首頁資訊居民時空行為與環(huán)境污染暴露對健康影響的研究進(jìn)展

居民時空行為與環(huán)境污染暴露對健康影響的研究進(jìn)展

來源：泰然健康網(wǎng) 時間：2024年11月24日 05:52

1 引言

作為世界上最大的發(fā)展中國家,中國在過去的30年間經(jīng)歷了快速的城市化過程以及經(jīng)濟(jì)發(fā)展階段,GDP 年均增長率達(dá)到9%左右,但同時也產(chǎn)生了各種環(huán)境污染問題,包括空氣污染、水污染、噪音污染、土壤污染、工業(yè)廢棄物污染等;其中空氣污染(例如PM2.5)成為危害居民健康的重大環(huán)境問題之一(Gee et al, 2004)。相關(guān)研究表明,2010年中國由于空氣污染所導(dǎo)致的過早死亡人數(shù)達(dá)120萬左右,約占世界死亡人數(shù)總和的40%(Lim et al, 2012)。隨著空氣污染不斷加劇,2014年初,北京市氣象局頻繁發(fā)布霾黃色預(yù)警;2015年12月,北京首次啟動空氣重污染紅色預(yù)警,并對機(jī)動車出行等實(shí)施一系列限制措施。

長期以來,關(guān)于環(huán)境污染與健康的研究一直受到國內(nèi)外學(xué)者的廣泛關(guān)注。醫(yī)學(xué)、環(huán)境流行病學(xué)、健康地理學(xué)等不同學(xué)科側(cè)重點(diǎn)各異,分別從不同側(cè)面對其進(jìn)行研究。如圖1所示,可將環(huán)境污染與健康研究主要劃分為三大部分：一是宏觀區(qū)域?qū)用娴沫h(huán)境污染與健康指標(biāo)(如各種疾病發(fā)病率、死亡率等)的相關(guān)關(guān)系研究;二是通過個人時空行為將環(huán)境污染與健康關(guān)聯(lián)起來,從微觀層面上分別探討基于個人時空行為軌跡的環(huán)境(或空氣)污染暴露,以及居民日常交通出行的健康效應(yīng)(如Body Mass Index, BMI);三是關(guān)注社會經(jīng)濟(jì)屬性,重點(diǎn)探討不同社會群體,尤其是黑人、兒童、低收入者等弱勢群體所承受的環(huán)境負(fù)面影響,即環(huán)境公正(Environmental Justice)和健康不平等(Health Inequality)相關(guān)研究。

圖1 環(huán)境污染與健康研究框架

Fig.1 A framework of research on environmental pollution and health

本文希望通過對國際層面的環(huán)境污染與健康研究進(jìn)行較為系統(tǒng)的梳理與評價,關(guān)注生活質(zhì)量、社會公正、空氣污染等熱點(diǎn)問題,為今后立足于中國城市獨(dú)特背景的相關(guān)研究提供借鑒;同時,基于時空行為、環(huán)境公正等理論視角與學(xué)科前沿議題,為解釋環(huán)境污染與健康影響之間的復(fù)雜性與多樣性提供較為完整的分析框架,深入挖掘環(huán)境污染與居民時空行為的健康影響機(jī)理,為減少微觀個體居民的環(huán)境污染暴露,發(fā)展更為公平的、有效的環(huán)境健康政策等提供科學(xué)依據(jù)。

2 宏觀區(qū)域?qū)用娴沫h(huán)境污染與健康研究

該類研究主要運(yùn)用環(huán)境醫(yī)學(xué)以及流行病學(xué)等的理論與方法,基于宏觀尺度,分析自然因素以及環(huán)境污染等因素的時空演變過程及對人類健康的影響規(guī)律,重點(diǎn)探討不同環(huán)境因素與人類健康之間的暴露—效應(yīng)(Dose-response)關(guān)系,為制定宏觀層面的環(huán)境衛(wèi)生標(biāo)準(zhǔn)以及預(yù)防措施等提供依據(jù)(楊林生等, 2010; 楊彥等, 2014)。其中,作為環(huán)境污染的重要成分之一,空氣污染對疾病和健康的影響一直是多學(xué)科研究的重點(diǎn)內(nèi)容。大量研究表明,細(xì)顆粒物如PM2.5是對人體健康危害最大的污染物,會對呼吸道疾病、心血管疾病等產(chǎn)生非常顯著的負(fù)面影響(Pope, 2000; 闞海東等, 2002）。已有研究分別從空氣污染與肺癌、慢性/急性支氣管炎、心腦血管疾病、住院率、死亡率等與健康緊密相關(guān)的多個方面進(jìn)行實(shí)證分析(Pope et al, 2002; Reynolds et al, 2003; Sun et al, 2005; Hart et al, 2013)。這些研究主要基于空間地域單元的視角,從宏觀層面驗(yàn)證不同地方的空氣污染濃度與匯總層面的各種健康指標(biāo)之間的相關(guān)關(guān)系。

關(guān)于空氣污染暴露的測度與評估是這類研究的重點(diǎn)內(nèi)容之一。早期采用的方法是利用空氣質(zhì)量固定監(jiān)測點(diǎn)的數(shù)據(jù),基于居住區(qū)人口分布特征,假定居民一天24小時停留在同一地方,通常是居住地,利用臨近性、替代性等方法間接測量大都市區(qū)尺度范圍內(nèi)不同地區(qū)居民的潛在空氣污染暴露量(Mitchell et al, 2003)。這種間接替代性測度方法較為簡單,并未考慮土地利用類型、交通網(wǎng)絡(luò)、地形等因素,因此測量誤差較大。隨著計算機(jī)技術(shù)以及地理信息技術(shù)的發(fā)展,較為復(fù)雜的時空統(tǒng)計模型逐漸應(yīng)用于空氣污染的擴(kuò)散、傳播與測度研究,大大提升了空氣污染暴露測度的準(zhǔn)確性。近期研究主要根據(jù)環(huán)境監(jiān)測點(diǎn)數(shù)據(jù),考慮多種地理空間要素,如土地利用類型、人口密度、交通路網(wǎng)、氣候等因素,通過對長時段、高精度的空氣污染濃度值進(jìn)行地理空間插值或土地利用回歸建模,得出連續(xù)的空氣污染濃度曲面,進(jìn)而對微觀環(huán)境下的居民污染暴露量進(jìn)行測度與評估(Fang et al, 2011)。

此外,在全球風(fēng)險因素及環(huán)境衛(wèi)生標(biāo)準(zhǔn)方面,Lim等(2012)通過對世界上21個區(qū)域的67個風(fēng)險因素進(jìn)行較為系統(tǒng)的健康風(fēng)險評估,發(fā)現(xiàn)從1990年到2010年間全球風(fēng)險因素對疾病負(fù)擔(dān)的貢獻(xiàn)發(fā)生較大的轉(zhuǎn)變,主要風(fēng)險因素從引起兒童傳染病的因素轉(zhuǎn)變?yōu)橐鸪扇朔莻魅拘约膊〉娘L(fēng)險因素;其中環(huán)境顆粒物污染成為全球第九大健康風(fēng)險因素,但在東亞等國家,該風(fēng)險因素排名第四(僅次于高血壓,吸煙和飲食結(jié)構(gòu)不合理)。由于環(huán)境細(xì)顆粒物引發(fā)的患病率顯著增加(Pope et al, 2011),使得美國加緊制定環(huán)境細(xì)顆粒物標(biāo)準(zhǔn),將其年平均值從15 μg/m3降低為12 μg/m3。相關(guān)研究表明新標(biāo)準(zhǔn)的實(shí)施會為其帶來巨大的經(jīng)濟(jì)收益(主要可減少健康醫(yī)療和生活福利大量的運(yùn)營成本)(U.S EPA, 2012)。相比之下,中國的環(huán)境顆粒物標(biāo)準(zhǔn)(35 μg/m3)遠(yuǎn)遠(yuǎn)高于WHO建議的年限值(10 μg/m3),對居民健康狀況產(chǎn)生巨大威脅,需要綜合評估環(huán)境保護(hù)的經(jīng)濟(jì)效益與健康效應(yīng),以制定更為合理的環(huán)境衛(wèi)生標(biāo)準(zhǔn)。

總體而言,這類研究主要基于宏觀尺度,探討國家、區(qū)域等宏觀區(qū)域?qū)用娴目諝馕廴緷舛扰c健康指標(biāo)之間的相關(guān)關(guān)系,未考慮微觀個體居民日常的活動—移動行為,因而本質(zhì)上是一種潛在的空氣污染暴露測度,并不能準(zhǔn)確地反映個體居民真實(shí)的空氣污染暴露情況,缺乏從微觀層面對個體居民的環(huán)境污染暴露及健康效應(yīng)的正面關(guān)注,未能深入挖掘影響居民健康狀況的行為機(jī)理及其背后復(fù)雜的時空場景效應(yīng),因此未來研究需要從微觀層面將環(huán)境、行為與健康關(guān)聯(lián)起來進(jìn)行綜合分析。

3 以時空行為為媒介的環(huán)境污染與健康研究

3.1 城市建成環(huán)境對交通出行及健康的影響

城市建成環(huán)境與居民出行的關(guān)系一直是城市地理、城市規(guī)劃、交通等多學(xué)科研究的重要內(nèi)容。研究表明,城市空間結(jié)構(gòu)(如人口密度、職住關(guān)系等)對居民的出行行為會產(chǎn)生顯著的影響,不同類型居民的日?；顒优c行為模式表現(xiàn)為一定程度的社會與空間分異(柴彥威等, 2011; 孟斌等, 2012)。也有部分學(xué)者對社區(qū)形態(tài)、居民出行以及與空氣污染有關(guān)的城市交通碳排放等進(jìn)行實(shí)證分析(馬靜等, 2011; 秦波等, 2012; 曹小曙等, 2015)。但是,由于長期缺乏對居民健康狀況的關(guān)注,關(guān)于交通出行與個體居民健康的研究總體而言較為缺乏(Handy et al, 2002; 魯斐棟等, 2015)。步行、自行車等交通方式作為重要的體力活動形式之一,被認(rèn)為是防治肥胖、心腦血管疾病等慢性病的有效方法,交通出行是影響人類健康狀況的重要的、可干預(yù)的因素之一(Saelens et al, 2008; Alvarado et al, 2013)。

國際上關(guān)于交通出行與健康的研究近些年發(fā)展較快,成為熱點(diǎn)問題之一。已有研究主要從體育運(yùn)動學(xué)、城市規(guī)劃、預(yù)防醫(yī)學(xué)等多學(xué)科視角,分析交通方式、通勤時間等因素對居民身體健康狀況產(chǎn)生的影響(Papas et al, 2007; Macmillan et al, 2013)。例如,基于美國時間利用調(diào)查以及飲食健康數(shù)據(jù),Yang 等(2013)研究交通出行與身體質(zhì)量指數(shù)(BMI)之間的關(guān)系,結(jié)果表明長時間使用小汽車出行能顯著增加肥胖的比例,而步行、自行車等非機(jī)動方式則有助于降低肥胖。其他學(xué)者關(guān)于通勤方式、出行時間與睡眠質(zhì)量、精神健康以及自評健康等之間的關(guān)系進(jìn)行的實(shí)證研究表明,長距離通勤對健康產(chǎn)生負(fù)面影響(Greenberg et al, 2005; Hansson et al, 2011)。另外,也有少量關(guān)于收入水平、交通出行與健康關(guān)系的研究(Craig, 2005)。

