Inequality in green space distribution and its association with preventable deaths across urban neighbourhoods in the UK, stratified by Index of Multiple Deprivation.

IF 4.9 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Journal of Epidemiology and Community Health Pub Date : 2025-01-13 DOI:10.1136/jech-2024-222485
Tran Thu Ngan, Ruoyu Wang, Christopher Tate, Mark Green, Richard Mitchell, Ruth F Hunter, Ciaran O'Neill
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Abstract

Background: This study investigated inequalities in the distribution of green space (GS) and the association between inequalities in amounts of GS and preventable deaths across urban neighbourhoods with different Index of Multiple Deprivation (IMD) scores in the UK.

Methods: Data on preventable deaths, IMD, percentage of grassland and woodland, urban/rural, population size, and density were sourced for each of 6791 middle-layer super output areas (MSOAs) in England, 410 MSOAs in Wales, 1279 intermediate zones (IZs) in Scotland, and 890 super output areas (SOAs) in Northern Ireland (NI). While appreciating the potential for ecological fallacy we related area-based measures of deprivation to deaths. Concentration curves, Lorenz dominance tests, and negative binomial regression models were used to analyse the data.

Results: In urban areas of England, Scotland, and NI, the percentage of grassland was significantly lower among the more deprived neighbourhoods (Lorenz test, p<0.0001). In England, a 1% increase in grassland area was associated with a 37% reduction in annual preventable deaths among the most deprived urban MSOAs (incidence rate ratio (IRR) 0.63, 95% CI 0.52 to 0.76). In NI and Scotland, a 1% increase in grassland area was associated with a 37% (IRR 0.63, 95% CI 0.43 to 0.91) and 41% (IRR 0.59, 95% CI 0.42 to 0.81) reduction in 5-year accumulated preventable deaths in the most deprived urban SOAs/IZs, respectively.

Conclusions: Results suggest that investment in GS in urban areas may be an important public health prevention strategy. There is evidence that investments in the most deprived urban neighbourhoods where the highest inequality currently exists would see the largest effect on preventable deaths.

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英国城市街区绿地分布的不平等及其与可预防死亡的关系,按多重贫困指数分层。
背景:本研究调查了英国不同多重贫困指数(IMD)得分的城市社区中绿地(GS)分布的不平等以及绿地数量的不平等与可预防死亡之间的关联:在英格兰的 6791 个中层超产出区 (MSOA)、威尔士的 410 个中层超产出区、苏格兰的 1279 个中间区 (IZ) 和北爱尔兰 (NI) 的 890 个超产出区 (SOA) 中,分别获取了有关可预防死亡、IMD、草地和林地百分比、城市/农村、人口规模和密度的数据。在考虑到可能存在生态谬误的同时,我们将基于地区的贫困度量与死亡相关联。我们使用了集中曲线、洛伦兹优势检验和负二项回归模型来分析数据:结果:在英格兰、苏格兰和北爱尔兰的城市地区,较贫困社区的草地比例明显较低(洛伦兹检验,p):结果表明,对城市地区的 GS 进行投资可能是一项重要的公共健康预防策略。有证据表明,在目前不平等现象最严重的最贫困城市街区进行投资,将对可预防的死亡产生最大的影响。
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来源期刊
Journal of Epidemiology and Community Health
Journal of Epidemiology and Community Health 医学-公共卫生、环境卫生与职业卫生
CiteScore
11.10
自引率
0.00%
发文量
100
审稿时长
3-6 weeks
期刊介绍: The Journal of Epidemiology and Community Health is a leading international journal devoted to publication of original research and reviews covering applied, methodological and theoretical issues with emphasis on studies using multidisciplinary or integrative approaches. The journal aims to improve epidemiological knowledge and ultimately health worldwide.
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