Abstract
We investigated the effects of living environment on the health status of urban residents using a quantitative model of social determinants of health, focusing on the cognitive mechanism of urban residents. A cross-sectional survey through an online questionnaire was conducted in Koto Ward, Tokyo, Japan (n = 1553). We developed a “social determinants of health” model based on the hypothetical model in the field of social epidemiology by structural equation modeling, which has three layers: social infrastructure layer (macro), community layer (meso), and personal layer (micro). The model also has five main latent factors: social environment, living environment, social capital, self-efficacy, and health status. We estimated the standardization total effects of all the latent factors for investigating the effect of urban living environment on the health status of the residents. We determined that the latent factors, social environment (0.606), living environment (0.723), social capital (0.156), and self-efficacy (0.356), affect the health status with regard to the standardization total effects. The urban living environment had the greatest effect on the health status of the residents among other latent factors. Furthermore, living environment (0.530) affected social capital the most, and social environment (0.500) affected self-efficacy the most. We conclude that improving the urban infrastructure, especially the urban living environment, can promote the health status of urban residents most effectively.
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References
Bay Area Regional Health Inequities Initiative (2020) https://www.barhii.org/barhii-framework. Accessed 26 Apr 2021
Berkman LF, Glass T, Brissette I, Seeman TE (2000) From social integration to health: Durkheim in the new millennium. Soc Sci Med 51(6):843–857
Braveman P, Egerter S, Williams DR (2011) The social determinants of health: coming of age. Ann Rev Pub Health 32:381–398
Cabinet Office (2002) https://www.npo-homepage.g.o.jp/uploads/report_h14_sc_gaiyou.pdf. Accessed 24 Sep 2020
Göran D, Whitehead M (1991) Policies and strategies to promote social equity in health.
Gordon-Larsen P, Nelson MC, Page P, Popkin BM (2006) Inequality in the built environment underlies key health disparities in physical activity and obesity. Pediatrics 117(2):417–424
Grahn P, Stigsdotter UK (2010) The relation between perceived sensory dimensions of urban green space and stress restoration. Landsc Urban Plan 94:264–275
Hanazato M (2019) Designing healthy places and the possibility of natural environment and green space from the viewpoint of preventive medical sciences. J Jpn Instit Lands Archit 83(3):250–253 (in Japanese)
Hanibuchi T, Kawachi I, Nakaya T, Hirai H, Kondo K (2011) Neighborhood built environment and physical activity of Japanese older adults: results from the Aichi Gerontological Evaluation Study (AGES). Public Health 11(1):657–668
Hanibushi T, Muranaka A, Ando M (2015) Challenges of data collection through internet research: analysis of “frivolous” responses, response time, and geographical pattern. E-Journal GEO 10(1):81–98 (in Japanese)
Kjellstrom T, Mercado S (2008) Towards action on social determinants for health equity in urban settings. Environ Urban 20:551–574
Kondo K, Rosenberg M, World Health Organization (2018) Advancing universal health coverage through knowledge translation for healthy ageing: lessons learnt from the Japan Gerontological Evaluation Study. WHO, Geneva
Koto ward (2007) Master plan of Koto city green. https://www.city.koto.lg.jp/470132/machizukuri/midori/green/documents/kyuukeikaku.pdf. Accessed 24 Sep 2020 (in Japanese)
Koto ward (2017) Chapter 1 The population of Koto city and financial conditions. https://www.city.koto.lg.jp/010162/kuse/shisaku/torikumi/documents/01issyou.pdf. Accessed 24 Sep 2020 (in Japanese)
Koto ward (2018) 2017 Koto Ward Green Coverage Survey Report https://www.city.koto.lg.jp/470132/machizukuri/midori/green/ryokuhiritu.html. Accessed 10 Aug 2021 (in Japanese)
Koto ward (2019) national population census. https://www.city.koto.lg.jp/101020/kuse/tokeshiryo/tokehyo/5520.html. Accessed 10 August 2021 (in Japanese)
Koto ward (2021a) Household and population (1st of every month). https://www.city.koto.lg.jp/060305/kuse/profile/shokai/15817.html. Accessed 14 Apr 2021 (in Japanese).