總體而言,近期關(guān)于交通出行與健康效應(yīng)的研究是在傳統(tǒng)城市形態(tài)與交通出行研究基礎(chǔ)上的延伸與拓展,此類研究重點(diǎn)關(guān)注城市建成環(huán)境方面,通過居民日常交通出行將城市規(guī)劃與人類健康相關(guān)聯(lián),探索如何通過城市與交通規(guī)劃減少道路交通事故和非傳染性疾病,提高城市宜居性和居民健康狀況。早期研究關(guān)注的城市建成環(huán)境指標(biāo)包括密度(Density)、土地利用混合度(Diversity)及道路設(shè)計(Design)等,之后的研究逐漸在原有3D指標(biāo)基礎(chǔ)上擴(kuò)展為6D指標(biāo),即增加目的地可達(dá)性(Destination Accessibility)、公共交通可達(dá)性(Distance to Transit)以及交通出行需求管理(Demand Management)等(Cervero et al, 1997; Ewing et al, 2010)。不同方面的城市與交通規(guī)劃措施需要在不同層面執(zhí)行。例如,區(qū)域?qū)用嫔婕熬蜆I(yè)機(jī)會的分布,主要活動地點(diǎn)(醫(yī)療、教育、商場等)的可達(dá)性,以及停車場的布局和價格政策等;而社區(qū)層面則著重考慮居住密度、人行道設(shè)計以及公共交通可達(dá)性等方面。城市規(guī)劃主要通過直接或間接地影響居民日常生活和交通模式的選擇進(jìn)而影響居民健康狀況,包括肥胖癥、心腦血管疾病、癌癥等身體健康,以及壓力、睡眠質(zhì)量等精神健康。今后需通過發(fā)展緊湊城市,鼓勵居民采用步行、自行車、公共交通等綠色出行方式,減少小汽車依賴,通過降低風(fēng)險暴露量進(jìn)而減少非傳染性疾病及道路交通事故,提升居民整體健康狀況及生活質(zhì)量(Giles-Corti et al, 2016)。

相比之下,國內(nèi)關(guān)于交通出行與健康的研究尚處于起步階段。少量研究從城市規(guī)劃的視角出發(fā),分析建成環(huán)境對體力活動的影響,以及交通出行的健康效應(yīng)等(朱菁等, 2014; 孫斌棟等, 2016)。但以上研究對城市建成環(huán)境及健康方面的測度較為簡單,未能深入挖掘建成環(huán)境、交通出行及健康三者之間的內(nèi)在關(guān)系。此外,沒有考慮自然環(huán)境如空氣污染對交通出行及健康的影響。例如,在空氣質(zhì)量良好情況下,步行、自行車等交通方式有利于增加體力活動和減少肥胖等,對健康產(chǎn)生正面影響;但在霧霾天,步行、自行車等交通方式的空氣污染指數(shù)遠(yuǎn)大于出租車和私家車,采用步行、自行車方式出行的居民其空氣污染暴露總量要顯著大于采用小汽車出行的居民(Huang et al, 2012),進(jìn)而會對其健康狀況如呼吸道疾病等產(chǎn)生負(fù)面影響。由此可見,交通出行(如交通方式、出行距離、出行時間等）除對居民的健康狀況產(chǎn)生直接影響外,還會通過空氣污染暴露對居民的健康狀況產(chǎn)生間接影響。環(huán)境、出行、健康之間存在一個非常復(fù)雜的關(guān)系。隨著中國多數(shù)城市頻繁發(fā)生霧霾現(xiàn)象,遠(yuǎn)距離、長時間的交通出行使得居民長期暴露在不利的環(huán)境中,在一定程度上會增加呼吸道疾病以及心血管疾病等的發(fā)病率(林雄斌等, 2015)。需要綜合考慮交通出行與空氣污染暴露對健康的影響。

3.2 居民日常行為模式與空氣污染暴露的健康影響

空氣污染暴露(Air Pollution Exposure)是指個體居民與空氣污染物直接接觸使其暴露在空氣污染中的狀態(tài)或過程(Ott, 1982)。交通出行作為居民日常生活的重要組成部分,除直接關(guān)聯(lián)城市建成環(huán)境與健康效應(yīng)之外,同時也是關(guān)聯(lián)自然環(huán)境,如空氣污染與健康的關(guān)鍵要素。不同交通方式微觀環(huán)境(Transport Microenvironment)下的空氣污染濃度具有顯著差異(Adams et al, 2001),居民選擇不同的交通出行模式使其承受的空氣污染暴露也很不相同。同時,基于交通出行(尤其是早晚高峰時段)的空氣污染暴露占居民日常污染暴露總量的較大比例,會對居民的健康狀況,例如呼吸道疾病等產(chǎn)生更為直接和顯著的影響(Gulliver et al, 2005)。

基于個體行為研究范式分析居民出行模式與微觀行為環(huán)境下的空氣污染暴露是國際時空行為研究的前沿課題。近年來,已有少量從微觀層面研究居民基于交通出行的空氣污染暴露的群體差異(Gulliver et al, 2005; Kaur et al, 2007)。例如,Huang等(2012)基于通勤者經(jīng)常使用的兩條固定線路,利用便攜式PM2.5實(shí)時監(jiān)測儀對不同交通方式在早晚高峰時段以及中午時段的空氣污染指數(shù)進(jìn)行18天的監(jiān)測,從微觀層面研究不同居民基于交通出行的空氣污染暴露的社會差異。結(jié)果顯示,使用出租車方式進(jìn)行通勤的居民其空氣污染暴露度要顯著低于采用公共汽車和自行車通勤的居民。如果同時考慮空氣污染物吸入率和出行時間,使用自行車方式出行的居民其空氣污染暴露總量為最大。此外,Tsai等(2008)通過數(shù)名志愿者攜帶專業(yè)微粒質(zhì)譜儀對臺北地區(qū)不同通勤方式(如摩托車、小汽車、公交車、快速軌道交通等)進(jìn)行多時段實(shí)時監(jiān)測,顯示不同交通方式的空氣污染指數(shù)具有顯著差異,小汽車為最低。長時間通勤也是影響使用公共交通方式出行的居民空氣污染暴露總量較大的重要因素之一。

以上研究從微觀層面揭示不同居民由于交通出行模式的不同導(dǎo)致在空氣污染暴露程度上具有顯著的差異。同時,也證明了空氣質(zhì)量固定監(jiān)測點(diǎn)的數(shù)據(jù)并不能很好地代表不同交通方式微觀環(huán)境下(尤其是早晚高峰時段)的空氣污染濃度(Adams et al, 2001; Tsai et al, 2008; Huang et al, 2012)。例如,空氣質(zhì)量固定監(jiān)測點(diǎn)的數(shù)據(jù)往往低估了自行車、摩托車以及地鐵等交通方式的細(xì)顆粒物污染濃度,同時往往高估了出租車和私家車的PM2.5污染濃度。由此可見,不同的交通出行模式?jīng)Q定了不同的情景變量(Contextual Variables),不同類型居民由于其時空行為軌跡的不同會導(dǎo)致其承受的空氣污染暴露具有顯著差異(關(guān)美寶等, 2013; 郭文伯等, 2015),進(jìn)而也會對其健康效應(yīng)產(chǎn)生一定的影響。為此,需要從微觀層面深入研究基于居民時空行為軌跡的空氣污染暴露及其社會分異,并對健康效應(yīng)的影響機(jī)理進(jìn)行深入研究。

4 環(huán)境公正與健康不平等研究

4.1 環(huán)境公正

環(huán)境公正(Environmental Justice)是基于環(huán)境保護(hù)和社會公正相結(jié)合提出的一套理論概念,試圖確保不同社會經(jīng)濟(jì)屬性的人群,即不論其社會經(jīng)濟(jì)地位如何,都應(yīng)承受同等程度由于社會經(jīng)濟(jì)發(fā)展所帶來的環(huán)境負(fù)面影響(Cutter, 1995)。環(huán)境公正研究起源于美國,標(biāo)志性事件是1982年在美國北卡羅來納州一個大型黑人社區(qū)反對建立有毒垃圾填埋場。早期環(huán)境公正研究僅限于美國,研究對象聚焦于有色人種社區(qū),主要關(guān)注垃圾填埋場和工業(yè)污染源的不均等分布(Laurent, 2011)。20世紀(jì)90年代后期傳播到英國等歐洲國家,主要運(yùn)用貧困(Deprivation)指標(biāo)來研究環(huán)境不公正現(xiàn)象,關(guān)注的環(huán)境因素不僅包括垃圾填埋場、工業(yè)污染源,同時還拓展到空氣質(zhì)量、洪水災(zāi)害、道路交通事故,以及公園綠地的可達(dá)性等(Martuzzi et al, 2010)。相關(guān)研究表明,不同社會經(jīng)濟(jì)屬性的人群所承受的環(huán)境負(fù)擔(dān)存在顯著差異。例如,在發(fā)達(dá)國家,尤其是英美國家,弱勢群體(如低收入者、黑人等)通常更多地居住在空氣污染比較嚴(yán)重的地方或者有害的工業(yè)設(shè)施、垃圾填埋場附近,較多地承受了環(huán)境負(fù)面影響,其健康狀況也顯著低于平均水平(Mitchell et al, 2003; Brulle et al, 2006)。上述研究,促進(jìn)了西方發(fā)達(dá)國家環(huán)境公正理論的提出與發(fā)展,并制定相應(yīng)的環(huán)境公正政策,以促進(jìn)社會的可持續(xù)發(fā)展(UN ECE, 1999)。

然而,也有一些學(xué)者認(rèn)為,在研究環(huán)境負(fù)擔(dān)(Environmental Burden)的社會不平等同時,應(yīng)考慮其社會分布的形成與發(fā)展,怎樣才算是一種公平的社會分布等。例如,一些人住在有害的工業(yè)設(shè)施附近,從環(huán)境影響的角度來講對他們是不公平的,但從其他角度考慮,這些人住在這里可以擁有更便宜的住房和享有更多的就業(yè)機(jī)會等。但在深入考慮環(huán)境污染對健康的負(fù)面影響的同時,環(huán)境公正的理論及研究就會得到更多的支持。Mitchell等(2003)的研究表明,2001年英國大約有250萬人口居住在空氣質(zhì)量不符合國家標(biāo)準(zhǔn)的地區(qū);這些人中有超過50%屬于社會經(jīng)濟(jì)地位較低的群體,他們對空氣污染所負(fù)的責(zé)任很小,但卻承受著較多的環(huán)境負(fù)面影響。由于空氣質(zhì)量標(biāo)準(zhǔn)可看作為政府和市民的一種社會契約,用來保護(hù)公眾健康,因此政策制定者和城市規(guī)劃者一定要考慮環(huán)境因素所帶來的健康不平等的負(fù)面影響。

