Volume 35 Issue 12
Dec.  2022
Turn off MathJax
Article Contents

ZHENG Wen Jing, QI Xiao, YAO Hong Yan, LIU Jian Jun, YU Shi Cheng, ZHANG Tao. Influence of Built Environment in Hygienic City in China on Self-rated Health of Residents[J]. Biomedical and Environmental Sciences, 2022, 35(12): 1126-1132. doi: 10.3967/bes2022.142
Citation: ZHENG Wen Jing, QI Xiao, YAO Hong Yan, LIU Jian Jun, YU Shi Cheng, ZHANG Tao. Influence of Built Environment in Hygienic City in China on Self-rated Health of Residents[J]. Biomedical and Environmental Sciences, 2022, 35(12): 1126-1132. doi: 10.3967/bes2022.142

Influence of Built Environment in Hygienic City in China on Self-rated Health of Residents

doi: 10.3967/bes2022.142
Funds:  Operation Project of Public Health Emergency Response Mechanism of Chinese Center for Disease Control and Prevention [131031001000150001]
More Information
  • Author Bio:

    ZHENG Wen Jing, female, born in 1984, Assistant Researcher, majoring in public health policy

  • Corresponding author: QI Xiao, Assistant Researcher, Tel: 86-10-58900524, E-mail: qixiao@chinacdc.cn
  • Received Date: 2022-01-22
  • Accepted Date: 2022-05-05
  •   Objective   To assess the subjective perception of residents on the built environment in hygienic cities and its relation to the self-rated health (SRH) status of residents, providing a basis for a better promotion on construction of health-supportive environments.   Methods   The online survey was adopted with the respondents recruited from residents living in Chaoyang District of Beijing in January 2021. With SRH level as the dependent variable, two-category logistic regression analysis was conducted to analyze the impact of the built environment in hygienic cities on the SRH status of residents.   Results   A total of 1,357 respondents were enrolled in this study. After controlling confounding factors, four aspects in the built environment in hygienic cities were detected remarkable influences on the SRH level of residents, including enough green space in the living area [odds ratio (OR) = 1.395, 95% confidence interval (95% CI): 1.055–1.845], clean and hygienic living environment (OR = 1.472, 95% CI: 1.107–1.956), residents' confidence in drinking water safety in the living area (OR = 1.856, 95% CI: 1.354–2.544) and residents' confidence in food safety in the living area (OR = 1.405, 95% CI: 1.027–1.921).   Conclusion   Regarding city construction, the government should focus more on the subjective perception of residents on built environments to build a supportive environment benefiting the health of residents.
  • 加载中
  • [1] Handy SL, Boarnet MG, Ewing R, et al. How the built environment affects physical activity: views from urban planning. Am J Prev Med, 2002; 23, 64−73. doi:  10.1016/S0749-3797(02)00475-0
    [2] Croucher K, Myers L, Jones R, et al. Health and the physical characteristics of urban neighbourhoods: a critical literature review. Glasgow: Glasgow Centre for Population Health, 2007.
    [3] Sarkar C, Webster C, Gallacher J. Healthy cities: public Health through urban planning. Edward Elgar Publishers, 2014.
    [4] Joshu CE, Boehmer TK, Brownson RC, et al. Personal, neighbourhood and urban factors associated with obesity in the United States. J Epidemiol Community Health, 2008; 62, 202−8. doi:  10.1136/jech.2006.058321
    [5] Lv J, Cheng SX. Surveillance and analysis for foodborne pathogens in food products before and after the initiative of hygienic cities. J Pub Health Prev Med, 2017; 28, 129−30. (In Chinese
    [6] Yue DH, Ruan SM, Xu J, et al. Impact of the China healthy cities initiative on urban environment. J Urban Health, 2017; 94, 149−57. doi:  10.1007/s11524-016-0106-1
    [7] Qi Hl, Dong YD, Mei Y, et al. Impact of creating national healthy city on vector control effect. Chin J Hyg Insect Equip, 2016; 22, 145−7, 152. (In Chinese
    [8] Wang JQ, Liu JJ, Sun JF, et al. Geographical distribution of accredited healthy cities and towns in China: 1989-2019. China J Public Health, 2020; 36, 89−92. (In Chinese
    [9] Ergin I, Mandiracioglu A. Demographic and socioeconomic inequalities for self-rated health and happiness in elderly: the situation for Turkey regarding World Values Survey between 1990 and 2013. Arch Gerontol Geriatr, 2015; 61, 224−30. doi:  10.1016/j.archger.2015.06.011
