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Trade-off between diversity and provision of specialized healthcare in US cities 在美国城市的多样性和提供专业医疗保健之间的权衡
Pub Date : 2025-09-17 DOI: 10.1038/s44284-025-00326-7
Tian Gan, Tanisha Dighe, Maurizio Porfiri
There is consensus that urban residents have better access to healthcare than rural residents in the USA, yet this knowledge is based mostly on primary care services. Here we put forward a multidimensional examination of healthcare access to 75 medical specialties in 898 US cities. Leveraging urban scaling theory, economic geography and network science, we confirm the expectation that residents in large cities have access to a more diverse range of specialists. Concurrently, we register a surprising sublinear scaling of the prevalence of most specialty providers: the larger the city, the less the provision of specialized healthcare per capita and per unit area. We propose that the trade-off between diversity and provision is related to economic clustering in the healthcare sector and high patient loading of providers in large cities. These findings suggest the need for city-specific strategies to address emerging inequalities in healthcare services. Healthcare access varies dramatically across urban areas, yet most research focuses on primary care in rural versus urban settings. Analysis of medical specialties across US cities reveals a surprising paradox: larger cities offer more diverse healthcare but fewer specialists per capita.
人们一致认为,在美国,城市居民比农村居民更容易获得医疗保健服务,但这种认识主要是基于初级保健服务。在这里,我们对美国898个城市的75个医学专业的医疗保健可及性进行了多维度检查。利用城市规模理论、经济地理学和网络科学,我们证实了大城市居民有机会接触到更多样化的专家的期望。与此同时,我们发现大多数专业医疗机构的普及程度出现了令人惊讶的次线性增长:城市越大,人均和单位面积提供的专业医疗服务就越少。我们提出,多样性和提供之间的权衡与医疗保健部门的经济集群和大城市提供者的高患者负荷有关。这些发现表明,有必要制定针对城市的战略,以解决医疗保健服务中出现的不平等现象。城市地区的医疗保健机会差异很大,但大多数研究都侧重于农村与城市环境的初级保健。对美国各城市医学专业的分析揭示了一个令人惊讶的悖论:大城市提供的医疗服务更多样化,但人均专科医生却更少。
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引用次数: 0
Tackling urban challenges with synthetic biology in SynCity 在SynCity用合成生物学解决城市挑战
Pub Date : 2025-09-16 DOI: 10.1038/s44284-025-00313-y
Agnieszka Krzyżaniak, Daisy Hessenberger
Cities urgently require sustainable and regenerative practices, such as nature-based solutions (NbSs). Successful in climate adaptation and increasing biodiversity, NbSs often combine gray and green infrastructure to tackle more complex issues. Simultaneously, synthetic biology (SynBio)—the ability to ‘write’ DNA and thereby enhance organisms—is on the rise. Despite its own set of challenges, including ethical ones, SynBio has the potential to address limitations in resources, increases in pollution and even the fading biodiversity of our cities. Hence, its role in regeneration, especially in conjunction with NbSs, should be explored. After all, interesting times require interesting measures. Nature-based solutions have long been touted as important for addressing urban challenges, such as from climate change. This Perspective argues for using synthetic biology to help to meet such challenges and make our cities more sustainable.
