From built environment to health inequalities: An explanatory framework based on evidence.
From built environment to health inequalities: An explanatory framework based on evidence.
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DOI：
10.1016/j.pmedr.2015.08.019
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发表时间：
2015
影响因子：
2.8
通讯作者：
Costa G
中科院分区：
文献类型：
--
作者：
Gelormino E;Melis G;Marietta C;Costa G
目标：“将健康纳入所有政策”战略旨在使每个政策领域都参与健康促进工作。社会处境较为不利的群体，如果不是以健康为导向，通常更容易受到政策的潜在负面影响。人造环境是一个重要的政策领域，除了其住房部分之外，很少评估其对健康不平等的影响。研究方法：对建筑环境及其健康公平影响的证据进行了范围审查，搜索自2000年以来分析建筑环境不同组成部分的社会经济不平等的城市和医学文献。结果如下：拟议的解释性框架假定，建筑环境的主要特征（确定为密度、功能组合以及公共空间和服务）可能通过对自然环境和社会背景以及行为的影响而影响个人健康，而且这些影响可能根据个人的社会地位而分布不均。结论：一般而言，该框架提出的预期联系在文献中有很好的记载;然而，由于混杂因素、研究设计的异质性以及难以将仍然非常嵌入当地环境的证据进行概括，因此其对健康不平等影响的证据仍然不确定。
Objective: The Health in All Policies strategy aims to engage every policy domain in health promotion. The more socially disadvantaged groups are usually more affected by potential negative impacts of policies if they are not health oriented. The built environment represents an important policy domain and, apart from its housing component, its impact on health inequalities is seldom assessed. Methods: A scoping review of evidence on the built environment and its health equity impact was carried out, searching both urban and medical literature since 2000 analysing socio-economic inequalities in relation to different components of the built environment. Results: The proposed explanatory framework assumes that key features of built environment (identified as density, functional mix and public spaces and services), may influence individual health through their impact on both natural environment and social context, as well as behaviours, and that these effects may be unequally distributed according to the social position of individuals. Conclusion: In general, the expected links proposed by the framework are well documented in the literature; however, evidence of their impact on health inequalities remains uncertain due to confounding factors, heterogeneity in study design, and difficulty to generalize evidence that is still very embedded to local contexts.