    [10] Zheng WJ, Yao HY, Liu JJ, et al. Developing a subjective evaluation scale for assessing the built environments of China’s hygienic city initiative. Biomed Environ Sci, 2021; 34, 372−8.
    [11] Au N, Johnston DW. Self-assessed health: what does it mean and what does it hide? Soc Sci Med, 2014; 121, 21−8.
    [12] Perlman F, Bobak M. Determinants of self rated health and mortality in Russia-are they the same? Int J Equity Health, 2008; 7, 19.
    [13] Dong WL, Li YC, Wang ZQ, et al. Self-rated health and health-related quality of life among Chinese residents, China, 2010. Health Qual Life Outcomes, 2016; 14, 5. doi:  10.1186/s12955-016-0409-7
    [14] Jia XX, Hu HY, Wang XX, et al. Analysis on Self-rated health status and its influencing factors among Chinese residents aged 15 and above. Chin J Health Policy, 2016; 9, 62−7. (In Chinese
    [15] Gebel K, Bauman AE, Sugiyama T, et al. Mismatch between perceived and objectively assessed neighborhood walkability attributes: prospective relationships with walking and weight gain. Health Place, 2011; 17, 519−24. doi:  10.1016/j.healthplace.2010.12.008
    [16] YU CY. How differences in roadways affect school travel safety. J Am Plann Assoc, 2015; 81, 203−20. doi:  10.1080/01944363.2015.1080599
    [17] Sallis JF, Bowles HR, Bauman A, et al. Neighborhood environments and physical activity among adults in 11 countries. Am J Prev Med, 2009; 36, 484−90. doi:  10.1016/j.amepre.2009.01.031
    [18] Craveiro D. The role of personal social networks on health inequalities across European regions. Health Place, 2017; 45, 24−31. doi:  10.1016/j.healthplace.2017.02.007
    [19] Hayward E, Ibe C, Young JH, et al. Linking social and built environmental factors to the health of public housing residents: a focus group study. BMC Public Health, 2015; 15, 351. doi:  10.1186/s12889-015-1710-9
    [20] Gidlow C, Cochrane T, Davey RC, et al. Relative importance of physical and social aspects of perceived neighbourhood environment for self-reported health. Preventive Medicine, 2010; 51, 157−63. doi:  10.1016/j.ypmed.2010.05.006
    [21] Xu YQ, Wen M, Wang FH. Multilevel built environment features and individual odds of overweight and obesity in Utah. Appl Geogr, 2015; 60, 197−203. doi:  10.1016/j.apgeog.2014.10.006
    [22] Gilliland JA, Rangel CY, Healy MA, et al. Linking childhood obesity to the built environment: a multi-level analysis of home and school neighbourhood factors associated with body mass index. Can J Public Health, 2012; 103, S15−21.
    [23] Konteh FH. Urban sanitation and health in the developing world: reminiscing the nineteenth century industrial nations. Health Place, 2009; 15, 69−78. doi:  10.1016/j.healthplace.2008.02.003
    [24] Preventing disease through healthy environments: towards an estimate of the environmental burden of disease. https://www.who.int/publications/i/item/9241593822. [2021-2-11].
    [25] Wang XY, Hu S. Influence of safe drinking water accessibility on middle and old-age residents' health in rural areas——an empirical analysis based on data CHARLS. J Green Sci Technol, 2016; 65−7, 70. (In Chinese
    [26] Howard G, Bartram J. Domestic water quantity, service level and health. Geneva World Health Organization. 2003; 1−33.
    [27] Kremer M, Leino J, Miguel E, et al. Spring cleaning: rural water impacts, valuation, and Property rights institutions. Quart J Econom, 2011; 126, 145−205. doi:  10.1093/qje/qjq010
    [28] Feng J, Yu YY. Income inequality and health in rural China. Econom Res J, 2007; 42, 79−88. (In Chinese
    [29] Tang X. Food safety Per cognition of and subjective Well-being of Urban Residents. J Nanchang Univ, 2017; 48, 72−80. (In Chinese
    [30] Chen JH, Jin KJ, Zhao L, et al. Correlation between self-rated health status, depression and subjective well-being of the elderly in old-age institutions. International Journal of Nursing, 2021; 40, 4428−33. (In Chinese
    [31] Xu YQ, Wang FH. Built environment and obesity by urbanicity in the U. S. Health Place, 2015; 34, 19−29. doi:  10.1016/j.healthplace.2015.03.010
    [32] Walker RE, Keane CR, Burke JG. Disparities and access to healthy food in the United States: a review of food deserts literature. Health Place, 2010; 16, 876−84. doi:  10.1016/j.healthplace.2010.04.013
    [33] Fraser LK, Edwards KL, Cade J, et al. The geography of fast food outlets: a review. Int J Environ Res Public Health, 2010; 7, 2290−308. doi:  10.3390/ijerph7052290
  • 加载中
通讯作者: 陈斌, bchen63@163.com
  • 1. 