城市迫切需要可持续和可再生的做法,例如基于自然的解决方案(nbs)。国家基础设施在适应气候变化和增加生物多样性方面取得成功,往往将灰色和绿色基础设施结合起来,以解决更复杂的问题。与此同时,合成生物学(SynBio)——“编写”DNA从而增强生物体的能力——正在崛起。尽管SynBio自身也面临着一系列挑战,包括伦理问题,但它有潜力解决资源限制、污染增加,甚至是城市生物多样性的衰退。因此,应探讨其在再生中的作用,特别是与国家统计局结合的作用。毕竟,有趣的时代需要有趣的衡量标准。长期以来,基于自然的解决方案一直被吹捧为应对气候变化等城市挑战的重要方法。《透视》主张使用合成生物学来帮助应对这些挑战,使我们的城市更具可持续性。
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引用次数: 0
Individual and city-level variations in heat-related road traffic deaths in Latin America 拉丁美洲与高温有关的道路交通死亡的个人和城市差异
Pub Date : 2025-09-15 DOI: 10.1038/s44284-025-00279-x
Cheng-Kai Hsu, D. Alex Quistberg, Brisa N. Sánchez, Josiah L. Kephart, Usama Bilal, Nelson Gouveia, Carolina Pérez Ferrer, Waleska T. Caiaffa, Amélia Augusta de Lima Friche, Ignacio Yannone, Daniel A. Rodríguez
Latin America experiences both high road traffic mortality and extreme heat, which have been shown elsewhere to be interrelated. However, few studies have examined this association in Latin America—one of the world’s most urbanized, fastest-motorizing regions, with a high share of vulnerable road users—and even fewer have analyzed multiple cities across diverse climates and urban settings. Leveraging ambient temperature and road traffic mortality data (2000–2019) from 272 cities in six Latin American countries, we conducted a time-stratified case-crossover study. On the basis of over 1.9 million city-days of data, we found that road traffic mortality risk generally increased with temperature in a monotonic pattern, with significantly elevated risk on extremely hot days, defined at the 95th and 99th temperature percentiles. Risks were particularly high among younger individuals (≤19 years), males, motorcyclists and bicyclists and in cities with hotter climates, longer commutes and more extended street segments. Cities in the tropical Global South should prioritize protecting vulnerable road users, particularly those in peripheral areas, where many endure long, heat-exposed commutes in informal, non-climate-controlled transport. Extreme heat in Latin America increases road traffic mortality risks, with motorcyclists and bicyclists facing a 27% higher risk on the hottest days. Urban protection measures for vulnerable commuters in cities in the Global South are critical as climate change intensifies heat exposure.
拉丁美洲经历了高道路交通死亡率和极端高温,而在其他地方,这两者已被证明是相互关联的。然而,很少有研究在拉丁美洲(世界上城市化程度最高、机动化速度最快的地区之一,弱势道路使用者的比例很高)考察这种关联,而分析不同气候和城市环境下的多个城市的研究就更少了。利用来自六个拉丁美洲国家272个城市的环境温度和道路交通死亡率数据(2000-2019年),我们进行了一项时间分层的病例交叉研究。基于超过190万个城市日的数据,我们发现道路交通死亡风险总体上随温度呈单调模式增加,在极热的天气(定义为95和99个温度百分位数)风险显著升高。在年轻人(≤19岁)、男性、摩托车手和骑自行车者以及气候较热、通勤时间较长和街道段较长的城市中,风险尤其高。全球南方热带地区的城市应优先保护脆弱的道路使用者,特别是边缘地区的道路使用者,那里的许多人在非正式的、不受气候控制的交通工具中忍受长时间的高温通勤。拉丁美洲的极端高温增加了道路交通死亡风险,骑摩托车和骑自行车的人在最热的日子里面临27%的风险。由于气候变化加剧了热暴露,对全球南方城市中脆弱的通勤者采取城市保护措施至关重要。
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引用次数: 0
Geographic restrictions in stimulus spending mitigated COVID-19 transmission in Seoul 刺激支出的地域限制缓解了首尔的COVID-19传播
Pub Date : 2025-09-12 DOI: 10.1038/s44284-025-00318-7
Ji Eun Lee, Kwan Ok Lee, Hyojung Lee
Stimulus payment programs have been instrumental in supporting economic activity during the COVID-19 pandemic, yet their public health implications remain underexplored. This study examines a unique policy in Seoul, South Korea, which restricted stimulus spending to recipients’ residential cities, to assess its potential in mitigating virus transmission. Using credit card transactions, mobility records and COVID-19 case data, we apply a triple difference-in-differences approach to analyze how the policy reshaped spatial consumption patterns. Results indicate that while the stimulus program boosted overall spending, it also significantly redistributed spending geographically. The restriction led to reduced consumption outside Seoul and a greater concentration of local spending, effectively limiting mobility. Spillover analysis shows localized consumption had a lower impact on infection rates than cross-neighborhood consumption. Simulations suggest the geographic restriction reduced COVID-19 cases by 17% versus an unrestricted scenario. These findings suggest geographically targeted stimulus policies can balance economic recovery with public health objectives. Seoul’s stimulus program restricted spending to recipients’ residential cities during the COVID-19 pandemic, redistributing consumption geographically. Analysis of credit card data reveals a decrease in virus spread compared to scenarios without restrictions, offering insights for future pandemics.
