013年中国综合社会调查（CGSS）数据，对3,402名城镇居民（46±16岁）和2,439名农村居民（48±15岁）的代表性数据样本进行了分析。用于逻辑回归的因变量是受访者是否报告健康。自变量包括受访者对生活环境的评价以及参加体育活动的频率。采用交互项来衡量体育锻炼对感知环境质量与健康之间关系的调节作用。健康城市居民的比例明显高于健康农村居民的比例（70.87%比62.87%）。居住在拥有充足绿地的城市受访者更有可能报告健康状况良好（OR = 0.749，CI = [0.628，0.895]），而无法可靠获得淡水的农村受访者更有可能报告健康状况不佳（OR = 0.762，CI = [0.612，0.949]）。接触绿色空间并经常锻炼的城市受访者比不经常锻炼的人健康状况良好的可能性高出 21.6%（OR = 1.216，CI = [1.047, 1.413]）。那些生活在绿地不足地区且经常锻炼的人比那些不经常锻炼的人报告健康状况良好的可能性低 19.1%（OR = 0.805，CI = [0.469, 1.381]）。没有证据表明体育锻炼对空气污染暴露与健康之间的关系有调节作用。平均而言，城市居民的健康状况好于农村居民。在四个低环境质量指标（空气污染、绿地缺乏、水污染、淡水资源获取不确定性）中，绿地是城市居民健康状况的重要决定因素，而不可靠的淡水获取损害了农村居民的健康。体育锻炼减轻了接触绿色空间对城市居民健康的影响。
China’s rapid urbanization over the past decades has exacerbated the problems of environmental degradation and health disparities. However, few studies have analysed the differences between urban and rural residents in relation to how environmental quality impacts health outcomes. This study examines the associations between Chinese people's perceptions of environmental quality and their self-rated health, particularly focusing on differences between rural and urban residents in environment-health relationships. Using a logistic regression model and data from the 2013 Chinese General Social Survey (CGSS), a representative sample of data for 3,402 urban residents (46 ± 16 years) and 2,439 rural residents (48 ± 15 years) was analysed. The dependent variable used for the logistic regressions was whether or not respondents reported being healthy. Independent variables included respondents’ evaluations of the living environment, and how frequently they participated in physical activities. Interaction terms were employed to measure the moderating effects of physical exercise on the relationship between perceived environmental quality and health. The percentage of healthy urban residents was significantly larger than that of healthy rural respondents (70.87% versus 62.87%). Urban respondents living in areas with sufficient green space were more likely to report good health (OR = 0.749, CI = [0.628, 0.895]), while rural respondents without reliable access to fresh water were more likely to report poor health (OR = 0.762, CI = [0.612, 0.949]). Urban respondents who were exposed to green spaces and exercised frequently were 21.6 per cent more likely to report good health than those who exercised infrequently (OR = 1.216, CI = [1.047, 1.413]). Those who lived in areas with insufficient green space and exercised frequently were 19.1 per cent less likely to report good health than those who exercised infrequently (OR = 0.805, CI = [0.469, 1.381]). No evidence suggested that physical exercise exerted a moderating effect on the relationship between exposure to air pollution and health. On average, urban residents have better health than rural residents. Among four indicators for low environmental quality (air pollution, lack of green spaces, water pollution, uncertain access to freshwater resources), green space was an important determinant of urban residents’ health status, while unreliable access to fresh water harmed rural residents’ health. Physical exercise moderated the effects of exposure to green spaces on urban residents’ health.