    沈阳化工大学材料科学与工程学院 沈阳 110142

  1. 本站搜索
  2. 百度学术搜索
  3. 万方数据库搜索
  4. CNKI搜索

Tables(3)

Article Metrics

Article views(354) PDF downloads(54) Cited by()

Proportional views
Related

Influence of Built Environment in Hygienic City in China on Self-rated Health of Residents

doi: 10.3967/bes2022.142
Funds:  Operation Project of Public Health Emergency Response Mechanism of Chinese Center for Disease Control and Prevention [131031001000150001]
  • Author Bio:

  • Corresponding author: QI Xiao, Assistant Researcher, Tel: 86-10-58900524, E-mail: qixiao@chinacdc.cn

Abstract:   Objective   To assess the subjective perception of residents on the built environment in hygienic cities and its relation to the self-rated health (SRH) status of residents, providing a basis for a better promotion on construction of health-supportive environments.   Methods   The online survey was adopted with the respondents recruited from residents living in Chaoyang District of Beijing in January 2021. With SRH level as the dependent variable, two-category logistic regression analysis was conducted to analyze the impact of the built environment in hygienic cities on the SRH status of residents.   Results   A total of 1,357 respondents were enrolled in this study. After controlling confounding factors, four aspects in the built environment in hygienic cities were detected remarkable influences on the SRH level of residents, including enough green space in the living area [odds ratio (OR) = 1.395, 95% confidence interval (95% CI): 1.055–1.845], clean and hygienic living environment (OR = 1.472, 95% CI: 1.107–1.956), residents' confidence in drinking water safety in the living area (OR = 1.856, 95% CI: 1.354–2.544) and residents' confidence in food safety in the living area (OR = 1.405, 95% CI: 1.027–1.921).   Conclusion   Regarding city construction, the government should focus more on the subjective perception of residents on built environments to build a supportive environment benefiting the health of residents.

ZHENG Wen Jing, QI Xiao, YAO Hong Yan, LIU Jian Jun, YU Shi Cheng, ZHANG Tao. Influence of Built Environment in Hygienic City in China on Self-rated Health of Residents[J]. Biomedical and Environmental Sciences, 2022, 35(12): 1126-1132. doi: 10.3967/bes2022.142
Citation: ZHENG Wen Jing, QI Xiao, YAO Hong Yan, LIU Jian Jun, YU Shi Cheng, ZHANG Tao. Influence of Built Environment in Hygienic City in China on Self-rated Health of Residents[J]. Biomedical and Environmental Sciences, 2022, 35(12): 1126-1132. doi: 10.3967/bes2022.142
    • Built environments refer to all kinds of buildings and places artificially constructed and renovated as well as environments able to be changed through policies and human behaviors[1]. Studies have demonstrated that built environments have a close association with human health [2]. Such factors as population density, walkability and facility layout in built environments would affect the behaviors and activities of individuals, thereby impacting personal health, including the lifespan, cardiovascular disease incidence rate, mental health and subjective health assessment of residents, such as Self-rated health status (SRH)[3]. Based on empirical studies in the United States, community environment is the second largest influencing factor for the physical health of residents, only second to individual characteristics. As a result, the improvement of urban built environments plays a positive role in promoting public health [4].