在2019冠状病毒病大流行期间,刺激支付计划在支持经济活动方面发挥了重要作用,但其对公共卫生的影响仍未得到充分探讨。本研究考察了韩国首尔的一项独特政策,该政策将刺激支出限制在接受者的居住城市,以评估其在减轻病毒传播方面的潜力。利用信用卡交易、流动记录和COVID-19病例数据,我们采用三差中差方法分析了政策如何重塑空间消费模式。结果表明,虽然刺激计划促进了总体支出,但它也显著地重新分配了地域上的支出。这一限制导致首尔以外的消费减少,地方消费更加集中,有效地限制了流动性。溢出分析表明,本地消费对感染率的影响低于跨社区消费。模拟表明,与不受限制的情况相比,地理限制使COVID-19病例减少了17%。这些发现表明,地理上有针对性的刺激政策可以平衡经济复苏与公共卫生目标。在新冠疫情期间,韩国政府的经济刺激计划限制了对受援国居住城市的支出,从而重新分配了消费地域。对信用卡数据的分析显示,与没有限制的情况相比,病毒传播有所减少,这为未来的大流行提供了洞见。
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引用次数: 0
Urban expansion onto hillsides poses unprecedented threats to terrestrial biodiversity 城市向山坡的扩张对陆地生物多样性构成了前所未有的威胁
Pub Date : 2025-09-10 DOI: 10.1038/s44284-025-00319-6
There was a considerable trend of urban expansion onto hillsides from 2000 to 2020, which covered 11.65 million hectares globally. This expansion has destroyed 6.73 million hectares of natural habitats and further directly affected about 70% of threatened species, which highlights the fact that urgent policy action is needed to balance such development with terrestrial biodiversity conservation.
2000 - 2020年,全球城市向山坡扩展的趋势明显,覆盖面积达1165万公顷。这种扩张已经破坏了673万公顷的自然栖息地,并进一步直接影响了约70%的受威胁物种,这突显了需要采取紧急政策行动来平衡这种发展与陆地生物多样性保护的事实。
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引用次数: 0
The governance of informal street work in San Francisco and New York City 旧金山和纽约非正式街头工作的管理
Pub Date : 2025-09-09 DOI: 10.1038/s44284-025-00321-y
Irene Farah, Ryan Thomas Devlin, Chris Hartmann, Jenna Harvey, Christine Hegel
How do local regulations and practices enable or constrain informal work’s potential to contribute to inclusive economic development in US cities? Amid employment and migration crises, informal work provides critical safety nets for those excluded from formal labor markets. Urban planning approaches in San Francisco and New York City often dismiss, disregard or disable informal workers. Examining street vendors and waste pickers, we show how status quo regulatory approaches are not only exclusionary but also miss opportunities to recognize these workers’ contributions. We draw from case studies in the Global South to propose an alternate, inclusive governance approach. Informal workers contribute meaningfully to cities worldwide. This Perspective argues that current regulatory approaches in San Francisco and New York City constrain informal work and workers, considering cases from the Global South in service of a more inclusive approach.