總體而言,關(guān)于環(huán)境公正的研究表明,邊緣社會群體(例如貧困人群、黑人和兒童)為惡劣的環(huán)境狀況承受了更大的負(fù)擔(dān),包括垃圾污染、工業(yè)排放物及室外空氣污染等(Mitchell et al, 2003; Brulle et al, 2006; Pearce et al, 2008)。基于環(huán)境公正視角的研究重點(diǎn)關(guān)注特定人群,如老年人、兒童、貧困人口以及黑人等弱勢群體的環(huán)境健康效應(yīng),力圖證明弱勢群體對空氣污染所負(fù)的責(zé)任很小,但卻承受著較大程度的環(huán)境負(fù)面影響(Pearce et al, 2010; Chen et al, 2013)。近期環(huán)境公正研究還試圖通過長時段的動態(tài)分析,了解環(huán)境不平等現(xiàn)象的演變過程。例如,Mitchell等(2015)通過對2001-2011年英國空氣質(zhì)量的動態(tài)變化以及不同社會人群所承受的污染暴露程度進(jìn)行實(shí)證分析,發(fā)現(xiàn)富裕地區(qū)空氣質(zhì)量改善最大,而貧困地區(qū)空氣質(zhì)量卻出現(xiàn)了下降,該狀況將會進(jìn)一步加劇英國的環(huán)境不公正以及健康不平等現(xiàn)象。

相比之下,中國是世界上最大的發(fā)展中國家,目前正在經(jīng)歷快速的工業(yè)化以及城市化進(jìn)程,同時也產(chǎn)生了嚴(yán)重的環(huán)境污染問題,并對居民健康產(chǎn)生較大的負(fù)面影響。了解這些環(huán)境負(fù)擔(dān)如何在不同的社會人群中分布,以及環(huán)境影響與居民健康狀況之間的內(nèi)在關(guān)系,對于更好地保護(hù)弱勢群體(例如老年人、小孩和低收入群體)的健康具有至關(guān)重要的作用(Wong et al, 2008; 劉曉霞等, 2012)。目前國內(nèi)少數(shù)關(guān)于環(huán)境公正的研究主要集中在空氣污染的時空分布及對居民出行選擇的影響等方面。例如,利用2010年北京兩個典型郊區(qū)社區(qū)居民出行的GPS數(shù)據(jù)和活動日志調(diào)查數(shù)據(jù),郭文伯等測度了不同交通方式環(huán)境下居民日常出行所受到的空氣污染暴露度,并分析了不同人群對于PM2.5空氣污染暴露度的差異性(郭文伯等, 2015)。研究結(jié)果表明,中低收入群體的出行空氣污染暴露量要高于高收入群體,不同社會群體的空氣污染暴露度存在顯著差異?？傮w而言,目前大部分的環(huán)境公正研究主要集中于西方發(fā)達(dá)國家,尤其是美國和英國。然而,環(huán)境污染問題在發(fā)展中國家更為嚴(yán)峻,與公共健康相關(guān)的環(huán)境不平等現(xiàn)象也逐漸在發(fā)展中國家凸顯,但關(guān)于環(huán)境公正與健康不平等的研究在發(fā)展中國家卻開展較少。

4.2 健康不平等研究

世界衛(wèi)生組織的相關(guān)報告表明,所有的城市環(huán)境都會產(chǎn)生“系統(tǒng)性的、社會性的、不公平的”健康不平等現(xiàn)象,這種現(xiàn)象在不同的國家和地區(qū)表現(xiàn)特征和不平等程度具有顯著差異,一定程度上是由于不同地域的營養(yǎng)水平、人口結(jié)構(gòu)及流行病傳播造成的(WHO, 2010)。一般而言,社會經(jīng)濟(jì)更為貧困的地區(qū)傳染性疾病和非傳染性疾病的發(fā)病率和死亡率更高(Giles-Corti et al, 2016)。Holdaway(2010)對中國面臨與環(huán)境相關(guān)的主要健康風(fēng)險因素進(jìn)行了概述,并得出結(jié)論：“需要深入研究環(huán)境問題、貧困和健康不平等之間的關(guān)系,總之,我們需要知道更多關(guān)于中國環(huán)境健康風(fēng)險的地理和人口的差異性,以及找出哪些群體的健康狀況更易受到環(huán)境問題的影響”。利用抽樣調(diào)查數(shù)據(jù)或多時間序列觀察數(shù)據(jù),在國家、區(qū)域、城市等不同空間尺度上對環(huán)境污染和健康不平等的分析表明,環(huán)境污染的負(fù)面影響在社會、經(jīng)濟(jì)和人口層面上分布不均勻,脆弱或貧困群體,特別是老年人和流動人口等弱勢群體承擔(dān)著環(huán)境污染所導(dǎo)致的更大的健康風(fēng)險和傷害。另外,社會經(jīng)濟(jì)屬性與城市建成環(huán)境具有內(nèi)在聯(lián)系,不同社會經(jīng)濟(jì)屬性的人群居住地(和就業(yè)地)具有顯著差異,而不同地方的空間特征、可達(dá)性等背景因素對健康不平等產(chǎn)生重要影響(Chakraborty et al, 2011; Chen et al, 2013; Ma et al, 2017)。

此外,交通出行方式通過影響環(huán)境、社會以及行為等多種風(fēng)險暴露因素,是造成城市內(nèi)部和城市之間健康不平等現(xiàn)象產(chǎn)生、持續(xù)以及加劇的重要因素之一(Stevenson et al, 2016)。低收入者、老年人、殘疾人等弱勢群體較少能享受到由于小汽車發(fā)展而帶來的交通便利、舒適度等各種福利,但他們卻很有可能承受了更多的由于機(jī)動交通依賴所產(chǎn)生的各種負(fù)外部性,如空氣污染、噪音污染、道路交通傷害等,對他們的健康狀況產(chǎn)生嚴(yán)重危害(Giles-Corti et al, 2016)。在城市規(guī)劃、交通發(fā)展以及環(huán)境健康政策等的制定與實(shí)施過程中,需要優(yōu)先考慮弱勢群體的需求與利益,創(chuàng)建適宜綠色出行的緊湊城市,減少健康不平等現(xiàn)象,促進(jìn)社會可持續(xù)發(fā)展(Sallis et al, 2016)。

整體而言,目前關(guān)于環(huán)境公正與健康不平等的研究相對較為缺乏,尤其是在發(fā)展中國家,比如中國,關(guān)于環(huán)境負(fù)擔(dān)的社會與空間分布,以及環(huán)境不公正現(xiàn)象如何對居民健康不平等產(chǎn)生影響的研究甚少。這主要原因是受數(shù)據(jù)限制。在中國,有關(guān)環(huán)境污染和健康數(shù)據(jù)是由不同的政府部分或機(jī)構(gòu)為不同目的收集的,這些數(shù)據(jù)通常不能公開訪問或跨平臺共享(Holdaway, 2010)。環(huán)境污染統(tǒng)計數(shù)據(jù)(例如空氣質(zhì)量,工業(yè)廢棄物,垃圾填埋場等）主要在較大空間地域單元如城市尺度上公布,因此無法用于研究城市內(nèi)部不同人群暴露于環(huán)境危害的社會與空間差異性(Chen et al, 2013)。此外,中國沒有針對所有人口進(jìn)行的健康普查數(shù)據(jù),而醫(yī)院的病歷數(shù)據(jù)也難以獲取。因此,在缺乏政府支持的情況下,學(xué)者很難獲得大樣本微觀空間尺度的環(huán)境風(fēng)險和健康數(shù)據(jù),在一定程度上限制了中國環(huán)境公正與健康不平等研究的開展(Ma et al, 2017)。

然而,作為世界上最大的發(fā)展中國家,中國是研究環(huán)境公正及健康不平等的重要案例地區(qū)。從環(huán)境公正的角度看,中國是一個追求社會主義市場經(jīng)濟(jì)的國家,也是世界上消費(fèi)經(jīng)濟(jì)增長最快和中產(chǎn)階級比例上升最快的國家,在政治上倡導(dǎo)平等主義原則,也就意味著所有環(huán)境不平等現(xiàn)象是不公正的。目前中國正面臨重大的環(huán)境污染問題,嚴(yán)重危害居民的健康狀況,在發(fā)展環(huán)境保護(hù)、公共衛(wèi)生和更廣泛的社會政策等方面,研究環(huán)境污染、健康不平等和人口結(jié)構(gòu)之間的內(nèi)在關(guān)系是緊迫而必要的。需要從微觀層面深入了解各種環(huán)境危害的社會與空間分布,以及環(huán)境公正與健康不平等之間的內(nèi)在關(guān)系,有助于幫助政府決策者更好地制定針對相應(yīng)風(fēng)險災(zāi)害、人群和地方的環(huán)境保護(hù)和公共健康政策。

5 結(jié)論與討論

總體而言,已有環(huán)境污染與健康研究主要集中于宏觀區(qū)域?qū)用?以空間(通常是居住地)作為研究單元,缺乏從微觀層面對個體居民、即“人”這一行為主體的時空行為及其健康效應(yīng)的關(guān)注。例如,已有空氣污染研究主要利用空氣質(zhì)量固定監(jiān)測點(diǎn)數(shù)據(jù)驗(yàn)證不同地方的空氣污染濃度與宏觀區(qū)域?qū)用娴慕】抵笜?biāo)之間的關(guān)系,缺乏對微觀個體居民活動—移動行為的正面關(guān)注,忽略交通出行作為連接空氣污染暴露與健康機(jī)制這一關(guān)鍵要素,較少考慮微觀個體居民時空行為模式及空氣污染暴露等方面的社會分異,及其對健康不平等產(chǎn)生的影響。近年來,部分研究逐漸轉(zhuǎn)向微觀層面的分析,關(guān)注城市建成環(huán)境對居民出行模式及健康效應(yīng)的影響,以及基于居民時空行為軌跡的空氣污染暴露測度與評估。研究視角逐漸多樣化,采用的方法也更為復(fù)雜,但整體缺乏對居民健康影響機(jī)理的微觀行為分析及綜合評價。

