Marta Salgado1, Joana Madureira2,3, Ana Sofia Mendes2,3, Anália Torres4, João Paulo Teixeira2,3, Mónica Duarte Oliveira5. 1. Institute of Environmental Health (ISAMB), Faculty of Medicine of the University of Lisbon (FMUL), Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028, Lisbon, Portugal. marta.salgado@campus.ul.pt. 2. Environmental Health Department, National Institute of Health, R. de Alexandre Herculano 321, 4000-055, Porto, Portugal. 3. EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, 135, Porto, Portugal. 4. VALORSUL, Estação Mercadorias Bobadela, Plataforma Ribeirinha CP, 2696-801, Lisbon, São João da Talha, Portugal. 5. CEG-IST, Centro de Estudos de Gestão do Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais, 1, 1049-001, Lisbon, Portugal.
Abstract
BACKGROUND: Population health is influenced by interactions between environmental determinants, which are captured by dimensions and indicators. This study aims to systematically review key environmental determinants and respective dimensions and indicators, relevant to evaluate population health in urban settings, and to understand their potential implications into policies. METHODS: A search of literature published between 2008 and 2018 was conducted in PubMed, Web of Science, Scopus and SciELO Portugal databases, on studies with evidence on association between an environmental determinant and a health outcome in urban contexts. Health determinants, dimensions and indicators researched in the selected studies were synthetized, and associations analyzed. An independent assessment of quality of the studies was performed. Key conclusions and policy recommendations were extracted to build a framework to analyze environment related population health and policies in urban settings. RESULTS: Ninety four studies of varied methodological approaches and quality met the inclusion criteria. The review identified positive associations between all environmental determinants -socioeconomic, built environment, natural environment, healthcare, behaviors, and health outcomes - overall mortality and morbidity, in urban settings. Improvements in income, education, air quality, occupation status, mobility and smoking habits indicators have positive impact in overall mortality and chronic diseases morbidity indicators. Initiatives to improve population health in which policymakers can be more evidence-informed include socioeconomic, natural environment and built environment determinants. CONCLUSIONS: There is scope and need to further explore which environmental determinants and dimensions most contribute to population health to create a series of robust evidence-based measures to better inform urban planning policies.
BACKGROUND: Population health is influenced by interactions between environmental determinants, which are captured by dimensions and indicators. This study aims to systematically review key environmental determinants and respective dimensions and indicators, relevant to evaluate population health in urban settings, and to understand their potential implications into policies. METHODS: A search of literature published between 2008 and 2018 was conducted in PubMed, Web of Science, Scopus and SciELO Portugal databases, on studies with evidence on association between an environmental determinant and a health outcome in urban contexts. Health determinants, dimensions and indicators researched in the selected studies were synthetized, and associations analyzed. An independent assessment of quality of the studies was performed. Key conclusions and policy recommendations were extracted to build a framework to analyze environment related population health and policies in urban settings. RESULTS: Ninety four studies of varied methodological approaches and quality met the inclusion criteria. The review identified positive associations between all environmental determinants -socioeconomic, built environment, natural environment, healthcare, behaviors, and health outcomes - overall mortality and morbidity, in urban settings. Improvements in income, education, air quality, occupation status, mobility and smoking habits indicators have positive impact in overall mortality and chronic diseases morbidity indicators. Initiatives to improve population health in which policymakers can be more evidence-informed include socioeconomic, natural environment and built environment determinants. CONCLUSIONS: There is scope and need to further explore which environmental determinants and dimensions most contribute to population health to create a series of robust evidence-based measures to better inform urban planning policies.
Entities:
Keywords:
Environmental determinants; Population health; Systematic review; Urban settings
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