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我国建成环境影响健康活动实证研究的Meta分析
高伟, 王志新, 刘奕杉, 吴佳怡, 李昊燃
西南交通大学
摘要:
通过知网、维普和万方数据库,以建成环境、健康活动、居民健康和体力活动为关键词,检索2010年1月1日至2020年9月30日发表的相关文献,经过明确研究对象、文献的检索、筛选、评价、数据提取和统计分析,最终筛选出九篇符合Meta分析要求的文献,并得出:公共设施布局、目的地可达性和交通安全均与健康活动正相关,且相关程度逐渐降低;居住密度为负相关,但除筛选文献之外也有研究指出为正相关;环境美学感知无明确相关性,但其中的绿化为正相关。建成环境与健康活动之间的因果关系是复杂的,普遍存在非线性关系和阈值效应,同时绝大部分实证研究难以纳入到本次Meta分析的主要原因,包括选取的建成环境指标各异、研究框架缺乏必要的控制变量和对照研究、缺少对数据必要的回归分析以及可供筛选的文献数据库不足,针对性提出在研究过程中须规范建成环境分析指标、结合横断面和纵向研究方法、采用多元线性回归模型或非线性回归模型以及参考更多高质量文献报告等,以便能有效纳入Meta分析,从一个更为宏观的角度,梳理整体研究成果,并进一步揭示其因果关系的复杂性。
关键词:  建成环境,健康活动,相关性,实证研究,Meta分析
DOI:
分类号:TU984.2
基金项目:国家自然科学基金项目(面上项目,重点项目,重大项目)
Meta-analysis of Empirical Research on the Correlation between Built Environment and Health Activities in China
gaowei, wangzhixin, liuyishan, wujiayi, lihaoran
Abstract:
Abstract: Objective Insufficient health activities among residents are key risk factors for death and chronic diseases. However, the health quality of Chinese residents is generally low, and the proportion of the population participating in healthy activities is much lower than that in developed countries. Optimizing the built environment can promote healthy activities and create a living environment that is more conducive to public health. Currently, there are many empirical studies on the impact of built environment on health activities in developed countries, but there are still research limitations caused by different regional backgrounds. Moreover, existing evidence shows that there are different patterns in different countries, and even some of the conclusions are contradictory. It is difficult for the research conclusions to be directly applied to China. In order to understand the status of empirical research on the impact of built environment on healthy activities in China, built environment, healthy activities, resident health and physical activity are the key Words searched for relevant literature published from January 1, 2010 to September 30, 2020 based on China's three major literature data platforms CNKI, VIP and WanFang Data. Meta-analysis, an important research method in the field of evidence-based medicine, is used to integrate the research contents of different documents in the database into a unified system for analysis, and sort out the overall research results from a more macro perspective. The meta-analysis steps of this study include: 1) Clarify the concept and content of the research object; 2) Determine keywords and search for literature in the database; 3) Set inclusion and exclusion criteria for the literature, and screen the literature according to the criteria; 4) Determine the evaluation method and content, evaluate the quality of the selected literature; 5) extract the relevant data of literature that meet the quality evaluation requirements; 6) comprehensively analyze the extracted data to test the reliability and validity of the literature research results; 7) summarize and discuss the analysis results. Nine papers were finally screened out that met the requirements of Meta-analysis, and it was concluded that: 1) The layout of public facilities is positively related to health activities, increasing the number of public facilities , reasonable planning, etc. can promote residents’ healthy activities, but the diversity of facilities and differences in residents’ travel preferences may lead to contradictory research conclusions; 2) Residential density is negatively related to healthy activities. Although a high-density residential environment can reduce individual motorized travel, the space congestion caused will also reduce residents’ healthy activities. In China, the former effect is weaker than the latter; 3) Destination accessibility is positively associated with healthy activity. Destination accessibility and healthy activities for residents can be improved by shortening commuting distances, increasing land use mix, and improving transportation. However, there is also a non-linear relationship such as the increase in land use mix; 4) Traffic safety is positively related to health activities. Different community types, community development stages and economic bases of community residents will lead to big differences in the correlation between traffic safety and health activities; 5) There is no clear correlation between environmental aesthetics perception and health activities. The number and heterogeneity of research subjects included in the analyzed literature will lead to different correlations between environmental aesthetics perception and health activities. More research results are needed to support it, but environmental Greening in aesthetic perception can significantly affect residents' self-rated health, physical activity satisfaction and participation rate. The results above show that the relationship between the built environment and healthy activities is complex, with non-linear relationships and threshold effects prevalent. The main reasons for the literature that are difficult to include in this meta-analysis are as follows: 1) The selected built environment indicators are different, and the basic data obtained cannot be transformed into a unified meta-analysis system; 2) The research framework lacks necessary control variables and comparative studies. It is difficult to judge the representativeness, resulting in a low evaluation of the quality of the literature; 3) Lack of necessary regression analysis of the data, the study can prove the correlationWe make the following suggestions: 1) Standardize the built environment indicator system and use standardized tools such as the Walking Environment Scale and the International Physical Activity Questionnaire to obtain basic data; 2) Combine cross-sectional and longitudinal research methods and set up a reference group similar to the basic situation of the research subjects. Change a certain built environment element in the research object, keep the control group unchanged, and obtain data at regular intervals for comparative analysis; 3) Use multiple linear regression models or nonlinear regression models to clearly analyze the relationship between built environment indicators and health activities to further explore the non-linear relationship and potential threshold effects; 4) Collect published and unpublished high-quality literature, academic reports, etc. through multiple channels and include them in meta-analysis; 4) Literature databases available for screening are not enough, the literature has publication bias, leading to biased results.
Key words:  built  environment, health  activities, correlation, empirical  research, meta-analysis