基于多學(xué)科研究范式,本文嘗試構(gòu)建環(huán)境、行為與健康研究的綜合分析框架。如圖2所示,時空行為是連接環(huán)境風(fēng)險與健康效應(yīng)的關(guān)鍵要素。城市建成環(huán)境主要通過直接影響居民日常生活方式及時空行為模式的選擇,進(jìn)而對居民健康狀況,如肥胖癥、心腦血管疾病、精神壓力等產(chǎn)生間接影響。與此同時,自然環(huán)境如空氣污染、噪音污染、水污染等因素除對居民健康狀況產(chǎn)生直接影響之外,還可通過居民時空行為模式差異影響其環(huán)境污染暴露量,進(jìn)而對居民健康狀況,如呼吸道疾病等產(chǎn)生間接影響。由此可見,環(huán)境、行為與健康三者之間的關(guān)系非常復(fù)雜,需要多學(xué)科、跨視角的綜合分析。未來研究可利用GPS、便攜式環(huán)境質(zhì)量監(jiān)測儀、信息通訊網(wǎng)絡(luò)等技術(shù)與手段,基于個體時空行為視角,將環(huán)境要素、居民日常行為模式與健康直接關(guān)聯(lián),從微觀層面深入挖掘居民時空行為與環(huán)境污染暴露的健康影響機(jī)理,更好地理解影響居民健康效應(yīng)的微觀行為機(jī)制及環(huán)境因素,通過調(diào)控交通政策、規(guī)劃措施等手段以及優(yōu)化居民行為模式等鼓勵居民綠色出行,減少環(huán)境污染暴露量,提高居民整體生活質(zhì)量及健康狀況,促進(jìn)城市和社會的可持續(xù)發(fā)展。

圖2 環(huán)境、行為與健康三者的關(guān)系

Fig.2 Relationship between environment, behavior, and health

此外,中國正在經(jīng)歷快速郊區(qū)化以及城市空間重構(gòu)過程,不同類型居民由于受不同程度的宏觀制度性因素(如戶籍制度、郊區(qū)保障性住房政策)的影響以及自身經(jīng)濟(jì)能力的制約,居民在日?；顒优c行為模式等方面產(chǎn)生一定的社會與空間分異。在宏觀的環(huán)境污染背景下,微觀個體居民所承受的各種環(huán)境污染暴露量是否具有顯著差異?低收入者、流動人口、老年人等弱勢群體是否承受了較大程度的環(huán)境負(fù)面影響?不同類型居民在生活質(zhì)量及健康狀況等方面是否又具有顯著的社會與空間分異?其影響機(jī)制是什么?這些問題的研究有助于從微觀層面深化對環(huán)境公正的理解與認(rèn)識,更好地挖掘環(huán)境公正與健康不平等之間的內(nèi)在關(guān)系;同時也將為制定發(fā)展更為有效的、公正的環(huán)境與健康政策提供科學(xué)依據(jù)。

The authors have declared that no competing interests exist.

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基于智慧交通的可達(dá)性與交通出行碳排放: 理論與實(shí)證

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信息與通信技術(shù)的發(fā)展推動了智慧交通建設(shè),并將進(jìn)一步提高城市交通可達(dá)性和影響居民出行。在全球應(yīng)對氣候變化、減少碳排放的共識背景下,由于"智慧交通—可達(dá)性—出行行為(碳排放)"間復(fù)雜的影響作用機(jī)制,已有的研究難以判斷智慧化背景下的城市交通可達(dá)性提高將增加抑或減少出行碳排放。如何通過提高城市交通可達(dá)性來緩解交通擁堵,保障城市交通運(yùn)輸系統(tǒng)的有效運(yùn)行,并提高居民出行效率,減少出行碳排放是當(dāng)前中國智慧交通發(fā)展面臨的關(guān)鍵問題之一。針對以上科學(xué)問題,本文嘗試提出基于智慧交通的可達(dá)性與交通出行碳排放的理論框架,并以廣州為研究案例地,研究了社區(qū)居民通勤碳排放特征及其影響機(jī)理,社區(qū)出行低碳指數(shù)格局及其影響因素的空間異質(zhì)性,以及基于碳排放—位置分配模型的公共中心規(guī)劃支持系統(tǒng)設(shè)計與應(yīng)用,可為今后的相關(guān)研究提供借鑒。

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https://doi.org/10.1289/ehp.10850 URL PMID: 2535621 [本文引用: 1] 摘要

Poverty is a major determinant of population health, but little is known about its role in modifying air pollution effects. We set out to examine whether people residing in socially deprived communities are at higher mortality risk from ambient air pollution. This study included 209 tertiary planning units (TPUs), the smallest units for town planning in the Special Administrative Region of Hong Kong, China. The socioeconomic status of each TPU was measured by a social deprivation index (SDI) derived from the proportions of the population witha) unemployment,b) monthly household income < US$250,c) no schooling at all,d) one-person household,e) never-married status, andf) subtenancy, from the 2001 Population Census. TPUs were classified into three levels of SDI: low, middle, and high. We performed time-series analysis with Poisson regression to examine the association between changes in daily concentrations of ambient air pollution and daily number of deaths in each SDI group for the period from January 1996 to December 2002. We evaluated the differences in pollution effects between different SDI groups using a case-only approach with logistic regression. We found significant associations of nitrogen dioxide, sulfur dioxide, particulate matter with aerodynamic diameter < 10 m, and ozone with all nonaccidental and cardiovascular mortality in areas of middle or high SDI (p< 0.05). Health outcomes, measured as all nonaccidental, cardiovascular, and respiratory mortality, in people residing in high SDI areas were more strongly associated with SO2and NO2compared with those in middle or low SDI areas. Neighborhood socioeconomic deprivation increases mortality risks associated with air pollution.

[59]World Health Organization (WHO). 2010.

UN-Habitat. Hidden cities: unmasking and overcoming health inequities in urban settings

[R]. Geneva, Switzerland: WHO.

[本文引用: 1]

[60]Yang J W, French S.2013.

The travel: Obesity connection: Discerning the impacts of commuting trips with the perspective of individual energy expenditure and time use

[J]. Environment and Planning B: Planning and Design, 40(4): 617-629.

https://doi.org/10.1068/b38076 URL 摘要

It has been widely reported that individual travel has significant implications for obesity. In this research we try to clarify the connection between travel and obesity from an individual energy-expenditure perspective. It is hypothesized here that individual travel affects the likelihood of becoming obese not only directly through a reliance on automobile-based travel that requires low amounts of individual energy expenditure, but also indirectly through the fatigue and stress stemming from driving, which reduces time available for physical activities and exercise. We use the American Time Use Survey (http://www.bls.gov/tus/) for 2003-08 and its Eating and Health Module for 2006 and 2007 to examine individual travel, energy expenditure, and obesity. Empirical analysis illustrates how individual body mass index (BMI) and individual travel are correlated and how this correlation can be explained from the perspective of individual energy expenditure. In addition, a distinction is drawn between commuting and noncommuting trips: commuting trips have a relatively larger impact on individual BMI. Analysis results point to a potential to reduce obesity rates through planning efforts at the regional level.

[2]柴彥威, 張艷, 劉志林. 2011.

職住分離的空間差異性及其影響因素研究

[J]. 地理學(xué)報, 66(2): 157-166.

https://doi.org/10.11821/xb201102002 URL [本文引用: 1] 摘要

制度轉(zhuǎn)型與空間重構(gòu)背景下,中國大城市的居住與就業(yè)空間關(guān)系發(fā)生明顯變化,職住分離現(xiàn)象逐漸凸顯。盡管城市地理學(xué)者逐步關(guān)注轉(zhuǎn)型期城市居住與就業(yè)空間關(guān)系的變化對居民通勤行為的影響,然而深入探討微觀個體所承受的職住分離程度的差異性及其影響因素的實(shí)證研究仍然缺乏?；趯Ρ本┏鞘?20戶家庭、806個通勤樣本的問卷調(diào)查數(shù)據(jù),本文借助多元回歸模型驗(yàn)證了居住區(qū)類型、家庭及住房狀況、以及其他社會經(jīng)濟(jì)屬性等居民職住分離程度差異性的影響,從而折射城市轉(zhuǎn)型過程中宏觀制度性及結(jié)構(gòu)性因素（如土地市場化改革、住房政策、單位制度改革、城市空間擴(kuò)展等）對個體日常生活經(jīng)歷差異性的影響。

[Chai Y W, Zhang Y, Liu Z L.2011.

Spatial differences of home-work separation and the impacts of housing policy and urban sprawl: Evidence from household survey data in Beijing

[J]. Acta Geographica Sinica, 66(2): 157-166.]

https://doi.org/10.11821/xb201102002 URL [本文引用: 1] 摘要

[3]關(guān)美寶, 郭文伯, 柴彥威. 2013.

人類移動性與健康研究中的時間問題

[J]. 地理科學(xué)進(jìn)展, 32(9): 1344-1351.

https://doi.org/10.11820/dlkxjz.2013.09.004 URL Magsci [本文引用: 1] 摘要

隨著地理信息科學(xué)的發(fā)展,地理學(xué)圍繞著社會熱點(diǎn)問題不斷向其他學(xué)科交叉滲透,同時學(xué)科的交叉也為地理學(xué)研究本身注入了熱量?？臻g一直是地理學(xué)研究中的基本問題,而時間與空間密不可分,從時間維度研究人類移動性及其豐富內(nèi)涵具有重要意義。本文在總結(jié)人類移動性熱點(diǎn)問題的基礎(chǔ)上,重點(diǎn)從時間維度探討了可達(dá)性、出行體驗(yàn)與幸福感、人類健康與疾病等問題的研究內(nèi)容和方法,并從低收入者社區(qū)醫(yī)療保健可達(dá)性研究和阿帕拉契亞鄉(xiāng)村地區(qū)吸煙者影響因素研究等案例進(jìn)行詳細(xì)闡釋,最后對人類移動性與健康研究的發(fā)展方向進(jìn)行了展望。

[Kwan M P, Guo W B, Chai Y W.2013.

Temporally integrated human mobility and health research

[J]. Progress in Geography, 32(9): 1344-1351.]

https://doi.org/10.11820/dlkxjz.2013.09.004 URL Magsci [本文引用: 1] 摘要

[4]郭文伯, 張艷, 柴彥威. 2015.

城市居民出行的空氣污染暴露測度及其影響機(jī)制: 北京市郊區(qū)社區(qū)的案例分析

[J]. 地理研究, 34(7): 1310-1318.

https://doi.org/10.11821/dlyj201507010 URL [本文引用: 2] 摘要

健康一直是社會各界廣泛關(guān)注的議題，出行污染暴露研究是人類移動性與健康研究結(jié)合的新熱點(diǎn).本文利用2010北京郊區(qū)居民GPS出行與活動調(diào)查數(shù)據(jù)和不同交通環(huán)境下PM2.5和CO污染暴露強(qiáng)度數(shù)據(jù)對居民出行空氣污染暴露進(jìn)行測度并分析了郊區(qū)居民不同人群PM2.s污染暴露度和CO污染暴露度差異，并通過構(gòu)建結(jié)構(gòu)方程模型解釋和分析影響郊區(qū)居民PM2.s污染暴露度和CO污染暴露度的機(jī)制.研究發(fā)現(xiàn)：(1)郊區(qū)社區(qū)不同人群每人每天平均CO污染暴露度和PM2.5污染暴露度，中等收入群體顯著高于低收入群體和高收入群體，租房者顯著高于住房者；未婚群體PM2.s污染暴露度顯著高于已婚群體，駕照持有群體CO污染暴露度高于無駕照群體；(2)機(jī)動化出行率決定出行總時間和出行次數(shù)，與出行總時問和出行次數(shù)成正關(guān)系，說明機(jī)動化出行率高的居民在出行機(jī)會選擇上擁有更多機(jī)會，同樣增加了出行時間，另一個可能的原因是機(jī)動化出行率緊選取汽車出行次數(shù)占一天出行次數(shù)的比例，城市內(nèi)汽車出行速度與公共交通速度接近，且一般低于地鐵出行速度；職住距離與每日出行總時間成正關(guān)系，職住距離增加會增加機(jī)動化出行率，機(jī)動化出行率同職住距離、出行時間、出行次數(shù)一樣增加了郊區(qū)居民每日PM2.s和CO污染暴露程度；(3)家里有18歲以下小孩需要照料時會顯著增加家長出行過程的PM2.5污染暴露度和CO污染暴露度，私家車或駕照狀況是影響機(jī)動化出行的重要因素，進(jìn)而影響郊區(qū)居民出行過程中的PM2.s污染暴露度和CO污染暴露度；收入狀況僅對PM2.s污染暴露度存在顯著性影響，教育程度差異對CO污染暴露度有顯著性影響.最后在總結(jié)文章不足的基礎(chǔ)上對研究進(jìn)行總結(jié)和展望，鼓勵健康城市規(guī)劃與管理，引導(dǎo)健康的生活方式，提升居民健康水平、促進(jìn)健康公平.

