Urban Public Health in the context of Geography - Understanding the link between human health and the urban socio-ecological environment

背景：研究城市卫生至关重要，因为世界上大多数人口生活在城市地区。此外，健康和环境方面的不平等在城市内城社区也很严重。然而，大多数现有研究没有采用多学科和综合的方法解决城市卫生问题，而这些方法是捕捉城市社会生态环境复杂性所必需的。此外，还缺乏对城市环境中卫生相关问题的空间和时空分析。为了推进科学并为公共卫生政策提供信息，研究需要在多个地理尺度上深入研究卫生不平等和社会生态暴露的根源。研究目标：我的总体研究目标是建立一个框架，推动科学的发展，重点是理解健康与城市环境之间复杂的相互作用。为此，我将量化城市卫生的空间分布（卫生不平等）；评估社会生态环境暴露的空间格局，即城市社区的环境不平等；并确定环境不平等如何影响城市健康。方法：我提出了一种综合的、空间明确的方法，通过结合流行病学和地理学的方法方法来研究与健康有关的问题。这种健康地理学方法侧重于不同地理尺度上城市健康与社会生态环境之间的复杂关系。方法包括疾病制图、暴露制图和使用地理处理和空间统计的空间流行病学建模。将使用五个不同的数据集，重点关注城乡差异和城市邻里特征与公共卫生结果的关系。例如，将在撒哈拉以南非洲国家研究超重和体重不足的城乡差异。此外，将分析纽约市和麻萨诸塞州弗雷明汉的城市社区在心理健康和心血管疾病方面的情况。调查结果将在保健和城市环境的框架内加以综合。项目的相关性：拟议的项目将有助于巩固处理与卫生有关问题的地理方法。成果将有助于制定减少城市地区与卫生有关的不平等现象的战略框架，并为公共卫生政策提供信息。与项目相关的工作将导致至少六篇国际同行评审期刊，书籍章节和一些会议贡献。

Background: Studying urban health is of vital importance, because the majority of the world¿s population is living in urban areas. Moreover, health and environmental inequalities are significant in inner city neighbourhoods. However, most existing studies do not address urban health with the multidisciplinary and integrative approaches that are necessary to capture the complexity of socio-ecological environments in cities. Furthermore, spatial and spatio-temporal analyses of health related questions in urban settings are lacking. In order to advance science and inform public health policies, research needs to delve into the origins of health inequalities and socio-ecological exposures at multiple geographical scales. Research Goals: My overall research goal is to develop a framework that advances science concentrating on understanding the complex interactions between health and the urban environment. To do this, I will quantify the spatial distribution of urban health (health inequalities); assess the spatial patterns of exposures from the socio-ecological environment, i.e., environmental inequalities in urban neighbourhoods; and identify how environmental inequalities affect urban health. Methodology: I am proposing an integrative and spatially explicit approach for studying health-related questions by combining methodological approaches from epidemiology and geography. This health-geographical approach concentrates on the complex relationships between urban health and the socio-ecological environment at various geographical scales. The methodology includes disease mapping, exposure mapping, and spatial-epidemiological modelling using geo-processing and spatial statistics. Five different data sets will be used concentrating on rural-urban differences and urban neighbourhood characteristics with respect to public health outcomes. For example, rural-urban differences of over- and under-weight will be studied in sub-Saharan African countries. Furthermore, urban neighbourhoods with respect to mental health and cardiovascular diseases will be analysed in New York City and Framingham, MA. The findings will be integrated and synthesized in a framework for health and the urban environment. Relevance of the project: The proposed project will help consolidating geographical approaches for health related questions. Outcomes will contribute to frame strategies for reducing health-related inequalities in urban areas and inform public health policy. Project related work will lead to at least six publications in international peer-reviewed journals, book chapters, and a number of conference contributions.