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Urban Sprawl and Health Outcome Associations in Sicily

Author

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  • Vincenzo Restivo

    (Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Via del Vespro 131, 90127 Palermo, Italy)

  • Achille Cernigliaro

    (Department of Health Services and Epidemiological Observatory, Regional Health Authority, Sicilian Region, Via Mario Vaccaro 5, 90145 Palermo, Italy)

  • Alessandra Casuccio

    (Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Via del Vespro 131, 90127 Palermo, Italy)

Abstract

Urban sprawl has several negative impacts on the environment, the economy, and human health. The main objective of this work was to formulate and validate a sprawl/compactness index for Sicilian municipalities and evaluate its association with health outcomes. An ecological study was conducted with 110 municipalities in Sicily, Italy. Principal component analysis was adopted to create the sprawl/compactness Sicilian index, and linear regression analysis was used to evaluate the association between the sprawl index and health outcomes. More variance of the new sprawl index was explained by the working factor, followed by density, surface extension, and land use mix. When validating the index, we found that public transportation had an inverse relation with sprawl increase ( p < 0.001), and private transportation was directly related to the increase in sprawl ( p < 0.001). After controlling for the Sicilian socio-economic deprivation index and overall mortality, cardiovascular mortality was the only outcome directly associated with the increase in the sprawl index (odds ratio = 0.0068, p < 0.001). Urban sprawl has to be monitored in Sicily over time to understand the evolution of the urbanization phenomenon and its relationship with health outcomes such as cardiovascular mortality. The use of the sprawl index should help policymakers define the necessary strategic aspects and actions to improve human health and quality of life in cities through a multi-sectorial approach.

Suggested Citation

  • Vincenzo Restivo & Achille Cernigliaro & Alessandra Casuccio, 2019. "Urban Sprawl and Health Outcome Associations in Sicily," IJERPH, MDPI, vol. 16(8), pages 1-9, April.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:8:p:1350-:d:222927
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    References listed on IDEAS

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    Cited by:

    1. Walter Mazzucco & Claudio Costantino & Vincenzo Restivo & Davide Alba & Claudia Marotta & Elisa Tavormina & Achille Cernigliaro & Maurizio Macaluso & Rosanna Cusimano & Rosario Grammauta & Fabio Tramu, 2020. "The Management of Health Hazards Related to Municipal Solid Waste on Fire in Europe: An Environmental Justice Issue?," IJERPH, MDPI, vol. 17(18), pages 1-15, September.
    2. Emil Israel & Tal Feder, 2025. "Compliance with COVID-19 Regulations in Cities vs. Suburbs: The Role of Communities’ Forms of Capital in Communities’ Health Sustainability," Sustainability, MDPI, vol. 17(3), pages 1-25, January.

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