[Guo W B, Zhang Y, Chai Y W.2015.

Measurement of residents' daily travel air pollution exposure and its mechanism: A case study of suburban communities in Beijing

[J]. Geographical Research, 34(7): 1310-1318.]

https://doi.org/10.11821/dlyj201507010 URL [本文引用: 2] 摘要

[5]闞海東, 陳秉衡. 2002.

我國大氣顆粒物暴露與人群健康效應(yīng)的關(guān)系

[J]. 環(huán)境與健康雜志, 19(6): 422-424.

https://doi.org/10.3969/j.issn.1001-5914.2002.06.002 URL [本文引用: 1] 摘要

目的綜合分析我國大氣顆粒物暴露與人群健康效應(yīng)的流行病學(xué)資料,以獲取我國顆粒物-健康效應(yīng)的暴露-反應(yīng)關(guān)系.方法在聯(lián)機(jī)檢索文獻(xiàn)的基礎(chǔ)上,確定各健康效應(yīng)終點(diǎn)的定量暴露-反應(yīng)關(guān)系,多篇文獻(xiàn)的綜合評價采用Meta分析的方法進(jìn)行.結(jié)果建立了從發(fā)病到死亡各個健康效應(yīng)終點(diǎn)上,大氣顆粒物濃度每升高一定單位,人群不良健康效應(yīng)發(fā)生的相對危險度.結(jié)論該文建立的暴露-反應(yīng)關(guān)系,可用于我國大氣顆粒物污染的健康危險度評價工作.

[Kan H D, Chen B H.2002.

Analysis of exposure-response relationships of air particulate matter and adverse health outcomes in China

[J]. Journal of Environment and Health, 19(6): 422-424.]

https://doi.org/10.3969/j.issn.1001-5914.2002.06.002 URL [本文引用: 1] 摘要

[6]林雄斌, 楊家文. 2015.

北美都市區(qū)建成環(huán)境與公共健康關(guān)系的研究述評及其啟示

[J]. 規(guī)劃師, 31(6): 12-19.

https://doi.org/10.3969/j.issn.1006-0022.2015.06.002 URL [本文引用: 1] 摘要

我國工業(yè)化、城市化和機(jī)動化的快速發(fā)展顯著改變了城市建成環(huán)境的特征,帶來居民體力活動缺乏和環(huán)境污染等問題,導(dǎo)致肥胖、心血管等慢性疾病的增加。建成環(huán)境作為城市規(guī)劃建設(shè)在空間上的反映,是影響居民體力活動和健康的重要載體。從建成環(huán)境規(guī)劃與優(yōu)化的視角來鼓勵公眾體力活動、提升健康水平,成為國外城市規(guī)劃新的理念。北美都市區(qū)對"建成環(huán)境—公共健康"互動關(guān)系的研究已有豐富成果,并實(shí)施應(yīng)對健康問題的體力活動建議導(dǎo)則與建成環(huán)境規(guī)劃設(shè)計策略。研究重點(diǎn)論述土地利用、交通系統(tǒng)等建成環(huán)境因素對體力活動和健康的影響作用機(jī)制,進(jìn)而借鑒北美都市區(qū)的公共健康問題的規(guī)劃應(yīng)對,為緩解我國城市健康問題和推進(jìn)健康城市建成環(huán)境規(guī)劃提供借鑒。

[Lin X B, Yang J W.2015.

Built environment and public health review and planning in North American metropolitan areas

[J]. Planners, 31(6): 12-19.]

https://doi.org/10.3969/j.issn.1006-0022.2015.06.002 URL [本文引用: 1] 摘要

[7]劉曉霞, 鄒小華, 王興中. 2012.

國外健康地理學(xué)研究進(jìn)展

[J]. 人文地理, 27(3): 23-27.

[本文引用: 1]

[Liu X X, Zou X H, Wang X Z.2012.

Progress of health geography in Western Countries

[J]. Human Geography, 27(3): 23-27.]

[本文引用: 1]

[8]魯斐棟, 譚少華. 2015.

建成環(huán)境對體力活動的影響研究: 進(jìn)展與思考

[J]. 國際城市規(guī)劃, 30(2): 62-70.

[本文引用: 1]

[Lu F D, Tan S H.2015.

Built environment's influence on physical activity: Review and thought

[J]. Urban Planning International, 30(2): 62-70.]

[本文引用: 1]

[9]馬靜, 柴彥威, 劉志林. 2011.

基于居民出行行為的北京市交通碳排放影響機(jī)理

[J]. 地理學(xué)報, 66(8): 1023-1032.

https://doi.org/10.11821/xb201108002 URL [本文引用: 1] 摘要

近年來低碳城市逐漸成為眾多學(xué)科關(guān)注的焦點(diǎn)所在,國內(nèi)外學(xué)者從多個角度對其開展一系列的理論與實(shí)證研究,但從微觀層面深入探討城市交通碳排放的影響機(jī)理的研究相對較為缺乏。利用北京市居民活動日志調(diào)查獲取的第一手?jǐn)?shù)據(jù),基于居民日常出行行為計算微觀層面的城市交通碳排放,并采用結(jié)構(gòu)方程模型深入挖掘居住空間、個體行為以及交通碳排放三者之間的內(nèi)在關(guān)系。結(jié)果表明,出行距離、機(jī)動出行概率對交通碳排放產(chǎn)生顯著的正效應(yīng),而出行頻率的影響并不顯著;同時,出行結(jié)構(gòu)的影響要遠(yuǎn)遠(yuǎn)大于出行總量的影響。另外,城市空間結(jié)構(gòu)對城市交通碳排放產(chǎn)生顯著影響,單位社區(qū)居民的出行行為整體具有＂低碳＂性質(zhì),應(yīng)從低碳視角對單位社區(qū)進(jìn)行重新審視。

[Ma J, Chai Y W, Liu Z L.2011.

The mechanism of CO2 emissions from urban transport based on individuals' travel behavior in Beijing

[J]. Acta Geographica Sinica, 66(8): 1023-1032.]

https://doi.org/10.11821/xb201108002 URL [本文引用: 1] 摘要

[10]孟斌, 于慧麗, 鄭麗敏. 2012.

北京大型居住區(qū)居民通勤行為對比研究: 以望京居住區(qū)和天通苑居住區(qū)為例

[J]. 地理研究, 31(11): 2069-2079.

[本文引用: 1]

[Meng B, Yu H L, Zheng L M.2012.

The analysis of commuting behavior in the huge residential districts: A case study of Wangjing and Tiantongyuan in Beijing

[J]. Geographical Research, 31(11): 2069-2079.]

[本文引用: 1]

[11]秦波, 邵然. 2012.

城市形態(tài)對居民直接碳排放的影響: 基于社區(qū)的案例研究

[J]. 城市規(guī)劃, 36(6): 33-38.

URL [本文引用: 1] 摘要

基于北京1400份居民的建筑和出行能源消費(fèi)行為問卷數(shù)據(jù),利用空間統(tǒng)計工具LISA確定高(低)直接碳排放居民的聚集社區(qū),進(jìn)而通過五個社區(qū)的案例研究,探討居民直接碳排放和城市形態(tài)之間的關(guān)系。結(jié)果顯示,建筑密度、土地利用形態(tài)、就業(yè)可達(dá)性和公交可達(dá)性均對居民的直接碳排放產(chǎn)生顯著影響,這說明合理規(guī)劃空間形態(tài)是構(gòu)建低碳城市的重要政策手段。

[Qin B, Shao R.2012.

The impacts of urban form on household carbon emissions: A case study on neighborhoods

[J]. City Planning Review, 36(6): 33-38.]

URL [本文引用: 1] 摘要

[12]孫斌棟, 閻宏, 張婷麟. 2016.

社區(qū)建成環(huán)境對健康的影響: 基于居民個體超重的實(shí)證研究

[J]. 地理學(xué)報, 71(10): 1721-1730.

https://doi.org/10.11821/dlxb201610005 URL [本文引用: 1] 摘要

隨著中國經(jīng)濟(jì)發(fā)展和居民生活水平的提升,超重和肥胖問題開始顯現(xiàn),嚴(yán)重影響到居民的身體健康。基于中國家庭追蹤調(diào)查的全國抽樣數(shù)據(jù),采用結(jié)構(gòu)方程模型檢驗(yàn)社區(qū)建成環(huán)境對居民個體超重的影響。研究發(fā)現(xiàn),控制社會經(jīng)濟(jì)屬性后,提高社區(qū)人口密度或設(shè)施可達(dá)性、縮短居民到公交站距離,可以通過減少個體機(jī)動化出行傾向而間接降低超重的可能性,但對超重的直接效應(yīng)及總效應(yīng)為正。這一結(jié)論與西方發(fā)達(dá)國家的經(jīng)驗(yàn)不同,因此制定健康政策需要基于中國自身國情和規(guī)律,在建成環(huán)境方面應(yīng)重點(diǎn)提高室外空間可步行性和休閑吸引力。

[Sun B D, Yan H, Zhang T L.2016.

Impact of community built environment on residents' health: A case study on individual overweight

[J]. Acta Geographica Sinica, 71(10): 1721-1730.]

https://doi.org/10.11821/dlxb201610005 URL [本文引用: 1] 摘要

隨著中國經(jīng)濟(jì)發(fā)展和居民生活水平的提升,超重和肥胖問題開始顯現(xiàn),嚴(yán)重影響到居民的身體健康?；谥袊彝プ粉櫿{(diào)查的全國抽樣數(shù)據(jù),采用結(jié)構(gòu)方程模型檢驗(yàn)社區(qū)建成環(huán)境對居民個體超重的影響。研究發(fā)現(xiàn),控制社會經(jīng)濟(jì)屬性后,提高社區(qū)人口密度或設(shè)施可達(dá)性、縮短居民到公交站距離,可以通過減少個體機(jī)動化出行傾向而間接降低超重的可能性,但對超重的直接效應(yīng)及總效應(yīng)為正。這一結(jié)論與西方發(fā)達(dá)國家的經(jīng)驗(yàn)不同,因此制定健康政策需要基于中國自身國情和規(guī)律,在建成環(huán)境方面應(yīng)重點(diǎn)提高室外空間可步行性和休閑吸引力。

[13]楊林生, 李海蓉, 李永華, 等. 2010.