      In China, the construction of hygienic cities, which began in 1989, is originally aimed at solving the problems during urban development, i.e. dirty, chaotic and poor sanitation situation. Following 30 years of development, it has become a public policy led by the Chinese government, with cooperation between departments and the join of the entire society. Its main purpose is to change the living environment and health behavior of people through urban infrastructure construction, policy advocacy and other measures, and construct an urban built environment centered on population health. Studies have manifested that the construction of hygienic cities has achieved remarkable outcomes in improving urban hygienic environment, intensively treating domestic sewage, improving air quality, preventing and controlling vector organisms (rats, mosquitoes and flies) and reducing the incidence rate of infectious diseases [5-7]. “China Model” of healty cities has been estabilshed through achieving the greatest health benefits with the least investment[8]. In 2013, the Chinese government was awarded the “WHO special recognition to China for Healthy city (hygienic city) initiative” for the notable outcomes in the process of hygienic cities initiatives in China.

      SRH, also known as self-reported health status, is a subjective health measurement index comprehensively reflecting the physical and mental health of individuals. Compared with traditional health indicators, SRH indicator can more efficiently reflect the objective health status of the population with the advantage of easy applicability. This study aims to explore the relationship between the built environment in hygienic cities and the SRH status of residents from the perspective of subjective perception of residents on the built environment, with Chaoyang District of Beijing as the survey field, so as to offer a basis for better facilitating the construction of health-supportive environments in cities.

    • A cross-sectional survey was conducted using the network platform “Wen Juan Xing”, with the residents living in Chaoyang District of Beijing as the respondents. Chaoyang District of Beijing started the process of national hygienic city construction in 2017 and passed the acceptance of national hygienic city successfully In 2021. Residents can more clearly perceive the impact of policy implementation during this period. The inclusion criteria for respondents were set as follows: 1) people living in Chaoyang District of Beijing for 1 year and above, and 2) aged over 18 years old. Questionnaires were sent to the respondents through WeChat official account, web page, email and other forms. Residents who were willing to participate in the survey need finish the following two questions firstly: "Do you live in Chaoyang District of Beijing for 1 year and above", and "Are you aged over 18 years old". Only residents who answer "yes" to both of the above two questions can proceed to the formal questionnaire survey. In this study, a total of 1,603 residents were surveyed, and 1,357 of them submitted valid questionnaires.

    • Assessment of SRH Status of Respondents In this study, the health status of respondents was assessed according to their answer to the item "What do you think of your current health" [9], with a 5-Likert scale (from 1 to 5 = very unhealthy, unhealthy, general, healthy and very healthy).

      Evaluation of Subjective Perception on the Built Environment in Hygienic Cities A Subjective evaluation scale was used to assess the subjective perception of the residents[10]. The scale composed of five dimensions with 22 items, including urban lifestyle, governance, basic functions, environmental sanitation, and amenities. The Cronbach’s α coefficient of the scale was 0.876, and the split-half reliability coefficient was 0.796. The CFA (confirmatory factor analysis) results indicate that each inspection level was within the standard limit.

      Demographic Characteristics of Respondents The demographic information of respondents included gender, age, education level, annual household income, marital status, occupation, type of community, length of residence and regular physical activity.

    • The SRH status of residents was divided into high-score and low-score groups. The respondents rating "very unhealthy" "unhealthy" and "general" were categorized into low-score group, while those rating "healthy" and "very healthy" were categorized into high-score group.

      The demographic characteristics of respondents and their subjective perception on the built environment in hygienic cities were statistically described. Univariate analysis was implemented, with SRH status as the dependent variable and the demographic characteristics of respondents and the items determining the built environment in hygienic cities as the independent variables. The independent variables with statistical significances in the univariate analysis were selected for further multivariate logistic regression analysis, by using likelihood ratio (LR) method with P value for entry at 0.05 elimination at 0.10.