地方法规和实践如何促进或限制非正式工作对美国城市包容性经济发展的潜力?在就业和移民危机中,非正规工作为那些被排除在正规劳动力市场之外的人提供了至关重要的安全网。旧金山和纽约的城市规划方法经常忽视、忽视或使非正式工人残疾。通过对街头小贩和拾荒者的研究,我们展示了现状的监管方法不仅是排他性的,而且还错过了认识这些工人贡献的机会。我们借鉴了全球南方的案例研究,提出了另一种包容性的治理方法。非正式工人为世界各地的城市做出了有意义的贡献。本文认为,旧金山和纽约目前的监管方法限制了非正规工作和工人,并考虑了来自全球南方的案例,以促进更具包容性的方法。
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引用次数: 0
Extensive terrestrial biodiversity threats from global hillside urban expansion 全球山坡城市扩张带来的广泛陆地生物多样性威胁
Pub Date : 2025-09-09 DOI: 10.1038/s44284-025-00316-9
Kaifang Shi, Yizhen Wu, Xiufeng Sun, Yuanzheng Cui, Zuoqi Chen, Lisheng Song, Fengman Fang, Weidong Cao, Jinji Ma, Chang Huang, Lei Gao, Bailang Yu, Brett A. Bryan
The escalating trend of global hillside urban expansion threatens terrestrial biodiversity and undermines global initiatives, including the Sustainable Development Goals and the Global Biodiversity Framework. This study addresses a critical knowledge gap by examining the impacts of hillside urban expansion on terrestrial biodiversity across multiple scales, integrating multi-source high-resolution data with terrestrial vertebrate species datasets. Our results reveal substantial global hillside urban expansion (11.65 Mha) between 2000 and 2020, with 35% occurring within biodiversity hotspots. It encroaches disproportionately on natural habitat compared to urban expansion in flat areas, significantly exacerbating habitat fragmentation. This has far-reaching consequences for terrestrial biodiversity, directly affecting ~70% of globally threatened species and hindering progress towards biodiversity conservation by 2050. Our findings underscore an urgent need for tailored land-use and urban planning strategies that prioritize biodiversity conservation in ecologically sensitive areas. This study lays the groundwork for the development of more sustainable land-use planning, nature conservation and urban development policies. Hillside urbanization rises as cities exhaust flat land, threatening sensitive ecosystems. Mapping of 11.65 Mha added since 2000 reveals that 35% of them are in critical areas, fragmenting habitats and endangering 70% of globally threatened species.
全球山坡城市扩张的不断升级趋势威胁着陆地生物多样性,并破坏了包括可持续发展目标和全球生物多样性框架在内的全球倡议。本研究通过整合多源高分辨率数据和陆生脊椎动物物种数据集,在多个尺度上考察了山坡城市扩张对陆地生物多样性的影响,解决了一个关键的知识缺口。结果表明,2000年至2020年,全球山坡城市扩张幅度显著(11.65 Mha),其中35%发生在生物多样性热点地区。与平坦地区的城市扩张相比,它对自然栖息地的侵占不成比例,显著加剧了栖息地的破碎化。这对陆地生物多样性产生了深远的影响,直接影响到全球约70%的濒危物种,并阻碍了到2050年实现生物多样性保护的进展。我们的研究结果强调,迫切需要在生态敏感地区制定适合的土地利用和城市规划策略,优先考虑生物多样性保护。这项研究为制定更可持续的土地使用规划、自然保护和城市发展政策奠定了基础。随着城市耗尽平坦的土地,山坡上的城市化上升,威胁到敏感的生态系统。自2000年以来新增的11.65亿公顷的地图显示,其中35%位于关键地区,破坏了栖息地,危及70%的全球濒危物种。
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引用次数: 0
Satellite analysis of methane emissions connects war and urban sustainability 甲烷排放的卫星分析将战争和城市可持续性联系起来
Pub Date : 2025-09-05 DOI: 10.1038/s44284-025-00312-z
The effects of warfare on urban sustainability tend to escape traditional measurements and inventories, but now a satellite-constellation-based approach exposes how warfare is unleashing plumes of methane across battlefronts in Ukraine. Emission patterns flip: cities surge from levels that are a fraction of rural emissions to levels that are many times higher.