醫(yī)學(xué)地理和環(huán)境健康研究的主要領(lǐng)域與進(jìn)展

[J]. 地理科學(xué)進(jìn)展, 29(1): 31-44.

https://doi.org/10.11820/dlkxjz.2010.01.005 Magsci [本文引用: 1] 摘要

<p>通過對近年國內(nèi)外醫(yī)學(xué)地理和環(huán)境健康相關(guān)領(lǐng)域的文獻(xiàn)檢索分析發(fā)現(xiàn)，人口健康是當(dāng)前國際地理學(xué)和環(huán)境科學(xué)研究的核心內(nèi)容之一，其研究趨勢可以歸納為以下幾個方面：①重視全球環(huán)境變化對人類健康的影響。包括全球大氣組成改變(氣候變化和臭氧層耗散)對健康的影響、土地利用/土地覆被變化與健康、全球環(huán)境變化與傳染病、食物生產(chǎn)系統(tǒng)改變與健康和城市化與健康等；②環(huán)境健康風(fēng)險評估領(lǐng)域進(jìn)一步拓展，除重金屬、持久性有機(jī)污染物等有毒有害污染物的健康風(fēng)險外，有關(guān)生態(tài)、災(zāi)害和場地環(huán)境污染對健康影響的綜合風(fēng)險評估日益受到重視；③重視社會人文因素與自然因素交互作用對健康的影響，特別是經(jīng)濟(jì)發(fā)展和城市化過程中收入、產(chǎn)品和服務(wù)分配不均造成的衛(wèi)生不公平對健康的影響；④重視人口老齡化過程的時空差異及其對社會的影響和老齡人口的健康、醫(yī)療與養(yǎng)老需求及其可達(dá)性研究；⑤地理信息系統(tǒng)和模型等技術(shù)被廣泛用于疾病和健康的空間數(shù)據(jù)管理、空間分布規(guī)律和空間影響因素分析等領(lǐng)域，并為疾病監(jiān)測、衛(wèi)生管理和衛(wèi)生規(guī)劃提供了強(qiáng)有力的技術(shù)支撐。隨著國內(nèi)在相關(guān)領(lǐng)域需求和國際交流的增加，我國近年的相關(guān)研究有了較大的發(fā)展并得到國際社會的認(rèn)可，醫(yī)學(xué)地理作為一門學(xué)科，在我國人口健康研究中正發(fā)揮越來越重要的作用。</p>

[Yang L S, Li H R, Li Y H, et al.2010.

Progress of medical geography and environmental health studies

[J]. Progress in Geography, 29(1): 31-44.]

https://doi.org/10.11820/dlkxjz.2010.01.005 Magsci [本文引用: 1] 摘要

[14]楊彥, 陸曉松, 李定龍. 2014.

我國環(huán)境健康風(fēng)險評價研究進(jìn)展

[J]. 環(huán)境與健康雜志, 31(4): 357-363.

URL [本文引用: 1]

[Yang Y, Lu X S, Li D L.2014.

Research progress of environmental health risk assessment in China

[J]. Journal of Environment and Health, 31(4): 357-363.]

URL [本文引用: 1]

[15]朱菁, 高鵬華, 吳瀟, 等. 2014.

大城市居民通勤行為的健康效應(yīng)研究: 以西安市為例

[J]. 城市規(guī)劃學(xué)刊, (6): 46-51.

[本文引用: 1]

[Zhu J, Gao P H, Wu X, et al.2014.

The commuting effects to people's health: A case study of Xi'an

[J]. Urban Planning Forum, (6): 46-51.]

[本文引用: 1]

[16]Adams H S, Nieuwenhuijsen M J, Colvile R N, et al.2001.

Fine particle (PM2.5) personal exposure levels in transport microenvironments, London, UK

[J]. Science of the Total Environment, 279(1-3): 29-44.

https://doi.org/10.1016/S0048-9697(01)00723-9 URL [本文引用: 2]

[17]Alvarado M, Lofgren K T.2013.

How can city planners improve health and reduce mortality in Alameda County, California? A cross-sectional analysis

[J]. The Lancet, 381(S2): S7.

https://doi.org/10.1016/S0140-6736(13)61261-1 URL [本文引用: 1] 摘要

None.

[18]Brulle R J, Pellow D N.2006.

Environmental justice: Human health and environmental inequalities

[J]. Annual Review of Public Health, 27(1): 103-124.

https://doi.org/10.1146/annurev.publhealth.27.021405.102124 URL PMID: 16533111 [本文引用: 2] 摘要

In this review, we provide an introduction to the topics of environmental justice and environmental inequality. We provide an overview of the dimensions of unequal exposures to environmental pollution (environmental inequality), followed by a discussion of the theoretical literature that seeks to explain the origins of this phenomenon. We also consider the impact of the environmental justice movement in the United States and the role that federal and state governments have developed to address environmental inequalities. We conclude that more research is needed that links environmental inequalities with public health outcomes.

[19]Cervero R, Kockelman K.1997.

Travel demand and the 3Ds: Density, diversity, and design

[J]. Transportation Research Part D: Transport and Environment, 2(3): 199-219.

https://doi.org/10.1016/S1361-9209(97)00009-6 URL [本文引用: 1] 摘要

The built environment is thought to influence travel demand along three principal dimensions —density, diversity, and design. This paper tests this proposition by examining how the ‘3Ds’ affect trip rates and mode choice of residents in the San Francisco Bay Area. Using 1990 travel diary data and land-use records obtained from the U.S. census, regional inventories, and field surveys, models are estimated that relate features of the built environment to variations in vehicle miles traveled per household and mode choice, mainly for non-work trips. Factor analysis is used to linearly combine variables into the density and design dimensions of the built environment. The research finds that density, land-use diversity, and pedestrian-oriented designs generally reduce trip rates and encourage non-auto travel in statistically significant ways, though their influences appear to be fairly marginal. Elasticities between variables and factors that capture the 3Ds and various measures of travel demand are generally in the 0.06 to 0.18 range, expressed in absolute terms. Compact development was found to exert the strongest influence on personal business trips. Within-neighborhood retail shops, on the other hand, were most strongly associated with mode choice for work trips. And while a factor capturing ‘walking quality’ was only moderately related to mode choice for non-work trips, those living in neighborhoods with grid-iron street designs and restricted commercial parking were nonetheless found to average significantly less vehicle miles of travel and rely less on single-occupant vehicles for non-work trips. Overall, this research shows that the elasticities between each dimension of the built environment and travel demand are modest to moderate, though certainly not inconsequential. Thus it supports the contention of new urbanists and others that creating more compact, diverse, and pedestrian-orientated neighborhoods, in combination, can meaningfully influence how Americans travel.

[20]Chakraborty J, Maantay J A, Brender J D.2011.

Disproportionate proximity to environmental health hazards: Methods, models, and measurement

[J]. American Journal of Public Health, 101(S1): S27-S36.

https://doi.org/10.2105/AJPH.2010.300109 URL PMID: 21836113 [本文引用: 1] 摘要

Abstract We sought to provide a historical overview of methods, models, and data used in the environmental justice (EJ) research literature to measure proximity to environmental hazards and potential exposure to their adverse health effects. We explored how the assessment of disproportionate proximity and exposure has evolved from comparing the prevalence of minority or low-income residents in geographic entities hosting pollution sources and discrete buffer zones to more refined techniques that use continuous distances, pollutant fate-and-transport models, and estimates of health risk from toxic exposure. We also reviewed analytical techniques used to determine the characteristics of people residing in areas potentially exposed to environmental hazards and emerging geostatistical techniques that are more appropriate for EJ analysis than conventional statistical methods. We concluded by providing several recommendations regarding future research and data needs for EJ assessment that would lead to more reliable results and policy solutions.

[21]Chen J, Chen S, Landry P F.2013.

Migration, environmental hazards, and health outcomes in China

[J]. Social Science & Medicine, 80: 85-95.

https://doi.org/10.1016/j.socscimed.2012.12.002 URL PMID: 23273408 [本文引用: 3] 摘要

China's rapid economic growth has had a serious impact on the environment. Environmental hazards are major sources of health risk factors. The migration of over 200 million people to heavily polluted urban areas is likely to be significantly detrimental to health. Based on data from the 2009 national household survey hinese Attitudes toward Inequality and Distributive Injustice (N=2866) and various county-level and municipal indicators, we investigate the disparities in subjective exposure to environmental hazards and associated health outcomes in China. This study focuses particularly on migration-residency status and county-level socio-economic development. We employ multiple regressions that account for the complex multi-stage survey design to assess the associations between perceived environmental hazards and individual and county-level indicators and between perceived environmental hazards and health outcomes, controlling for physical and social environments at multiple levels. We find that perceived environmental hazards are associated with county-level industrialization and economic development: respondents living in more industrialized counties report greater exposure to environmental hazards. Rural-to-urban migrants are exposed to more water pollution and a higher measure of overall environmental hazard. Perceived environmental risk factors severely affect the physical and mental health of the respondents. The negative effects of perceived overall environmental hazard on physical health are more detrimental for rural-to-urban migrants than for urban residents. The research findings call for restructuring the household registration system in order to equalize access to public services and mitigate adverse environmental health effects, particularly among the migrant population.

[22]Craig N.2005.

Exploring the generalisability of the association between income inequality and self-assessed health

[J]. Social Science & Medicine, 60(11): 2477-2488.

https://doi.org/10.1016/j.socscimed.2004.11.018 URL PMID: 15814173 [本文引用: 1] 摘要

A growing between- and within-country literature suggests that the association between income inequality and health reflects individual- or area-level characteristics with which income inequality is associated, rather than the effects of income inequality per se. These studies also suggest that the association between income inequality and health is country-specific. Unresolved methodological issues include the geographical level at which to model the effects of income inequality, and the appropriate statistical methods to use. This study compares the results of single-level and multi-level logistic regression models estimating the association between income inequality and self-assessed health in local authorities in Scotland. The results suggest that there is a significant positive association between income inequality and health across local authorities in Scotland, even after adjusting for individual-level socio-economic status. They also suggest that there is significant local authority-level variation in self-assessed health, but this is small compared to the variation at the individual level. Income and other measures of individuals socio-economic status are more strongly associated with self-assessed health than income inequality. This study provides further evidence that the income inequality:health association is place-specific. It also suggests that methodological choices regarding the ways of estimating the association between self-assessed health, individual-level socio-economic status and area-level income inequality may not make a substantive difference to the results when contextual effects are small. Further work is required to test the sensitivity of these conclusions to alternative levels of geographical aggregation.