    • A total of 1,357 respondents (564 males and 793 females, 33.56 ± 9.21 years) were involved. The respondents with college level or above accounted for 94.6%. As to marital status, the proportion of respondents being married was 64%; 72.8% of respondents had the annual household income which was over RMB 100,000 yuan; 53.8% of respondents had lived in the aera for more than 5 years; most of respondents lived in new integrated communities (46.7%) and traditional neighborhood communities (30%); 52.3% of respondents participated in regular physical activities (Table 1).

      VariablesTotal, n (%)SRH status, n (%)χ2P
      Low-score groupHigh-score group
      Age (years old)
       < 2566 (11.7)66 (29.0)154 (71.0)41.306< 0.001
       25–35296 (52.5)169 (23.3)557 (76.7)
       35–45130 (23.0)94 (34.3)180 (65.7)
       > 4572 (12.8)68 (48.6)72 (51.4)
      Gender
       Male564 (41.6)144 (25.5)420 (74.5)5.7470.017
       Female793 (58.4)250 (31.5)543 (68.5)
      Education level
       High school or below73 (5.4)27 (37.0)46 (63.0)3.1470.207
       College1,044 (76.9)304 (29.1)740 (70.9)
       Master or higher240 (17.7)63 (26.3)177 (73.8)
      Annual household income (RMB)
       < 100,000369 (27.2)122 (33.1)247 (66.9)6.0630.109
       100,000–200,000475 (35.0)132 (27.8)343 (72.2)
       200,000–300,000281 (20.7)84 (29.9)197 (70.1)
       > 300,000232 (17.1)56 (24.1)176 (75.9)
      Marital status
       Unmarried488 (36.0)144 (29.5)344 (70.5)0.0830.773
       Married869 (64.0)250 (28.8)619 (71.2)
      Occupation
       Retiree/the unemployed143 (10.5)46 (32.2)97 (67.8)7.5940.055
       Company employee614 (45.2)157 (25.6)457 (74.4)
       laborer394 (29.0)120 (30.5)274 (69.5)
      Professional and technical personnel/ government personnel206 (15.2)71 (34.5)135 (65.5)
      Residential region
       Urban fringe community82 (6.0)35 (42.7)47 (57.3)15.5510.001
       Traditional neighborhood community407 (30.0)135 (33.2)272 (66.8)
       Unit community234 (17.2)64 (27.4)170 (72.6)
       Commercial comprehensive community634 (46.7)160 (25.2)474 (74.8)
      Length of residence (years)
       < 5626 (46.2)190 (30.4)436 (69.6)1.0870.581
       5–10230 (17.0)63 (27.4)167 (72.6)
       > 10500 (36.9)140 (28.0)360 (72.0)
      Regular physical activity
       No647 (47.7)309 (47.8)338 (52.2)210.413< 0.001
       Yes710 (52.3)85 (12.0)625 (88.0)
        Note. SRH, self-rated health.

      Table 1.  Demographic characteristics of respondents

    • The analysis results showed that there were no residents reported "very unhealthy", 33 (2.4%) residents reported "unhealthy" and 361 (26.6%) reported "general". The residents reported "healthy" and "very healthy" accounted for 46.4% and 24.5, respectively. After grouping the answers into two groups ("high-score group" and "low-score group"), 71% of respondents were in high-score group, while, 29% of them were in low-score group.

      According to χ2 test results, age, gender, occupation, type of community and regular physical exercise showed significant differences between high-score group and low-score group of SRH status of residents (Table 1).

    • χ2 test results showed that the 22 items, such as adequate public fitness facilities, enough green space and night lighting, displayed significant differences between high-score group and low-score group on the SRH status of residents (Table 2).

