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

与交通相关的噪声暴露已成为主要的公共健康问题。为此，欧盟委员会颁布了《环境噪声指令2002/49/EU》(完)。为了达到高水平的环境保护和健康，最终描述了两个行动领域：(1)使用基于人口平均的剂量-反应关系来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、有动力、愿意理解噪声是一个公共健康问题，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，目前的最终规划做法可能存在加剧健康不平等的风险，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)通过一项大型流行病学研究，对认知-动机决定因素作为健康(In-)股票关键因素的新概念模型进行了实证检验。统计分析应：(A)确定暴露于噪声中的居民的认知-动机模式；(B)评估作为影响因素的认知-动机决定因素在暴露于道路交通噪音与高血压作为心血管健康指标的关系中的作用；(C)审查认知-动机决定因素的社会差异及其对健康不平等的潜在贡献。(2)经验研究结果对预防性规划做法的影响应在研讨会上与专家在科学与实践的交界处进行讨论。该项目概述了一种整合环境心理学和社会流行病学见解的新方法，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.