[23]Cutter S L.1995.

Race, class and environmental justice

[J]. Progress in Human Geography, 19(1): 111-122.

https://doi.org/10.1177/030913259501900111 URL [本文引用: 1] 摘要

First page of article

[24]Ewing R, Cervero R.2010.

Travel and the built environment

[J]. Journal of the American Planning Association, 76(3): 265-294.

https://doi.org/10.1080/01944361003766766 URL [本文引用: 1] 摘要

Problem: Localities and states are turning to land planning and urban design for help in reducing automobile use and related social and environmental costs. The effects of such strategies on travel demand have not been generalized in recent years from the multitude of available studies. Purpose: We conducted a meta-analysis of the built environment-travel literature existing at the end of 2009 in order to draw generalizable conclusions for practice. We aimed to quantify effect sizes, update earlier work, include additional outcome measures, and address the methodological issue of self-selection. Methods: We computed elasticities for individual studies and pooled them to produce weighted averages. Results and conclusions: Travel variables are generally inelastic with respect to change in measures of the built environment. Of the environmental variables considered here, none has a weighted average travel elasticity of absolute magnitude greater than 0.39, and most are much less. Still, the combined effect of several such variables on travel could be quite large. Consistent with prior work, we find that vehicle miles traveled (VMT) is most strongly related to measures of accessibility to destinations and secondarily to street network design variables. Walking is most strongly related to measures of land use diversity, intersection density, and the number of destinations within walking distance. Bus and train use are equally related to proximity to transit and street network design variables, with land use diversity a secondary factor. Surprisingly, we find population and job densities to be only weakly associated with travel behavior once these other variables are controlled. Takeaway for practice: The elasticities we derived in this meta-analysis may be used to adjust outputs of travel or activity models that are otherwise insensitive to variation in the built environment, or be used in sketch planning applications ranging from climate action plans to health impact assessments. However, because sample sizes are small, and very few studies control for residential preferences and attitudes, we cannot say that planners should generalize broadly from our results. While these elasticities are as accurate as currently possible, they should be understood to contain unknown error and have unknown confidence intervals. They provide a base, and as more built-environment/travel studies appear in the planning literature, these elasticities should be updated and refined. Research support: U.S. Environmental Protection Agency.

[25]Fang T B, Lu Y M.2011.

Constructing a near real-time space-time cube to depict urban ambient air pollution scenario

[J]. Transactions in GIS, 15(5): 635-649.

https://doi.org/10.1111/j.1467-9671.2011.01283.x URL [本文引用: 1] 摘要

This study adopts a near real-time space-time cube approach to portray a dynamic urban air pollution scenario across space and time. Originating from time geography, space-time cubes provide an approach to integrate spatial and temporal air pollution information into a 3D space. The base of the cube represents the variation of air pollution in a 2D geographical space while the height represents time. This way, the changes of pollution over time can be described by the different component layers of the cube from the base up. The diurnal ambient ozone (O3) pollution in Houston, Texas is modeled in this study using the space-time air pollution cube. Two methods, land use regression (LUR) modeling and spatial interpolation, were applied to build the hourly component layers for the air pollution cube. It was found that the LUR modeling performed better than the spatial interpolation in predicting air pollution level. With the availability of real-time air pollution data, this approach can be extended to produce real-time air pollution cube is for more accurate air pollution measurement across space and time, which can provide important support to studies in epidemiology, health geography, and environmental regulation.

[26]Gee G C, Payne-Sturges D C.2004.

Environmental health disparities: A framework integrating psychosocial and environmental concepts

[J]. Environmental Health Perspectives, 112(17): 1645-1653.

https://doi.org/10.1289/ehp.7074 URL PMID: 1253653 [本文引用: 1] 摘要

Although it is often acknowledged that social and environmental factors interact to produce racial and ethnic environmental health disparities, it is still unclear how this occurs. Despite continued controversy, the environmental justice movement has provided some insight by suggesting that disadvantaged communities face greater likelihood of exposure to ambient hazards. The exposure-disease paradigm has long suggested that differential "vulnerability" may modify the effects of toxicants on biological systems. However, relatively little work has been done to specify whether racial and ethnic minorities may have greater vulnerability than do majority populations and, further, what these vulnerabilities may be. We suggest that psychosocial stress may be the vulnerability factor that links social conditions with environmental hazards. Psychosocial stress can lead to acute and chronic changes in the functioning of body systems (e.g., immune) and also lead directly to illness. In this article we present a multidisciplinary framework integrating these ideas. We also argue that residential segregation leads to differential experiences of community stress, exposure to pollutants, and access to community resources. When not counterbalanced by resources, stressors may lead to heightened vulnerability to environmental hazards.

[27]Giles-Corti B, Vernez-Moudon A, Reis R, et al.2016.

City planning and population health: A global challenge

[J]. The Lancet, 388: 2912-2924.

https://doi.org/10.1016/S0140-6736(16)30066-6 URL PMID: 27671668 [本文引用: 3] 摘要

Significant global health challenges are being confronted in the 21st century, prompting calls to rethink approaches to disease prevention. A key part of the solution is city planning that reduces non-communicable diseases and road trauma while also managing rapid urbanisation. This Series of papers considers the health impacts of city planning through transport mode choices. In this, the first paper, we identify eight integrated regional and local interventions that, when combined, encourage walking, cycling, and public transport use, while reducing private motor vehicle use. These interventions are destination accessibility, equitable distribution of employment across cities, managing demand by reducing the availability and increasing the cost of parking, designing pedestrian-friendly and cycling-friendly movement networks, achieving optimum levels of residential density, reducing distance to public transport, and enhancing the desirability of active travel modes (eg, creating safe attractive neighbourhoods and safe, affordable, and convenient public transport). Together, these interventions will create healthier and more sustainable compact cities that reduce the environmental, social, and behavioural risk factors that affect lifestyle choices, levels of traffic, environmental pollution, noise, and crime. The health sector, including health ministers, must lead in advocating for integrated multisector city planning that prioritises health, sustainability, and liveability outcomes, particularly in rapidly changing low-income and middle-income countries. We recommend establishing a set of indicators to benchmark and monitor progress towards achievement of more compact cities that promote health and reduce health inequities.

[28]Greenberg M, Renne J, Lane R, et al.2005.

Physical activity and use of suburban train stations: An exploratory analysis

[J]. Journal of Public Transportation, 8(3): 89-116.

https://doi.org/10.5038/2375-0901.8.3.5 URL [本文引用: 1] 摘要

Physical inactivity contributes to a growing proportion of illness and premature death in the United States. Only about 45 percent of Americans meet the recommended national standard for physical activity. Yet, analysis of 300 surveys collected from train riders at three walkable New Jersey suburban train stations showed that 78 percent met the activity guidelines. A new train station that allows these riders to save time in their commute has attracted new riders and has led existing commuters to change their commute. One-third of those surveyed reported additional physical activity primarily because they walked more after leaving the train in mid-town New York City. Only 8 percent reported less physical activity. The analysis revealed that the new public transit station and personal factors associated with a greater likelihood of using mass transit led to more physical activity.

[29]Gulliver J, Briggs D J.2005.

Time-space modeling of journey-time exposure to traffic-related air pollution using GIS

[J]. Environmental Research, 97(1): 10-25.

https://doi.org/10.1016/j.envres.2004.05.002 URL PMID: 15476729 [本文引用: 2] 摘要

Abstract Journey-time exposures represent an important, though as yet little-studied, component of human exposure to traffic-related air pollution, potentially with important health effects. Methods for assessing journey-time exposures, either as part of epidemiological studies or for policy assessment, are, however, poorly developed. This paper describes the development and testing of a GIS-based system for modeling human journey-time exposures to traffic-related air pollution: STEMS (Space-Time Exposure Modeling System). The model integrates data on source activity, pollutant dispersion, and travel behavior to derive individual- or group-level exposure measures to atmospheric pollution. The model, which is designed to simulate exposures of people as they move through a changing air pollution field, was developed, validated, and trialed in Northampton, UK. The system currently uses ArcInfo to couple four separate submodels: a source activity/emission model (SATURN), a proprietary atmospheric dispersion model (ADMS-Urban), an empirically derived background air pollution model, and a purposely designed time-activity-based exposure model (TOTEM). This paper describes the structure of the modeling system; presents results of field calibration, validation, and sensitivity analysis; and illustrates the use of the model to analyze journey-time exposures of schoolchildren.

[30]Handy S L, Boarnet M G, Ewing R, et al.2002.

How the built environment affects physical activity: Views from urban planning

[J]. American Journal of Preventive Medicine, 23(2): 64-73.

https://doi.org/10.1016/S0749-3797(02)00475-0 URL [本文引用: 1]

[31]Hansson E, Mattisson K, Bj?rk J, et al.2011.

Relationship between commuting and health outcomes in a cross-sectional population survey in Southern Sweden

[J]. BMC Public Health, 11: 834.

https://doi.org/10.1186/1471-2458-11-834 URL PMID: 22039952 [本文引用: 1] 摘要

Abstract BACKGROUND: The need for a mobile workforce inevitably means that the length of the total work day (working and traveling time) will increase, but the health effects of commuting have been surprisingly little studied apart from perceived stress and the benefits of physically active commuting. METHODS: We used data from two cross-sectional population-based public health surveys performed in 2004 and 2008 in Scania, Sweden (56% response rate). The final study population was 21, 088 persons aged 18-65, working > 30 h/week. Duration (one-way) and mode of commuting were reported. The outcomes studied were perceived poor sleep quality, everyday stress, low vitality, mental health, self-reported health, and absence from work due to sickness during the past 12 months. Covariates indicating socioeconomic status and family situation, overtime, job strain and urban/rural residency were included in multivariate analyses. Subjects walking or cycling to work 60 min odds ratios (ORs) ranged from 1.2 - 1.6 for the different outcomes. For car commuting, the relationships were concave downward or flat, with increasing subjective health complaints up to 30-60 min (ORs ranging from 1.2 - 1.4), and lower ORs in the > 60 min category. A similar concave downward relationship was observed for sickness absence, regardless of mode of transport. CONCLUSIONS: The results of this study are concordant with the few earlier studies in the field, in that associations were found between commutation and negative health outcomes. This further demonstrates the need to consider the negative side-effects of commuting when discussing policies aimed at increasing the mobility of the workforce. Studies identifying population groups with increased susceptibility are warranted.

[32]Hart J E, Garshick E, Smith T J, et al.2013.

