Exploring cognitive-motivational determinants of health (inequities) in the context of the European Environmental Noise Directive

与环境有关的噪音暴露已成为主要的公共卫生问题。为此，欧洲委员会颁布了环境噪音指令2002/49/EU（END）。为了达到高水平的环境保护和健康，END描述了两个行动领域：（1）使用基于人口平均水平的剂量-反应关系评估噪声暴露和健康影响;（2）噪声行动规划，要求公民有能力、积极性和意愿将噪声理解为一个公共健康问题，并参与公共信息和咨询。考虑到社会流行病学和环境心理学的论点，目前的END规划实践可能会加剧健康不公平的风险，从而违反环境规划的预防原则。因此，拟议项目旨在实现两个目标。(1)一个新的概念模型的认知动机的决定因素作为健康（在）股权的关键经验测试通过使用一个大型流行病学研究。统计分析应（a）确定预测暴露居民公民参与当地噪声政策的认知-动机模式，（B）评估认知-动机决定因素作为影响因素的作用，将道路交通噪声暴露与高血压作为心血管健康的指标，以及（c）检查认知-动机决定因素的社会差异及其对健康不平等的潜在影响。(2)应在研讨会上与科学和实践界的专家讨论经验性结论对预防性规划做法的影响。该项目概述了一种新的方法来整合环境心理学和社会流行病学的见解，以评估环境规划干预措施的健康（不）公平结果。

Traffic-related noise exposure has advanced as major public health problem. In response, the European Commission enacted the Environmental Noise Directive 2002/49/EU (END). In order to reach a high level of environmental protection and health, the END describes two fields of action: (1) the assessment of noise exposure and health effects using dose-response-relations based on the population average and (2) noise action planning requiring citizens capacity, motivation, and readiness to understand noise as a public health problem and to be involved in public information and consultation. Considering social epidemiological and environmental psychological arguments, current END planning practice might carry the risk of exacerbating health inequities, thereby violating the precautionary principle of environmental planning. The proposed project therefore aims to achieve two objectives. (1) A new conceptual model on cognitive-motivational determinants as key to health (in-)equities is tested empirically by using a large epidemiological study. Statistical analyses shall (a) identify cognitive-motivational patterns predictive of exposed residents civic engagement in local noise policies, (b) assess the role of cognitive-motivational determinants as effect modifiers in the association of exposure to road traffic noise with hypertension as an indicator of cardiovascular health, and (c) examine social differences in cognitive-motivational determinants and their potential contribution to health inequalities. (2) Implications of empirical findings for a precautionary planning practice shall be discussed with experts at the interface of science and practice in a workshop. This project outlines a new approach to integrate insights from environmental psychology and social epidemiology in order to evaluate the health (in-)equity outcome of environmental planning interventions.