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

背景：研究城市健康至关重要，因为世界上大多数人口生活在城市地区。此外，卫生和环境方面的不平等现象在市中心的居民区很严重。然而，大多数现有的研究没有解决城市健康的多学科和综合的方法，是必要的捕捉城市的社会生态环境的复杂性。此外，缺乏对城市环境中与健康有关的问题的空间和时空分析。为了推动科学发展并为公共卫生政策提供信息，研究需要深入探讨多个地理尺度上健康不平等和社会生态风险的根源。研究目标：我的总体研究目标是开发一个框架，推动科学专注于了解健康和城市环境之间的复杂相互作用。为此，我将量化城市健康的空间分布（健康不平等）;评估社会生态环境暴露的空间模式，即，城市居民区的环境不平等;并确定环境不平等如何影响城市健康。方法学：我提出了一个综合的和空间明确的方法来研究与健康有关的问题，结合流行病学和地理学的方法。这种健康地理方法集中于城市健康和社会生态环境之间在不同地理尺度上的复杂关系。该方法包括疾病绘图、接触绘图以及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，重点关注公共卫生成果方面的城乡差异和城市邻里特征。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别。此外，还将在纽约市和马萨诸塞州的弗拉托对城市居民区的精神健康和心血管疾病进行分析。将把调查结果综合纳入健康和城市环境框架。项目的相关性：拟议的项目将有助于统一处理与健康有关问题的地理方法。成果将有助于制定战略，减少城市地区与健康有关的不平等现象，并为公共卫生政策提供信息。与项目相关的工作将导致在国际同行评审的期刊，书籍章节和一些会议的贡献至少六个出版物。

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.