      VariablesSRH status, n (%)χ2P
      Low-score groupHigh-score group
      Adequate public fitness facilities
       No198 (50.3)349 (36.2)22.818< 0.001
       Yes196 (49.7)614 (63.8)
      Enough green space
       No193 (49.0)314 (32.6)32.049< 0.001
       Yes201 (51.0)649 (67.4)
      Enough night lighting
       No130 (33.0)216 (22.4)16.429< 0.001
       Yes264 (67.0)747 (77.6)
      Enough public toilets
       No296 (75.1)578 (60.0)27.832< 0.001
       Yes98 (24.9)385 (40.0)
      Enough health trails
       No255 (67.4)418 (43.4)50.815< 0.001
       Yes139 (35.3)545 (56.6)
      Enough garbage classification facilities
       No99 (25.1)164 (17.0)11.7320.001
       Yes295 (74.9)799 (83.0)
      Enough propaganda on garbage classification
       No264 (67.0)497 (51.6)26.907< 0.001
       Yes130 (33.0)466 (48.4)
      Enough "No Smoking" signs in public places
       No106 (26.9)172 (17.9)14.0360.000
       Yes288 (73.1)791 (82.1)
      Enough propaganda on smoking ban
       No260 (66.0)488 (50.7)26.510< 0.001
       Yes134 (34.0)475 (49.3)
      Ennough propaganda on vaccination
       No279 (70.8)524 (54.4)31.125< 0.001
       Yes115 (29.2)439 (45.6)
      Enough propaganda on unpaid blood donation
       No273 (69.3)563 (58.5)13.855< 0.001
       Yes121 (30.7)400 (41.5)
      Enough propaganda on healthy diet
       No324 (82.2)668 (69.4)23.542< 0.001
       Yes70 (17.8)295 (30.6)
      Enough propaganda on personal hygiene
       No217 (55.1)405 (42.1)19.0920.000
       Yes177 (44.9)558 (57.9)
      Enough propaganda on vector prevention and treatment
       No291 (73.9)594 (61.7)18.273< 0.001
       Yes103 (26.1)369 (38.3)
      Household garbage in community cleared every day
       No141 (35.8)245 (25.4)14.703< 0.001
       Yes253 (64.2)718 (74.6)
      Clean and hygienic community environment
       No221 (56.1)337 (35.0)51.398< 0.001
       Yes173 (43.9)626 (65.0)
      Good air quality
       No195 (49.6)419 (43.5)4.0390.044
       Yes199 (50.5)544 (56.5)
      Confidence in drinking water safety
       No166 (42.1)209 (21.7)58.3520.000
       Yes228 (57.9)754 (78.3)
      Confidence in food safety
       No169 (42.9)235 (24.4)45.722< 0.001
       Yes225 (57.1)728 (75.6)
      Clean and hygiene pedlars' markets
       No155 (39.3)310 (32.2)6.3440.012
       Yes239 (60.7)653 (67.8)
      Standard management of city peddlers
       No174 (44.2)322 (33.4)13.869< 0.001
       Yes220 (55.8)641 (66.6)
      Good services from community health service centers
       No281 (71.3)531 (55.1)30.457< 0.001
       Yes113 (28.7)432 (44.9)
        Note. SRH, self-rated health.

      Table 2.  Correlation between built environment and SRH status

    • Multivariate logistic regression analysis was used to identify the influencing factors of SRH status, with the factors statistically related to the dependent variable in the univariate analysis as the independent variables.

      The results showed that the residents aged 25 years old and below had a higher SRH compared with the residents aged 36–45 years old (OR = 0.546, 95% CI: 0.351–0.851 ) and 46 years old above (OR = 0.295, 95% CI: 0.175–0.497).

      Women had a lower SRH than men (OR = 0.680, 95% CI: 0.514–0.900). In addition, the SRH status of the residents living in commercial comprehensive community was higher than that living in urban fringe community (OR = 2.019, 95% CI: 1.177–3.464). Moreover, the residents who regularly participated in physical exercise had a higher SRH status than those who without regular physical exercise (OR = 6.589, 95% CI: 4.903–8.854). Additionally, the respondents with enough green space (OR = 1.395, 95% CI: 1.055–1.845), clean and hygienic community environment (OR = 1.472, 95% CI: 1.107–1.956), confidence in drinking water safety (OR = 1.856, 95% CI: 1.354–2.544) and food safety (OR = 1.405, 95% CI: 1.027–1.921) were detected a higher SRH status (Table 3).

