Urban Scaling of Health Outcomes: a Scoping Review

Urban scaling is a framework that describes how city-level characteristics scale with variations in city size. This scoping review mapped the existing evidence on the urban scaling of health outcomes to identify gaps and inform future research. Using a structured search strategy, we identified and reviewed a total of 102 studies, a majority set in high-income countries using diverse city definitions. We found several historical studies that examined the dynamic relationships between city size and mortality occurring during the nineteenth and early twentieth centuries. In more recent years, we documented heterogeneity in the relation between city size and health. Measles and influenza are influenced by city size in conjunction with other factors like geographic proximity, while STIs, HIV, and dengue tend to occur more frequently in larger cities. NCDs showed a heterogeneous pattern that depends on the specific outcome and context. Homicides and other crimes are more common in larger cities, suicides are more common in smaller cities, and traffic-related injuries show a less clear pattern that differs by context and type of injury. Future research should aim to understand the consequences of urban growth on health outcomes in low- and middle-income countries, capitalize on longitudinal designs, systematically adjust for covariates, and examine the implications of using different city definitions.     

影响中国人群心理健康的人口因素及机制——基于省级面板数据的实证研究

目的: 分析城镇化、老龄化、人口流动率对医院精神科就诊比例的影响以及独居率的调节作用。方法: 基于2010-2019年省级面板数据和Hausman-Taylor模型进行实证研究。结果: 城镇化和人口流动率分别与医院精神科就诊比例负相关和正相关。城镇化与老龄化的交互项、城镇化与独居率的交互项均与医院精神科就诊比例负相关,老龄化与独居率的交互项与医院精神科就诊比例正相关。结论: 城镇化和人口流动分别是中国人群心理健康的保护因素和风险因素,城镇化改善了老龄化对中国人群心理健康的不利影响。独居率的上升扩大了城镇化对心理健康的保护作用,加深了老龄化带来的心理健康问题。推进新型城镇化的同时,需重视农村老年人口、流动人口以及独居人口的心理健康评估和干预。     

Why have physical activity levels declined among Chinese adults? Findings from the 1991–2006 China health and nutrition surveys

Between 1991 and 2006, average weekly physical activity among adults in China fell by 32%. This paper discusses why total and occupational physical activity levels have fallen, and models the association between the rapid decline and various dimensions of exogenous community urbanization. We hypothesize that a) physical activity levels are negatively associated with urbanization; b) urbanization domains that affect job functions and opportunities will contribute most to changes in physical activity levels; and c) these urbanization domains will be more strongly associated for men than for women because home activities account for a larger proportion of physical activity for women. To test these hypotheses, we used longitudinal data from individuals aged 18–55 in the 1991–2006 China Health and Nutrition Surveys. We find that physical activity declines were strongly associated with greater availability of higher educational institutions, housing infrastructure, sanitation improvements and the economic wellbeing of the community in which people function. These urbanization factors predict more than four-fifths of the decline in occupational physical activity over the 1991–2006 period for men and nearly two-thirds of the decline for women. They are also associated with 57% of the decline in total physical activity for men and 40% of the decline for women. Intervention strategies to promote physical activity in the workplace, at home, for transit and via exercise should be considered a major health priority in China.     

The frequency of vesicoureteral reflux diagnosis is correlated with urbanization level of residence in pediatric population: A nationwide study in Taiwan

ObjectiveTo investigate the frequency and characteristics of newly diagnosed vesicoureteral reflux (VUR) in children younger than 18 years based on a nationwide database in Taiwan.MethodsThe present study utilizes a subset of the Taiwan's National Health Insurance Research Database, known as the Longitudinal Health Insurance Database 2005, which contains the data of all paid medical benefit claims over 1997–2007 for a subset of 1,000,000 beneficiaries randomly drawn from the population of 22.72 million individuals during any part of the 2005 calendar year. Our analysis includes the data of all pediatric patients with the diagnosis of VUR.ResultsA total of 738 subjects with VUR diagnosis were identified, including 412 (55.8%) boys and 326 (44.2%) girls. The peak age of VUR occurrence was the first year for males and 1–4 years for females. Approximately 49.7% of all subjects presented with urinary tract infection (UTI); moreover, there were significant differences between genders concerning the presence of UTI (RR = 0.8; p = 0.002). The occurrence rate of VUR in the pediatric population ranged from 2.63 in 1998 to 3.94 in 2003 per 10,000 children during 1998–2005. The frequency of newly-diagnosed VUR in the pediatric population was significantly correlated with urbanization levels of residence.ConclusionThe nationwide, population-based study of pediatric VUR shows there were gender differences in age distribution and presence of UTI. Further studies are warranted to clarify the correlations between urbanization level of residence and occurrence of VUR.     

First record of Leishmania braziliensis presence detected in bats,Mato Grosso do Sul,southwest Brazil

Leishmaniasis, a zoonotic disease caused by parasites of the genus Leishmania, has expanded beyond its natural range and is becoming increasingly urban. Using PCR and PCR-RFLP, we detected Leishmania (Viannia) braziliensis in two bats (Chiroptera) in Mato Grosso do Sul, Brazil, an endemic area. This is the first record of L. (V.) braziliensis in bats. It is also the first record of any Leishmania sp. in bats in the state. The animals testing positive were found in both a rural site and an urban site. These results indicate the need for further research into the viability of Leishmania in bats and could potentially have implications for public health in Mato Grosso do Sul, given the large populations of urban bats, their mobility, and their ability to roost at close proximity to humans within residences and other buildings.     