战争对城市可持续性的影响往往无法通过传统的测量和清单来衡量,但现在,一种基于卫星星座的方法揭示了战争是如何在乌克兰的战场上释放出大量甲烷的。排放模式发生了变化:城市的排放量从农村排放量的一小部分激增到高出农村许多倍的水平。
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引用次数: 0
Vast and hidden urban methane emissions from the Russia–Ukraine war 俄乌战争造成的大量隐蔽的城市甲烷排放
Pub Date : 2025-09-04 DOI: 10.1038/s44284-025-00309-8
Zeyu Feng, Rong Hu, Yuqing Pan, Qianjian Xv, Jing Zhang, Qingyong Wang, Kaiqin Cao, Shufeng Liu, Alexander Baklanov, Jens Hesselbjerg Christen, Daniel Rosenfeld, John H. Seinfeld, Shaocai Yu, Pengfei Li
Historically, cities have figured prominently in wars, including as targets. However, the impacts of warfare on the environmental signatures of urban systems remain less understood. Here we propose a comprehensive satellite-constellation-based framework to systematically assess methane emissions attributable to the Russia–Ukraine war. We find that this conflict overturns the conventional urban–rural methane emissions relationship, typically dominated by rural methane emissions. Urban methane emissions, initially just 21% of rural levels, rapidly rise to match rural levels after very few attacks and escalate to ~146%–588% of rural levels under extensive and intensive warfare, revealing urban systems’ greater vulnerability to warfare disruption. Civilian infrastructure, primarily residential buildings, emerges as a major emission source, matching military facilities in both emission intensity and frequency. These findings uncover an underappreciated, direct relationship between warfare, methane emissions and urban degradation. In the context of ongoing global conflicts, this relationship underscores the urgent need to monitor the greenhouse-gas signatures of besieged cities and highlights peace as a fundamental prerequisite for achieving climate-related Sustainable Development Goals. War has myriad recognized impacts on cities and the environment. This study adds insult to injury, providing spaceborne evidence that the destruction of warfare triggers rapid and substantial increases in urban methane emissions.
从历史上看,城市在战争中占有重要地位,包括作为目标。然而,战争对城市系统环境特征的影响仍然知之甚少。在这里,我们提出了一个全面的基于卫星星座的框架来系统地评估可归因于俄罗斯-乌克兰战争的甲烷排放。我们发现,这种冲突颠覆了传统的城乡甲烷排放关系,传统的城乡甲烷排放关系通常以农村甲烷排放为主。城市甲烷排放量最初仅为农村水平的21%,在很少的攻击之后迅速上升到农村水平,在广泛和密集的战争中上升到农村水平的146%-588%,这表明城市系统更容易受到战争破坏。民用基础设施(以住宅建筑为主)成为主要排放源,其排放强度和排放频率与军用设施相当。这些发现揭示了战争、甲烷排放和城市退化之间未被充分认识的直接关系。在全球冲突不断的背景下,这种关系强调了监测被围困城市温室气体特征的迫切需要,并强调和平是实现与气候相关的可持续发展目标的基本先决条件。战争对城市和环境有无数公认的影响。这项研究是雪上加霜,它提供了太空证据,证明战争的破坏引发了城市甲烷排放的迅速而实质性的增加。
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引用次数: 0
China’s new program gives cities check-ups 中国的新计划对城市进行检查
Pub Date : 2025-09-04 DOI: 10.1038/s44284-025-00317-8
Haimeng Liu, Chuanglin Fang
Cities — as with complex living systems — could benefit from check-ups, as is happening in a new program in China. However, improvements are needed through adjusting health assessment indicators, enhancing public participation, and integrating the insights of both Eastern and Western medicine.
城市和复杂的生活系统一样,可以从检查中受益,就像中国的一个新项目所做的那样。但是,需要通过调整健康评估指标、加强公众参与、结合东西方医学的见解来改进。
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引用次数: 0
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