Ischaemic heart disease mortality and years of work in trucking industry workers

[J]. Occupational and Environmental Medicine, 70(8): 523-528.

https://doi.org/10.1136/oemed-2011-100017 URL PMID: 22992341 [本文引用: 1] 摘要

Objectives Evidence from general population-based studies and occupational cohorts has identified air pollution from mobile sources as a risk factor for cardiovascular disease. In a cohort of US trucking industry workers, with regular exposure to vehicle exhaust, the authors previously observed elevated standardised mortality ratios for ischaemic heart disease (IHD) compared with members of the general US population. Therefore, the authors examined the association of increasing years of work in jobs with vehicle exhaust exposure and IHD mortality within the cohort.Methods The authors calculated years of work in eight job groups for 30?758 workers using work records from four nationwide companies. Proportional hazard regression was used to examine relationships between IHD mortality, 1985-2000, and employment duration in each job group.Results HRs for at least 1year of work in each job were elevated for dockworkers, long haul drivers, pick-up and delivery drivers, combination workers, hostlers, and shop workers. There was a suggestion of an increased risk of IHD mortality with increasing years of work as a long haul driver, pick-up and delivery driver, combination worker, and dockworker.Conclusion These results suggest an elevated risk of IHD mortality in workers with a previous history of regular exposure to vehicle exhaust.

[33]Holdaway J.2010.

Environment and health in China: An introduction to an emerging research field

[J]. Journal of Contemporary China, 19(63): 1-22.

https://doi.org/10.1080/10670560903335728 URL [本文引用: 2] 摘要

This paper is an introduction to the special issue. It provides an overview of the major environment-related health risks China faces, and a review of some of the responses currently being made by the government and societal actors. The paper concludes with a discussion of the contributions that the social sciences might make to our understanding of these issues.

[34]Huang J, Deng F R, Wu S W, Guo X B.2012.

Comparisons of personal exposure to PM2.5 and CO by different commuting modes in Beijing, China

[J]. Science of the Total Environment, 425: 52-59.

https://doi.org/10.1016/j.scitotenv.2012.03.007 URL PMID: 22472140 [本文引用: 2] 摘要

Abstract BACKGROUND: Epidemiological studies have shown that commuting in traffic is associated with adverse health effects. It is vital to investigate commuters' exposure to traffic-related air pollutants before considering potential health risks. However, there are relatively few publications considering commuters' personal exposure in China. METHOD: We carried out a field investigation measuring commuters' personal exposure to particulate matter ≤2.5 μm in aerodynamic diameter (PM(2.5)) and carbon monoxide (CO) by three commuting modes in Beijing. Both PM(2.5) and CO personal concentrations and whole trip exposures were compared among the three commuting modes. RESULTS: After controlling confounding factors, we found that taxi commuters were exposed to lower concentrations of PM(2.5) (31.64±20.77 μg/m(3)) compared with bus commuters (42.40±23.36 μg/m(3)) and cyclists (49.10±26.60 μg/m(3)). By contrast, CO personal concentrations were significantly higher when commuting by taxi (5.21±1.52 ppm) than by bus (2.41±0.99 ppm) and bicycle (1.90±0.55 ppm). However, when inhalation rates and trip duration were taken into consideration, cyclists experienced the highest whole trip exposures to both PM(2.5) and CO (p<0.05). We also found fixed site monitoring data were not appropriate surrogates for personal exposure while commuting, especially during traffic heavy times. CONCLUSION: PM(2.5) and CO personal concentrations were greatly influenced by the commuting mode. Furthermore, the highest whole trip exposures to PM(2.5) and CO which cyclists experienced indicates it is not preferable to commute by bicycle in a relatively high air polluted environment. Cyclists are possibly subject to greater health risks than other commuters. Thus further research needs to be conducted to investigate the health risks associated with cycling. Copyright 08 2012 Elsevier B.V. All rights reserved.

[35]Kaur S, Nieuwenhuijsen M J, Colvile R N.2007.

Fine particulate matter and carbon monoxide exposure concentrations in urban street transport microenvironments

[J]. Atmospheric Environment, 41(23): 4781-4810.

https://doi.org/10.1016/j.atmosenv.2007.02.002 URL [本文引用: 1] 摘要

Personal exposure studies are crucial alongside microenvironment and ambient studies in order to get a better understanding of the health risks posed by fine particulate matter and carbon monoxide in the urban transport microenvironment and for making informed decisions to manage and reduce the health risks. Studies specifically assessing the PM2.5, ultrafine particle count and carbon monoxide personal exposure concentrations of adults in an urban transport microenvironment have steadily increased in number over the last decade. However, no recent collective summary is available, particularly one which also considers ultrafine particles; therefore, we present a review of the personal exposure concentration studies for the above named pollutants on different modes of surface transportation (walking, cycling, bus, car and taxi) in the urban transport microenvironment. Comparisons between personal exposure measurements and concentrations recorded at fixed monitoring sites are considered in addition to the factors influencing personal exposure in the transport microenvironment. In general, the exposure studies examined revealed pedestrians and cyclists to experience lower fine particulate matter and CO exposure concentrations in comparison to those inside vehicles he vehicle shell provided no protection to the passengers. Proximity to the pollutant sources had a significant impact on exposure concentration levels experienced, consequently individuals should be encouraged to use back street routes. Fixed monitoring stations were found to be relatively poor predictors of CO and PM2.5 exposure concentration levels experienced by individuals in the urban transport microenvironment. Although the mode of transport, traffic and meteorology parameters were commonly identified as significant factors influencing exposure concentrations to the different pollutants under examination, a large amount of the exposure concentration variation in the exposure studies remained unexplaine

[36]Laurent é.2011.

Issues in environmental justice within the European Union

[J]. Ecological Economics, 70(11): 1846-1853.

https://doi.org/10.1016/j.ecolecon.2011.06.025 URL [本文引用: 1] 摘要

This paper surveys pressing issues facing current and future social policies in the European Union (EU) at the juncture of social justice demands and environmental concerns. European policy-makers have in fact only recently acknowledged the notions of environmental justice and environmental inequalities, which have been part of the US policy arsenal for almost two decades. Yet, challenges to equality and fairness in the environmental domain are many and growing within the European Union. After having defined environmental justice and environmental inequalities in the European context, the paper addresses two contemporary dimensions of those challenges for EU social policies: vulnerability and exposure to environmental disaster and risk; and fairness in environmental taxation and the related issue of fuel poverty.Highlights? Issues within the European Union (EU) at the juncture of social justice demands and environmental concerns. ? Definition of environmental justice and environmental inequalities in the European context. ? Focus on vulnerability and exposure to environmental disaster and risk. ? Focus on fairness in environmental taxation, including fuel poverty.

[37]Lim S S, Vos T, Flaxman A D, et al.2012.

A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1999-2010: A systematic analysis for the Global Burden of Disease Study 2010

[J]. The Lancet, 380(9859): 2224-2260.

https://doi.org/10.1016/S0140-6736(12)61766-8 URL [本文引用: 2]

[38]Ma J, Mitchell G, Dong G P, Zhang W Z.2017.

Inequality in Beijing: A spatial multilevel analysis of perceived environmental hazard and self-rated health

[J]. Annals of the American Association of Geographers, 107(1): 109-129.

https://doi.org/10.1080/24694452.2016.1224636 URL [本文引用: 2] 摘要

Environmental pollution is a major problem in China, subjecting people to significant health risk. However, surprisingly little is known about how these risks are distributed spatially or socially. Drawing upon a large-scale survey conducted in Beijing in 2013, we examine how environmental hazards and health, as perceived by residents, are distributed at fine (sub-district) scale in urban Beijing, and investigate association between hazards, health and geographical context. A Bayesian spatial multilevel logistic model is developed to account for spatial dependence in unobserved contextual influences (eighbourhood effects) on health. Results reveal robust associations between exposure to environmental hazards and health. A unit decrease on a 5-point Likert scale in exposure is associated with increases of 15.2% (air pollution), 17.5% (noise) and 9.3% (landfills) in the odds of reporting good health, with marginal groups including migrant workers reporting greater exposure. Health inequality is also evident, and associated with age, income, educational attainment and housing characteristics. Geographical context (neighbourhood features like local amenity) also plays a role in shaping the social distribution of health inequality. Results are discussed in the context of developing environmental justice policy within a Chinese social market system that experiences tension between its egalitarian roots and its pragmatic approach to tackling grand public policy challenges.

[39]Macmillan A K, Hosking J, Connor J L, et al.2013.

A Cochrane systematic review of the effectiveness of organisational travel plans: Improving the evidence base for transport decisions

[J]. Transport Policy, 29: 249-256.

https://doi.org/10.1016/j.tranpol.2012.06.019 URL [本文引用: 1]

[40]Martuzzi M, Mitis F, Forastiere F.2010.

Inequalities, inequities, environmental justice in waste management and health

[J]. European Journal of Public Health, 20(1): 21-61.

https://doi.org/10.1093/eurpub/ckp216 URL PMID: 20061348 [本文引用: 1] 摘要

The scientific evidence on the health effects of waste-related exposure is not conclusive. Differential exposure to waste by socio-economic status (SES) is often documented, but the interplay between environmental and social factors, crucial for policy making, is not well known. This review aims at investigating the role of health inequalities and inequities in waste management. Grey and peer-reviewed literature, published after 1983, was reviewed from Europe and the USA. Available data provide consistent indications that waste facilities are often disproportionally more located in areas with more deprived residents, or from ethnical minorities. This applies to waste incinerators, landfills, hazardous waste sites, legal and illegal. In studies considering health effects (mainly from Europe), risks are estimated with standardization for SES. Such standardization almost always decreases risk estimates for several cancers and reproductive outcomes. However, effect modification is not investigated in these studies. The patterns of association between waste-related environmental pressures and SES suggest that some of the observed inequalities in exposure and health represent a case of environmental injustice as they are the result of social processes and may be prevented, at least partly. Disentangling the possible health effects remains difficult, due to limitations in the methodology. It seems important to investigate if disadvantaged people are more vulnerable, i.e. risks differ in different social groups living in the same area. Notwithstanding these open questions, public health officers and decision makers should identify waste management policies to minimize their potential health impacts and their unequal distribution.

[41]Mitchell G, Dorling D.2003.

An environmental justice analysis of British air quality

[J]. Environment and Planning A, 35(5): 909-929.

https://doi.org/10.1068/a35240 URL [本文引用: 3]

[42]Mitchell G, Norman P, Mullin K.2015.

Who benefits from environmental policy? An environmental justice analysis of air quality change in Britain, 2001-2011

[J]. Environmental Research Letters, 10(10): 105009.

https://doi.org/10.1088/1748-9326/10/10/105009 URL 摘要

Air quality in Great Britain has improved in recent years, but not enough to prevent the European Commission (EC) taking legal action for non-compliance with limit values. Air quality is a national public health concern, with disease burden associated with current air quality estimated at 29 000 premature deaths per year due to fine particulates, with a further burden due to NO. National small-area analyses showed that in 2001 poor air quality was much more prevalent in socio-economically deprived areas. We extend this social distribution of air quality analysis to consider how the distribution changed over the following decade (2001鈥2011), a period when significant efforts to meet EC air quality directive limits have been made, and air quality has improved. We find air quality improvement is greatest in the least deprived areas, whilst the most deprived areas bear a disproportionate and rising share of declining air quality including non-compliance with air quality standards. We discuss the implications for health inequalities, progress towards environmental justice, and compatibility of social justice and environmental sustainability objectives.