浦东新区城镇化农民的营养干预效果分析

目的 探讨城镇化农民营养干预方法与措施.方法 在临港新城周边4个乡镇中单纯随机抽取2个镇,把每镇的城镇化农民动迁定居点作为调查点.一个作为干预点,一个作为对照点.对干预组社区城镇化农民,开展合理营养知识宣教,对体检中发现的肥胖农民进行重点行为干预,对对照组社区农民,除了常规的健康干预以外,不对其进行特殊化的营养干预活动.干预1年后,再对两组城镇化农民进行终期的问卷调查和体检,以评估干预效果.结果 对照组终期时超重率及肥胖率均较干预组为高,差异有统计学意义(P＜0.05)；对照组高血糖率较干预组及基线调查为高(P＜0.05).结论 营养干预活动可以使城镇化农民对营养健康问题加以关注,能有效的控制体重增长,对血糖控制具有良好的效果,防止营养健康问题持续恶化.     

2007年北京市居民糖尿病与代谢综合征患病状况调查

目的 了解2007年北京市居民糖尿病与代谢综合征的患病情况.方法 采用整群随机抽样方法,于2007年9月至11月抽取本市3个地区,分别代表城市、城镇和农村地区进行调查.共有20岁以上常住居民3 484名参与调查.通过询问病史、体格检查、检测空腹血糖、血脂及口服糖耐量试验,并依据1999年WHO糖尿病诊断标准和2005年IDF代谢综合征全球共识定义进行诊断.使用EPI data 3.02软件建立数据库,SPSS 13.0软件进行统计分析.计量资料采用(-x)±s表示,两组间比较采用t检验,多组阳比较采用方差分析,计数资料比较采用卡方检验.结果 北京市居民糖尿病患病率为10.16%(城市10.97%、城镇11.95%、农村6.86%):其中已知糖尿病患病率为5.02%(城市6.14%、城镇6.62%、农村1.71%)(x2=54.06,P＜0.01);新诊断糖尿病患病率为5.14%(城市4.83%、城镇5.33%、农村5.15%)(x2=2.35,P＞0.05);空腹血糖受损患病率为1.35%(城市0.58%、城镇2.26%、农村1.43%)(x2=12.97,P＜0.01);糖耐量异常患病率为9.84%(城市10.52%、城镇9.68%、农村9.27%)(x2=3.99,P＞0.05);代谢综合征患病率为20.39%(城市17.34%、城镇23.30%、农村20.78%)(x2=35.38,P＜0.01).糖尿病患者平均知晓率为49.85%.结论 北京市糖尿病及代谢综合征患病率高,城镇和农村地区患病率呈现加速升高趋势.     

Coping with urbanization: A cardiometabolic risk?: The THUSA study

An assessment of specific coping styles in rural-urban Africans is done to evaluate its contribution as cardiometabolic risk factor. In total, 608 apparently healthy Africans were included in a cross-sectional comparative study from the North-West Province in South Africa. The adapted and translated COPE Questionnaire classified participants according to their responses into active (AC) or passive (PC) copers. Fasting resting metabolic syndrome (MS) indicators using the WHO definition (glucose, high density lipoproteins, waist/hip ratio, hypertension prevalence, and triglyceride) and associated MS values, i.e. fibrinogen were obtained. The Finapres recorded resting blood pressure continuously. Co-variates for all statistical analyses included age, body mass index (BMI) and lifestyle factors (alcohol consumption, smoking habits and physical activity). The only MS values prevalent in urbanized participants were higher hypertension prevalence rates and fibrinogen (women only) compared to their rural counterparts. Adding coping styles, it was mainly the urbanized AC participants that indicated higher MS values (hypertension prevalence, glucose and fibrinogen) when compared to their rural and PC counterparts. In conclusion, urbanization is associated with enhanced blood pressure and fibrinogen (women) values only. Coping as cardiometabolic risk is accentuated in the urbanized AC group, especially the men. The urbanized AC group with their higher blood pressure values and more MS indicators appears to have behaviorally an AC style but physiologically a dissociated AC style.     

SOCIAL COHESION,CULTURAL IDENTITY,AND DRUG USE IN MEXICAN RURAL COMMUNITIES

The objective of this study was to explore drug use in Mexican rural communities and its relationship to social cohesion, cultural identity, migration, and transculturation. Community models typification was used, considering cohesion as the central point of analysis. The research was conducted during 15-day periods in each of nine communities during 1991. Both documentary and ethnographic techniques were used to gather information. Results indicated that rural communities where there was little or no drug use among its members show more social cohesion, cultural identity, and community links consolidation, and more capacity for integrating change. This pattern is most apparent among young community members who have had more contact with the outer world (drug trafficking, North American culture, and Mexican urban culture). [Translations are provided in the International Abstracts Section of this issue.]