Koto ward (2021b) Demographics https://www.city.koto.lg.jp/101020/kuse/tokeshiryo/tokehyo/862.html. Accessed 11 Aug 2021 (in Japanese)
Maas J, Verheij RA, Groenewegen PP, de Vries S, Spreeuwenberg P (2006) Green space, urbanity, and health: how strong is the relation? J Epidemiol Commun Health 60(7):587–592
Maas J, van Dillen SME, Verheij RA, Groenewegen PP (2009) Social contacts as a possible mechanism behind the relation between green space and health. Health Place 15(2):586–595
Marmot M (2005) Social determinants of health inequalities. Lancet 365(9464):1099–1104
Ministry of Health, Labour and Welfare (2012) Kenkonihon 21 (dainiji). https://www.mhlw.go.jp/bunya/kenkou/dl/kenkounippon21_01.pdf. Accessed 13 Oct 2020 (in Japanese)
Ministry of Land, Infrastructure, Transport and Tourism (2014) Kenkou iryou hukushi no machidukuri no suishin. https://www.mlit.go.jp/common/001049464.pdf. Accessed 13 Oct 2020 (in Japanese)
Mitchell R, Popham F (2008) Effect of exposure to natural environment on health inequalities: an observational population study. Lancet 372(9650):1655–1660
Mohnen SM, Groenewegen PP, Völker B, Flap H (2011) Neighborhood social capital and individual health. Soc Sci Med 72(5):660–667
Nakajima K, Kagawa K, Park C (2003) Chiikijyuumin no kenkou kanren ni kansuru manzokudo no sokutei. J Health Welf Stat 50(8):8–15 (No English title and abstract in Japanese)
National Institute of Population and Social Security Research (2020) http://www.ipss.go.jp/syoushika/tohkei/Popular/P_Detail2020.asp?fname=T09-20.htm&title1=%87%5C%81D%92n%88%E6%88%DA%93%AE%81E%92n%88%E6%95%AA%95z&title2=%95%25. Accessed 13 Oct 2020 (in Japanese)
Ohsumi N (2002) Internet surveys: a review of several experimental results: applying data science approach to the exploration of internet surveys. Jpn J Behaviormetrics 29(1):20–44 (in Japanese)
Otsuka Y, Nasu M, Watanabe Y, Takaoka Y, Iwasaki Y (2016) Relationship between using urban green spaces and causality of the social and health states of the neighborhood residents. J Jpn Soc Reveg Tech 42(1):50–55 (in Japanese)
Putnam PD (1993) Making democracy work: civic traditions in modern Italy. Princeton University Press, New Jersey
Srinivasan S, O’Fallon LR, Dearry A (2003) Creating healthy communities, healthy homes, healthy people: initiating a research agenda on the built environment and public health. Am J Public Health 93:1446–1450
Stigsdotter UK, Grahn P (2011) Stressed individuals’ preferences for activities and environmental characteristics in green spaces. Urban for Urban Green 10:295–304
Sugisawa H (2012) Social relationships as social determinants of health: a review of related concepts and major findings regarding social relationships. Q Soc Secur Res 48(3):252–265 (in Japanese)
Vlahov D, Galea S (2002) Urbanization, urbanicity, and health. J Urban Health 79:S1–S12
Ware J, Kosinski M, Keller SD (1996) A 12-item short-form health survey: construction of scales and preliminary tests of reliability and validity. Med Care 34(3):220–233
Ware J, Kosinski M, Keller SD (1998) SF-12: How to score the SF-12 physical and mental health summary scales, 3rd edn. Quality Metric Incorporated, Boston, Lincoln
Waverijn G, Heijmans M, Spreeuwenberg P, Groenewegen PP (2016) Associations between neighborhood social capital, health literacy, and self-rated health among people with chronic illness. J Health Commun 21(sup2):36–44
Wilkinson R, Marmot M (2003) The solid facts. World Health Organization, Copenhagen
World Health Organization (2010a) A conceptual framework for action on the social determinants of health. World Health Organization, Geneva, pp 1–75
World Health Organization (2010b) Hidden cities: unmasking and overcoming health inequities in urban settings. World Health Organization, Geneva, pp 1–16
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This research data were partly supported by Dr. Yosuke Watanabe of SHIMIZU CORPORATION and Dr. Yumiko Takaoka of Green Purchasing Network. We express our deepest gratitude to them.
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Otsuka, Y., Nasu, M. & Iwasakai, Y. Effects of the living environment in a model of social determinants of health focusing on the cognitive mechanism of urban residents. Landscape Ecol Eng 18, 57–73 (2022). https://doi.org/10.1007/s11355-021-00482-7
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DOI: https://doi.org/10.1007/s11355-021-00482-7