      VariablesβSDWald χ2POR95% CI
      Influencing factors
       Enough green space0.3330.1435.4460.0201.3951.055–1.845
       Clean and hygienic community environment0.3860.1457.0810.0081.4721.107–1.956
       Confidence in Drinking water safety0.6180.16114.7710.0001.8561.354–2.544
       Confidence in food safety0.3400.1604.5310.0331.4051.027–1.921
      Control variables
       36−45 years old−0.6050.2267.1620.0070.5460.351–0.851
       ≥ 46 years old−1.2220.26621.0660.0000.2950.175–0.497
       Female−0.3850.1437.2510.0070.6800.514–0.900
       Commercial comprehensive community0.7030.2756.5170.0112.0191.177–3.464
       Regular exercise1.8850.151156.3060.0006.5894.903–8.854
        Note. Confounding varaibles: age, gender, education level, annual household income, marital status, occupation, residential region, and regular physical exercise. SRH, self-rated health.

      Table 3.  Multivariate logistic regression analysis on influencing factors of SRH status

    • SRH has been included in periodically collected items of public health surveys by the WHO and other institutions [11-13]. A study demonstrated that SRH is affected by many factors, such as sociodemographic factors, economic and social factors and health-related lifestyles[14]. This study focused on the relationship between the urban built environment and SRH status of residents.

      The measurement indicators of urban built environments include objective indicators and subjective perception indicators. According to the findings of a study, subjective perception and objective measurement on the urban environments do not match in about one-third of the population[15]. For instance, a walking-friendly community based on objective indicators may offer poor spatial experience in the micro environment due to shortcomings in quality maintenance, hygiene and management systems [16]. Therefore, subjective perception indicators can better reflect the problems in the details of city management. However, existing studies have paid scant attention to the role of subjective perception on built environments. In this study, the built environment in hygienic cities was subjectively measured from 22 aspects including public fitness facilities, green coverage, environmental hygiene and air quality, and the relation between the built environment in hygienic cities and the SRH status of residents was investigated from the perspective of subjective perception of residents on the built environment.

      It was found in this study that after controlling confounding factors, the enough green space in the living area can significantly affect the SRH level of residents, consistent with existing research conclusions [17]. The accessibility to such public spaces as green spaces and parks can directly or indirectly affect the level of physical and mental health by lowering exposure to environmental pollution, providing opportunities for outdoor physical activities and increasing social interaction and community participation [18-19]. In addition, there are studies demonstrating that increasing public facilities such as green parks and sports venues can effectually reduce the rate of obesity and the development of chronic diseases [20-22].

      Based on the reports of the WHO, hygienic environment is the main influencing factor for the health of residents[23]. The report of Preventing Disease Through Healthy Environments showed at least a quarter of the global burden of disease is caused by environmental factors, which account for 36% of deaths among children aged 0–14. Globally, 24% of DALYs and 23% of deaths can be attributed to environmental factors[24]. The results of this study also revealed that the residents living in clean and hygiene environments had a higher SRH level.

      Furthermore, the confidence in drinking water safety was found to be an important factor affecting the SRH of residents. Access to safe drinking water means that people can persistently, stably and permanently obtain drinking water that does not notably impair health. It is a key factor in determining the personal health status of residents[25]. Where the access to safe drinking water is difficult, health risks are often high [26]. Improving water quality has been proven to make a significant contribution to the reduction of diarrhea and mortality in different countries[27]. The residents drinking tap water have significantly better SRH than those drinking non-tap water[28].

      Regarding the correlation between food safety and health status of residents, existing studies have denoted that a higher food safety awareness score suggests stronger subjective well-being of residents [29], and the subjective well-being is positively related to the SRH status of residents [30]. Moreover, the access to healthy and safe food has a significant impact on the health status of the population [31-33]. In this study, the relationship between the access to healthy and safe food and the health level of residents was also confirmed from the standpoint of residents' confidence in food safety.

      This study has several limitations. This study was performed in the form of web survey that is suitable for the rapid evaluation of a certain problem. This form of survey maynot include the population who are not web/phone users. The proportion of the elderly in respondents was very small, which may have affect the generalization of results. And the survey is only conducted in Chaoyang District. It could not represent the status in other regions of China.

      In conclusion, this study found that, the enough green space, clean and hygienic living environments, confidence in drinking water safety and food safety in the living area signally affect the SRH level of residents. It is suggested that the government should pay more attention to the subjective perception of residents on the built environment during urban construction, and build a supportive environment that is conducive to the health of residents.

Reference (33)

Catalog

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return