archived project

Public health and justice: Chronic Diseases, Alcohol Abuse, Walkability

Posted by Yifan on January 1, 2020

1. Introduction

 Public health and social justice is one of the main research directions of my current laboratory. In this research direction, I have participated in three independent studies. First of all, I assisted my colleague to explore the neighborhood social determinants of three prevalent non-communicable chronic diseases. Next, I assisted my professor to auditing the street walkability and associated social inequalities. Finally, I chose my own research topic independently and designed a series of studies on alcohol abuse. These studies first explore the association between excessive alcohol drinking and neighborhood social depreviation and physical environment in China based on a solid conceptual framework. What is interesting is that the main conclusions of these studies significantly different from those of previous studies, which focused mainly on western developed countries.

2. Main content

2.1 Neighborhood social determinants of public health: Analysis of three prevalent non-communicable chronic diseases in Shenzhen, China

 Past literature has reported the ubiquitous differences in health outcomes associated with socioeconomic status across different international settings. Due to the absence of fine level aggregated data, however, rather limited studies have been conducted to explore the neighborhood social determinants of public health in developing countries, especially in China. Using district level official data in 2010, this study examines the neighborhood social determinants of three prevalent non-communicable diseases (NCDs) in Shenzhen, China. In total, 22 exploratory social variables are selected from five domains: employment, education, housing, demographic structure and income. Spatial regression in binary and stepwise form is used to recognize the most influential social determinants. Results indicate the social determinants vary with the three NCDs and they have some general similarities. Spatial binary regression identifies four principle social determinants of NCDs prevalence: employment, income, housing and demographic structure. One essential social determinant (percentage of the floating population) is identified for all the three diseases by stepwise regression. Our study highlights that the main social determinant related to the incidence rates of all NCDs is the indicator of demographic structure denoting percentage of the floating population. This paper advances the understanding of the essential social determinants of NCDs in China. 在这里插入图片描述

2.2 Intra-urban excessive alcohol drinking: Geographic disparities, associated neighborhood characteristics and implications for healthy city planning

 Urban China is now faced with the considerable challenge of sustainability, given that it has the highest incidence of excessive alcohol drinking (EAD)-related deaths worldwide. The current study presents a conceptual framework explaining the geographic disparities in EAD; and explores the associations between EAD and the neighborhood physical environment and sociodemographic characteristics across the districts within Wuhan, China. Four regression models are built to verify related hypotheses and examine the role of alcohol outlets accessibility, transport convenience and social deprivation. Geographically weighted regression (GWR) is employed to further explore the spatial nonstationary associations. Our results demonstrate that similarities and differences exist between China and other nations in regard to the associations between EAD and related neighborhood characteristics. In China, the neighborhood physical environment strongly influences the occurrence of EAD, while social deprivation is not a significant contributor. EAD is more likely to be found in neighborhoods with greater alcohol outlet accessibility, and on-premise alcohol outlets represented by restaurants contribute much more than off-premise alcohol outlets. In addition, the relationship between alcohol outlet accessibility and EAD varies across regions in strength but is the same in nature. Based on these findings, several suggestions are provided for healthy city planning. 在这里插入图片描述

2.3 Auditing street walkability and associated social inequalities for planning implications

 Transport planning is gradually shifting targets towards modifying the pedestrian streetscapes that favor walking and enhance urban sustainability. We cannot be optimistic about walkability on condition that walkable streets are not evenly distributed within urban settings. Auditing the street walkability and associated social inequalities in developing countries should provide critical implications for transport planning. This paper identifies the most common indicators in existing indicator classification frameworks based on word frequency; and then establishes an indicator classification system (connectivity, accessibility, suitability, serviceability, and perceptibility) through expert panel evaluation for auditing street walkability in China. Using a case of Hangzhou metropolitan area, a set of 13 indicators are first selected by referring to the established indicator classification system and then aggregated into an integrated walkability index (IWI) through the catastrophe theory (CT) model after appropriate data treatment (standardization, normalization and correlation calculation). Camera signaling data are employed to validate the developed IWI. Results show that IWI is efficient to audit street walkability. IWI presents great heterogeneity at segment level. In general, higher walkability is observed in streets across the central and western areas. Walkability profiles of the segments are further produced by the clustering approach and the categorized groups can inform more targeted planning options. Spatial regression is finally utilized to quantify the associations between community socio-demographics and neighborhood IWI at two levels. We discover that lower neighborhood walkability would be observed in socioeconomically disadvantaged communities. These results suggest that significant social inequalities in street walkability should exist across the communities within Hangzhou metropolitan area. The developed IWI not only brings a standardized measurement of street walkability in the field of transport planning, but also paves the way for addressing the social inequalities in street design across various jurisdictions. 在这里插入图片描述

3. My contribution

  • Established a conceptual framework for intra-urban excessive alcohol drinking occurrence, which combined social deprivation, neighborhood physical environment and Chinese wine culture.
  • Assisted to identified neighborhood social determinants of three prevalent non-communicable chronic diseases in Shenzhen, using spatial regression models, and furthered discussed their importance through random forest algorithm.
  • Assisted to establish an innovative indicator system for street walkability auditing.
  • Extracted green land in Shenzhen using eCognition.

4. Publications

[1] Pi, J., Sun, Y., Xu, M.,Su, S.,Weng, M.,2018. Neighborhood social determinants of public health: Analysis of three prevalent non-communicable chronic diseases in Shenzhen, China.Social Indicators Research, 135: 683-698. [2] Sun, Y., Li, J., Jin, X., Xiao, H., He, Z., Su, S., Weng, M., 2019. Intra-urban excessive alcohol drinking: Geographic disparities, associated neighborhood characteristics and implications for healthy city planning. Sustainable Cities and Society, 46, 101414. [3] Su, S., Zhou, H., Xu, M., Ru, H., Wang, W., Weng, M., 2019. Auditing street walkability and associated social inequalities for planning implications. Journal of Transport Geography, 74: 62-76.

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